Experience with an acute case nurse practitioner on a surgical teaching service

Across the country, numerous changes in the health care system are emerging in academic settings. Decreasing length of stay, providing continuity of care, and maintaining a learning environment for residents and other health care providers have emerged as critical concerns. Concurrently, academic centers must be able to provide cost-effective and compassionate patient care while emphasizing quality and excellent patient management. The Mount Sinai Medical Center Department of Surgery in collaboration with the Department of Nursing and Hospital Administration created an Acute Care Nurse Practitioner (ACNP) role to work on an active general surgical service to help address and manage the above concerns. Nurse Practitioners (NP) are registered nurses who have advanced education and training and who have full prescriptive privileges in the state of New York. The NP is in collaborative practice with the Chairman of the Department of Surgery and has specific responsibilities for managing patients who enter the health care system without a primary care provider and whose medical condition requires surgical intervention. After 3 years of practice on a teaching service, the position has demonstrated effectiveness in providing continuity of care and decreasing the length of stay for this population. The role has also helped to improve the learning experiences of the house staff by providing support for the residents in reducing their workload and helping in the teaching of the junior house staff. The addition of an ACNP to a surgical teaching service has proven to be a valuable clinical role in providing quality patient care and maintaining fiscal viability.