Abstract
Specialists in nursing have existed since the turn of the century. The term denoted a nurse with extensive experience in a particular area of nursing who performed with technical expertise. The modern advanced practice nurse (APN) is a master's degree-prepared clinical expert who has a high level of expertise in the assessment, diagnosis, and treatment of the complex responses of individuals or populations to health problems. The APN delivers comprehensive, cost-effective care and has a recognized role in the multidisciplinary world of healthcare. Despite these advancements, the role of the hospital-based APN is poorly understood. Other hospital positions such as "nurse educator" or "nurse clinician" add to the role confusion. The APN practice in a large urban hospital will be examined. The journey of preserving the role integrity of the hospital-based APN will be explored.