2: EVOLUTION OF PROFESSIONAL ROLES IN NURSING ■ 57on these chapters and provides both a contemporary and futuristic analysis of what
roles the DAPN possesses or should possess. The central thesis of Chapter 4 is: “How do
doctoral advanced practice nursing roles differ, or how should they differ, from master’s
advanced practice nursing roles?” In a real sense, the specific role of DAPNs, the sphere
of influence they will cast, the boundaries of their work, and what they will do with a
DNP degree that is explicitly different, are still evolving. In other words, the history of
the role of the DNP graduate is being written as you live it.
■ ROLE AND ROLE THEORY IN THE PROFESSION OF NURSING
Perhaps the seminal book on role theory in the health professions is Role Theory:
Perspectives for Health Professionals , first published by Hardy and Conway in 1979 fol-
lowed by a second edition in 1988. Unfortunately, the book did not have a third edition.
This chapter extends only some of the work of their contributors and analyzes the con-
tent that would specifically pertain to role theory for present- day DAPNs. The term role
is largely a sociological one (Biddle, 1986). However, its sociological application has uni-
versal meaning for society at both the individual and the group level and for disciplines
that are accorded the status of a profession where roles and role functions are important.
ROLES IN THE PROFESSION
Although the early classical professions were divinity, law, and medicine (Klass, 1961),
more contemporary definitions of a profession include nursing, dentistry, engineering,
architecture, social work, accountancy, and others. Professions such as nursing are dif-
ferent from other types of work, as the work of the professional nurse is characterized
by the following: professional autonomy; a clearly defined, highly developed, special-
ized, and theoretical knowledge base; control of training, certification, and licensing
of those newly entering the profession; self- governing and self- policing authority; an
explicit ethical code especially pertaining to professional ethics; and a commitment to
public service (Burbules & Densmore, 1991). A very recent analysis of the word profes-
sion emphasizes that what makes the work of the professional nurse different from, for
example, the work of an engineer is that there is a distinctive reliance on interpersonal
skills and on ethical codes of work behavior (Dreher & Dahnke, 2016).
A separate discussion, and not the focus of this chapter, is whether nurses with
associate degrees in nursing are also professionals. Although the Carnegie Foundation
and the Institute of Medicine (2010) have both come out strongly in support of a more
highly educated nursing workforce (Benner, Sutphen, Leonard, & Day, 2009), many
take the position that, while nursing is a profession, some practitioners (without a bac-
calaureate degree) are technically not professionals (AACN, 2000; Barter & McFarland,
2001). Liaschenko and Peter (2004) even declare that nursing is not a profession, but
simply “work.” Melosh (1982) also flatly writes: “nursing is not and cannot be a profes-
sion” (p. 15). Certainly, Melosh was historically correct in her critique in 1982 when she
wrote: “Clearly, nurses never gained the large measure of control over their work that
defines a profession” (p. 19). She further indicated that, by classical definitions of a pro-
fession, “Professionals are their own bosses” (p. 15) and “If professions maintain their
authority through controlling the division of labor related to their work... then doctors’
own professionalization organizes and requires nurses’ subordination” (p. 19). Perhaps
this was true in 1982 (except where military nurses could outrank their physician