The First 50 Years of NPs: An Illustrated Timeline Shows Triumphs, Continuing Practice Barriers

By Amanda Anderson, a critical care nurse and graduate student in New York City currently doing a graduate placement at AJN.

This year marks the 50th anniversary of the nurse practitioner (NP) role. Themes of innovation and sustainability emerge as one examines an illustrated timeline of the history of NPs in AJN‘s October issue and reads the accompanying text. (The first section of the timeline is below. Click to enlarge.)

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How did this advanced practice nursing role come into being? As the timeline explains, ” [d]uring the 1960s, health care was becoming increasingly specialized. Physicians were moving out of general practice and into more complex and lucrative specialties, creating a void in primary care and prevention services, and in care of the chronically ill.”

To fill this void, public health nurse Loretta Ford, working with Dr. Henry Silver at the University of Colorado in 1965, launched the first NP certificate program, a seminal moment in the history of this prevention-driven, primary-care-focused nursing role.

Ford wrote about the compelling need for NPs. Calling health care a capital investment, Ford said:

“We have failed to realize the full potential of professional nurses to improve the quality of life. This group has great unused potential for bringing about health care reforms. Properly prepared and effectively utilized, nurses could advance the nation’s […]

The Afterlife of Trauma, Near and Far

Julianna Paradisi, RN, OCN, is an oncology nurse navigator and writes a monthly post for this blog.

Mixed media illustration by Julianna Paradisi Mixed media illustration by Julianna Paradisi

The alarm clock rang noisily. I wasn’t ready to surrender the cozy cocoon of my bed and venture into the emotional turbulence of this particular day: The 14th anniversary of 9/11.

The week leading up to it was rough. My stepfather had quadruple coronary bypass surgery in another city. Although it was successful, and his children were there to help and support my mother, I’ve felt guilty for not being there myself, because I’m the nurse in the family, and I feel responsible for every medical problem that arises for the ones I love—even if I’m not really needed.

Besides this, at work we’re in one of those cycles where every patient gets bad news: The cancer has invaded the borders of another organ, or the patient is incredibly young for the diagnosis that’s been received. Six months into my career as an oncology nurse navigator, I realize the emotional toll from secondary trauma is often more related to a previous job as a pediatric intensive care nurse than that of my more recent position as an oncology infusion nurse.

Because of all this, I decided to minimize my media exposure to the trauma of 9/11 this year. I stayed off of Facebook, and instead of watching the morning news I listened to Lyle Lovett croon the delightfully […]

Reflective Writing as a Crucial Counterweight to Clinical Experience

By Amanda Anderson, a critical care nurse and graduate student in New York City currently doing a graduate placement at AJN.

Kevin V. Pxl/Flickr Kevin V. Pxl/Flickr

When I first started working as a nurse, I didn’t write much. My shifts, twelve hours of chaos, weren’t stories to be told, just days to survive. I wrote only when, after a traumatic event surrounding a patient’s death, I felt like I didn’t know who I could talk to about it. I had always written in a journal, but I hadn’t really thought of writing as a tool for healing—I just knew that I felt better after banging on the keyboard a bit.

Other than this single instance, I didn’t make writing a regular practice during my first year of nursing—a choice I still regret. I covet all of those forgotten lessons, missed descriptors, and stories that I might use in my writing now, but mostly, I wish I had known that moving my pen on a piece of paper might’ve helped me heal from the consistent stress of my new work.

A few years ago, by then a relatively experienced ICU nurse as well as a graduate student, I took a class called, “Writing, Communication, & Healing.” Taught by a poet and health care journalist, Joy Jacobson, it came at a time when I needed to learn how to […]

Some Notes on Miss Colorado’s ‘I’m Just a Nurse’ Speech

By Amanda Anderson, a critical care nurse and graduate student in New York City currently doing a graduate placement at AJN.

I’m a sucker for beauty pageants. There’s something about the old-fashioned simplicity that fascinates me. While Miss America is, at its roots, a generous scholarship program, it’d be hard for me to say that I tune in for anything other than the sparkle and style.

With that said, I still love a Miss Congeniality angle, which this year’s Miss Colorado seemed to proffer in a much-praised speech. Similar to Sandra Bullock’s character, Gracie Lou Freebush, Kelley Johnson’s nurse-specific monologue was both engaging and educational. But her talent struck a little closer to home—she used the phrase “I’m just a nurse.”

Her two-minute speech won her a second-runner-up prize, as well as millions of hits online. But what did it get us nurses?

Sure, all PR for our profession is great, but the age-old, ubiquitous slur that served as the tagline for much of Ms. Johnson’s monologue makes a lot of us uneasy. Although Ms. Johnson very skillfully ended her monologue by refuting her initial proclamation, the public expression of it deserves a second look.

“Just a nurse” is not a new phrase to our profession; a brief scroll through Tumblr will do more than update the casual viewer. However, most of us steer away from association with the phrase; it discredits, it’s a conversation killer, and it has long been seen as a sarcastic way […]

Coming Home to Nursing: A Career Change Eases a Return to a Small Town

“Working as a nurse in the county where your family has lived for seven generations has a social complexity that can’t be prepared for.”

The Reflections essay in the September issue of AJN isn’t focused on a dire clinical situation, a wrenching ethical quandary, or a challenging coworker or boss. Called “Coming Home to Nursing,” the essay describes the many ways becoming a nurse helped the author begin to feel a sense of belonging when she returned to her small town. Here’s the opening:

Illustration by Gingermoth for AJN. All rights reserved. Illustration by Gingermoth for AJN. All rights reserved.

I had been taking care of people, in one way or another, for as long as I could remember, first growing up in Maine and then for 20 years in New York City. I had returned to my small town to help care for my mother, who had end-stage Parkinson’s disease. After she died, I felt a void. I looked around at this tiny place, where people are considered to be “from away” even if they’ve lived here for multiple generations. I wondered what I had to give back to the supportive community I’d grown up a part of—and I also wondered if I could fit in after 20 years away. Could I turn my love of taking care […]

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