The history of nurse practitioners began with a pioneering pediatric program in 1965. Since then, NPs have expanded into many specialties and care settings. Their role continues to grow as health systems respond to aging populations, chronic disease and the need for accessible care.
The history of nurse practitioners (NPs) began with a practical need, as more children and families needed access to preventive care, according to the American Association of Nurse Practitioners. The first NP program opened at the University of Colorado in 1965, giving registered nurses a new way to combine nursing knowledge with expanded clinical skills.
Today, nurse practitioners provide primary, acute and specialty care across the lifespan in many settings. They assess patients, diagnose conditions, develop care plans and prescribe medications when state law permits.
Demand has grown along with the role. More patients need care for chronic conditions, and the U.S. population is getting older. Health systems also need qualified providers in rural and underserved communities. These needs help explain why the number of NPs has risen and why employment is expected to keep growing.
For people entering nursing through Marquette University, it is important to understand where nurse practitioner education fits. Marquette’s Direct Entry Master of Science in Nursing prepares eligible students with non-nursing bachelor’s degrees to pursue RN licensure. It does not qualify graduates to practice as NPs, but after becoming licensed nurses and gaining experience, graduates may continue into NP-specific postgraduate education and certification.
What Is a Nurse Practitioner?
A nurse practitioner is an advanced practice registered nurse, or APRN. NPs complete graduate-level education for their intended role and patient group. They also complete advanced clinical training, pass a national board certification exam and meet state licensing rules. This preparation builds on the knowledge and experience required of an RN.
Duties might include:
- Collecting health histories
- Performing physical exams
- Ordering or reviewing diagnostic tests
- Diagnosing health conditions
- Developing treatment plans
- Monitoring a patient’s response to care
In addition, many NPs prescribe medications. Their exact authority depends on state law, certification and employer policies.
Nurse practitioners are educated to serve defined patient groups. These may include families, children, adults, older adults, women or people who need psychiatric mental health care. Within that population focus, an NP may work in primary care, acute care or a specialty practice.
Interested in becoming an NP? Learn more about what an NP does.
How the History of Nurse Practitioners Began in Modern Health Care
The NP title did not exist in the years after World War II. Even so, nurses were already taking on broad duties. Public health nurses often worked in communities with limited access to physicians and hospitals. They provided health education, monitored children, supported families and helped prevent disease. Their work showed how nursing could improve health care access outside traditional hospital settings.
At the same time, the U.S. health system was changing. Medical advances helped people live longer, while insurance coverage and hospital use increased. The 1963 Surgeon General’s Report Toward Quality in Nursing warned of a growing workforce gap. The need for nurses was rising faster than the supply. The report also called for stronger training and clearer standards. This national focus on nursing education helped create a climate where expanded nursing roles could develop.
The first NP program was not simply an attempt to replace physicians. Educator Loretta Ford saw that nurses could provide more complete well-child care with deeper clinical preparation. She and physician Henry Silver built a model around nursing’s focus on prevention and families. The model also strengthened assessment and decision-making skills.
The Origins of the Nurse Practitioner Role
Ford and Silver launched the country’s first pediatric nurse practitioner program at the University of Colorado in fall 1965. The first course lasted about three to four months and combined classroom study with supervised clinical practice for experienced RNs.
The curriculum focused on the care of children in community settings. It emphasized accountability, health promotion, self-care, family education and hands-on practice. Students learned to gather health information and conduct detailed assessments. They also learned when a child needed care from a physician or another professional.
Early graduates put the model into practice in communities that needed better access to care. Ford and Silver published encouraging results within two years, helping other educators understand how the new role could work.
The University of Colorado’s account of the program reports that it prepared 64 nurse practitioners by 1972. Although the number was small, the model attracted national interest. It showed that experienced nurses could take on expanded clinical duties while keeping the patient-centered values of nursing.
The Evolution of Nurse Practitioners Over Time
The evolution of nurse practitioners moved quickly after the Colorado project. Boston College started one of the earliest master’s programs for NPs in 1967. By 1973, more than 65 NP programs operated in the U.S. Programs soon expanded beyond pediatrics to prepare nurses for family, adult, maternity and psychiatric care.
Professional standards developed as education expanded. The American Nurses Association created a council for primary care nurse practitioners in 1974. It later offered certification exams. By 1980, students could choose from more than 200 NP programs or tracks. By 1989, 90% of NP programs were master’s or post-master’s programs, according to the AANP historical timeline.
