Having spent decades in urban clinical practice while working simultaneously as an academic administrator, teacher, and writer, Frances Ward is especially well equipped to analyze the American health care system. In this memoir, she explores the practice of nurse practitioners through her experiences in Newark and Camden, New Jersey, and in north Philadelphia.
Ward views nurse practitioners as important providers of primary health care (including the prevention of and attention to the root causes of ill health) in independent practice and as equal members of professional teams of physicians, registered nurses, and other health care personnel. She describes the education of nurse practitioners, their scope of practice, their abilities to prescribe medications and diagnostic tests, and their overall management of patients’ acute and chronic illnesses. Also explored are the battles that nurse practitioners have waged to win the right to practice—battles with physicians, health insurance companies, and even other nurses. The Door of Last Resort, though informed by Ward’s experiences, is not a traditional memoir. Rather, it explores issues in primary health care delivery to poor, urban populations from the perspective of nurse practitioners and is intended to be their voice. In doing so, it investigates the factors affecting health care delivery in the United States that have remained obscure throughout the current national debate
1. Bread Is Not Sugar 2. Health Care: Perspectives from the Street Level 3. Nurse, Are You a Doctor? 4. Protection of the Public or Creation of a Guild? 5. Context, Data, and Judgment: When Is Enough, Enough? 6. Barriers, Opportunities, and Militancy
FRANCES WARD is professor emerita at Temple University where she served as David R. Devereaux Chair of Nursing. The founding dean of the School of Nursing at the University of Medicine and Dentistry of New Jersey, she maintains a clinical practice as an adult nurse practitioner. She is the author of On Duty: Power, Politics, and the History of Nursing in New Jersey (Rutgers University Press).
“A wonderful personal story of what it means to be part of a disruptive movement that changed healthcare in the United States, making nurse practitioners the future of primary care.”
~Tine Hansen-Turton, National Nursing Centers Consortium
"Ward makes a convincing case for a view of health care that relies on clinical skills and diagnosis with sensitivity to the differences among groups—against one that pursues only curing at the expense of thorough diagnosis and caring."
~Barbra Wall, University of Pennsylvania, School of Nursing