What Is Acute Care Nursing? The Ultimate Guide
The US population, which is both growing and aging, increasingly demands acute care services to treat patients with life-threatening conditions, critically ill patients, and other individuals requiring immediate healthcare.
Since acute or critical care is required in practically all healthcare settings, acute care nurses are in great demand. Read on to learn what working as an acute care nurse is like, how to become one, how much critical care nurses earn, and more!
What Does Acute Care Mean in Medical Terms?
Acute care refers to a level of health care in which patients are treated for acute or critical conditions, such as severe episodes of an illness, conditions resulting from disease or trauma, or recovery from surgery.
According to Hirshon and others (2013), any standard medical definition of acute care emphasizes the essential aspect of time pressure. Whether acute care is promotive, preventive, curative, rehabilitative, or palliative, its effectiveness largely depends on rapid intervention. Acute care is often used as a broad category encompassing trauma care, emergency medicine, urgent care, critical care, pre-hospital emergency care, acute care surgery, and short-term inpatient stabilization. The following are some specific examples of the multiple domains of acute care:
- Treatment of patients with acute surgical needs, including acute appendicitis, life-threatening injuries, or strangulated hernias
- Treatment of patients with acute limb- or life-threatening medical and possibly surgical needs, including acute cerebrovascular accidents
- Ambulatory care in facilities delivering medical care outside hospital emergency departments, such as evaluation of an injured ankle or fever in a child
- Treatment of patients with acute needs before delivery of definitive treatment, such as administering intravenous (IV) fluids to a critically injured patient before transferring them to an operating room
- Care provided until the patient arrives at a formal healthcare facility capable of giving definitive care, including care by ambulance personnel or evaluation of acute health problems by local healthcare providers
- Specialized care of patients with life-threatening conditions who require comprehensive care and constant monitoring, such as patients with seizures or severe respiratory problems requiring endotracheal intubation
Acute care is an entry point to healthcare for patients with urgent conditions. The integration of acute care services with primary and preventive care completes all aspects of healthcare delivery.
What Does ACU Stand For?
The abbreviation ACU stands for acute care unit. By definition, an acute care unit offers time-sensitive, short-term care to patients in critical condition. Acute care patients are recovering from illness or surgery and are usually ready to be discharged within a few days. Patients who are stable but unable to return to their homes may move to a transitional care unit or a skilled nursing facility.
What Is an Acute Care Unit in a Hospital?
Since acute care is such a broad term, in many hospitals, acute care units may encompass other units, such as the medical-surgical (Med/Surg) and intensive care units (ICU).
Patients requiring acute care may be cared for by various healthcare professionals, including the following:
- Cardiopulmonary specialists
- Registered nurses (RNs)
- Licensed practical nurses (LPNs)
- Patient care assistants
- Respiratory therapists
- Physical therapists
- Speech therapists
- Social workers
- Ward clerks
What Is the Role of an Acute Care Nurse?
Acute care or critical care nurses care for critically ill patients and patients before and after surgeries. These patients need continuous monitoring and treatment for life-threatening conditions caused by injuries, long-term illnesses, heart attacks, strokes, etc. Acute care nurses carry out complex assessments, monitor patients, and implement interventions and therapies. Since critically ill or injured patients’ conditions may worsen suddenly, critical care nurses must be able to act quickly and provide emergency care.
Critical care nurses collaborate with other healthcare professionals, including physicians, surgeons, nurse practitioners, clinical nurse specialists, nurse researchers, nurse educators, and case managers in diverse settings. In the hospital setting, acute care nurses work in ICUs, including neonatal intensive care units (NICUs), pediatric intensive care units (PICUs), and cardiovascular intensive care units (CVICUs), as well as in emergency departments, cardiac catheter labs, telemetry units, recovery rooms, and emergency transport. In addition, critical care nurses work in outpatient surgery centers, private physicians’ offices, managed care centers, nursing schools, and home health.
What Does an Acute Care Nurse Do?
The responsibilities of an acute care nurse vary depending on their specific role and work setting. For example, here are some of the duties of a critical care registered nurse in an acute care hospital unit:
- Providing leadership in a professional practice setting
- Contributing to teamwork by helping others succeed through role modeling and mentoring
- Delegating tasks based on the needs of the patient and the skill level of the RN, LPN, or support staff
- Considering the maintenance of a safe environment, the patient’s condition, the complexity of the intervention, and the predictability of the outcome.
