The Role of Advanced Practice Clinicians in the Neuroscience ICU




© Springer International Publishing AG 2018
Jessica L. White and Kevin N. Sheth (eds.)Neurocritical Care for the Advanced Practice Clinicianhttps://doi.org/10.1007/978-3-319-48669-7_1


1. The Role of Advanced Practice Clinicians in the Neuroscience ICU



Jessica L. White  and Kevin N. Sheth 


(1)
Yale University, New Haven, CT, USA

 



 

Jessica L. White (Corresponding author)



 

Kevin N. Sheth



Keywords
Advanced practice clinicianNurse practitionerPhysician assistantNeurocritical Care Unit


The field of neurocritical care encompasses a broad range of neurological pathology and requires a multidisciplinary approach to provide best patient care. At institutions across the country, physicians work alongside physician assistants and nurse practitioners to care for neurologically ill patients. This collaborative relationship serves to provide an ideal complement of specialized medical knowledge and experienced bedside care. Stemming from a historical genesis in primary care practice, the fundamental education of nurse practitioners and physician assistants is general by design, including basic principles of medical science and clinical management. This educational foundation offers the benefit of professional flexibility and the ability to adapt to a myriad of subspecialties; however, such adaptation requires continued focused learning when entering a subspecialty to acquire advanced understanding of patient care. Recognizing this challenge, we embarked on a project to meet the knowledge needs of physician assistants and nurse practitioners that have selected neurocritical care as their field of practice.

Many terms have been used to describe the collective role of physician assistants and nurse practitioners—midlevel provider, nonphysician provider, and advanced practice provider among them. For the purposes of this project, the term advanced practice clinician (APC) is used to encompass both professions. The role of APCs has evolved considerably over the past several decades. Both professions were developed in the 1960s to adjunct a shortage of primary care providers in the United States. The implementation of restrictions on house staff work hours in the 1990s set the stage for the rapid expansion of the APC role into the hospital setting [1, 2]. This role of APCs working in inpatient medicine has grown substantially since that shift. In 1995 the acute care nurse practitioner certification was developed for the purpose of focusing training on caring for critically ill patients. This certification now represents the fifth most common area of practice for nurse practitioners [3]. Similarly, a hospital medicine specialty certification is available for physician assistants and ~25% of these professionals now work in hospital settings [4]. As the medical community is faced with continued projections of physician shortages across the board, the role of APCs in the inpatient realm is projected to increase [1, 2, 5]. The field of neurocritical care has experienced significant growth in recent years, outpacing the growth of residency and fellowship training programs. Across the country, this rapid expansion has provided a considerable opportunity for APCs to enter the field of neurocritical care and work in a dynamically evolving area.

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Jan 31, 2018 | Posted by in NEUROSURGERY | Comments Off on The Role of Advanced Practice Clinicians in the Neuroscience ICU

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