On the last Sunday of 2020, Loretta Ford walked out of the front door of her Florida home and was greeted by a parade of passing golf carts.
The nursing legend was one day away from her 100th birthday, and her friends and neighbors surprised her by putting on a physically distant celebration. As longtime friends and former colleagues watched on Zoom, Ford opened gifts and watched a stream of golf carts decorated with balloons and banners putter by. One cart was filled with banners representing the University of Rochester School of Nursing, where Ford built on an already prominent role in the profession by becoming the school’s founding dean. But there was also the somewhat curious appearance of a Susan B. Anthony impersonator and a host of other suffragettes.
Curious, that is, unless you’d spent any time around Ford in the run up to her landmark year.
“One of the things that Loretta was excited about was that she had two things left on her bucket list: turning 100 years old and celebrating the 100th anniversary of women’s right to vote in the U.S.,” said Kathy Rideout, dean of the UR School of Nursing. “I think it was a little bit of a sobering moment to really recognize how significant her 100th birthday was, but it was really an important day for her. It was also a really good day for us to be able to celebrate her as a person and all the work that she has done.”
A few days later Rideout spoke to Ford by phone and reminded her of her completed bucket list only to find out Ford was working on a new list for her next century.
About Loretta Ford
- Born Dec. 28, 1920, in New York City, in the midst of the Spanish Flu pandemic
- Began her nursing career at age 16 at Middlesex General Hospital in New Brunswick, NJ
- Earned her nursing diploma in 1941 and enlisted in the US Air Force, serving three years during WWII.
- Attended the University of Colorado on the GI Bill and earned a bachelor’s degree in nursing in 1949 and a master’s in public health in 1951. She joined the University of Colorado faculty in 1961.
- With Dr. Henry Silver, she created the first nurse practitioner program at the University of Colorado in 1965.
- In 1972, she was named the first dean of the newly independent University of Rochester School of Nursing, where she would develop the Unification Model of Nursing, linking clinical practice, education, and research.
- She was named a “Living Legend” by the American Academy of Nursing and was inducted into the National Women’s Hall of Fame in 2011.
- USA Today honored her in 2020, naming her one of its “Women of the Century” in recognition of the 100-year anniversary of women’s suffrage.
- Hours before her 100th birthday, Ford was honored with the Surgeon General’s Medallion, awarded by the U.S. Surgeon General for exceptional achievements to the cause of public health and medicine.
The University of Rochester played a huge role in Ford’s career. Perhaps just as impactful as her work at the University of Colorado was Ford’s development of the Unification Model at the UR School of Nursing. Recruited in 1972 to be the first dean of the newly independent school of nursing and director of nursing at Strong Memorial Hospital, Ford bridged the two roles to create a unified model of nursing, which combined education, research, and clinical practice to form a more holistic approach to nursing and health care.
“Her belief was that nurses in an academic unit needed not to be siloed, but they needed to focus not only on teaching, but on research and clinical practice,” Rideout said. “She thought that it was critical that whoever was educating nurses was still practicing as clinicians and also involved in research. And that became the unification model, blending education, practice, and research with each mission informing each other bi-directionally. And we still operate that way today.”
Ford retired from the University in 1986, but her shadow still looms large on both sides of Crittenden Boulevard. As Ford’s 100th birthday approached, Rideout spearheaded planning for a celebration fitting of her stature in the profession. But then the pandemic hit.
The new plan was to start a birthday card drive. The school started a campaign through social media and targeted emails soliciting birthday messages and collected over 300 birthday wishes from former students, colleagues, and nurses. Some had no direct relationship with her, but simply wanted to thank her for paving the way for others.
“We weren’t able to have her here to celebrate, so we decided that we could really honor her best by reaching out to all of the people that she has touched,” said Rideout. “It was really important for us to do that so that she could really see all the love and impact that she’s had over the years.
“We had tears in our eyes as we were packing up all these warm wishes from people all over the country that had a memory about when they met her, or even more importantly, what role she played in their lives. It was really heartwarming.”
The cards were packaged up with a few small gifts and sent to Ford along with a huge bouquet of flowers, which arrived just in time for her party. The UR package was certainly among the highlights of Ford’s day, as she noted in a thank you message Rideout shared with the school.
Another high point was a video message presenting Ford with the Surgeon General’s Medallion, the highest honor a civilian can receive for public service. The award is bestowed by the U.S. Surgeon General for “action of exceptional achievement to the cause of public health and medicine.” Ford was honored for her role in creating the nation’s first nurse practitioner program, founding a profession that would become an integral part of the country’s health care infrastructure, and her half-century as an advocate and champion for the NP community.
