Imagine a person is taken to a hospital emergency room for a problem with their health, such as a myocardial infarction, otherwise known as a heart attack. When the patient arrives in the emergency room they will see multiple types of healthcare providers working as a team. Team members would include the general nurses and doctors, anesthesiologists, and EMTs. There is a specialty often forgotten, but a valuable part of the team, the Acute Care Nurse Practitioner (ACNP).
Acute care nurse practitioners are highly skilled and educated healthcare providers that are able to diagnose and treat acute, or sudden and severe, illnesses.
They have the similar responsibilities as doctors, but have different approaches on how to best care for the patient. This profession requires skills that are needed to be a successful nurse of any specialty, including independence, flexibility, and humility. These professionals can work in a number of settings, including emergency rooms, operating rooms, and critical care units. Due to their flexibility in work settings, they can work with a range of patients, from pediatric to trauma.
Nurse Practitioners have been around for decades, but they were not educated to provide acute care until the 1990s. There is now a specific specialty in nursing that allows them to have the skills needed to provide acute care. This is due to the demand for higher-quality care that these nurse practitioners can provide. The requirements to become an acute care nurse practitioner include additional schooling after earning a Bachelor degree in Nursing, certification, and experience in acute care through clinical hours.
They usually acquire a Master’s degree in Nursing through an accredited school. Certification is granted through the state of a nursing agency, such as the American Nurses Association.
The specialty of acute care nurse practitioner is a noble and exciting role in healthcare. It provides excellent care for patients with acute illnesses while expanding the abilities of the nurse. This paper will discuss the role, education, skills and other matters that may affect the career of an acute care nurse practitioner.
Acute Care Nurse Practitioners are healthcare professionals that can diagnose, treat and care for patients with acute and chronic conditions (“Career Profile” 2018). Acute conditions are illnesses are those that are effective for less than six months and are treated quickly. These conditions include a broken leg, appendicitis and common cold. Chronic conditions are those that are long term and do not have a definitive cure. Examples of chronic conditions include rheumatoid arthritis, Parkinson’s disease and diabetes (Berman, Kozier, Erb, 2016).
Acute Care Nurse Practitioners have the ability to work in many types of healthcare facilities. Facilities with these professionals include intensive care units, hospitals, and nursing homes. They often work and collaborate with all types of healthcare professionals, including physicians, registered nurses, and physician assistants. With this wide variety of workplaces these professionals will care for many types of patients, from infants and pregnant women to geriatrics and mental health patients. In fact, there are subspecialties based on populations or disease types. Populations they are able to specialize in include pediatrics, geriatrics, and neonatology. They can also focus on certain diseases or body systems, including cardiology, emergency care, or neurology (“What Acute Care Nurse Practitioners Do”).
Acute Care Nurse Practitioners are able to work as a licensed primary or specialty care provider. They are advanced practice registered nurses, which means they are able to have more responsibilities than a registered nurse would have. Responsibilities that are part of this includes performing physical examinations, ordering and interpreting diagnostic tests, and prescribing medications and treatments (“Career Profile” 2018).
In many ways, Acute Care Nurse Practitioners have the similar responsibilities as physicians or physician assistants. In fact, the only difference between nurse practitioners and physician assistants are the models they follow to provide care and the training they have received (“Nurse Practitioner vs Physician Assistant”). Nurse practitioners are trained in line with the nursing model, which provides holistic care to a patient. Holistic care is described as looking at the patient as a whole and not simply the disease they have. This includes taking into account the patient’s emotional, cognitive, and physical state (Berman, Kozier, Erb, 2016). Physician assistants follow the medical model to provide care. This model focuses more on the disease the patient has and how to cure it as efficiently as possible (“Nurse Practitioner vs Physician Assistant” 2018).
Acute care nurse practitioners are also able to have their own practice, while physician assistants usually work under the supervision of a doctor with a medical degree. Acute care nurse practitioners may also work in collaboration with a doctor if they do not have or are unable to have their own practice. The amount an acute care nurse practitioner is able to do in the United States is highly dependable on the state’s regulations. Some states allow nurse practitioners full freedom and they can have their own practice, others are very restrictive on the procedures or treatments they are able to do. This causes relocation for nurse practitioners of any type to be difficult. To ensure full understanding of abilities research the state’s regulations and restrictiveness (Morten 1999).
