50 Years Ago in TheJournalofPediatrics: Pediatric Nurse Practitioners: 50 Years of Partnering for Children's Health

Abstract

Silver HK. A blueprint for pediatric health manpower for the 1970's: the 1972 George Armstrong Lecture. J Pediatr 1973;82:149-56. Dr Henry Silver's lecture to the Ambulatory Pediatric Association is as resonant today as it was 50 years ago. He noted that there was an inadequate supply of pediatric health care providers and recounted a few rejected solutions, such as shortening the medical school curriculum. The focus of his lecture, however, was emphasizing the importance of nurse practitioners (NPs) in providing care for children. The first NPs in the US graduated from Dr Silver's program in 1965 after 4 months of postnursing training. Dr Silver found that both pediatricians and parents were satisfied with care received from the NP when using a combined model: having a NP provide care with a physician available for consultation as needed. NPs showed the potential to provide quality health care in primary are settings, and Dr Silver proposed that their roles could be expanded into the community by providing care in school-based clinics. The role of the NP has continued to evolve, and training has become more intense since Dr Silver's “blueprint for pediatric health manpower” lecture. NPs can select a master's program that can be completed in 2-3 years and, for those interested in educational advancement, a post-master's doctoral program that can be completed in 2-3 years. They also have the option to select the primary care or acute care tracks. The primary care track focuses education within the primary care setting, specialty clinics, or in the community, whereas the acute care track focuses on the care of hospitalized patients. Today, NPs have a presence in a variety of settings fulfilling their roles in the “diagnosis and management of acute and chronic illness, health promotion, disease prevention, health education and counseling.”1American Association of Nurse PractitionersDiscussion Paper: Standards of Practice for Nurse Practitioners, 2019 update.https://storage.aanp.org/www/documents/advocacy/position-papers/StandardsOfPractice.pdfDate accessed: October 11, 2020Google Scholar NPs play critical roles partnering with pediatricians in the care of children in primary care offices, school-based health centers, neonatal intensive care units, as members of surgical teams, and many other areas. Dr Silver was prescient in his call for enhancing the care for children by partnering with NPs, yet the shortage of health care providers is likely to continue. By the year 2030, there is estimated to be 76.3 million children in the US, with a decreasing number of pediatricians and only 1025 pediatric NPs becoming licensed yearly.2Gigli K.H. Beauchesne M.A. Dirks M.S. Peck J.L. White Paper: Critical shortage of pediatric nurse practitioners predicted.J Pediatr Health Care. 2019; 33: 347-355Abstract Full Text Full Text PDF PubMed Scopus (13) Google Scholar It remains as important as ever for pediatricians and NPs to continue working together and encourage ongoing development of both workforces.