History of Nurse Practitioners


In August 1965 the Nurse Practitioner Profession originated in the United States by Drs. Loretta Ford and Henry Silver, who developed the first NP program at the University of Colorado.

It wasn't until October 1990 that the first NP Committee convened in New South Wales, beginning the NP movement in Australia at the NSW Nurses' Association Annual Conference.

In January 1994, the NP Pilot Projects was established, and commenced that year in September. The pilot projects evaluated NP models in rural and remote areas, midwifery, well women's screening, emergency services, urban homeless men service, and general medical practice.  The outcome of the evaluation found that these nurse practitioners were "feasible, safe, effective in their roles and provide quality health services." 

In December 1999, the NP trial commenced in the Australian Capital Territory (ACT). Models included Wound Care, Sexual Health, Mental Health Liaison and Military.

The first two nurse practitioners to be authorised in Australia on 12 December 2000 were trailblazers Sue Denison (specialising in rural and remote health) and Jane O'Connell (emergency).

In May 2001, Olwyn (Ollie) Johnston was the first nurse practitioner approved to work in a remote area of far west NSW and recognised for her specialities in rural and remote health care.

A pioneer, Ms Johnston paved the way for nurse practitioners nationally. The development work that began in New South Wales was quickly followed by other jurisdictions and within nine years all Australian States and Territories had achieved official recognition and a legislative framework for nurse practitioner practice. By looking to international developments Australian nurse clinicians and service leaders envisioned and achieved the most dramatic change in the Australian health care landscape since Lucy Osburn and her team of Nightingale-trained nurses arrived at Sydney Hospital in 1868.

The driver for this vision was deeply rooted in the discipline’s commitment to patient-centred care and patient-centred health service. Service improvement was on the agenda of early change agents in governments and this was matched by the work of reformists in nursing. The rapid uptake of the nurse practitioner role attests to recognition by those at the coal face of health service that this new level of health care provider improves the quality, timeliness and access to health care for underserved groups.

Australia is unique in the world in the careful and strategic approach taken by nursing leaders and regulators to development and implementation of the nurse practitioner role. In 2004 the (then) Australian Nursing Council (now the ANMC) commissioned a trans-Tasman study to inform development of NP standards. These standards have formed the basis for a national approach to NP practice competencies and standards for NP education and authorisation.

The recently completed Australian Nurse Practitioner Study (AUSPRAC) was a further landmark in development of the nurse practitioner project in Australia. This Australia wide study is the first national research project on nurse practitioner service globally. The study had three phases, implemented over three years and investigated the profile, work process and practice outcomes of Australian nurse practitioners. Multiple publications from the study findings contributed important knowledge to the international community on nurse practitioner service. The findings provided baseline data to inform service planners and governments and for ongoing research by Australian nurse practitioners. Furthermore, a range of instruments for researching nurse practitioner service and clinical outcomes were developed and validated.