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What is an NP?

A Brief History of Nurse Practitioners


Nurse practitioners (NPs) are registered nurses with advanced academic, medical and clinical education that enables them to diagnose and manage acute, episodic, and chronic illness, either independently or as part of a health care team. NPs often provide care once offered solely by physicians, and in most States they have the ability to prescribe medications.


At the University of Colorado in the 1960ís, Dr. Henry Silver, MD and Loretta Ford, PhD (a nurse educator), created a program to educate nurses to respond to the need for primary care providers in rural areas. Dr. Silver and Dr. Ford established a pediatric practitioner program that merged nursing with medicine. This was a groundbreaking achievement in that it was the first NP program that educated nurses to make medical diagnoses, while providing care in a nursing model. To meet admission criteria, this masterís level program required a professional nursing degree and license as well as a wealth of clinical experience. 

These early NPs were clearly courageous trailblazers. They were all talented and diligent professionals who were willing to enter educational programs without any assurance of securing a position at the programís conclusion. They were also daring in that they knew they must be highly competent, must satisfy all physician, nurse and patient opponents, and must successfully blend the new role which combined the best of nursing with the assessment, diagnostic, and treatment skills of medicine. Taken as a whole, the NP profession arose from an exceptional group of nurses with a diverse array of skills, vitality and resolve that has sustained its practitioners over the past 40 years.  

Nurse practitioners evaluate, diagnose, treat and manage acute illness and chronic health conditions as well as provide preventive care. And, like their physician colleagues, NPs are permitted to order, perform, and interpret laboratory and radiographic tests as well as prescribe medications. NP practice crosses boundaries between nursing and medicine so that their services can both substitute for and compliment the care of physicians. Because the care they provide is grounded in a nursing model, the emphasis is on the treatment of illness in the context of a patientís total well-being and encourages patient education. However, unlike their physician assistant (PA) colleagues, NPs seek professional autonomy in practice while utilizing a collaborative approach with physician partners, whereas PAs practice directly under physician supervision.

Additional advanced practice roles include the certified registered nurse anesthetist (CRNA), certified nurse midwife (CNM), and clinical nurse specialist (CNS). All advanced practice RNs have completed extensive academic and clinical training, and have a dramatically expanded scope of practice over the traditional RN role. Their clinical knowledge and experience as RNs, coupled with their advanced medical training, enables NPs to work with patients on a wide range of clinical problems. Laws in most States allow NPs to provide patient services independently, or in collaboration with a physician.