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Nurse Practitioners in Acute Care Settings

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The role of Acute Care Nurse Practitioner (ACNP) is a fairly recent newcomer to nursing. This advanced practice nursing profession emerged in the 1970s and was officially recognized in 1995, when a national certification examination was offered for the first time by the American Nurses Credentialing Center.

The ACNP role developed over time as a response to the developments in acute care settings. For example, hospitals wanted to reduce the length of stay for patients and to improve patient care at the same time. There was also a trend to decrease the number of medical residency programs. During the late 1980s, the first graduate-level Acute Care Nurse Practitioner programs were offered as an answer to the obvious need for formal preparation for the ACNP role.

As nurses began taking on the new role of ACNP, several studies were done in the USA and in Canada to evaluate the usefulness of the specialty. The results were overwhelmingly positive. For example, the American Journal of Critical Care published a study in November 2004 in which attending physicians, respiratory therapists, and nurses in 2 intensive care units were asked to list 3 advantages and 3 disadvantages of collaborative care provided by ACNPs. The results showed that acute care nurse practitioners were valued by all three groups of surveyed respondents for various reasons.

The general finding of the study was that ACNPs were appreciated for their "accessibility, expertise in routine daily management of patients, and ability to meet patient/family needs, especially for "long-stay" patients," according to the AJCC. Also, "..they were respected for their commitment to providing quality care and for their communication skills, exemplified through teaching of nursing staff, patient/family involvement, and fluency in weaning protocols."

Other studies are congruent with these findings, and the role of an Acute Care Nurse Practitioner continues to become more popular in hospitals and clinics. Not only does an ACNP fill a needed role, but he or she also saves on health care costs since many of the tasks performed by higher-charging medical providers can be done by an ACNP.

There's no argument that the role of an ACNP has been beneficial for health care. But what about the nurses themselves? How has this career opportunity impacted RNs who are eager to move into an advanced practice role?

Again, the response from nurses has been overwhelmingly positive. "This role is ideally suited to perioperative nurses and RNFAs who want to take on an advanced practice role but do not want to leave the hands-on, acute care setting of the perioperative arena," wrote Janice L. Schroeder in the 2008 issue of AORN Journal.

Advanced practice nurses enjoy more diverse career opportunities and higher salaries, so as more advanced practice options become available this is good news for nurses who want to take their careers to the next level. There are only four advanced practice clinical professions within nursing, one of which is the nurse practitioner. An ACNP is a nurse practitioner who provides care to acutely ill patients in a variety of settings.

An ACNP will perform advanced physical assessments, diagnostic reasoning, and therapeutic management. He or she is also responsible for integration of care through the acute care phase. The ACNP's day-to-day responsibilities could include doing in-depth physical evaluations, interpreting test results, treating wounds, inserting catheters, and ordering medications.

Nurses who are interested in becoming an ACNP will typically need to pursue a Master's in Nursing Science degree (MSN). In addition, there is a growing national trend for all nurse practitioners to have a Doctor of Nursing Practice (DNP) degree. This degree gives nurse practitioners similar academic credentials to those held by dentists, medical doctors, and clinical pharmacists.

During the course of their graduate-level education, future nurse practitioners take courses in health sciences, such as pharmacology, epidemiology, and pathophysiology, as well as courses in the diagnosis and clinical management of health and illness. In addition to their coursework, students must also complete several semesters of supervised clinical practice.

After graduating and passing the national certification examination, an ACNP can choose to go into private practice, like 15% of all NPs, to work in a nurse-managed health center, or to work in a hospital or other health care setting. Becoming an ACNP is a perfect choice for any RN who is looking for new challenges and brighter career options.


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