Acute medical conditions refer to those illnesses or injuries that come on suddenly and require immediate medical attention to prevent further complications or even death. So, when a person visits a healthcare facility with an acute medical condition, it is important to provide immediate diagnosis and treatment. That is where acute care practitioners come into the picture.
An acute care nurse practitioner (ACNP) is responsible for providing patients with timely and effective care so that there are no complications or life-threatening emergencies. Acute care nurses work in numerous healthcare settings, including ERs, urgent care clinics and intensive care units.
A registered nurse who wants to specialize as an acute care nurse should know the role they will play in diagnosing and treating acute medical conditions in older adolescents and adults. That will enable them to get a better understanding of their role as an ACNP and determine whether this is the right career choice for them.
Roles and responsibilities of an acute care nurse
Here is a peek into the different responsibilities of acute care nurses when diagnosing and treating patients with acute medical conditions:
One of the primary responsibilities of an ACNP is to assess and diagnose acute medical conditions. When a patient visits them, they have to note down the complete medical history of the patient. In addition, they have to perform a physical examination and evaluate the patient’s vital signs. It is prudent to remember that some conditions, like cardiovascular diseases and diabetes, can run in families or occur due to lifestyle habits. So, an ACNP should inquire about the patient’s family medical history as well as their lifestyle, including exercise, diet and sleeping habits.
The ACNP must be able to recognize the signs and symptoms of acute medical conditions and differentiate them from other conditions that may present with similar symptoms. For example, chest pain may be a symptom of a heart attack or a pulmonary embolism, but it could also be caused by a musculoskeletal injury or gastroesophageal reflux disease (GERD). An acute care nurse must be able to distinguish between these different conditions and provide appropriate treatment.
Ordering and interpreting diagnostic tests
After identifying the medical condition, an ACNP must order diagnostic tests such as blood tests, imaging studies and electrocardiograms (ECGs). When the results come out, they should have the skills and expertise to interpret these tests. These diagnostic tests enable them to identify the underlying causes of the patient’s symptoms and determine the most appropriate treatment plan.
The ACNP should have a thorough understanding of the indications, limitations and interpretation of diagnostic tests, which will enable them to make an accurate diagnosis. Misinterpretation of test results can lead to delayed treatment or inappropriate treatment. This could have serious consequences for the patient.
Developing and implementing treatment plans
Once the ACNP makes the diagnosis, it is time to develop and implement the treatment plan. This plan may involve pharmacological and non-pharmacological interventions, like medications, oxygen therapy and mechanical ventilation.
The ACNP should have a thorough understanding of the pharmacology of the medications used in the treatment of acute medical conditions. Also, they should be familiar with the appropriate dosages, indications, contraindications and adverse effects of the medications they prescribe to patients. In some cases, they may need to administer medications via intravenous, intramuscular or subcutaneous routes. These methods of administration require specialized training and expertise.
Managing acute pain
Many patients with acute medical conditions may experience pain and hence, require effective pain management. Pain can be a debilitating symptom and can interfere with the patient’s ability to function and recover. So, the ACNP needs to have a thorough understanding of the different types of pain and the most appropriate treatment modalities for each type.
When managing pain, the ACNP has the option of using medications like opioids and non-steroidal anti-inflammatory drugs or choosing non-pharmacological interventions, such as heat therapy, massage or relaxation techniques. The choice will depend on the severity of the pain and the condition of the patient.
Monitoring the patient’s progress
Patients with acute medical conditions require continuous monitoring. Monitoring shows whether the treatment plan is the right one. If yes, it should be effective in minimizing symptoms and helping the patient recover.
When monitoring the patient, the ACNP regularly assesses their vital signs, symptoms and response to the treatment. They should be alert to recognize signs of complications or adverse reactions to medications so that they can take appropriate measures.
Many times, an acute care nurse practitioner has to perform a procedure to treat or save a patient’s life. This may include inserting a central line or placing a chest tube.
The ACNP should have the necessary skills and training to perform these procedures safely and effectively. Furthermore, they should also be able to recognize and manage any complications that may arise during or after the procedure.
Collaborating with other healthcare professionals
Working as an acute care nurse requires collaboration with other healthcare professionals, like specialists, doctors, nurses and pharmacists. This ensures that the patient receives comprehensive and coordinated care.
