NP Role development History of the Nurse Practitioner Movement
Dr. Roxana Orta
Florida National University
Define Nurse Practitioner
Identify the foundation and pioneers of practice
Understand role progression
Timeline of events
Implications for APRN and future Evolution
What is a Nurse Practitioner?
A nurse practitioner is an advanced practice nurse that is trained to provide care throughout the lifespan. The NP will generally focus on health promotion, health education, and the foundations of health care (Lowe, Plummer, O’Brien, & Boyd, 2012).
There are more than 234,000 nurse practitioners (NPs) licensed in the U.S. They are considered the largest group of independently licensed primary care providers.
NP Role Development
The nurse practitioner was introduced with the hopes of closing the gaps found in health care services.
Literature has pinpointed the mid 1960’s as the general time frame in which the first reported nurse practitioner role was introduced within the United States.
Development in the 1960’s of the advanced practice nurse role was primarily to assess and treat patients in an ambulatory
Timeline of Events: 1940’s-1960’s
1942 - Ford received her Diploma in Nursing from Middlesex General Hospital in New Jersey.
1949 - Ford received her B.S. from the University of Colorado, School of Nursing.
1951 – Ford obtained her M.S. from the University of Colorado.
1961 - Ford earned her Ed.D. from the University of Colorado School of Education.
1965- Dr. Loretta Ford and Dr. Henry Silver develop the first Nurse Practitioner (NP) program at the University of Colorado.
1967- Boston College initiates one of first master’sdegree programs for NPs
Timeline of Events: 1970’s
1971– One of first family NP programs established at University of Washington.
1973- More than 65 NP programs exist and establishment of National Association of Pediatric Nurse Practitioners (NAPNP).
1974- American Nurses Association helps legitimize role by creating Council of Primary Care Nurse Practitioners
1975- University of Colorado hold first continuing education symposium
Timeline of Events: 1980’s
1980- >200 NP programs or tracks available; 15,000-20,000 NPs practicing; Establishment of Nurse Practitioner Associates for Continuing Education (NPACE); Publication of Guidelines for Family Nurse Practitioner Curricular Planning after five years of development at the University of New Mexico
1985- American Academy of Nurse Practitioners (AANP) established; AANP creates development of NP database
1987- $100 million spent by federal government for NP education
1989- 90% NP programs either master’s degree or postmaster’s degree
Timeline of Events: 1990’s
1992- work to develop NP role internationally
1994- Mundinger publishes "Advanced Practice Nursing – Good Medicine for Physicians" in The New England Journal of Medicine, provides supportive evidence that NPs are cost effective and quality primary care providers
1995- In attempt to enhance communication and collaboration with industry leaders the AANP initiates the Corporate Advisory Council (ACAC)
1999- Estimated 60,000 NPs practicing in United States
Timeline of Events: 2000’s
2000- AANP establishes the Fellows program; hosts first international NP conference in U.S.; creates the Political Action Committee (PAC)
2001- Estimated 87,000 NPs in U.S.; number of NPs enlisted to offer support and aid to NYC and Washington
2003- Estimated 97,000 NPs in U.S.
2004- U.S. The American Association of Colleges of Nursing (AACN) publishes position paper on Doctorate of Nursing Practice
2005- Estimated 106,000 NPs in U.S.; NPs celebrate 40 years of practice
2008- Initiate development of online CE tracking; increase presence of AANP as a major advocate and leader for all NPs through lobbying and direct communication with policy makers
Timeline of Events: 2010’s
2013- American Academy of Nurse Practitioners and the American College of Nurse Practitioners combine to create the largest membership organization for nurse practitioners of all specialties
The Value of the NP
In the mid-1980’s, research indicated that the NP role was most valuable in providing access to underserved, uninsured, rural, and minority populations (Brown & Draye, 2003).
Becoming an FNP
A Master of Science degree in Nursing affords bachelor’s-prepared registered nurses (RNs) the opportunity to broaden their scope of practice as advanced practice registered nurses (APRNs).
APRNs assess, diagnose, order tests, prescribe medications, and manage patient problems. According to the APRN Consensus Model, certified nurse-midwives (CNMs), certified registered nurse anesthetists (CRNAs), clinical nurse specialists (CNSs), and certified nurse practitioners (CNPs) classify as APRN roles.
Family nurse practitioners (FNPs) are certified nurse practitioners who focus on the family unit and individuals belonging to the family. FNPs provide a diverse range of health care services for patients in all age groups.
FNP Role Description
Primary care services
Health promotion and disease prevention
Diagnose and treat injuries and illness
Manage chronic diseases
Order diagnostic test and interpret results
Prescribe medications and therapy
The Role of Family Nurse Practitioners
According to the American Association of Colleges of Nursing (AACN), a family nurse practitioner is a clinician who combines clinical expertise in the diagnoses and treatment of health conditions with an emphasis on values-based health management and disease prevention.
FNPs are able to work in a wide range of settings. Employers include private practices, hospitals, urgent care centers, health maintenance organizations (HMOs), long-term care facilities, veterans’ facilities, community clinics, schools, and correctional facilities. FNPs practice in rural, suburban, and urban communities and often provide care for underserved multicultural populations.