The advanced practice nursing role of nurse practitioner began in the 1950s and 1960s when the physicians started collaborating with nurses who had clinical experience (O’Brien, 2003). During this period, increase in medical specialization saw a huge reduction of physicians in primary care. In 1965, the introduction of Medicare and Medicaid programs provides health cover for low-income groups, children, the elderly and people with disability (O’Brien, 2003). This created a demand for expanded primary care services. With the physicians unable to meet this new demand, the nurses stepped up to offer their services as nurse practitioners.
In the United States, the roles of advanced practice nurse have been shaped by social, political, and economic forces from within the American society. The socio-political environment offered dynamics that were unique in the development of each advanced practice role. The roles of nurse midwives were influenced by the large immigrant population with preference of public health. The political environment and more specifically the wars in the 20th century contributed to the increased need of anesthetist (Ketefian, et al. 2001). After world war II and Korean war, the government of USA offered funding for returning veterans which saw nurses acquire advanced education in clinical nurse specialists. The economics of the healthcare workforce supply and demand provided opportunities for the increased need for APN roles (Ketefian, et al. 2001). This, according to my perspective was the most important factor that helped the advancement of the advanced practice nursing roles. This opened a window of opportunity for nurses to advance their skills and serve in the areas that experienced shortage of physicians.
Ketefian, S., Redman, R. W., Hanucharurnkul, S., Masterson, A., & Neves, E. P. (2001). The development of advanced practice roles: implications in the international nursing community. International Nursing Review, 48(3), 152-163.
O’Brien, J. M. (2003). How nurse practitioners obtained provider status: lessons for pharmacists. American Journal of Health-System Pharmacy, 60(22), 2301-2307.
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