Although nurse practitioners (NPs) as a collective group have reached the stage of role confirmation, in new settings they must transition through several phases of role development. The role confirmation issues for a team of NPs who were hired to work in a large academic teaching hospital in the Southeastern part of the United States are explored over a 3-year period. Characteristics of the organization and strategies that the NPs implemented over time impacted favorably on the evolution of the NP role in that setting. The NPs gained prescriptive privileges, independent practice, and market-place salaries. Effective negotiation and marketing strategies enhanced both personal and professional development.