The Public, Pharmacist and Self-Medication**Based on a presentation to the Academy of the General Practice of Pharmacy at the American Pharmaceutical Association annual meeting in Dallas, Texas, April 28, 1966. Supported in part by grants from the Ohio State University council on research and the division of community health services of the U.S. Public Health Service (Grant No. CH-00177-01).

Abstract

Nursing's acquisition of autonomy is examined from the perspective of an occupational interest group competing with other occupational interest groups for a market monopoly. Nursing and other health occupations are seen as competing within the policy arena for monopoly over the market of health care services currently provided or hoped to be provided by these interests. The focus of this study is nursing's efforts, during the 1970s and 1980s, to change legal definitions of nursing practice in the 50 states and to provide for expanded services of nurse practitioners and other nurse specialists. A bidirectional measure of autonomy was used, comparing (1) expansion of service (specialty functions, diagnosis, drug prescription) and (2) locus of control over these expanded services. Data included revisions of nurse practice acts as policy outcomes. Legislative, regulatory, and judicial revisions of state laws affecting nursing service and control from 1970 to 1984 were examined. Frequency distributions were used to test for a relationship between expansion of nursing service and exclusive nursing authority over the expanded service. Results support the competition perspective, suggesting that market competition is a major factor in the policy-designated distribution of autonomy among nondominant occupations providing service shared with others in a common market area.