“Dr. Ford, along with pediatrician Dr. Henry Silver, envisioned a model for an advanced practice nursing role where patient treatment focused on prevention with more patient involvement. This training program combined clinical care and research to teach nurses to factor in the social, psychological, environmental, and economic situations of patients when developing care plans. Little did she know then that today, patients across the U.S. benefit from the high-quality health care provided by over 290,000 nurse practitioners,” said Sophia L. Thomas, DNP, APRN, FNP-BC, PPCNP-BC, FNAP, FAANP, president, American Association of Nurse Practitioners (AANP). “It takes a village to care for a nation and it took one nurse’s vision to help create these partners in health.”
“Through her leadership and innovation, Dr. Loretta Ford has forever changed the trajectory of the nursing profession. In every state and around the world, every nurse practitioner owes a debt of gratitude to the creator of this essential nursing role.”
Ford’s nursing career began humbly. At the age of 16, she became a nurse’s aide at Middlesex General Hospital in New Brunswick, New Jersey. She entered the nursing program when she turned 18 and earned her diploma in 1941. She then joined the Visiting Nurse Service of New Brunswick, but signed up for the US Air Force after her fiancé was killed in World War II.
After the war, Ford attended the University of Colorado on the GI Bill. She earned her bachelor’s degree in nursing in 1949, a master’s degree in public health in 1951, and a doctorate in education in 1961. During her doctoral studies, Ford became an assistant professor at the University of Colorado School of Nursing in Denver, later advancing to full professor.
Ford teamed with pediatrician Henry K. Silver to create the first pediatric nurse practitioner training program at the University of Colorado Medical Center in 1965. Her actions resulted in the first-ever educational program for advanced nursing and the creation of a new role in medicine: the nurse practitioner.
“Her contribution has been priceless. We wouldn’t be able to provide the care that we do today without Loretta Ford,” said Anne Swantz, RN, MSN, C-PNP, senior director of the Sovie Center for Advanced Practice, which includes about 650 NPs at Strong and UR Medicine’s affiliate hospitals. “Because of the NP role, there’s been a huge shift in access to high-level care.”
At a time when doctors did not welcome or appreciate input from nurses, Ford was met with considerable resistance and criticism in the medical community.
“There was a time when nursing was seen more in this hierarchy, where medicine was at the top and then came nursing. And Loretta’s desire and passion and mission was to equalize that, that there was not a hierarchy when it came to medicine and nursing,” Rideout said. “And she worked diligently to advocate for the role of nurses, not only at the bedside, but as educators, as researchers, and then in the advancement of nurses into an advanced practice role of nurse practitioner.”
“I can only imagine how difficult it was for her in the 1960s. It was a very paternalistic time and everything was in turmoil. She had to be quite brave and quite persistent to make this change happen,” said Marianne Chiafery, ‘79N, ‘96N (MS), ‘16N (DNP), DNP, PNP-BC, an associate professor of clinical nursing who was a student under Ford. “Not only did she need to have her physician colleagues think that it was a good idea, but she needed their buy in. She needed to argue her case, prove value and convince people that it was a good way to go.”
As time has passed, many people came to believe that the role of nurse practitioner came about due to a shortage of medical doctors. While it’s true that few doctors cared to practice in rural communities or treat the underprivileged, Ford didn’t set out to fill a void in medicine. She simply aimed to help provide care for children and families in need.
To that end, Ford and her nursing team went to help in remote areas. They set up temporary clinics in schools and churches and offered basic health care to the community.
“It was transformational,” said Chiafery. “Medicine’s focus is slightly different from the nurses’ focus, and I think NPs, having worked as nurses, add value to patient care. While some nurse practitioners work in independent practice, others work as a team with physician colleagues in specialty areas. A fully integrated practice with a doctor and an NP with the skill set from a nursing background really enhances the patient care experience.”
“Early in her career, she was a public health nurse and that role never left her,” said Mitchell Wharton, ‘13N (Phd), PhD, RN, FNP-BC, CNS, UR Nursing’s associate dean for equity and inclusion.
Wharton co-taught an NP course last year in which Ford made a guest appearance, and he said that even at age 98, Ford continued to press these emerging providers to keep their focus on patient needs and insisted that nurses were uniquely equipped to provide that care. “Don’t forget that you are a nurse,” she said. “Don’t forget the human interaction, that’s what helps people.”
Over the course of many years, Ford succeeded in establishing the nurse practitioner as an integral part of medical teams. Through her many contributions as a nurse, educator, and innovator, Ford changed the face of medicine, bringing greater respect and appreciation to the critical role of nurses and nurse practitioners and to the nursing profession as a whole.
“I think that for us we wouldn't be where we are today as a school if she hadn't really committed many years to being the dean,” said Rideout. “And our profession, of which I'm very proud to be a nurse practitioner to this day, our profession would not be where it is today, if it hadn't been for Lee Ford.”