When working in a team, ACNPs must make sure they can communicate effectively with other members of the team so that all involved receive timely and accurate information about the patient’s condition and treatment.
Educating and counseling patients
The responsibility of an acute care nurse does not stop with diagnosing and treating a patient. They also need to counsel and educate patients to take better care of themselves so that they do not suffer from another acute medical condition in the future.
So, they have to explain to patients in layman’s terms their medical condition and how to manage their medication. In addition, they may have to suggest lifestyle changes so that they focus on their diet and exercise.
Some common acute medical conditions
As a person ages, acute medical conditions can affect any part of the body and may have varying degrees of severity. Some of the most common acute medical conditions include:
Cardiovascular emergencies, such as acute myocardial infarction (heart attack) and stroke, require immediate diagnosis and treatment to prevent further damage to the heart or brain. Treatment may involve administering medications, such as thrombolytic and antiplatelet agents, or surgical procedures like angioplasty and stenting.
These emergencies can include conditions like pneumonia, pulmonary embolism, and acute exacerbation of obstructive lung disease. These respiratory conditions can be life-threatening and hence require prompt treatment, which can be oxygen therapy, bronchodilators and mechanical ventilation.
Emergencies, like seizures and head injuries, require prompt diagnosis and treatment as they can result in brain damage. ACNPs may need to administer antiseizure medications or analgesics to treat these conditions.
Conditions like acute pancreatitis and gastrointestinal bleeding can cause severe pain and result in potentially life-threatening complications. Treatment can include medications like proton pump inhibitors and antibiotics, or procedures such as endoscopy and surgery.
Many infectious diseases like sepsis and meningitis, can rapidly progress. Hence, patients with these diseases require early and prompt diagnosis and treatment as it minimizes the chances of septic shock and organ failure. Treatment usually includes antibiotics and antivirals.
Trauma and injuries
Traumatic injuries like fractures and burns require immediate assessment and treatment. This prevents further damage and promotes healing. Treatment can be administering antibiotics and painkillers, providing wound care, or performing surgery to fix the problem.
Diagnosis and treatment of acute medical conditions
Acute care nurses learn how to diagnose and treat patients during their training and master it with the help of hands-on practice. Some of the ways that these nursing professionals diagnose as well as treat patients with acute health conditions are as follows:
Assessment and triage
These are critical components of the diagnosis and treatment of acute medical conditions. An ACNP must quickly assess the patient’s condition and prioritize treatment based on the severity of the condition. This can mean using standardized triage tools, such as the Manchester Triage System or the Emergency Severity Index (ESI) to determine the level of urgency.
Diagnostic tests and procedures
These are essential in diagnosing and treating acute medical conditions. ACNPs must be able to select the appropriate tests and procedures based on the patient’s symptoms and medical history. This may involve ordering blood tests, imaging studies or other diagnostic tests like lumbar puncture or electroencephalogram (EEG).
Medications are often necessary for the treatment of acute medical conditions. An ACNP must be knowledgeable about the appropriate medications for each condition besides having the knowledge and understanding of different dosages, side effects and potential interactions with other medications. They may have to administer medication intravenously, orally or via inhalation. The route of administration will depend on the condition of the patient.
Sometimes, besides medications, a patient may also require non-pharmacological interventions, such as oxygen therapy and mechanical ventilation. The ACNP should be able to choose the right intervention based on the patient’s condition and response to treatment.
These interventions may be necessary for certain acute medical conditions, such as trauma and gastrointestinal emergencies. An acute care nurse must be able to recognize the need for surgery and refer the patient to a surgical specialist without wasting time if the need arises.
Invariably, an acute care nurse does not work alone when diagnosing and treating acute medical conditions. They often work with interdisciplinary teams to provide comprehensive team-based care. Hence, an ACNP should be able to work effectively with other healthcare professionals, such as physicians, nurses and therapists, to provide coordinated and all-around patient care.
Managing complete patient care
It is an ACNP’s fundamental responsibility to manage patient care. Usually, they will be responsible for the patient from the time they get admitted until they are discharged. During this period, they need to ensure that the patient receives the right treatment. For this, they have to monitor each patient carefully and adjust their treatment plan based on the response or changes in their condition.
