The Door of Last Resort: Memoirs of a Nurse Practitioner

Having spent decades in urban clinical practice while working simultaneously as an academic administrator, teacher and writer, Frances Ward is especially well equipped to analyse 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