The 40-year story of PNP caregiving-still being written

August 1, 2005

In the four decades since nurse practitioners appeared on the health-care scene, they have become an integral part of pediatric care. Here are some things you may not know about this important practice role.

A pediatric nurse practitioner (PNP) is an advanced-practice registered nurse who provides health care to children from birth through 21 years of age and, in specific situations, to young adults older than 21 years. To function in this role, the PNP must have completed a formal educational program specializing in pediatric health care and complied with the state board of nursing's regulations governing advanced-practice nursing.1

The nurse practitioner (NP) role originated in 1965, when Loretta Ford, PhD in nursing, and Henry Silver, MD, a pediatrician, developed a program at the University of Colorado to prepare registered nurses for an expanded role. The need for NPs at that time arose from a shortage of pediatricians in urban and rural communities. Over the next 40 years, the NP became an integral part of cost-effective, quality pediatric and family care.

The faculty of the first nurse practitioner programs was comprised of nurses and physicians. The original focus of those programs was on meeting the primary health-care needs of children and families. PNPs trained in these programs pioneered a new role in clinics, health departments, and private pediatric practices. Despite initial resistance from some nursing academicians, physicians, and federal agencies, the health outcomes achieved by these early practitioners firmly established the PNP role in the late 1960s and the 1970s.

During the 1990s, the number of family NPs in primary care grew steadily, and PNPs began increasingly to subspecialize. Some shifted their focus from traditional primary care to inpatient care and specialties such as cardiology, neurology, oncology, pulmonary care, dermatology, and critical care.

As the complexity of the health-care system and patient care increases, so does the need for collaboration among all members of the health-care team. Interdisciplinary teams with diverse skills offer a flexible, dynamic, efficient, and responsive model of care delivery to meet the complex requirements of today's pediatric health-care environment. Collaboration is vital to clinical practice across all practice settings and subspecialties. The complementary and collaborative relationship between PNPs and physicians-with each sharing equally in patient care within their respective scope of practice-continues to serve patients well.