Ambulatory Care Nurses care for individuals, families, and groups in a variety of settings outside the hospital. Ambulatory care nursing is a nursing specialty with its own professional society, standards of practice, certification, performance measurement criteria, and body of literature for evidence-based practice.
With patients living longer with chronic diseases, complications, and comorbidities, patient care is shifting to the outpatient setting, bringing sicker patients into the ambulatory care arena. Hospital stays are shorter today with follow up care being handled in ambulatory care settings. The need for more and better prepared RNs has never been greater. As a result of these changes, RNs have more opportunities for a variety of roles in a broad array of settings.
Work Environment
Ambulatory nurses work in a variety of settings: primary care and specialty outpatient clinics, call centers, physicians' offices, community centers, freestanding health clinics, nurse-managed clinics, ambulatory surgery centers, patients' homes, and telehealth service environments. The responsibilities, working environment, resources, and degree of independence vary considerably between these different ambulatory settings.
Skills and Responsibilities
Although ambulatory nursing can involve direct patient care, an ambulatory care nurse is often more the organizer and manager of care rather than the direct provider of care. This type of working environment requires a strong clinical background, leadership skills, and autonomous critical thinking ability that is very different from that employed in acute care. Ambulatory nurses interact with patients not only face to face but over the telephone and computer as well. In the absence of direct sensory input, very different assessment and communication skills are needed.
Education Requirements
In the past, Ambulatory care nurses were required to be Registered Nurses with a minimum of two years' experience working as an RN. Although that still may be preferred in some settings, many nurses are able to obtain positions in an ambulatory care setting with less experience. In fact, some settings will even consider new grads.
Although there is no additional training required, certification is available, and is preferred in most states.
Criteria for certification is as follows:
- Hold a current, active RN license within a state or territory of the United States or the professional, legally recognized equivalent in another country.
- Have practiced the equivalent of 2 years full-time as a registered nurse.
- Have a minimum of 2,000 hours of clinical practice in ambulatory care and/or telehealth nursing within the last 3 years.
- Have completed 30 hours of continuing education in ambulatory care and/or telehealth nursing within the last 3 years
Job Outlook
As a result of the Affordable Care Act (ACA) which ensures access to health insurance for millions of Americans who are currently uninsured, it is anticipated that these newly insured people will flood the healthcare system, particularly ambulatory care settings. Additionally the Affordable Care Act's emphasis on primary care and prevention will increase patient volume in existing primary care practices. Nurses will be needed for new roles in the ambulatory setting such as care coordination, chronic disease management, and telehealth.
With the development of these new roles in healthcare and the increase in procedural care occurring outside the hospital in settings such as infusion centers and ambulatory surgery centers, opportunities for RNs in ambulatory care will continue to increase. Many of the more traditional ambulatory settings such as primary care are beginning to hire more RNs in preference to medical assistants.We have already seen a downward trend in hospital hiring. Nurses seeking jobs will increasingly look to ambulatory care settings as a viable option for employment.
According to the Bureau of Labor Statistics, ambulatory care nursing jobs have a positive outlook. There will be a 22 percent growth in this field between 2011 and 2018. This is much faster than the national average of all other occupations. The increased demand will be due to a rising elderly population, and an emphasis on preemptive health care.
Salary
The median expected salary for an ambulatory care nurse in the United States is $61,464 based on data as of December 1, 2013 on salary.com. This figure will vary depending on where the job is located and the amount of previous experience the nurse has.
Organizations
American Academy of Ambulatory Care Nursing (AAACN)
Resources
American Nurses Credentialing Center
AAACN Viewpoint Newsletter CNE
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