50 years a Nurse Practitioner | improving health care since 1965

This year is the 50th anniversary of the nurse practitioner (NP) profession, today there are more than 205,000 NPs licensed in the United States. Here is how they got there:

Nurse Practitioners (NPs) have been providing primary, acute and specialty healthcare to patients of all ages and walks of life. The role of NP’s is to assess patients, order and interpret diagnostic tests, make diagnoses, and initiate and manage treatment plans – including prescribing medications.

As NPs continue to take on an even more responsibility in the years to come, here is a glimpse of how far the profession has come since 1965:

In 1965, Medicare and Medicaid coverage expanded their coverage to low-income women, children, the elderly, and people with disabilities. The NP profession began in response to a dearth of primary care providers, particularly for children, in urban and rural areas in the United States.

The first NP program was founded in 1965 by Loretta Ford, EdD, PNP, FAAN, and Henry Silver, MD, at the University of Colorado. Initially, it was established as a certificate program, but it became a master's degree program in the early 1970s. Many of the earliest NP programs were either certificate or post-graduate programs.

NPs primarily worked in pediatrics at first, but in the 1970s many new NP specialties were created. One of the first family NP programs originated at the University of Washington in 1971, and several adult NP programs began during that same time.

• By 1973, the United States was home to more than 65 NP programs. The Nurse Practitioner was here to stay and become a stronger group in the years ahead.
• In 1974, the American Nurses Association (ANA) helped legitimize the role of NPs by establishing the Council of Primary Care Nurse Practitioners, which created an early description of an NP's duties. To further standardize the duties of NPs, the ANA began offering NP certification exams in 1977.
• In 1985, the American Academy of Nurse Practitioners was established. By the end of its first year, AANP had accrued 100 members and had begun to develop a national database of NPs.
• From 1979 statistics of 15,000 active NP’s grew to over 205,000 by 2015. Growth in this field has had a strong impact on patient outcomes and quality of care.

Many other hospital-based roles suffered during the fiscal crisis in health care in the 1990s. As these roles declined, it led to rapid growth for the NP profession. The number of NPs increased from 40,000 in 1995 to more than 60,000 in 1999, and the number of NP education programs continued to outnumber all other nursing specialties.

As the number of NP programs continued to grow, various NP organizations worked together to incorporate NP education standards into the nursing accreditation process. The Commission on Collegiate Nursing Education revised its Standards of Accreditation to include the Criteria for Evaluation of Nurse Practitioner Programs, which went into effect in January 2005.

The role of NPs has become even more important as additional patients are covered under the Affordable Care Act. Currently, NPs have full scope of practice in 21 states and the District of Columbia, and organizations such as AANP are working to increase this number.

The NP profession is anticipated to continue its growth, with 244,000 NPs expected to be practicing by 2025. Congratulations to all that have put the time, effort and care that is necessary to become an active NP, keep up the great work.

References:
Historical Timeline. American Association of Nurse Practitioners website. https://www.aanp.org/all-about-nps/historical-timeline. accessed January 12, 2016.
History of Nurse Practitioners in the United States (Slideshow). Simmons School of Nursing and Health Sciences website. Published November 13, 2014. https://onlinenursing.simmons.edu/nursing-blog/history-nurse-practitioners/. accessed January 12, 2016.