Acute care nurse practitioner program at Emory on the rise
Pulse editor
Sunday, October 19, 2008
Compared to other nurse practitioner programs, acute care is the new kid on the block.
“It was one of the last nurse practitioner programs to get started,” said Darla Ura, MA, RN, ANP, BC, clinical associate professor and specialty coordinator for adult and acute care nurse practitioner programs at the Nell Hodgson Woodruff School of Nursing at Emory University in Atlanta. “The American Nurses Credentialing Center first certified it in 1995, and Emory started its program in 1997. It’s still the only one in Georgia, but our program is growing.”
Photos by BARRY WILLIAMS /Special
Elyce Friedlander, a nurse in the cardiovascular intensive care unit at WellStar Kennestone Hospital, recently graduated from the Nell Hodgson Woodruff School of Nursing at Emory University.
In August, the program graduated 18 acute care nurse practitioners, and most of them had job offers in hand.
Hospitals are catching on to the advantages of having mid-level providers in the ICU, Ura said. Advanced practice nurses can make decisions about patient care, order tests, write prescriptions and perform invasive interventions — things beyond the scope and practice of registered nurses — which cuts down the number of hours that residents and physicians are needed to staff intensive care units.
The neurology ICU at Emory Healthcare has developed a model that uses ACNPs as intensivists. When a patient is admitted to the ICU, an intensivist takes over the care of the patient and collaborates with the medical team.
“The hospital started with one ACNP in the intensivist role and now has eight or nine,” said Julie Davey, RN, MSN, APRN, BC, assistant clinical professor at Emory’s nursing school.
A 1999 graduate of the ACNP program, she teaches acute care courses and coordinates clinical placement.
“The ACNP does daily rounds on patients and provides advanced care, which may include inserting arterial lines, doing lumbar punctures or intubating patients as needed,” Davey said. “Research studies in the neuro ICU have shown that patients followed by an intensivist had a decreased length of stay in the unit and fewer complications.”
Other hospital neuro intensive care units are modeling themselves after Emory’s, because they’ve seen that patients get more comprehensive care, Ura said.
The role of ACNPs is growing, Davey said.
“One of our graduates is working with a physician team in Albany and another in a burn unit in Augusta,” she said.
Advanced practice nurses like the autonomy of making important decisions about patients, Davey said. “They can make more of an impact on their patients’ lives.”
“It’s an expanded nursing role, and the rewards are that the nurse gets to take care of the whole patient,” Ura said. “We’re still educating the medical and nursing community about the role of the ACNP, but as people find out what they can do, the demand is growing.”
‘This has been the perfect program for me’
Elyce Friedlander’s work in the cardiovascular intensive care unit at WellStar Kennestone Hospital has always been challenging and fulfilling. She loved caring for patients with complex medical problems, but wished that she could do more for them.
The acute care nurse practitioner program at the Nell Hodgson Woodruff School of Nursing at Emory University has made that possible. Friedlander, who graduated on Aug. 9, is preparing to take her certification boards.
“This has been the perfect program for me,” said Friedlander, RN, BSN. “I’ve been trained to work specifically with critically ill cardiovascular patients, and that’s my passion.”
When she was in high school, Friedlander thought about becoming a doctor like her older brother, who’s a pulmonologist in Denver. She knew she had the temperament and desire for a health care career, but after witnessing her brother’s long road through medical school and residency, Friedlander decided to go a different route and entered nursing school at the University of Florida.
“Being a nurse was one of the few undergraduate degrees that put you in patient care right off the bat, and I wanted to work with patients,” Friedlander said.
She came to Atlanta five years ago and landed a job in the cardiovascular ICU at WellStar Kennestone.
“I had planned to stay two years in Atlanta and move on — maybe become a traveling nurse — but I fell in love with what I was doing,” she said.
Friedlander credits her mentors and managers, Beth Chapman and Liz Sobcyzk, for pushing her to learn more and for introducing her to Darla Ura and the ACNP program at Emory University. They made it possible for her to combine work and graduate school by being flexible with her schedule. Friedlander worked full time the first year, and then one or two days a week so she could finish the 500-plus hours of clinical work needed to complete the program.
Friedlander worked under the direction of an ACNP at Emory Hospital’s cardiovascular intensive care unit, and wants to work as a cardiovascular intensivist.
“With this training, my role would change to working directly with the physician team of the ICU,” she said. “I’d be seeing patients, diagnosing conditions, ordering tests, performing procedures. If I see an infection starting, I’ll be able to order antibiotics.”
While working with the Emory team, Friedlander discovered that doctors listened to her and respected her opinions because of her bedside experience in the ICU.
“We’re there all the time and doctors can’t be,” Friedlander said. “Now that my brother is a doctor and I’ve been a nurse for five years, we bounce ideas off each other all the time.”
The program was challenging, but Friedlander maintained a 4.0 GPA.
“When you love something, it’s not hard to study,” she said.
She recently received a letter from a patient who had emergency heart surgery. Friedlander woke him after surgery, took him off the breathing machine and followed up with him for two days.
“He said I changed his life,” she said. “It’s wonderful to love your work and know that you make a difference. This degree is just going to enhance my career opportunities.”