The role of the primary care/ambulatory nurse has grown in recent years in response to population health initiatives, which are an attempt to drive down the cost of care, keep patients out of the hospital, and manage them at home. This approach has become especially important during the COVID-19 pandemic. Keeping patients safe at home versus bringing them into an urgent care center, a hospital, or even an office has expanded the primary care nurse role to include public health nursing.
Characteristics needed. Primary care nurses need excellent triage and assessment skills, so they can determine what’s happening with patients and their environments. Understanding how social determinants of health affect patients and what community interventions can support high-risk patients also is key. Helping patients overcome barriers to care access (such as transportation and cost) requires a resourceful nurse who will go the extra mile.
Rewards. Cradle-to-grave relationships with patients and families are rewarding, as is serving as a member of a primary care team that helps those with severe chronic diseases age in place with a good quality of life. Other rewards include affecting a person’s health with education and guidance and working as part of an engaged team focused on problem solving.
Challenges. If the physician isn’t available when patients need quick access to care, nurses have to troubleshoot and make rapid decisions, which requires a high skill level. In addition, frequently changing technology platforms can be challenging for patients and nurses.
Education requirements. A BSN is preferred in most primary care positions; certification (in care coordination or ambulatory nursing) usually isn’t a requirement but may be encouraged. Typically, nurses need inpatient experience, but that requirement is changing as the demand for primary care staff increases.
Professional associations. The American Association of Ambulatory Care Nurses, the Care Management Society of America, and the National Association of Case Management offer education opportunities for primary care nurses.
Bottom line. “Primary care nursing provides the opportunity to engage with patients and families over a very long period via many technologies and in person, to keep them at their highest level of wellness, to prevent disease, and to ensure a high quality of life for your community.”
Kristine Adams is associate chief nurse officer for care management and ambulatory services at Cleveland Clinic in Ohio.
