Loretta Ford, who co-founded the first academic program for nurse practitioners in 1965, then spent decades transforming the field of nursing into an area of serious clinical practice, education and research, died on Jan. 22 at her home in Wildwood, Fla. She was 104.
Her daughter, Valerie Monrad, confirmed the death.
Today there are more than 350,000 nurse practitioners in America; it is one of the fastest growing fields, and last year U.S. News and World Report ranked it the top job in the country, a reflection of salary potential, job satisfaction and career opportunities.
That success is in large part the result of a single person, Dr. Ford, who in 1965 co-founded the first graduate program for nurse practitioners, at the University of Colorado, and subsequently mapped the outlines of what the field entailed.
At the time, nurses were important figures in the medical field, providing not just administrative support but also vital services where and when doctors were unavailable. But the training and career framework for nurses was almost completely absent.
“In nurses’ training, the focus is too much on teaching and administration,” Dr. Ford said in a speech at Duke University in 1970. “We want to make the nurse into a clinician.”
She went further in 1972, when she was hired as the first dean of the school of nursing at the University of Rochester. There she implemented the “unification” model of nursing, in which education, practice and research are fully integrated.
“It gives the profession the ability to study itself with the research, and have nurse-practitioner researchers conducting that work while educating the future work force,” Stephen A. Ferrara, the president of the American Association of Nurse Practitioners, said in an interview.
Dr. Ford’s work in the 1970s often faced resistance from doctors, who scoffed at the idea of nurses wielding influence within the medical field and, perhaps, threatening their dominance of it.
“We actually got hate letters in the mail,” Eileen Sullivan-Marx, who studied under Dr. Ford at Rochester and is now the dean emerita of the school of nursing at New York University, said in an interview.
But Dr. Ford and others pushed on, establishing state-level licensing protocols, standardizing curriculums and adjusting insurance programs to allow nurse practitioners to have a substantive, and often independent, role within the health care system.
And she emphasized that nurse practitioners were not there to replace doctors but to complement them — to do the frontline work in hospitals, but also to be out in the community, focused on health and prevention at a grass-roots level.
“It was obvious to me,” she told Healthy Women magazine in 2022, “that we needed advanced skills and an expanded knowledge base to make the decisions. Because it happens in a hospital. Who do they think makes decisions at 3 a.m.?”
Loretta Cecelia Pfingstel was born on Dec. 28, 1920, in the Bronx and raised in Passaic, N.J. Her father, Joseph, was a lithographer, and her mother, Nellie (Williams) Pfingstel, oversaw the home.
As a child, Loretta hoped to become a teacher, but the onset of the Great Depression hit her family’s finances hard, and she was forced to find work at 16. She became a nurse, and in 1941 earned a diploma in nursing from Middlesex General Hospital in New Jersey.
Her fiancé was killed in combat in 1942, inspiring her to join the U.S. Army Air Forces, intending to be a flight nurse. But her poor eyesight disqualified her from flying, and by the end of the war she was based at a hospital in Denver.
She received a bachelor’s degree in nursing in 1949 from the University of Colorado, and a master’s in public health there in 1951.
Early in her career she specialized in pediatric public health, while also teaching in the nursing program at the University of Colorado; by 1955 she was an assistant professor, and in 1961 she earned a doctorate in education from the school.
She married William J. Ford in 1947. He died in 2014. Their daughter is her only survivor.
Dr. Ford’s work took her into rural parts of Colorado, where doctors were few, poor families were many and the need for basic preventive medical care was acute. She found herself playing many roles under the title “nurse” — she was part public health official, part counselor, part all-around clinician.
At the same time, the Kennedy and Johnson administrations were bringing a new sense of urgency to the issues of rural public health and supporting innovation across all medical fields.
Working alongside Henry Silver, a pediatrician at Colorado, Dr. Ford created a graduate program for nurses, though at first it was in the form of continuing education, without a degree. But the kernel of her vision was already there: that nurses should be sufficiently trained to make independent decisions, have their own practices and participate in health care as part of a team.
“Complete independence for any health practitioner today is a myth,” she said at Duke. “It could be downright poor practice.”
By the time she retired from Rochester, in 1986, there were thousands of licensed nurse practitioners, and many doctors had come to accept them as colleagues, not supporting players.
Dr. Ford continued to write and lecture, and in 2011 she was inducted into the U.S. Women’s Hall of Fame.
“I get a lot of credit for 140,000 nurses, and I don’t deserve it,” she said in her acceptance speech. “They’re the ones who fought the good fight. They took the heat, and they stood it, and they’ve done beautifully.”