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History of Nurse Practitioners

August 11, 2021

Nurse practitioners help provide needed care to a wide variety of patient populations. Their practice is patient-centered. Currently, they are the fastest-growing segment of primary care providers. NPs work in a variety of settings, including doctors’ offices and hospitals, to provide care to patients. Currently, almost 90% of NPs focus on primary care.


Since the first program for educating NPs was founded during the 1960s, the field has grown rapidly. How the medical establishment sees the role that NPs play in providing health care has also changed.

  • 1965: Loretta Ford, working with Dr. Henry Silver and the University of Colorado, establishes the first-ever nurse practitioner degree program
  • 1974: The Council of Primacy Care Nurse Practitioners is begun by the American Nurses Association or ANA.
  • 1977: The first nurse practitioner certification exams are offered.
  • 1979: Around 15,000 nurse practitioners are practicing around the country.
  • 1985: One hundred founding members establish the American Academy of Nurse Practitioners.
  • 1989: Thanks to lobbying efforts by the AANP, Congress includes rules in the Omnibus Reconciliation Act of 1989 that allow for NPs to be paid through government programs like Medicare when they provide health care.
  • 1993: The American Academy of Nurse Practitioners Certification Program is established.
  • 1999: More than 60,000 NPs are practicing around the country thanks to the many new education programs that have sprung up.
  • 2010: The 25th anniversary of AANP is focused on redefining the nurse practitioner’s role in providing access to health care for underserved communities.
  • Today: It’s expected that by 2025, almost 245,000 NPs will be practicing around the country.

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Influential Female Nurses in History

Nurses provided life-saving and compassionate care to patients long before the role of the nurse practitioner was officially established. A number of women helped to define and redefine the role of nurses in the medical field.

Florence Nightingale (1820-1910)

Florence Nightingale was a British woman. Historians have credited her with founding modern nursing during the Crimean War.

  • Nightingale professionalized the role of the nurse.
  • She established the first-ever formal nursing school.
  • Along with being a prodigious writer, Nightingale also loved statistics and pioneered ways of sharing these statistical findings with the general public. In some ways, it could be said that Nightingale was an early adopter of infographics.

Clara Barton (1821-1912)

Clara Barton was born in Massachusetts. After first working as a teacher, she eventually became one of the first women ever employed by the federal government when she went to work for the U.S. Patent Office. She was working for the government and living in Washington, D.C., when the Civil War began.

  • Barton’s work delivering supplies behind battle lines and caring for injured soldiers earned her the nickname “Angel of the Battlefield.”
  • She sought and received permission from President Abraham Lincoln to create the Office of Missing Soldiers, whose aim was to help families find their missing loved ones.
  • While visiting Europe in 1869, Barton learned about the Red Cross movement, which wanted to provide help to any soldier on any side who was injured in battle. Barton ended up volunteering with the Red Cross during the Franco-Prussian War.
  • In 1881, Barton founded the American Red Cross. She served as its president until 1904.

Mary Eliza Mahoney (1845-1926)

Mary Eliza Mahoney lived in New England was a trailblazer in many different ways. Not only did she help open up the field of nursing for all women, no matter their race, but she was also one of the first women to register to vote in the city of Boston when suffrage for women was finally granted in 1920.

  • Mahoney worked at the New England Hospital for Women and Children for 15 years in roles including janitor and cook.
  • After Mahoney was allowed to enter the hospital’s nurse training program, in 1879, she became the first-ever African-American licensed nurse.
  • In 1908, she helped establish the National Association of Colored Graduate Nurses.

Mary Breckenridge (1881-1965)

Mary Breckenridge believed that all people deserved access to high-quality health care, but she saw that often, rural areas were underserved. After early experiences as a public health nurse during an influenza outbreak in D.C. and as a volunteer nurse during World War I, Breckenridge began focusing on broadening her education.

  • During the time she spent in France during World War I, Breckenridge learned how to provide disaster relief.
  • Once back in the states, Breckenridge completed a graduate degree in public health from Columbia University.
  • Next, Breckenridge traveled to London to obtain midwife certification from the British Hospital for Mothers and Babies.
  • Breckenridge founded the Kentucky Committee for Mothers and Babies in 1925, which evolved into the Frontier Nursing Service in 1928.

Loretta C. Ford (1920- )

Loretta Ford knew that the American medical profession had a problem: It wasn’t providing adequate care to children and families in deeply rural or remote areas. So she took action to fix the problem.

  • Ford recruited teams of nurses to set up temporary medical offices in community buildings in remote places that lacked doctors and consistent medical care.
  • Limitations on how nurses could treat patients without the supervision of a doctor caused issues. Ford wanted to train nurses to make independent decisions and treat patients on their own.
  • She established the first-ever nurse practitioner education program at the University of Colorado.
  • Ford also founded the University of Rochester School of Nursing.

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