A review of NP history also shows how law and certification shaped the profession. States revised nurse practice acts to recognize advanced duties, but they did not all grant the same authority. National certification helped define the knowledge expected of NPs who serve different patient groups. Those differences still matter because an NP’s scope of practice continues to vary by state.
The profession kept growing, and NPs entered hospitals, clinics, private practices and community health programs. They also moved into education, research, leadership and specialty care. This growth turned a small demonstration project into a major part of the U.S. health care workforce.
Training became more consistent as the profession matured.
- Accredited programs added courses for defined patient groups and supervised clinical hours.
- Certification boards measured knowledge for specific NP roles.
- Professional groups set standards for faculty, curriculum and clinical preparation.
These steps helped patients, employers and regulators understand an NP’s training. They also created clearer paths from registered nursing into advanced practice.
The Growing Demand for Nurse Practitioners
Current numbers show how far the profession has come. The U.S. Bureau of Labor Statistics recorded 336,300 NPs in 2025.
The BLS also projects that NP employment will grow by 41% to 474,100 from 2025 to 2035. Nurse practitioner is one of the fastest-growing roles in health care.
Several factors support nurse practitioner demand.
- Older adults often need help managing multiple conditions.
- Chronic illnesses such as diabetes and heart disease require continued monitoring and education.
- Hospitals, clinics and physician offices use team-based care to serve more patients and coordinate treatment across settings.
The future of nurse practitioners will also be shaped by access to care. NPs provide preventive, primary, acute and specialty services across a range of communities. They can help health systems reach patients who face long travel times or limited provider options. Their work complements the care provided by physicians, nurses, pharmacists and other members of the health care team.
Learn more about essential skills for nursing leaders.
Where Nurse Practitioners Work Today
NPs work in nearly every part of the health care system. They practice in community health centers, hospitals and long-term care facilities. Other settings include physician offices, private practices, schools, specialty clinics, telehealth services and urgent care centers. Daily duties depend on the patient group, clinical focus, employer and state practice rules.
Some NPs provide ongoing primary care for families or older adults. Others treat patients with acute illnesses in hospitals or focus on specialty care. Their focus may include cardiology, oncology or mental health. This flexibility reflects one of the profession’s original strengths. NPs use advanced nursing knowledge to meet the needs of patients and communities.
Technology has widened those options. Through telehealth, NPs may conduct follow-up visits and review symptoms. They can also help patients manage chronic conditions remotely. In hospitals and clinics, NPs coordinate with several professionals. They may guide a patient from assessment through treatment and follow-up care. The setting may change, but communication and patient education remain central to the role.
Why More Registered Nurses Are Pursuing Advanced Practice Careers
Registered nurses may pursue NP education because they want greater responsibility for assessment, diagnosis and treatment. The role can help them build expertise with a chosen patient group. It may also give them a larger part in clinical decisions. Other paths may lead to work in education, policy, research or organizational leadership.
Advanced education builds on an RN foundation and experience in direct patient care. Time spent as an RN helps nurses strengthen communication, judgment and teamwork before they enter an advanced practice role.
How Marquette’s Direct Entry MSN Program Prepares Nurses for Advanced Practice Roles
Marquette University’s Direct Entry Master of Science in Nursing is designed for career changers. Applicants must hold a non-nursing bachelor’s degree. The program uses their previous college education as a starting point for an intensive nursing curriculum. Students can complete the program in five semesters or choose an extended eight-semester option.
The curriculum combines nursing theory with skills labs, clinical simulation and rotations in health care settings. Students learn to assess patients, use evidence in care, communicate across teams and support safe outcomes.
Graduates earn an MSN and become eligible to take the NCLEX-RN. After passing the exam and meeting state requirements, they can begin professional nursing practice. Marquette’s Direct Entry MSN does not prepare graduates to practice as NPs. The role requires additional postgraduate education and certifications.
Graduates who want to pursue an advanced practice path can gain RN experience and pursue additional education. Marquette offers post-master’s advanced nursing certificates, including primary care and acute care NP options. Completing the appropriate certificate prepares eligible nurses to pursue the national certification examination for that role. State licensing requirements also apply.
This pathway gives career changers a clear first step to eventually move into advanced practice. Students first build a strong foundation as RNs. They can then gain clinical experience, which can help them decide whether NP practice or another area of nursing fits their goals. They can then plan the next stage of their education.
Request information today to connect with an admissions adviser and start the conversation about your future in nursing.