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Primary care and acute care nurse practitioners function in many ways. The primary care NP may see a patient for the first time without a diagnosis and will have to gather information, assess and order labs to come to a conclusion. They also see patients who need assistance with the management of illnesses on a day to day basis. The flow of the day can be more mentally than physically challenging for the primary care NP who may see 30 patients per day (Dunphy et al., 2015).
The primary care NP develops a long-term relationship with patients and families and is key in health promotion and disease/injury prevention along with screening patients for illness. The nurse must make sure to ask all relevant questions before the patient leaves the office. They write orders for the patient and family to carry out. (Dunphy et al., 2015).
The acute care NP sees patients who are critically ill and are admitted with a diagnosis. Their job may be more physically draining than a primary care NP. They see patients who are in crisis management and write orders for nurses to carry out (Dunphy et al., 2015).
The NP must be familiar with their scope of practice as well as their employer. In the past, an NP could bridge between the two specialties without specific training. Currently, a primary care NP who sees a patient with an acute problem must know to refer them to a specialist. The NP is only certified to practice based on the NP education program, and not their pre-licensure practice. This refers to specialty as well as the age range of patients to be seen (Gardenier, Knestrick, & Edwards-Tuttle, 2017).
Performing outside of the scope of training (POST) is an ethical and legal issue and must be avoided to prevent loss of license (Doobay-Persaud et al., 2019).
Doobay-Persaud, A., Evert, J., DeCamp, M., Evans, C. T., Jacobsen, K. H., Sheneman, N. E., … Nelson, B. D. (2019). Extent, nature, and consequences of performing outside the scope of training in global health. Globalization & Health, 15(1), N.PAG. https://doi.org/10.1186/s12992-019-0506-6
Gardenier, D., Knestrick, J., & Edwards-Tuttle, C. (2017). Should Primary Care Nurse Practitioners be Permitted to Work in Acute Care Settings? The Journal for Nurse Practitioners, 13(5), 326–327. doi: 10.1016/j.nurpra.2017.02.012
Dunphy, L. M. H., Winland-Brown, J. E., Porter, B. O., & Thomas, D. J. (2015). Primary care: the art and science of advanced practice nursing (4th ed.). Philadelphia, PA: F.A. Davis Company.
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