Even though acute care nurse practitioners, physicians, and physician assistants have similar roles, many believe that nurse practitioners cannot provide the same level of care as physician assistants and physicians. However, Haut and Madden state that acute care nurse practitioners provide care that indicates “shorter stays, higher satisfaction among patients, increased work efficiency, and higher quality outcomes” (Haut, Madden 2015).
Studies have been done to determine if nurse practitioners do offer equal, if not superior care as physicians or physicians assistants. One study was done by Horrocks, Anderson, and Salisbury in 2002. They held random trials on patients to determine the quality and satisfaction with care by both physicians and nurse practitioners. They also compared the health status’ of the patients of both professionals. It was found that patients were more satisfied with their care by nurse practitioners than by their physicians. The quality of care given by nurse practitioners was also seemed to be superior to physicians. In the study nurse practitioners identified physical abnormalities more often, communicated better and made more complete records. They were also able to provide more advice to the patient to promoting health and wellness. The health status’ of the patients of nurse practitioners were also similar to the physicians’ patients (Horrocks, Anderson, Salisbury 2002). As this study suggests nurse practitioners are able to provide equal and, in some ways, superior patient care than physicians assistants.
Education to become an acute care nurse practitioner was limited until recently. Nurse practitioners, which were first introduced in the 1960’s, were educated chiefly for primary care. This meant that there were no programs dedicated to acute care education, even though primary care nurse practitioners were able to work in acute care settings. Nurse practitioners that wanted to learn the necessary skills for acute care had to learn by observing physicians, learning on their own and possibly be mentored by physicians (Morton 1999). In fact, the first national acute care nurse practitioner certification exam was not offered until December 1995 (Kleinpell 1999). There are now several acute care programs available all over the United States, including online programs.
To become an acute care nurse practitioner one must first earn a degree in nursing from a two to four-year program and be certified as a registered nurse (RN). They then gain experience in the acute care setting, usually two to three years, and return to school to achieve an advanced degree. A Master’s degree in Nursing (MSN) or higher education, such as a doctorate, in nursing is required. The Master’s programs are given through a two-year program. About 40 credit hours of classes is required to achieve this degree, along with hundreds of hours of clinical experience (“What Acute Care…” 2018).
This Master’s degree must be a program specific to acute care nurse practitioners (“Your Guide to Certification” 2001). The next step is to become certified by the State Board of Nursing or through a certain agency, such as the American Association of Nurse Practitioners. When certified the new acute care nurse practitioner is able to practice based on the guidelines set by the state they are working in (“What Acute Care…” 2018).
The skills required to be a successful acute care nurse practitioner can be summarized by Susan Yeager, MS, RN, CCRN, ACNP when giving an interview for the Journal for Nurse Practitioners. Yeager described that the skills needed to be an acute care nurse practitioner build from the foundation of skills required for a registered nurse (“Acute Care Nurse Practitioner” 2010). Skills required of a nurse include flexibility, communication and humility, along with many others such as independence, integrity and compassion (Berman, Kozier, Erb, 2016).
Flexibility or adaptability is a skill needed because often times a problem or change will come up and you will need to be able to adapt to that change. For example, a patient may come in with a broken leg and you begin treating the leg, but then they suddenly begin vomiting. The nurse practitioner must adapt their care plan to the immediate need of the patient, which is to stop the vomiting. Nurse practitioners also have schedules that often change and include night or weekend shifts, even shifts on the holidays.
Communication is an essential skill needed for any health care professional, but an acute care nurse practitioner must be an expert. An acute care nurse practitioner will often be the leader of a health care team therefore good communication is needed for many reasons. Some of these examples include determining if a treatment is working, knowing what the patient is complaining of such as pain, and knowing what medications have been given. Another reason an acute care nurse practitioner needs good communication is because they have to communicate with the patient about their condition and the treatments they will receive. For communication to be effective, the acute care nurse practitioner must also listen to the patient. These professionals will listen to things such as the patient’s concerns, symptoms that they are experiencing, and what actions would make the patient’s care better.
Humility, more specifically cognitive humility, is an important skill for any healthcare professional to have. Cognitive humility is the ability to recognize that you do not know everything. It is important because you will be approached with a problem that you will not have a solution for. It would be better to admit that you do not understand the situation, rather than pretend you know what is going on and possibly put the patient in great danger. This would provide yourself with an opportunity to bring in a more knowledgeable professional to give the patient the best care possible.
