What Can Nurse Practitioners Do for Emergency Care?

Abstract

I am thrilled to announce that I have completed a Masters in Nursing as a Family Nurse Practitioner. I am also hoping that by the time this editorial is published, I will have passed my boards! This is why I am particularly proud that we are publishing in the September 2010 issue of the Journal of Emergency Nursing the “Nurse Practitioner Delphi Study: Competencies for Practice in Emergency Care.” The report is currently available online at www.jenonline.org. These competencies were developed through the work of the ENA Nurse Practitioner Validation Work Team. Since the passage of the Health Care and Education Reconciliation Act of 2010, concern has been expressed as to how health care will be provided. If additional millions of people will have access to health care coverage, who will be available to meet their health care needs? This is a need that the Advanced Practice Registered Nurse (APRN) can skillfully and compassionately fill. The APRN is a nurse who has completed an accredited graduate-level program; has passed a national certification examination that measures APRN role and population-focused competencies; has acquired advanced clinical knowledge and skills to provide direct patient care; is educationally prepared to assume responsibility and accountability for health promotion and/or maintenance, as well as the assessment, diagnosis, and management of patient problems that may include the use and prescription of pharmacologic and nonpharmacologic interventions; and has the clinical experience of sufficient depth and breadth to reflect the intended license and has obtained a license in the state in which he or she practices as an APRN. Of course, as usual, nursing cannot make it simple, because the practice of an APRN is state based, something we will have to work on. Currently, there is not a specific certification for the ED nurse practitioner, even though there is a supported role for nurse practitioners in the emergency department. There are also roles to be developed and funded through the Health Care and Education Reconciliation Act of 2010. These include funding for family nurse practitioners to provide primary care in federally qualified health centers and nurse-managed health centers and the provision of care to Medicare beneficiaries. The report presents entry-level competencies for management of patient health/illness states; professional roles; ABCD procedures; skin and wound procedures; head, eye, ear, nose, and throat procedures; chest and abdomen procedures; neck, back, and spine procedures; gynecologic, genitourinary, and rectal procedures; extremity procedures; and other procedures such as the role of the APRN in prehospital care. Advanced-level procedures such as chest tube insertion and performance and interpretation of bedside ultrasound are also included. This landmark report has laid the foundation for the development of a certification examination for the ED nurse practitioner. So, what can emergency nurse practitioners do for emergency care? The ED practitioner can become an additional resource in the provision of emergency care to diverse populations. As the role of the emergency department has expanded in many communities, the ED APRN is well prepared to manage multiple patient populations with multiple problems through the broad lens of a registered nurse. As the implications of the Health Care and Education Reconciliation Act of 2010 continue to unfold, so will the role of the APRN and Renee Semonin-Holleran is Editor-in-Chief of Journal of Emergency Nursing.