If the terms acute and ambulatory make you think of triangles and ambulances, you’re not alone. But even if you are familiar with the essential differences between acute care and ambulatory care, you may still have questions about what each environment offers as a workplace.
There are many options to consider when looking at a nursing career, and weighing them carefully will help you make the best decisions possible. Lay your questions about acute care versus ambulatory care to rest in this close-up comparison.
Acute vs. ambulatory: 101
Simply put, acute refers to inpatient care while ambulatory refers to outpatient care. An acute setting is a medical facility in which patients remain under constant care. An ambulatory setting might be a non-medical facility like a school or nursing home, but it also includes clinics and medical settings that typically deal with non-emergency issues.
The line between the two can get blurry because an urgent care clinic is still considered an ambulatory setting even though it receives patients with possibly life-threatening symptoms.
“As the costs of acute care services increase, patient care is being shifted to the outpatient setting resulting in increased ambulatory care visits,” writes Beth Ann Swan, Associate Dean of Nursing at Thomas Jefferson University, in her academic journal article. It’s important for nurses to consider which environment they are working toward because the competencies required for each can differ.
Acute vs. ambulatory: Care settings
So what do these two settings look like? “Many nurses go through school believing that the only place for a nurse to work is in a hospital setting, preferably at the bedside,” says Nancy Brook, RN. But she insists that nothing could be further from the truth.
Your typical TV medical drama most likely showcases an acute care setting. This environment includes places like hospitals, intensive care units and cardiology floors. Acute care settings tend to be busy and open 24/7, available for the sickest patients, Brook explains. Nurses in these environments likely have schedules that include night shifts, weekends and holidays.
The ambulatory care environment can be much more diverse in setting. These nurses typically work in locations like clinics, urgent care facilities, school and even patient homes. Brook describes these settings as professional and busy, but pleasant.
“While patients come and go, the atmosphere is all about wellness,” she says. She also points out that most outpatient clinics open for normal daytime hours (with a few urgent care clinics open later), meaning these nurses typically work during the day. “Very few ambulatory settings are open on the weekends or holidays, and if you are raising a family, that can make a big difference in your family life and job satisfaction,” she adds.
Acute vs. ambulatory: Job duties
Nurses in an acute care setting are primarily responsible for creating the organization structure of care, according to Swan's article. They take charge of inpatient admissions and have continuous contact with their patients.
Acute care nurses need to make decisions that jive with hospital protocols and physician orders. They advocate for individual patients within their system, but usually have limited contact with third-parties like insurance companies, social services or community groups.
Nurses in an ambulatory care setting make recommendations for care plans primarily determined by the patient or the patient’s family. The nurses may not have access to complete medical records and need to make decisions based on sporadic visits over a longer period of time. They play an important role in their patients’ screening and in identifying at-risk individuals.
Ambulatory care nurses tend to work with entire communities. Their assessments involve factors beyond the individual patient, often considering family members and unstable environments. Ambulatory care also involves working with many non-medical organizations. These nurses evaluate available resources and eligibility requirements, which makes patient advocacy much more complex.
Acute vs. ambulatory: Important skills & characteristics
Working in an emergency or constant care setting will appeal to nurses who enjoy the excitement and can handle high-stress situations well. “This kind of work is definitely suited toward a certain personality type: high energy, focused and committed to working with an acutely ill patient population,” Brook says.
Since ambulatory care tends to involve more interaction than just nurse-to-patient contact, Swan suggests these nurses need some inter-disciplinary communication and coordination skills. This applies even in providing care for their patients, since these nurses are often working with limited data and thus require critical thinking and clinical judgment in determining care priorities.
Working in ambulatory care is great for nurses who have flexible personalities, according to Brook. Working with many different people toward a positive result means these nurses should be open to learning new things and enjoy working as part of a team, she adds.
Acute vs. ambulatory: Getting started
Now that you have a better understanding of acute care versus ambulatory care, you are better equipped to decide which environment is the better fit for you.
Can you see yourself working in acute or ambulatory care? If you have an idea of what kind of nurse you want to be, it's time to find out which nursing credential will best support your career plan. Check out this handy infographic for more information: Types of Nursing Degrees: Diagnosing Your Ideal Healthcare Career.