This profession works in tense and demanding situations, so they experience many challenges within the workplace. Some of these include constant unplanned interruptions, heightened level of stress with an acute illness, and gathering data from a distressed patient (“Acute Care Nurse Practitioner” 2010). Unplanned interruptions within the health care setting is a normal thing to see, but an acute care nurse practitioner must be flexible and ready when they happen. Nurse practitioners will often be in the middle of a procedure or important conversation with a family and their pager will be going off with a patient in need of their assistance (“Acute Care Nurse Practitioner” 2010).
When someone has an acute illness it is often painful and intense, which can increase the stress of the patient and their family. This can be a challenge because the acute care nurse practitioner must communicate to them the severity and difficulty of illness. An example of this would be having to tell a patient that they must have a risky surgery. This is would cause stress and confusion for the patient and their family (“Acute Care Nurse Practitioner” 2010). Another example would be performing an assessment on an acutely ill patient. When a patient is admitted in the hospital a health care professional must do an assessment on them. In an acute care setting this can be a challenge because the patient is usually in distress and pain. They will not be interested in answering certain questions. The acute care nurse practitioner must then use their skills to relieve some of the patient’s pain and try to get as much information as possible.
The salary of an acute care nurse practitioner can range depending on the facility and region they work in. The US Bureau of Labor Statistics says that the median income for advanced practice nurses, including acute care nurse practitioners, is $100,910 per year (“Career Profile” 2018).
Their salary is also influenced by these professionals specialty. The 2011 National Salary Report published a number of salaries of acute care nurse practitioners based on populations and work settings they chose. Those who work in emergency settings earn the most with a salary of $103,722. Acute care nurse practitioners that specialize in pediatrics earn $82,101 per year. Those who specialize in gerontology earn $94,485 per year (“Acute Care Nurse Practitioner (ACNP)” 2018).
Acute care nurse practitioners have been surveyed discussing their point of view of their career choice. In 1999 Ruth Kleinpell sent surveys to those who had recently taken the acute care nurse practitioner exam. Kleinpell conducted this study to find out the role development and employment patterns of newly certified acute care nurse practitioners. The results indicated that these professionals were able to interpret diagnostic tests, examine and clean wounds, initiate discharge planning, among many other skills. Almost all of the study participants stated that they were either “very satisfied” or “somewhat satisfied” with their profession. They also said that they were either “very satisfied” or “somewhat satisfied” with collaborations with physicians and other health care professionals (Kleinpell 1999).
Nurse practitioners in acute care settings have become a valuable part of the healthcare facilities. The need for acute care nurse practitioners has increased in past years due to the accessible high-quality care that is needed. With the growing elderly population, due to the aging “baby boomer” generation, this level of care is needed even more in the near future. This population is also primarily based in rural or non-urban areas, so there will be more need in these areas (Berman, Kozier, Erb, 2016).
As stated before, acute care nurse practitioners are able to provide equal or even higher quality of care compared to physicians and physician assistants. Susan Yeager even stated that “the variety of opportunities in unique settings grow. I can envision this leading to an environment where nurse practitioners can consult nurse practitioners” (“Acute Care Nurse Practitioner 2010). Yeager goes on to predict that nurse practitioners will become experts in medical procedures and continue in providing excellent care (“Acute Care Nurse Practitioners” 2010). The role of the acute care nurse practitioner is one that is growing need and in value. It is also expanding in responsibilities. With their flexibility and willingness to learn the future of acute care nurse practitioners is exciting and unlimited.
Acute care nurse practitioners are valuable members of a health care team that provide excellent care to the patients. The profession of acute care nurse practitioner is one that is challenging and offers great reward. They are a valuable member of a healthcare team and they provide excellent care. They are able to work in a number of health care settings and provide care to all types of populations. Acute care nurse practitioners are able to provide the same level of care as other professionals with medical degrees, including physicians and physician assistants. Patients have even said that the care they received from nurse practitioners exceeds that of physician assistants.
The education of acute care nurse practitioners has greatly expanded within the last 20 years. There are now programs available throughout the United States that provide excellent preparation for their career in the medical field. Certification through a test allows the new acute care nurse practitioner to practice. However, they will have to research state regulations to fully understand what they are able to do.
The acute care nurse practitioner is a profession that requires many skills that will help the person to deal with different situations. These include adaptability, cognitive humility and good communication. With these skills mastered and excellent education the need and performance of an acute care nurse practitioner will be first-rate.
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