This is the first in a blog series, based on the keynote presentation I made at TNP’s 2014 conference: It’s a Great Time to Be an NP—Our Golden Moment! I took the opportunity to briefly remind my audience of the historical situations that made the mid-1960’s a Golden Moment for the creation of the NP movement, to identify factors that currently present another Golden Moment, and to present a call to action to ensure that we act accordingly now and the future, as:
to improve the golden moment of opportunity and catch the good that is within our reach, is the great art of life (William Samuel Johnson).
In this installment, I’ll again provide a brief overview of the events leading up to 1965, that golden moment of 50 years ago, that our NP founders so proactively recognized in establishing the first NP program. However, we cannot look at 1965 in isolation and so . . . Where to start?
For the purpose of this essay, we start with the 1950’s, which may well harken the emergence of modern medicine and modern nursing. While many of us look back at the 1950’s nostalgically, this decade was, in fact, a time of change. 1949 was the peak of the post-WWII Baby Boom and the following years continued a trend of population growth. The 1950’s witnessed the dawn of the Space Age and new technologies. The Korean War, beginning in 1950, placed nurses near the front line in MASH units, where they were exposed to a new and challenging environment and, by necessity, functioned in a new and expansive scope of practice. During the 1950’s we witnessed the emergence of new miracle drugs such as penicillin and streptomycin, as well as the early triumph over polio. Medical technologies exploded with advancements such as heart-lung machines, which influenced medical and surgical practices and, ultimately, nursing advancement with the growing need for nursing critical care. Academic nursing evolved with the growth of university-based programs that imparted more scientific content and focused increasingly on knowledge versus technical skills. While the ADN was introduced, so was there a growth in advanced nursing degrees and nursing faculty needs.
Of course, the 1960’s followed with the explosion of the Space Age and the Vietnam War, another opportunity for nurses to serve in new and expansive roles. It was a time of significant social change with the emergence of Civil Rights and Women’s Rights, and continued technological advancements. During the 1960’s the MMR vaccine, CPR, portable defibrillators, and even diazepam became available. With continually emerging devices such as balloon catheters, medical advancements and the growth of critical care continued. As a child of the 60’s, I always put in a plug for the popular culture including the growth of Rock ‘n Roll and, of course, THE BEATLES! But the early 60’s were also a period in which there was growing federal support for Health Care.
Major major legislative initiatives important to this discussion include the Health Professions Education Act of 1963, Nurse Training Act of 1964 and the Social Security Amendments of 1965. The Health Professions Education Act was signed into law by President Kennedy who expressed the expectation that new training facilities for physicians, nurses, dentists, and others would support the modern healthcare deserved by the growing population. The Nurse Training Act acknowledged the critical role and the growing shortage of nursing. This legislation allowed for new and renovated schools of nursing and development of advanced nursing training. This legislation was soon followed by the Social Security Amendments signed into law exactly 50 years ago--July 1965. This landmark legislation established the Medicare and Medicaid programs with the need for expanded health care coverage at a time when we were experiencing a growing U.S. population, the increasing potential for survival, and the potential of ongoing advanced nursing and medical knowledge and specialization.
These and many other societal, scientific, and political factors shaped healthcare and nursing environment in the 1950s and 1960s, setting the stage for 1965 to present a Golden Moment for two innovative and collaborative professionals, Drs. Loretta Ford and Henry Silver, to recognize the environment and societal changes, the maldistribution and gaps in healthcare, and the vast untapped ability of nurses--- and to test the boundaries by establishing the innovative program that lay the foundation for and created the nurse practitioner role. Of course, that process and what followed is an amazing history in itself and we now are celebrating the 50th anniversary of the NP role, with over 200,000 NPs practicing with support based on their high-quality, cost-effective, and patient-centered healthcare in a myriad of settings.
But wait, there’s more! The next installment of this series will outline how we again find ourselves uniquely poised to “improve the golden moment of opportunity and catch the good that is within our reach.” Please check back for the next discussions to review many of the current societal, political, and scientific influences that now establish the significance and need of NP practice and learn how to optimize the Golden Moment.