Ambulatory Care Nursing: Yes, It's a Specialty

Laura A. Stokowski, RN, MS

Disclosures

September 26, 2011

In This Article

Ambulatory Nursing

Ask an acute care hospital-based nurse whether he or she has ever considered ambulatory nursing, and you might get this response: "Why would I want to be an ambulatory nurse?"

Or, "What is ambulatory nursing, anyway?"

It's a fair question. Few schools of nursing include any ambulatory theory or clinical experience in their curricula. Nurses who transition straight from nursing school into the hospital might have little understanding of how ambulatory nursing differs from inpatient hospital nursing.

The diversity of ambulatory nursing makes it the most difficult nursing specialty to pin down with a precise definition. An ambulatory nurse might practice in a primary care clinic, an outpatient surgery center, or a correctional setting. The following is a sample of ambulatory nursing settings and roles:

  • Primary care;

  • Office nurse;

  • Community health center;

  • Nurse-managed clinic;

  • Ambulatory surgery;

  • Call center;

  • Community health;

  • School nurse;

  • Occupational health;

  • Home health;

  • Parish nurse;

  • Patient education;

  • Urgent care;

  • Telehealth;

  • Correctional facility;

  • Chronic disease management;

  • Transitional care;

  • Care coordinator;

  • Infusion center;

  • Dialysis center;

  • Endoscopy/gastrointestinal lab;

  • Interventional cardiology;

  • Interventional radiology;

  • Ambulatory oncology; and

  • End-of-life care.

The common thread holding these disparate roles and settings together is that they take place outside of the hospital. Patients come from, and return to, their homes, as suggested by the word "ambulatory." This word can be misleading, however, because what was considered "ambulatory care" a decade ago is very different from what constitutes ambulatory care today. Patients are sicker; they have more chronic diseases and complications; hospital stays are shorter; and more invasive and complex procedures are performed on outpatients than ever before.

Make no mistake, however. Ambulatory nursing is a nursing specialty, with its own professional society, standards of practice, certification, performance measurement criteria, and body of literature for evidence-based practice. The American Academy of Ambulatory Care Nurses (AAACN) defines professional ambulatory care nursing as:

...a complex, multifaceted specialty that encompasses independent and collaborative practice. The comprehensive practice of ambulatory care nursing is built on a broad knowledge base of nursing and health sciences, and applies clinical expertise rooted in the nursing process. Nurses use evidence-based information across a variety of outpatient healthcare settings to achieve and ensure patient safety and quality of care while improving patient outcomes.[1]

In describing ambulatory care nursing as a distinct professional nursing specialty, Margaret Fisk Mastal emphasized the differences in the patient-nurse encounter that characterize ambulatory care.[2] Although the encounter is episodic, often short, and might be face to face, over the telephone, or even electronic, ambulatory care nurses often have long-term relationships with patients, families, and caregivers that can last months or even years.[2]

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