What Are Some of the Challenges for Nurses Working in Ambulatory Care?
Ambulatory care nurses are registered nurses who were in the outpatient or clinic setting. In this environment, patients are not likely critically ill, and they do not stay overnight. Examples of ambulatory care departments may include:
- Doctor's offices (adult medicine, pediatrics, OBGYN, etc.)
- Outpatient surgery centers
- Occupational Medicine
As with any area of nursing, ambulatory care nurses can face a specific set of challenges. For example, as more and more patient care is shifted to the outpatient setting, patients with higher acuity are being seen in clinics. An example of this is in primary care. Many patients are discharged from the hospital or emergency department with instructions to follow up with their primary care doctor. Sometimes the issues they were admitted with are still ongoing, and they still need a higher level of care than can be provided in the clinic setting.
Another example of this is when patients come see their primary care doctor and an acute disease process is identified, such as a rule out stroke or MI. Many patients do not recognize the warning signs for certain potentially life-threatening conditions and schedule a routine visit with their doctor for advice. Ambulatory care nurses need to act quickly to get them transferred to the appropriate level of care.
Another challenge that ambulatory care nurses face is working with less nursing staff. Unlike the hospital setting, an army of nurses sometimes is not needed (depending on the department). Many ambulatory care RNs work solo or with one or two others. Although physicians and nurse practitioners are more likely to be present during a shift, RNs frequently rely on each other for support, communication, and commiseration over specific patient care issues.
Another challenge is taking on more administrative duties. In some ambulatory care areas, the environment is much like a business. Learning skills such as ordering supplies, making appointments, and telephone calls/ telephonic patient care are skills that are generally not part of nursing school! However, it is usually easily mastered.
Ambulatory care nursing can be challenging, as with any area in healthcare. But nurses are trained to adapt to change which helps overcome these challenges.
Amanda Bucceri Androus RN, BSN
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