Reflections by Sue Hagedorn RN, PhD, FAAN, FAANP and
Bonnie Gance-Cleveland, RN, PNP, PhD, FAAN, FAANP
Loretta Ford was born Loretta Cecelia Pfingstel in 1920 in the Bronx before her family moved to a farm in New Jersey during the Depression. She graduated from high school at 16, but too young to enter nursing school, worked as a nurse’s aide at Middlesex General Hospital in New Brunswick, New Jersey. At 18, she matriculated into their nursing school and graduated in 1941. After practicing as a visiting nurse, she joined the US Air Force where she was stationed in Maine and Miami. With her Bronx accent and typical good humor, she proudly remarked, “What a way to spend a War!”
Lee had read about a new bachelor’s program in public health nursing in Colorado and applied. Knowing little about life west of the Hudson River, she continued her nursing adventures and headed west on a 3-day train trip to Denver. She started school at the University of Colorado Boulder in the fall of 1947. She fell in love with Bill Ford (1920-2014), learned to ride horses, graduated, and took over the reins of the Boulder County Health Department. Lee earned a master’s degree in public health nursing in 1951. Their child, Val, was born in 1952.
As a public health nurse leading the Boulder County Health Department, Lee quickly realized that the needs of their rural patients demanded the expert care that was considered, at that time, beyond nurses’ scope of practice. While, at first, she had high expectations of the few pediatricians in Boulder, she was unable to interest any in partnering with nurses in providing care to the uninsured populations of mothers and children the health department was serving. Lee studied the problem, doing early research into the health needs of rural families, and concluded that public health nurses already had the skills needed to provide comprehensive care as nurses without needing the consent of a physician. Soon Boulder’s public health nurses were fully practicing the nursing they’d learned in school and in the field.
Lee started teaching at the University of Colorado School of Nursing in 1959 as an Assistant Professor. As Lee told the story, Dean Henrietta Adams Loughran handed Lee an application for a doctoral program and gruffly told her to fill it out and get a doctorate if she wanted to stay at the school. While a parent of a young child, teaching full-time, and practicing public health nursing on the side, Lee figured she’d “give it a try.” Lee graduated in 1961 from the University of Colorado Boulder’s School of Education with an EdD.
Having heard of Lee’s innovative work at the Boulder Health Department and at the School of Nursing, Dr. Henry Kemp of the School of Medicine approached Lee with an idea that she and his medical colleague, Dr. Henry Silver, develop a model of community-based and nurse-led pediatric practice. With Dr. Silver, Sue Sterley, an experienced pediatric nurse who Lee had sent to rural Trinidad, CO to try out the curriculum, the first nurse practitioner educational program of 12 students was born at the University of Colorado in 1965. In 1967, the 3 published the initial article about the Pediatric Nurse Practitioner program (H K Silver, L C Ford, S G Stearly, Pediatrics (1967 May;39(5):756-60).
News spread quickly that a revolution in community health was happening in Colorado. The country was ready for an expanded role for nurses in the mid-1960s, even if the Lee’s College of Nursing wasn’t. Concurrently, similar programs were beginning throughout the country in places as widespread as Boston and Cambridge, Rochester, Kansas City, and San Francisco. Public policy leaders, economists, educators, physicians and nurses from across the country visited the University, anxious to emulate this new health care program that better served children. There was not instant acceptance of the PNP role at the School of Nursing. She was isolated as a rule-breaker, described being “kicked and kissed…reviled and revered…crucified and credited”, but secure in the belief that she was pioneering an important new practice of care, expanding, not contaminating nursing, said, “I think if you care deeply, you’re willing to stick your neck out.”
In 1972, Lee left Colorado for the University of Rochester as the first Dean of School of Nursing, the Director of Nursing at Strong Memorial Hospital and full Professor. Loretta Ford was welcomed in Rochester for her leadership, innovative clinical practice, clinically-based nursing education, and relevant research. She led Rochester’s school and hospital—using what she called the Unification Model that combines education, research, and practice with the patient in the center. The practice was multi-disciplinary and was based on respectful partnerships with all members of the healthcare community, from physicians and nurses to the cleaning personnel in the hospital.
