The quintessential issue of nurse practitioner practice is the establishment of autonomy. The intention o f the pioneers o f nursing was to build on existing nursing autonomy and significantly expand it to accommodate the new role (Brown & Draye, 2003). While it is true nurse practitioners enjoy a limited amount of practice autonomy today, true autonomy cannot be achieved until the stigmata of collaborating physician is removed as a requirement for practice. The purpose o f this integrative literature review was to investigate the level of knowledge regarding nurse practitioner coping with role transition. The current level o f healthcare knowledge regarding nurse practitioner autonomy and role settings is limited. A systematic review o f the literature using a computer search o f CINAHL, MEDLINE, and COCHRANE, identified gaps in the nursing knowledgebase regarding the relationship of autonomy and the role of the nurse practitioner. The search resulted in 119 articles pertaining to “family nurse practitioner and autonomy”, "family nurse practitioner and practice settings”, “autonomy and practice settings”, and “autonomy and advanced practice nursing”. O f these only 18 explored the variables of family nurse practitioner and autonomy. Many explored each individual variable independently, but none explored the concept o f autonomy as it related to the role of the nurse practitioner. Each article explored the expanding role o f the nurse practitioner with emphasis only on autonomy as it related to job satisfaction realized by the participating practitioners. Benner’s From Novice to Expert (Benner, 2001) served as the theoretical foundation for this project and guided the integrative review of the literature through data collection of research based and theoretical articles. This theory includes five stages of nursing practice which are: (a) novice, (b) advanced beginner, (c) competent, (d) proficient, and (e) expert. Recommendations from this integrated literature review include the need for further research to investigate barriers to full practice autonomy realized by the nurse practitioner. Further elaboration of conditions and indicators o f successful transition into the role of complete autonomic practice o f the nurse practitioner are expected to be a major focus of research and practice in the future. Conclusions are drawn and recommendations made for nurse practitioners in the areas of linking nursing theory, nursing research, and advanced nurse practitioner education.


Master of Science in Nursing (MSN)


Graduate Nursing

Degree Date


Publication Number


First Advisor

Dr. Sandra Kirkland

Second Advisor

Dr. Rebecca Cagle

Third Advisor

Amelia Higginbottom

Document Type


Included in

Nursing Commons