Evolution of Critical Care Nurse Practitioner Role Within a US Academic Medical Center

A paper co-authored by Thomas Farley, RN, NP, ACNP-BC, co-Director of the Surgical and Critical Care NP Fellowship Program at UCSF, in the journal "ICU Director", discusses the integration of nurse practitioners into the Critical Care Medicine Service at UCSF Medical Center:

Abstract: Nurse practitioners are becoming established clinicians in the intensive care unit. This article describes the integration of nurse practitioners into the Critical Care Medicine Service at the University of California San Francisco Medical Center. The development and current form of the nurse practitioner role is detailed. The model of employing nurse practitioners in an academic critical care medicine service is provided as a blueprint for other institutions facing a shortage of intensivists. This study addresses future direction for program development.

Article Excerpt: Several factors are currently contributing to an imbalance of the supply and demand of intensivists. Factors decreasing supply include a reduction in number of physician trainees concurrent with a reduction in allowable weekly work hours for physician trainees.1,2 Factors increasing demand include an understanding that intensivists improve outcomes, an aging population, and a greater overall demand for critical care services.3-5 This situation has resulted in new opportunities for nurse practitioners.6-8 Nurse practitioners (NPs) are well established in the primary care setting. Now NPs have expanded into the hospital setting with a new national certification specialty, acute care.7,9-11 In 2009 in the United States, approximately 15% of the advance practice nursing national certifications were in acute care.12 A recent survey indicated that approximately 15% of NPs in the United States are practicing at an inpatient setting as acute care NPs.