Profiles in Nursing
Loretta Ford, Founded Nurse Practitioner Movement
Although the specialty is only 40 years old, there are now 115,000 NPs in the U.S.
Loretta Ford, NP, EdD, FAAN, considered the founder of the nurse practitioner movement, has received many awards for her work. Although she once predicted that the nurse practitioner would some day be working in all settings, on the occasion of being honored by the American College of Nurse Practitioners in 2003, she said “the profession has expanded beyond my wildest dreams.” Although the specialty is only 40 years old, there are now 115,000 NPs practicing in the United States.
Innovating Healthcare Delivery
Ford has graduate degrees in nursing and a Doctorate in Education from the University of Colorado and was certified as a Public Health Nurse. In the early 1960s, she and pediatrician Henry K. Silver were colleagues at the University of Colorado. With a regional shortage of family care physicians and pediatricians hampering healthcare delivery to rural and underserved areas, they saw that innovation was needed to solve the problem. They got a small grant from the University in 1965 and created a demonstration project, focusing on extending the role of the nurse in the community. They published their findings and developed an educational curriculum for nurse practitioners.
The first NP program at the University of Colorado was a certificate program for nurses with a baccalaureate and encompassed child care, family education, and preventive health. It later became a master’s degree program, and what began as a pediatric specialty quickly expanded to broader populations as the need grew. Nurse practitioners integrated the traditional role of the nurse, advanced medical training, and community outreach in order to provide patient care and education through a different avenue.
"Transformed the Profession"
Ford says “Nurse practitioners have become embedded in every aspect of healthcare” and have “transformed the profession.” NPs now are required to have a masters and post-masters education, plus advanced medical and nurse training, specialty certification, and intensive clinical experience.
They learn basic medicine, but use a nurse’s approach. They now order, perform and interpret diagnostic tests; diagnose and treat acute and chronic conditions such as diabetes, high blood pressure, infections, and injuries; prescribe medications and other treatments, and do health counseling and teaching, sometimes triaging critical patients and managing their recovery.
Despite early struggles with physician resistance to their taking on more responsibilities, they have become essential and integral members of a medical team.
Independent of Physicians In Half the Country
In 21 states and the District of Columbia, NPs may practice independently of physicians, but since there is no national regulatory system, the states regulate their own nursing practices. The state-by-state and constant legislative battles slow down advancement, which Ford calls a “miserable situation.” She says, “Advance practice is dynamic, and it moves with every new bit of knowledge and technology. We cannot run and ask for permission every time we want to do something new. What other profession does that?”
In becoming a highly skilled specialist who can handle complex problems in diverse patient populations, the NP has become essential. Because the healthcare delivery system has become an environment where the patients’ options are increasingly limited, Ford says “the NP must continue to work to bring about patient empowerment and to teach about preventive care.”
In 1972, Ford became Founding Dean of the School of Nursing at the University of Rochester and Director of the Nursing Service at the University Hospital. She has authored more than 100 articles on nurse practitioners and advance nursing practice.
Ford is described as “warm” and “affable,” with a quick sense of humor. In 2003, she was awarded the Blackwell Award (named for the first female doctor in America) from Hobart and William Smith Colleges, which is given to a woman whose life exemplifies outstanding service to humanity. Now retired, Ford is 86 and living in Florida.