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Acute and urgent care skills required by family nurse practitioners

There is no question that today, family nurse practitioner (FNPs) fulfill a vital role in the US healthcare system. However, while most people are by now familiar with the high level of care FNPs provide to families who visit their practices and receive regular check-ups and treatment from them, their role in providing acute and urgent care is probably less well known to many. So when are family nurse practitioners required to provide patients with urgent or acute care, what kind of actions are they usually required to take, and what kind of preparation is required for a career in this field?

In this article, we look at the importance of nurse practitioners in providing acute care to patients, why and when these situations are likely to occur, and the type of education that can assist them. In addition, we also look at the importance of experience and lifelong learning for FNPs, as well as the skills and qualities required, particularly in situations of high stress and significant pressure. 

Acute care vs chronic treatment 

Nurse practitioners (NPs) are qualified registered nurses (RNs) who have undertaken a further education degree to qualify as an NP. Generally speaking, in addition to performing many of the same tasks as an RN, nurse practitioners will also take on a greater level of responsibility, often carrying out additional tasks such as prescribing medication, diagnosing patients and providing thorough physical examinations, as well as taking on more administrative and managerial tasks. Though it can sometimes be more stressful or more demanding, generally speaking NPs report greater job satisfaction than RNs, in part due to the potential for increased responsibility, improved working conditions, better pay and more flexibility.

Emergency or urgent care typically refers to a severe case where immediate and sometimes drastic medical treatment is required. Acute care is a slightly broader term, and refers to any situation where a patient receives immediate treatment for a temporary illness or condition. This is in contrast to chronic care, where patients have a longer-term issue and require treatment over an extended period. Generally speaking, nurse practitioners who provide acute care on a regular basis tend to work in urgent care settings, such as hospital wards, inpatient care facilities and potentially drug rehabilitation centers and psychiatric wards. Though some qualified family nurse practitioners may operate in these kinds of settings, even FNPs who work in outpatient clinics or practices may also find that they are required to provide urgent care. So what kind of skills are required in this field?

Emergency treatment

Any nurse practitioner that works in a setting where urgent care is regularly required will soon become used to dealing with a wide range of situations. These can range from heart attacks, cardiac arrests and strokes to injuries sustained in car crashes, sports or any other type of accident, not to mention alcohol or drug overdoses. In almost all cases, patients receive inpatient care, meaning that they stay in a hospital or care setting and receive careful monitoring and/or continual or frequent treatment. In some instances, emergency on-site care may also be required, i.e. the medical professional will travel to the scene of the accident or injury to provide on the spot care. In these kinds of situations, nurse practitioners may be asked to provide assistance to the physician responsible for treating the patient, though they may also be required to provide direct assistance themselves.

As a result, NPs are expected to develop a wide range of skills and expertise in relation to providing acute care. Just by way of example, all nurse practitioners are expected to be trained to provide Advanced Cardiovascular Life Support (ACLS) to deal with heart injury – not to mention cardioversion and defibrillation – airway management to ensure that patients are able to breathe properly, and central line insertion for issues like hematoma, bleeding, and infection. In addition, NPs should also be capable of dealing with treatment processes related to treating broken bones or severe wounds, and resuscitation using pharmacotherapy. Naturally, patients are almost always directed towards emergency healthcare services to resolve these issues. At the same time, even NPs who do not work in ER might find that they need to provide urgent care from time to time.

Acute care for FNPs in family practices

While NPs operating in emergency rooms will naturally come across cases that require immediate treatment on a daily basis, family nurse practitioners who operate in local practices and often receive patients by appointment will also deal with urgent care situations. In some cases, these can be just as dramatic – they might find themselves faced with a heart injury, an immediate leg break or something similar. This is particularly true for nurse practitioners who work in a remote location, where people often have far more limited access to emergency services, and where NPs and local GPs are more likely to be the first point of call in an emergency situation.

In addition, family nurse practitioners often provide more general healthcare options where the patient does not necessarily have a long-standing ailment or condition that requires long-term care care, but instead has a temporary issue or some kind of problem that requires examination and potential diagnosis.  These include a number of acute issues that do not necessarily require the help of the emergency services, but do often need to be treated. For example, issues such as colds, flus, and sinuses or ear infections are (usually) temporary problems where specific treatment is required. In these cases, NPs not only have to be adept at treating the issue at hand, but must also be extremely skilled at determining when they are dealing with a singular event, or when the symptoms might be the sign of a more serious underlying issue, where further tests or specialist examinations may be required.

