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FNP advising patient

Nurse Practitioners have been providing primary care to patients in the United States for nearly fifty years. Loretta Ford, RN, and Henry Silver, MD, started the first nurse practitioner program in 1965, at the University of Colorado, at a time when this was an unheard of role for nurses. The curriculum focused on health promotion, disease prevention, and the health of children and families which remain core fundamentals in today's programs. Dr. Ford suggested that the need for primary care services, especially for children and nursing's ability to meet these needs were sufficient reason to develop a new role, that of a nurse practitioner. The physician shortage in the 1960s and the institution of Medicare in 1965 also were justification for the new role. Physicians were leaving primary care for the higher paying specializations. There was a shortage of primary care physicians especially in rural areas, and for those who were medically underserved.

 The number of nurse practitioners increased as a result of a growing need for accessible, cost-effective care. Over time, NPs have demanded competitive salaries but more importantly professional recognition as a partner in the provision of health care for all. The scope of practice, regulation of practice, and reimbursement issues were important to NPs; however, legitimizing practice was still elusive. At this point, advanced-practice nursing organizations began offering voluntary certifications and titles. While the confusion regarding titles and credentials, reimbursement and scope of practice continued, the "National Council of State Boards of Nursing ultimately defined advanced-practice nursing, established the master of science in nursing degree and licensure as a registered nurse as the minimum standards for certification, and recommended licensure as the preferred method for regulating the profession."

AGACNPs provide care to adult patients in acute care settings in collaboration with physicians and other qualified healthcare professionals. As advanced practice nurses, AGACNPs practice with a high degree of autonomy and are employed in acute care settings such as hospitals including intensive care units, burn units, trauma units, emergency departments, step down units, and also in long term acute care hospitals, specialized hospitals, and specialized clinics where acute episodes of a chronic condition are treated.

NPs provide primary care in collaboration with physicians and other qualified healthcare professionals. By virtue of the title, the focus of the NP's practice is based on the nursing model. The NP's practice is also based in nursing theory. As advanced practice nurses, NPs practice with a high degree of autonomy. The data support a high level of patient satisfaction, based on the fact that NPs practice from the nursing model, one inherently focused on caring. NPs practice in every setting in which primary and specialty care is provided. These sites include a traditional physician based practice, community health centers, NP owned practices, rural and urban practices, and Veteran's Affairs healthcare facilities. NPs also may get hospital and admitting privileges.