ACNP: procedures and scope


As a acute care nurse practitioner what skills are you allowed to and what skills do you perform? Please list what advanced practice procedures you do regularly! Are you allowed to order and adjust medications on your own? How much autonomy do you have? Basically what do you do? And how advanced of a role do you have? I'm deciding between NP specialties!

Trauma Columnist

traumaRUs, MSN, APRN

153 Articles; 21,229 Posts

Specializes in Nephrology, Cardiology, ER, ICU. Has 31 years experience.

Moved to student NP forum


14 Posts

Hey! Im about half way done with an AGACNP program, so anything I have to say is of course, only from a student.

What I have seen both as an RN and NP student is it has more to do with what the specific hospital will let you do, rather than what is technically within our "scope". We are taught to place central lines, a-lines, intubate, perform LPs, suture, and place chest tubes. Many procedures are within the scope of practice of an AGACNP, many NPs also work as first assist in the OR. While these things are wonderful learning opportunities, it will depend both on hospital protocol and available staff if you will actually be performing these procedures. Same thing with independently prescribing. From what I have experienced as nurse, smaller day to day decisions can be made by the NP, however larger decisions i.e drip changes, antibiotics, consults, are often discussed with the attending MD/DO. (as they should be)

The idea of independent practice is slightly less important in acute care in my opinion because NPs work as part of a team with physicians. In the ICU for example, there are usually multiple physicians available and part of the patient's care team. Personally, I am thrilled to be learning these procedures however, my ability to intubate per hospital protocol will not be a factor in the job I choose. Good luck!