Dr. Ford retired from academia in 1986 and continued as an international nurse leader and advocate for nursing, health policy, children, and interdisciplinary education across the world. Lee took on the next—and perhaps most important phase of her career–as an international advocate for children, advanced practice nursing, and entrepreneurship in nursing. Until her death in January of 2025 at 104 years of age, Dr. Loretta Ford was a mentor to thousands of nurse practitioner faculty and hundreds of thousand nurse practitioners. From one nurse practitioner in Colorado in 1965, NP numbers have grown to 400,000 in 2024, thanks to Dr. Loretta C. Ford. According to US News and World Report, the nurse practitioner role is considered the “best job”, ”best health care job”, and the “best STEM job” in 2024.
Loretta Ford transformed healthcare and nursing. She leaves her daughter, Val Monrad and millions of admirers, over 100 publications, and so many trophies and awards that Bill had to build a special case (and then expand it) to hold them all at their home in Florida. Some of her awards included Living Legend Award from the American Academy of Nursing, the Gustav O. Lienhard Award from the Institute of Medicine of the National Academies, and, at 100 years of age, the Surgeon General’s Medallion — the highest civilian honor given by the Public Health Service. She was a fellow of the American Academy of Nursing, the American Academy of Nurse Practitioners, the National Academies of Practice. She was an inspiration to many, a mentor, a friend, a teacher and a rule-breaker and -maker. Loretta Ford, a trailblazer and innovator, pioneered the nurse practitioner movement and made a global impact.
The authors knew Dr. Ford well. Both Bonnie and Sue became PNPs in 1982 and earned their PhDs in Nursing from the University of Colorado in 1995. They taught at the College of Nursing and practiced in the PNP faculty practice system, modeling and integrating practice, research and education as described by Dr. Ford’s unification model. Bonnie retired from the University in 2021 as the Loretta C. Ford Endowed Professor. Sue retired from the University in 2009 to earn a Certificate in Documentary Filmmaking and a MS in Media Studies at The New School. Being a documentary filmmaker required the same skills—listening, presence, and seeing patterns in stories—as nursing. Dr. Hagedorn developed a storytelling program, Nurstory (www.nurstory.org) through which hundreds of nurses have told important nursing stories and became what Lee called her “paparazzi”, making over 20 documentary films, mostly related to nursing, including six that feature Dr. Ford. Her films are available at http://www.seedworksfilms.org.
View “Today Show” tribute to Dr. Ford aired on February 16, 2025 –
Inventing the Nurse Practitioner in America: Film Produced and Directed by Sue Hagedorn
About the contributors
Sue Hagedorn
Sue is a Professor Emeritus from the University of Colorado Anschutz Medical Campus. She is co-founder of the NurseManifest project, and has been involved in the research that has been conducted through the project. She is a documentary filmmaker and political activist. She has taught at the University of Colorado School of Nursing, and for many years provided nursing care to high-risk children in the city of Denver.
Bonnie Gance-Cleveland
Bonnie Gance-Cleveland, PhD, PNP, RN is a Professor Emeritus from the University of Colorado Anschutz Medical Campus. She retired as the Loretta Ford Professor embodying the components of Dr. Ford’s unification model – practicing in a school-based health center she opened in 1995, researching outcomes of nurse practitioner practice, and teaching in the nurse practitioner and PhD programs.
Resources
Hagedorn, S. (2016). The Invention of the Nurse Practitioner in America.
Hagedorn, S. and Erickson, V. (2015). The Invention of the Nurse Practitioner in Colorado. (https://www.youtube.com/watch?v=WWJR7YJdxiw)
Hagedorn, S. (2012). Disruptive Innovator: Loretta C. Ford (https://nursing.cuanschutz.edu/about/news-archives/article/CU-nursing/cunursing-and-seedworks-films-virtual-film-festival)
Hagedorn, S. and Erickson, V. (2011). Legacy of Innovation: History of the University of CO College of Nursing. (https://vimeo.com/402757225)
Hagedorn, S. and Erickson, V. (2008). Caring for Colorado: Advanced Practice Nurses. (https://vimeo.com/402789427)
Selected LC Ford Publications
Editorial Comments. Ford LC, Morrison-Beedy D., Fla Nurse. 2016 Jun;64(2):16-7. PMID: 27455590. No abstract available.
A deviant comes of age. Ford LC., Heart Lung. 1997 Mar-Apr;26(2):87-91. doi: 10.1016/s0147-9563(97)90067-4. PMID: 9090512 Review.
The future is local and global. Ford LC., Nurs Health Sci. 2005 Sep;7(3):148-9. doi: 10.1111/j.1442-2018.2005.00239.x.PMID: 16083476 No abstract available.
