Assignment: Role Of Insulin

Years of Revolution, Protest, and the New Order, 1961– 2000 During the social upheaval of the 1960s, nursing was influenced by many changes in society, such as the women’s movement, organized protest against the Vietnam conflict, civil rights movement, President Lyndon Johnson’s “Great Society” social reforms, and increased consumer involvement in health care. Specialization in nursing, such as cardiac intensive care unit, nurse anesthetist training, and the clinical specialist role for nursing, became trends that affected both education and practice in the healthcare system. Medicare and Medicaid, enacted in 1965 under Title XVIII of the Social Security Act, provided access to health care for older adults, poor persons, and people with disabilities. The ANA took a courageous and controversial stand in that same year (1965) by approving its first position paper on nursing education, advocating for all nursing education for professional practice to take place in colleges and universities (ANA, 1965). Nurses returning from Vietnam faced emotional challenges in the form of PTSD that affected their postwar lives.

With increased specialization in medicine, the demand for primary care healthcare providers exceeded the supply (Christman, 1971). As a response to this need for general practitioners, Dr. Henry Silver, MD, and Dr. Loretta Ford, RN, collaborated to develop the first NP program in the United States at the University of Colorado (Ford & Silver, 1967). NPs were initially prepared in pediatrics, with advanced role preparation in common childhood illness management and well-child care (Figure 1-4). Ford and Silver (1967) found that NPs could manage as much as 75% of the pediatric patients in community clinics, leading to the widespread use of and educational programs for NPs. The first state in 1971 to recognize diagnosis and treatment as part of the legal scope of practice for NPs was Idaho. Alaska and North Carolina were among the first states to expand the NP role to include prescriptive authority (Ford, 1979). By the turn of the century, NP programs were offered at the master of science in nursing level in family nursing; gerontology; and adult, neonatal, mental health, and maternal–child areas and have expanded to include the acute care practitioner as well (Huch, 2001). Currently, the preferred educational preparation for advanced practice nurse is the doctor of nursing practice. Certification of NPs now occurs at the national level through the ANA and several specialty organizations. NPs are licensed throughout the United States by state boards of nursing.