As a part of patient care, acute care nurses also communicate with family members and caregivers to keep them informed about the patient’s progress and changes to the treatment plan.
Maintaining clinical competence
As an acute care nurse, it is important to stay up to date with the latest advances in acute care medicine. This means participating in training programs, seminars and conferences to learn about new treatment modalities and emerging infectious diseases.
Adhering to ethical standards
An acute care nurse should comply with ethical principles and adhere to nursing values. Not only should they respect their patient’s autonomy but they should also be familiar with the laws and regulations that govern acute care nursing. This includes maintaining privacy and confidentiality, understanding informed consent and maintaining seamless documentation.
While it is easy to get emotional and attached to patients, an acute care practitioner should always exhibit professional behavior at work and outside. They must not only be accountable but also demonstrate integrity and respect for patients and colleagues. While their work will be stressful, they must learn to manage their stress levels and emotions so that they are always calm and composed in high-pressure situations.
Rehabilitation and follow-up care
Many patients suffering from acute medical conditions may require rehabilitation. ACNPs must be able to provide appropriate referrals for rehabilitation services, such as physical therapy and occupational therapy. Their responsibility does not end there, as they must provide appropriate follow-up care. This can include managing medications and monitoring the patient for possible complications.
Challenges and ethical considerations in acute care practice
Acute care practice can be challenging due to the fast-paced nature of the work and the complexity of the conditions that patients have. ACNPs also need to account for ethical considerations when diagnosing and treating patients with acute medical conditions.
Time constraints and workload
Acute care practitioners often face time constraints and heavy workloads. This can make it difficult to provide comprehensive and coordinated care. An ACNP should be able to manage time effectively and prioritize tasks based on the patient’s condition and urgency.
Resource allocation and cost-effectiveness
When working in any healthcare setting, ACNPs will have to consider resource allocation and cost-effectiveness in the diagnosis and treatment of acute medical conditions. They should be able to balance the need for optimal care with the available resources. Sometimes, they will be forced to make difficult decisions about resource allocation and determining the most cost-effective treatment options.
Patient autonomy and informed consent
ACNPs must thoroughly inform patients about their health condition and the different treatment options. They explain the pros and cons of each treatment so that the patient can make an informed decision. When a patient decides, it is best to respect their decision rather than try to change their mind. That is especially true when the patient is alert enough to decide about their treatment and care.
End-of-life care and decision making can be challenging, especially when the patient’s condition is rapidly deteriorating. Should this happen, the ACNP should provide compassionate care not just to the patient but also to their family members. At the same time, they have to respect the patient’s wishes regarding end-of-life care.
Cultural and social diversity
In a country like the US, ACNPs will come across patients from diverse cultures and walks of life, so it is important to provide culturally sensitive care to patients from diverse backgrounds. They also must understand how social factors, such as poverty and homelessness, can impact a patient’s health and access to care.
Education and training for acute care nurse practitioners
Acute care nurse practitioners must have extensive education and training to effectively diagnose and treat acute medical conditions. This may involve completing a degree program in nursing, medicine, or another healthcare profession, as well as completing specialized training in acute care.
A registered nurse with a bachelor’s degree in nursing can become an acute care nurse by completing a qualification, such as the online MSN-AGACNP degree through Rockhurst University. This master’s degree coursework is completely online with one campus immersion and is designed to be accessible, to help nurses enter the specialized world of acute care without a problem.
However, after becoming an acute care nurse, one cannot rest as this field constantly evolves and changes. That is why ACNPs also need to focus on ongoing education and professional development. This can be done by attending conferences and workshops, completing online courses or participating in clinical rotations. When acute care practitioners do this, it enables them to stay up to date with the latest advances in acute care practice.
Certification and licensure
Acute care nurses must maintain certification and licensure to practice in their field. This may involve completing continuing education requirements and passing a certification exam by organizations such as the American Association of Critical-Care Nurses (AACN). Once certified, they can get a license from their state of residence to become an advanced practice registered nurse and work as an acute care nurse practitioner.
Those interested in becoming an acute care nurse will want to know what the future holds for them and whether it is worthwhile to specialize in this field.
The future is quite bright for nurses in acute care. The US Bureau of Labor Statistics (BLS) projects that the demand for registered nurses from 2021 to 2031 will grow by 6%. Over these 10 years, around 200,000 openings will be available.