Editorial Comments. Ford LC, Morrison-Beedy D., Fla Nurse. 2016 Jun;64(2):16-7. PMID: 27455590. No abstract available.
A deviant comes of age. Ford LC., Heart Lung. 1997 Mar-Apr;26(2):87-91. doi: 10.1016/s0147-9563(97)90067-4. PMID: 9090512 Review.
The future is local and global. Ford LC., Nurs Health Sci. 2005 Sep;7(3):148-9. doi: 10.1111/j.1442-2018.2005.00239.x.PMID: 16083476 No abstract available.
Celebrate the past and create a vision for the future. Ford LC., J Am Acad Nurse Pract. 2010 Apr;22(4):177. doi: 10.1111/j.1745-7599.2010.00497.x. PMID: 20409253 No abstract available.
Nursing–evolution or revolution?Ford LC., Can Nurse. 1971 Jan;67(1):32-7. PMID: 4395606 No abstract available.
Nursing–evolution or revolution? Ford LC., Weather Vane. 1971 Apr;40(2):6-7 passim. PMID: 4396616 No abstract available.
Advanced nursing practice. Ford LC, Knight RM., Todays OR Nurse. 1990 Jan;12(1):22-5. PMID: 2321250
Reflections on 50 years of change.Ford LC., J Am Assoc Nurse Pract. 2015 Jun;27(6):294-5. doi: 10.1002/2327-6924.12271. Epub 2015 May 19. PMID: 25989987
The future of pediatric nurse practitioners. Ford LC., Pediatrics. 1979 Jul;64(1):113-4. PMID: 450541 No abstract available.
Reaffirmation of the nurse practitioner movement. Ford LC., Am Nurse. 1978 Jun 15;10(6):4. PMID: 247922 No abstract available.
A nurse for all settings: the nurse practitioner. Ford LC., Nurs Outlook. 1979 Aug;27(8):516-21. PMID: 257381 No abstract available.
Nurse practitioners: myths and misconceptions. Ford LC., Pulse. 1995 Jul-Aug;32(4):9-10.PMID: 7568672 No abstract available.
Unification model of nursing at the University of Rochester. Ford LC. Nurs Adm Q. 1981 Fall;6(1):1-9. PMID: 6913801 No abstract available.
Physician’s assistant: why, who and how? Ford LC. AORN J. 1972 Apr;15(4):41-60. doi: 10.1016/s0001-2092(07)61138-7. PMID: 4401206 No abstract available.
Successes and aspirations. Ford LC., Adv Nurse Pract. 2005 Jan;13(1):94. PMID: 15679300 No abstract available.
Influencing health values. Ford LC., Health Values. 1977 Jan-Feb;1(1):17-22. PMID: 10306218 No abstract available.
Perspectives 20 years later. From the pioneers of the nurse practitioner movement. Silver HK, Ford LC, Ripley SS, Igoe J. Nurse Pract. 1985 Jan;10(1):15-8. PMID: 3881696 No abstract available.
Educating the health professions for high-quality care: nursing education. Ford LC. Bull N Y Acad Med. 1976 Jan;52(1):93-104.PMID: 1060501 Free PMC article. No abstract available.
The changing role of the nurse in child health care. Ford LC., Am J Dis Child. 1974 Apr;127(4):543-5. doi: 10.1001/archpedi.1974.02110230089015. PMID: 4821318 No abstract available.
“The school nurse role–a changing concept in preparation and practice”. Ford LC., J Sch Health. 1970 Jan;40(1):21-3. doi: 10.1111/j.1746-1561.1970.tb00940.x. PMID: 5196829 No abstract available.
Pediatric nurse practitioners: a view from the founder. Inaugural Jansson lecture. Ford LC., Acad Nurse. 1990 Spring;9(1):30-1.PMID: 2198914 No abstract available.
Unification of nursing practice, education and research. Ford LC., Int Nurs Rev. 1980 Nov-Dec;27(6):178-83, 192. PMID: 6904400 No abstract available.
One hundred years of powerful women: a conversation with Loretta C. Ford. Interview by Thelma J. Wells. Ford LC., Public Health Nurs. 1993 Jun;10(2):72-7. doi: 10.1111/j.1525-1446.1993.tb00028.x. PMID: 8378237 No abstract available.
