Essay On Nurse Practitioner Practice

NP 50th Anniversary Celebration and Timeline

Nurse practitioners (NPs), one type of advanced practice nurses, are licensed by the states where they practice and certified by private boards. Nurse practitioners hold advanced degrees in clinical practice and function in a wide variety of settings and across the life span. They provide a broad array of healthcare services ranging from managing treatment plans, to prescribing medications, to implementing health promotion services. As of 2014, 205,000 NPs were licensed in the United States with 86% of those prepared to deliver care to patients in primary care settings (NP Facts, 2015). The progression of the Nurse Practitioner movement that occurred in the 1960 and 1970s emerged as a creative and

Even so, physicians and nurses debated the best way and extent to which the NP role should be integrated into care, as well as how far NPs could extend their scope of practice. The National Joint Practice Commission (NJPC), funded by the Kellogg foundation in 1972 was one attempt to bring nurses, physicians, and broader professional organizations together to model the collaborative behavior that made nurse-physician teams so effective at the practice level. The NJPC funded nurse Virginia Hall to investigate legal issues related to expanding nursing roles related to nurse practitioner practice. In 1974, she published Statutory Regulation of the Scope of Nursing Practice – A Critical Survey. Hall’s work was one of few nationally unifying positions to guide physicians, nurse practitioners, and state boards (Hall, 1975). The Commission also published Together, as series of exemplars that highlighted effective NP-physician collaborations (Hidgen, Offan, & Starr, 1977). Still, the American Medical Association and other physician organizations could not accept the broader scope of practice recommended by the NJPC, and it folded in 1981 after only 9 years of existence. (Fairman, 2008,

In tandem with growing scientific knowledge, programs expanded their length and credit loads. Nurse practitioner specialties such as cardiology and intensive care appeared in graduate programs across the country with educational programs aimed at their specialized knowledge. NAPNAP had been founded as one of the first national specialty nurse advanced practice organizations in 1973. By the end of the 1980s, nurse practitioner care was part of the normal menu of services offered by many health care institutions, supported by the 1986 OTA study that found that NPs “provide care whose quality is equivalent to that of care provided by physicians,” particularly when such care depended on preventative services and communication with patients (Office of Technology Assessment, 1986, 5). In 2003, health care institutions began to hire large numbers of NPs in response to the Accreditation Council for Graduate Medical Education’s Resident Duty Hours standards, which limited the number of hours medical residents could work (Nasca, Day & Amis, 2010). Numerous studies, including a Cochrane review, reports from the Rand Health Foundation, Commonwealth Fund, and Western Governor’s Association all provided positive evidence of the value and quality of NP-provided services. Today, NPs have proven their effectiveness in delivering high quality, lower