The Role of the ANP in Acute Medicine: my perspective

By Gabrielle Sulich


It’s always difficult to articulate a job role into a snappy succinct paragraph that isn’t clearly defined.


The definition according to the Royal College of Nursing (2020) is ‘Advanced practitioners are educated at master’s level in advanced practice and are assessed as competent in practice, using expert knowledge and skills. They have the freedom and authority to act, making autonomous decisions in the assessment, diagnosis and treatment of patients.’

Which is a little bit fluffy and it doesn’t really tell you much.


The wordy definitions exist because there is no ‘one size fits all’ of the role of the Advanced Nurse Practitioner; which is both a beauty and a bit of a curse.


The beauty: the role is both diverse and flexible in view of the lack of rigidity to the job role and description- which allows you to meet the needs of your patient group in many different ways. For example, if your patient population requires the skillset to do Lumbar Punctures- then you learn to do that (with rigorous training and support of course!)


The curse: The public, patients and often even your own colleagues and family don’t know exactly what you do! (Also, it’s hard to make a snappy succinct definition for things like this!)


Day to day role working in an Ambulatory Assessment Unit (AAU):

AAU- receives referrals direct from GP’s and ED and AMU. Mostly see things that can be dealt with same day- often referred to as the ‘walking wounded unit.’


0900: hand over time- the team- made up of ANP’s, GP trainee’s , Medical Registrars and the wider Nursing team (made up of staff nurses and healthcare assistants)- discuss today’s new referrals (that have been received already) expected and discuss any complex cases. Handover is a time for a quick debrief too- perhaps of the previous day and a time to cascade any changes from the wider hospital team/management.


0930-1630: start seeing patients-typically we see a variety of patients who present as ?DVT or ? PE or a non-complex cellulitis which require intravenous antibiotics or a low risk cardiac sounding chest pain patient.

As an ANP I am able to assess and examine, request tests to investigate and diagnose, treat, prescribe and manage my own patients’ in the same ways you guys will when you qualify. This level of autonomy provides me with a sense of job satisfaction, knowing that I am able to put my experience and knowledge to use in a way that helps my patient get treatment and care in a timely manner.


Currently- the only thing in an acute medical setting that I cannot do is sign a death certificate and a sick note!


We see the same patients as you. Young/old, sick/ well.


However, I am not a medic- I am well aware of my limitations, there are somethings that I do not know- and if I need to I will ask for help or support with something that is beyond my level of expertise!


My passion for acute medicine:

Its pure excitement- and lots of head scratching!!

A lot of the stuff we see is routine/similar- however there is always an odd case which is complex and exciting.

My motto for acute medicine- start simple and listen to the patient- most of the time, they can you give you your answer to the diagnosis from taking a really detailed history.


Team working:

Use your wider team as your allies- there will be hard times- speak with everyone, listen to them and learn from them and always be kind (Sorry, I sound like your mum, but this is what I found useful). Sometimes you can pick up pearls of wisdom from the most unusual places.


Pearls for medical students:

Start simple; learn to take a good history- listen to your patients!


Reference:

Royal college of Nursing (2020) Advanced Nursing Practice. Retrieved from: https://www.rcn.org.uk/library/subject-guides/advanced-nursing-practice

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