The pediatric nurse-practitioner program: expanding the role of the nurse to provide increased health care for children. Silver HK, Ford LC, Day LR., JAMA. 1968 Apr 22;204(4):298-302. doi: 10.1001/jama.204.4.298. PMID: 5694623 No abstract available.
Nursing and integrative health care. Mittelman M, Alperson SY, Arcari PM, Donnelly GF, Ford LC, Koithan M, Kreitzer MJ., Altern Ther Health Med. 2010 Sep-Oct;16(5):74-84.PMID: 20882736 No abstract available.
A program to increase health care for children: the pediatric nurse practitioner program. Silver HK, Ford LC, Stearly SG., Pediatrics. 1967 May;39(5):756-60.PMID: 6026876 No abstract available.
THE CHANGING NATURE OF NURSING. FORD LC., J Am Coll Health Assoc. 1964 Dec;13:197-211. PMID: 14229956 No abstract available.
Who’s who among nursing leaders. Ford LC., Nurs Leadersh. 1980 Sep;3(3):4-7. PMID: 6902818 No abstract available.
Nurse practitioners: myths and misconceptions. Ford LC., J N Y State Nurses Assoc. 1995 Mar;26(1):12-3. PMID: 7636583 No abstract available.
The academic community–an ecological viewpoint. Ford LC., J Am Coll Health Assoc. 1971 Apr;19(4):253-5. PMID: 5548580 No abstract available.
Interview with co-founder of NP movement. Ford LC.NP News. 1995 Jul-Aug;3(4):8, 10, , 12. PMID: 7553210 No abstract available.
Reactions to the two foregoing presentations. Ford LC., NLN Publ. 1972;(15-1456):24-8. PMID: 4482096 No abstract available.
The nurse practitioner: competitive or collaborative? Ford LC., J Am Coll Health Assoc. 1981 Feb;29(4):197-200. doi: 10.1080/01644300.1981.10393006. PMID: 7264086 No abstract available.
Nurse practitioners: what the future holds. Ford LC., Am Nurse. 1974 Nov;6(11):4. PMID: 4499695 No abstract available.
Nursing’s place on the map–keynote address. Ford LC., Kans Nurse. 1972 Nov;47(10):1-4. PMID: 4486012 No abstract available.
New perspectives in college health nursing. Ford LC, Popiel ES., J Am Coll Health Assoc. 1968 Apr;16(4):372-7. PMID: 5642802 No abstract available.
Learning experiences–privilege, power, potential and predictions. Ford LC., J Am Coll Health Assoc. 1969 Apr;17(4):360-2. PMID: 5797510 No abstract available.
Loretta C. Ford: a modern olympian, she lit a torch …. Interview by Shirley H Fondiller. Ford LC., N HC Perspect Community. 1995 Jan-Feb;16(1):6-11. PMID: 7743411 No abstract available.
Organizational perspectives on faculty practice: issues and challenges. Ford LC, Kitzman HJ., Annu Symp Nurs Fac Pract. 1983;(1):13-29. PMID: 6559556 No abstract available.
Nursing in the mind’s eye…in the hospital. Ford LC., Tar Heel Nurse. 1970 Dec;32(4):27-33. PMID: 5204112 No abstract available.
One nurse’s view of pediatric nurse practitioners. Ford LC., Pediatrics. 1974 Nov;54(5):534-7.PMID: 4453449 No abstract available.
Opportunities and obstacles in occupational health nursing. Ford LC., Occup Health Nurs. 1973 Jul;21(7):9-14. doi: 10.1177/216507997302100701. PMID: 4736401 No abstract available.
Interdisciplinary education for nurses in the expanded role: the way of the future. No. NP-47. Ford LC., ANA Publ. 1975 Apr;(NP-47):4-15. PMID: 1041203 No abstract available.
Reflections on the past decade in health manpower. Ford LC. Health Care Dimen. 1975 Spring:1-15. PMID: 1052961 No abstract available.
Response to “Institutionalizing practice: historical and future perspectives”. Ford LC., Annu Symp Nurs Fac Pract. 1985;(2):17-23. PMID: 3854913 No abstract available.
Returning to the roots of the nurse practitioner role. Ford LC., Nurs Outlook. 1989 Mar-Apr;37(2):66. PMID: 2928134 No abstract available.
Nursing at the cutting edge of health services reform. Ford LC., Am J Nurs. 1980 Aug;80(8):1476-9. PMID: 6903102 No abstract available.