Increasing competition, health care complexity, threats to quality, and rapidly changing environments confront nurse practitioners (NPs) as they enter the new millennium. If NPs are to strengthen their positions as health care providers and continue to make a lasting contribution, they must exhibit proficiency in creating and managing change. Lessons gleaned from those who pioneered the NP role can provide the wisdom needed to address contemporary role challenges. The purpose of this study was to identify the strategies employed by NP pioneers who contributed to role survival and growth. This article provides a discussion of the change strategies utilized by NP pioneers and highlights their relevance to current practice issues.