The History of Independent Nurse Practitioners

A nurse practitioner, or an NP, is a registered nurse who is granted privileges typically reserved for medical doctors. NPs may diagnosis disease or conditions, write prescriptions and administer treatments. Nurse practitioners are licensed to practice across the United States. NPs work in clinics, health departments, hospitals, nursing homes and health maintenance organizations. The position originated in the 1960s. Today, there are more than 300 NP degree programs and about 120,000 practicing Nurse Practitioners in the U.S. providing care to millions of Americans today, according to the World of Nurse Practitioners website.

Difference Between NPs and MDs

• Physicians primarily focus on diagnosis and treatment, whereas nurse practitioners tend to be more holistic with a focus on prevention. A common misconception is that NPs are "doctors in training." Nurse practitioners have taken on many of the responsibilities previously reserved for physicians, but nursing remains their primary focus. A nurse practitioner is a registered nurse who has a master's degree in nursing with certification from American Academy of Nurse Practitioners. NPs do not have a medical degree. Nurse practitioners fill the gap in basic nursing care by diagnosing and treating illness. NPs can order diagnostic tests and prescribe some medications.

Origin of Nurse Practitioners

• In the 1960s the U.S. experienced a serious shortage of primary care physicians, according to the World of Nurse Practitioners website. This lead to existing physicians working with nurses to expand nursing care responsibilities. Loretta C. Ford and pediatrician Henry K. Silver introduced a formal position called a Nurse Practitioner. The pilot program was developed at the University of Colorado. Gradually, more universities offered the degree beginning with first master's level program at Boston College. The American Nurses Association was founded in 1974. It is responsible for overseeing the Council of Primary Care Nurse Practitioners.

Notable Nurse Practitioners

• Some notable women have paved the way for the nurse practitioners of today. Loretta Ford founded the profession of nurse practitioners at the University of Colorado. Louise Kaplan was instrumental in securing federal money for advancement of the field through grants. She is credited with being a catalyst for developing a national policy for nurse practitioners due to her political advocacy. Marsha Siegel led the way in having nurse practitioners serve rural areas where people have less access to health care. Her efforts helped to expand the role of NPs across the country, according to the American College of Nurse Practitioners.

Future of Nurse Practitioners

• The profession of nurse practitioner continues to grow and develop as more health care responsibilities are granted to NPs. They bridge the gap between physicians and nurses, having greater duties than nurses but less than physicians. Some states limit the NP privileges, such as prohibiting NPs from writing prescriptions for controlled substances. They are currently dependent on physicians both legally and financially. NPs are authorized to receive reimbursement from Medicare and Medicaid, but exclusions for payment often interfere with what care an NP can offer. Increasing Medicare and Medicaid direct payment authorization and participation of NPs in the home health care industry are goals to expand nurse practitioner medical care roles.