The right person for the job

Naturally, it takes a special kind of person to provide a high level of acute or urgent care. Attention to detail and level-headedness are essential qualities, while quick-thinking and the ability to use critical thinking and problem-solving skills are also vital. A high tolerance to stress and resilience under pressure are also key in order to avoid becoming overwhelmed, though the value of excellent communication and empathy with others cannot be overestimated. After all, in situations with a high degree of uncertainty and often no little risk, most patients will appreciate those health professionals who are able to calmly and skilfully explain to them the situation and any procedures that are likely to take place.

Of course, preparation and excellent judgment are both absolutely essential for family nurse practitioners who find themselves in a situation where they have to provide urgent or even acute care. As we mentioned above, there is not always ample time to discuss possible courses of action with others, and FNPs must be prepared to not only take on the huge responsibility of decision-making, but also to follow through on those decisions and face the consequences of their actions. And there can be a danger to too-bold decisions, as well as being too cautious. For example, if an elderly patient has been suffering from a serious bout of flu and the nurse practitioner is concerned about their state of health, they may recommend that they undergo hospital treatment and observation, or they may recommend bed rest. In each case, there are a number of positives and negatives that must be weighed up, with the final outcome often extremely hard to predict.

Preparation is everything

When it comes to deciding what kind of nursing career to follow, it can be extremely difficult to choose. For qualified nurses, the two main pathways to follow are whether to complete a Master of Science in Nursing (BSN), or a Bachelor of Science in Nursing (BSN). While a BSN can help registered nurses advance their career, an MSN is a more advanced qualification that can provide a broader range of future career options. In terms of MSN Vs BSN salary, the fact that an MSN can lead to a specialization as a family practitioner or another field means that the salaries for graduates are usually much higher on average. An MSN can also help prepare graduates for a position of responsibility, as they will typically receive coursework in management, learn how best to navigate the healthcare system, and also reach a detailed understanding of advanced theories and practices. Though an MSN can take longer to learn than a BSN and the cost is often higher, there are also some flexible options available, particularly for those already in employment.

An Online Master of Science in Nursing (MSN) — Family Nurse Practitioner (FNP) from Wilkes University, for example, will provide students with the chance to earn an advanced qualification entirely online. Graduates emerge with a broad depth of knowledge and the ability to go on to gain a license as a nurse practitioner. Students also undergo work placements to ensure practical experience in a clinical setting, while the flexible online nature of the degree means it is perfect for people who would like to continue their education while still maintaining a full or part-time job.

Learning never stops

Naturally, even upon graduation, new RNs or NPs still have much to learn, and experience will always be a vital aspect of any path related to healthcare. In the initial phase of their career, recent graduates in this field will often lean on the assistance of other more senior colleagues. This is particularly important when it comes to acute or urgent care, where decisions often have to be made extremely quickly, and in many cases the situation is critical. As well as providing on-site assistance, senior colleagues are often available to review situations and provide guidance on how to do things differently in the future.

Lifelong learning is also a key aspect in the development of any successful nurse practitioner, of course, and again this is particularly vital in acute care. In addition to mentoring and peer-to-peer conversations, the best NPs usually work hard to stay up-to-date with scientific research and development in their chosen field, while there are also a number of online training courses and organizations that can help with professional development. The American Association of Nurse Practitioners, for example, is both an excellent source of information and also regularly organizes educational opportunities and has a wide range of additional resources.

The right path

Acute care is unquestionably one of the most vital aspects of healthcare, where decisions need to be taken fast and where the consequences of a mistake can be catastrophic. Family nurse practitioners often play hugely important roles in this process, whether it’s dealing with a broken limb, providing first aid to someone who has just suffered heart attack, or trying to determine whether someone experiencing a crushing headache or blurred vision simply needs to sleep it off, or is in immediate need of urgent medical care.

In each case, the NP requires the ability to maintain a cool head and make the right decisions, communicate effectively with patients, family members or close friends, as well as other medical staff, and also the medical training and preparation to ensure that the right course of action is taken. In these situations, the education, medical experience and the personality of the nurse practitioner are all crucial elements that will help determine the final outcome. For family nurse practitioners in particular, who deal with a wide range of issues for patients of all ages, the responsibility is great, but with the right amount of preparation and the special qualities listed above, they will always be a vital, integral element of the very best healthcare.

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