- Sharing skills and knowledge with peers and colleagues
- Participating with an interdisciplinary team to evaluate clinical care or health services
- Promoting patient safety initiatives, such as the National Patient Safety Goals
- Supervising LPNs
- Utilizing the nursing process to assess, plan, evaluate and implement a patient plan of care
- Analyzing the health status of patients to determine patient care needs
- Assessing patient records and change of condition, notifying the physician or supervisor, and intervening appropriately
- Promoting patient and family-centered compassionate communication
- Utilizing effective time management skills to complete assigned duties and responsibilities within the nursing shift
How to Become an Acute Care Nurse and How Long Does It Take
Licensed practical nurses, registered nurses, and advanced practice registered nurses can all work in acute care. Therefore, becoming an acute care nurse depends on the level of education aspiring nurses wish to achieve.
- Aspiring acute care nurses can become LPNs in as little as one year.
- Individuals with bachelor’s degrees in other fields can complete accelerated programs to obtain bachelor’s of science in nursing (BSN) degrees in one to two years, qualifying them to become RNs.
- Aspiring RNs without bachelor’s degrees can pursue two-year associate’s degrees or four-year BSNs.
- Finally, individuals who wish to become APRNs must complete master’s or doctoral degrees after becoming licensed RNs, which takes an additional one and a half to three years.
It must be noted that although RNs with associate’s degrees may find employment in acute care, many employers prefer hiring RNs with BSNs. Furthermore, although nurses may find employment in acute care straight out of nursing school, many employers require at least six months of work experience and prefer relevant experience in acute care settings.
Acute Care Nurse Certification
As with jobs in most nursing specialties, jobs in acute care require Basic Life Support (BLS) certifications. In addition, although most employers won’t require additional certifications, they will prefer hiring nurses with acute care nursing credentials.
The American Association of Critical-Care Nurses (AACN) offers many certification options for acute care nurses:
- Acute/Critical Care Nursing – CCRN (Adult): This credential is available for RNs or APRNs providing direct care to critically ill adult patients.
- Acute/Critical Care Nursing – CCRN (Pediatric): This certification is available for RNs or APRNs providing direct care to acutely ill pediatric patients.
- Acute/Critical Care Nursing – CCRN (Neonatal): RNs or APRNs providing direct care to acutely ill neonatal patients may obtain this certification.
- Acute/Critical Care Knowledge Professional – CCRN-K (Adult): This credential is for RNs or APRNs influencing the care of critically ill adults but not providing direct care.
- Acute/Critical Care Knowledge Professional – CCRN-K (Pediatric): This certification is for RNs or APRNs who influence the care of critically ill pediatric patients but don’t provide direct care.
- Acute/Critical Care Knowledge Professional – CCRN-K (Neonatal): RNs or APRNs who influence the care of critically ill neonatal patients but do not provide direct care can obtain this certification.
- TeleICU Acute/Critical Care Nursing – CCRN-E (Adult): This credential is for RNs or APRNs working remotely with critically ill adult patients.
- Progressive Care Nursing – PCCN (Adult): This certification is for RNs or APRNs providing direct care to acutely ill adult patients in progressive care settings.
- Progressive Care Knowledge Professional – PCCN-K (Adult): RNs or APRNs influencing the care of acutely ill adult patients in progressive care settings without providing direct care can obtain this credential.
- Cardiac Medicine: This credential is available for RNs or APRNs providing direct care to acutely ill adult cardiac patients.
- Cardiac Surgery – CSC (Adult): RNs and APRNs who provide direct care to acutely ill adult cardiac surgery patients can obtain this credential.
In addition, the AACN offers some certification options exclusively for nurses with graduate-level education:
- Acute Care NP – ACNPC-AG (Adult-Gero.)
- CNS Wellness through Acute Care – ACCNS-AG (Adult-Gero.)
- CNS Wellness through Acute Care – ACCNS-P (Pediatric)
- CNS Wellness through Acute Care – ACCNS-N (Neonatal)
How Much Do Acute Care Nurses Make?
Since nurses providing acute care may have different levels of education and work in multiple settings, there is no simple answer to the question of salary. Nevertheless, the following salaries will help nurses find the average salary that most closely fits their level of education and potential job location.
Acute Care LPN Salary
According to the US Bureau of Labor Statistics (BLS), the average LPN salary is $51,850 annually. Furthermore, here are average salaries for LPNs in different settings that offer acute care:
- General medical and surgical hospitals: $48,050
- Psychiatric and substance abuse hospitals: $52,440
- Outpatient care centers: $58,170
- Home health care services: $52,670
- Offices of physicians: $46,950
Acute Care RN Salary
According to BLS, the average RN salary is $82,750 per year. In addition, these are average RN salaries in different facilities providing acute care:
- General medical and surgical hospitals: $85,020
- Psychiatric and substance abuse hospitals: $80,260
- Specialty hospitals, not including psychiatric and substance abuse hospitals: $84,800
- Outpatient care centers: $93,070
- Home health care services: $78,190
- Offices of physicians: $73,860
Acute Care NP Salary
Finally, advanced practice registered nurses who have become nurse practitioners (NPs) earn, on average, $118,040 per year. Additionally, these are average NP salaries in different settings offering acute care:
- Home health care services: $133,170
- Psychiatric and substance abuse hospitals: $131,830
- Outpatient care centers: $129,190
- General medical and surgical hospitals: $122,960
- Offices of physicians: $114,870
- Offices of other health practitioners: $108,890
What Is Acute Care Nursing Like?
