ACNP and hospitalist Roles

vanburbian · Jan 3, 2004

lee, there is an ACNp on the board here, i just asked him a question regarding his role less than an hour ago, his user name is MD Terminator, i sent him a private message and he was quite nice about being willing to give me info....maybe you should try him and see if he can answer any questions you have....

good luck, hopefully those of us who want to pursue this field can open up some new avenues...

peace, sheri

ainz · Jan 3, 2004

From the hospital administration point of view, the main barriers I have run into with establishing a hospitalist program include overcoming the fear the existing medical staff have of turning their patients over to someone else and the fear the patients have of not having "their doctor" care for them. It is strange how different medical staffs in different regions vary so much on their view of this subject. Personally, if I were a primary care physician and had a hospitalist available for my patients I think I would take advantage of it, certainly for certain patients anyway. Some medical staffs love the idea others hate it and fight every step of the way. I think the largest determinant of whether you will be successful in Hawaii is how the doctors on staff at the hospital you would like to practice in feel about hospitalists in general. You will have to win them and the administration over since they are the ones who generally control whether something like this will ever get off the ground or not. One thing to remember, the hospitalist cuts the primary care doc out of revenue. If you have doctors with very busy clinic practices and it is economically beneficial for them to work more in the clinic than hospital, you have a good shot at being successful. I would target those doctors first to rally support for a hospitalist program. If you go at it purely from all of the capabilities and contributions you can make clinically and in the name of patient care, you will probably run into stiff resistance and get no where. Follow the money trail, it is the major motivator of physician behavior. Sorry if that offends anyone but the truth is sometimes offensive. Good luck and keep us posted.

leeboon63 · Jan 3, 2004

Thank you all for your advice and support. It has been an eye opener using this forum and learning about the difficulty in establishing oneself in the hospital. I would like to hear more feedback so that it will help me plan my career. As I will be a new ACNP in 2005, does anyone know which state that has a more receptive view of utilizing ACNP? I may need to make a decision and not return to Hawaii if I want a career as an ACNP, so keep those feedback coming.

PennyNP · Jan 4, 2004

I presently work as a neurosurgery nurse practitioner hospitalist in a busy trauma hospital. Some of the surgeons in my practice were reluctant at first however, when they saw the results, their minds were changed. I make rounds on all the non-SICU pts, put on halos, remove ventric drains , do spinal taps, discharge pts and do the discharge summary, see pts in the ER, pre-op teaching, gen education, do consults and first assist . I am also available to assess situations for the surgeon when he/she is in the OR. I think the thing they like best is having someone with the skills to trouble shot. This is a large teaching hospital, and lots can go wrong esp. when a pt is scheduled for surgery like the pt's coags are out of range or Na+ low. Yes, I know simple stuff. Again, it is a large teaching hospital. Since the introduction of a mid-level provider hospitalist, surgeries are rarely canceled due to problems with the pt's fitness. In the the hospital were I work, there are trauma nurse, cardiology and I believe pulmonology mid-level providers who are hospitalist.

I am hired by a neurosurgery practice, not the hospital. My office manager tells me that the doctors and administration folks at the hospital are pleased with the improved level of pt care. There is someone there in house to address issues from 6am-6pm five days a week. I do not work weekends or take call. We do not have a resident assigned to our service. This is a new role for my practice. I am presently writing the job description and scope of practice. I will keep you posted.

Janis Story · Jun 11, 2004

I was hired 6 months ago to work as an NP for a Hospitalist Group. I would appreciate any advice I can get about developing the role and developing protocols for this job. I work with 9 different physicians (4 per day), they all have different practice ideas, as well as different ideas about what my role should be. This has made learning difficult. I would appreciate any help with finding or developing protocols and how to define my role. I should point out that I work in a regional tertiary care center and our patient population is very challenging with multiple medical problems.

agrn2000 · Jun 11, 2004

Here is an article that discusses ACNPs role in hospitals and creating a model of care for inpatient services:

Article Title: Acute Care Nurse Practitioners: Creating and Implementing a Model of Care for an Inpatient General Medical Service.

Authors: Jill N. Howie, RN,MS,FNP,ACNP, and Mitchel Erickson,RN,MS,ANP,ACNP

American Journal of Critical Care, September 2002, Volume 11, No. 5

This article goes over the general responsibilities for a NP in an inpatient hospital service. Even though the responsibilities are aimed towards a NP in a cardiology focus, it will give you a good idea about what is entailed in the hospitalist role, and hopefully you can use it as a guide for developing your position (I did :).

deltasis02 · Feb 21, 2011

I've just recently got hired to work with a Hospitalist Group of Physicians; However, they are very nice and receptive...shocking for Alabama. The local hospital that I work just hired the Hospitalist group to run a hospitalist unit within the hospital so they are clueless like me. However, one of the physicians and I have to come up with a policy/protocol for the unit. So, can you please provide me a copy of the hospitalist policy/protocol? You can email me at [email protected] or post it on this forum. I will greatly appreciate it.