School of Nursing: Connections

Nurse practitioner program: from resistance to preeminence in 30 years

Rosemary Pittman in 1997.

Although public health nurses have been a part of the health care system since early in the century, often working alone in rural areas, it was not until nurse practitioners that nurses were able to take a "lead role" in the diagnosis and treatment of patients.

In the School of Nursing the development of the nurse practitioner (NP) program was spurred by the social movements of the late 1960’s. Recognizing the need for primary care and frustrated with traditional roles, several emeritus faculty including Rosemary Pittman, Evelyn Burke (deceased), and Dolores Little started a graduate NP program in 1972.

Early days of the program found Pittman visiting various health agencies in the area to generate interest and understanding about nurse practitioners. "A lot of us went out and worked in clinics to demonstrate the role of the NP," Pittman explains, this before formalized support for faculty practice. Finding clinical sites for NP students was a challenge and several faculty such as Burke called on friends and relatives in health care to provide clinical experiences for students. Pittman recalls initial resistance from some members of the medical community. But, as the role developed, more physicians were eager to work with NPs, especially in underserved areas. In order to expand the program, Dean Leininger helped faculty secure their first of many federal training grants.

Since its inception, the University of Washington NP program has played a significant leadership role in the development of the nurse practitioner movement. Several graduates and faculty have assumed state and national leadership positions, including Phyllis Zimmer and Marie Annette Brown, past presidents of the National Organization of Nurse Practitioner Faculties; and Cynthia Lietch and Linda Pearson, founder and editor respectively of The Nurse Practitioner Journal.

Current faculty members Mary Ann Draye and Brown recently described the strategies of successful nurse practitioners in "The Pioneer NP Study," which examines the experience of pioneer NPs in Washington state. After three decades of "traversing uncharted waters" to clarify their roles, according to Draye and Brown, today’s nurse practitioners are making lasting contributions to health care. Although NPs continually face new challenges, it is certainly true, as Pittman notes, that "nurse practitioners have changed the role of nursing and enhanced it." Nine nurse practitioner specialties are currently included in the master’s in nursing program. In addition, a post-master’s and distance learning courses have been added.

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