Not all acute care nursing is the same—especially since acute care is provided in so many settings, such as ICUs, ERs, and Med/Surg units. The following testimonial by an acute care nurse on Reddit helps paint a picture illustrating what typical days in the ICU are like providing a glimpse of this area of acute care.
“The kind of day where you aim to achieve 1 new thing towards getting the patient out of ICU or hospital. 1 thing in 12hrs doesn’t sound like much, but it’s surprising what can happen to sidetrack you from your goal.
The second kind of day is one where you work one thing after another to keep a very sick patient going. Think one of those dramatic scenes in ER, in slow motion. Adding infusions, administering blood, giving medications and taking trips to Radiology, Cath lab or theatre.
The last kind of day is the day where there is nothing spectacular left to do for the patient except for comfort cares – the heart of all nursing care. We spend a lot of time with family and friends of the patient on those days.”
Is Acute Care Nursing Hard?
Like all nursing specialties, acute care has its challenges. However, since critical care is so broad, the challenges vary significantly from one setting to another. For example, this testimonial describes the challenges of working in Med/Surg:
“And your management keeps telling you that you need to do more work more quickly than you all ready do when you’ve all ready got a plate so full it’s a miracle it hasn’t all toppled over all ready.” Reddit – u/TheMarkHasBeenMade
The following testimonial points out one of the challenges of working in an ICU:
“The ethical dilemmas people point out regarding ICU care are real. For example, I work with transplant patients and there’s been a few extremely sad cases that surgeons will absolutely not give up on (by giving the family constant futile hope to keep going) because a negative outcome would adversely affect their numbers and statistics. Patients are put through surgery after surgery, complication after complication, just to get them to a certain point where a negative outcome won’t affect statistics… and then the team will recommend palliative/hospice. It’s tough.” Reddit – u/hkkensin
Why Choose Acute Care Nursing
As with its challenges, the advantages of working in acute care vary depending on the setting. Here is why an ICU nurse loves their job:
“I love it. I love the acuity, I am fascinated by the pathophysiology of critically ill patients as most of them have multi organ dysfunction. Obviously it takes time to get the hang of things, but I think basically anyone is capable of learning and growing into an ICU nurse…I wouldn’t want to work anywhere else.” Reddit – u/benzosandespresso
The following testimonial shows what a Med/Surg nurse loves about their acute care nursing job:
“You learn time management, you do full assessments, you can get to have good relationships with your patients, you can see improvement, you can get really sick people there too and your assessments and care can save their life.” Reddit – u/krisiepoo
What Makes a Good Acute Care Nurse: Tips for New Nurses
New nurses graduate from their nursing programs with a wide array of skills and with visions of NCLEX study guides still flashing before them. Nevertheless, not all nursing specialties require the same knowledge or skills. The following are nursing skills and knowledge that are essential in acute care:
- Knowledge of cardiac rhythms and telemetry
- Knowledge of infection control
- Knowledge of central lines
- Ability to make accurate clinical assessments and judgments
- Ability to document patient care in an electronic medical record
- Ability to work effectively as part of a team
- Ability to educate staff
- Ability to prioritize tasks
- Initiative and ability to work independently
- Ability to maintain the confidentiality of medical records
- Excellent verbal, written, and presentation skills
- Ability to provide compassionate and respectful counseling and emotional support
“You don’t have to be any “smarter” to be in the ICU compared to any other unit in acute care…What you need is the ability to monitor and manage stress, internally and externally, for 12 hours at a time. This is more of a personality trait rather than an academic knowledge…” Reddit – u/whtabt2ndbreakfast
Although many nurses find jobs in ICUs or ERs straight out of nursing school, many experienced nurses recommend beginning acute care nursing careers in Med/Surg. Here is a reason why:
“As an ICU nurse, I don’t recommend students to come to ICU out of school. In my opinion Med-surg is the best experience a new nurse can get. First you need to see what relatively stable patients look like before you jump to unstable patients…Med-surg will allow you to learn at your own pace.” Reddit – u/Vent-ilator
Final Thoughts on Working as an Acute Care Nurse
Acute care is a very broad specialty, encompassing many others, such as Med/Surg, ICU, and ER nursing. Therefore, if acute care nursing has caught your attention, read on to learn more about these more specific nursing specialties to help you determine which one is the best fit for you.
Furthermore, besides obtaining all the information you need to make an informed decision, get some hands-on experience in different nursing settings by picking up per diem nursing shifts. Nothing beats first-hand experience when it comes to choosing a career path.