The Acute Care Nurse Practitioner (NP) serves as an integral member of the anesthesia care team, providing perioperative patient assessment, optimization, acute pain consultation, and post-anesthesia care coordination. This position works collaboratively with anesthesiologists, CRNAs, SRNAs, surgeons, intensivists, nursing staff, and other healthcare professionals to improve patient outcomes, enhance operating room efficiency, and ensure the delivery of high-quality perioperative care.

The NP functions under the supervision of a designated anesthesiologist and practices within the scope of state licensure, institutional policies, and applicable regulations.

Essential Duties and Responsibilities

1. ICU Preoperative Assessment and Patient Optimization

The NP is responsible for evaluating and optimizing critically ill patients scheduled for surgical procedures.

Responsibilities include:

·         Conduct daily rounds on ICU patients scheduled for surgery.

·         Perform comprehensive preoperative assessments and risk evaluations.

·         Identify physiologic abnormalities that may impact anesthetic care, including:

o   Electrolyte disturbances

o   Coagulation abnormalities

o   Hemodynamic instability

o   Respiratory compromise

o   Other modifiable perioperative risks

·         Coordinate corrective interventions with ICU providers, consulting services, and surgical teams.

·         Communicate patient readiness and optimization needs to anesthesia and surgical stakeholders.

·         Ensure patients meet criteria for safe anesthetic administration.

·         Document assessment findings, recommendations, and optimization plans in the medical record.

·         Facilitate efficient perioperative planning and reduce day-of-surgery delays and cancellations.

2. Acute Pain Consultation Service

The NP provides timely evaluation and management of patients requiring acute pain interventions.

Responsibilities include:

·         Receive and respond to acute pain consultation requests from surgical services, inpatient units, and the emergency department.

·         Perform comprehensive pain assessments and review analgesic history.

·         Develop multimodal pain management recommendations in collaboration with anesthesiologists.

·         Evaluate patients for regional anesthesia and peripheral nerve block appropriateness.

·         Coordinate scheduling and logistics for regional anesthesia procedures with anesthesia personnel and support staff.

·         Monitor patient response to interventions and provide follow-up care as appropriate.

·         Document consultation findings, treatment recommendations, and patient outcomes.

·         Promote evidence-based pain management strategies that optimize patient comfort while minimizing opioid utilization.

3. PACU Coordination and Post-Anesthesia Care Management

The NP provides clinical support within the Post-Anesthesia Care Unit (PACU) and assists with post-operative patient management.

Responsibilities include:

·         Coordinate patient care within the PACU during peak operational periods.

·         Assess and manage common post-operative issues within NP scope of practice, including:

o   Pain management

o   Post-operative nausea and vomiting

o   Basic hemodynamic concerns

o   Recovery progression

·         Evaluate patients for discharge readiness using established criteria and protocols.

·         Complete discharge assessments and facilitate appropriate PACU sign-out processes.

·         Identify patients requiring escalation of care and communicate concerns to the supervising anesthesiologist.

·         Collaborate with nursing staff and procedural teams to improve patient throughput and operational efficiency.

·         Serve as a liaison between anesthesia providers and other hospital service lines.

4. Next-Day Surgical Patient Assessment and Optimization

The NP proactively evaluates patients scheduled for surgery on the following day.

Responsibilities include:

·         Manage and coordinate all next-day preoperative orders, ensuring required testing, blood product availability, and optimization interventions are completed prior to surgery.

·         Review surgical schedules to identify ICU patients requiring preoperative evaluation.

·         Perform preoperative assessments in advance of scheduled procedures.

·         Identify optimization needs and coordinate necessary interventions.

·         Collaborate with ICU teams, surgeons, consultants, and anesthesiologists regarding patient readiness.

·         Recommend additional testing, consultations, or treatment plans when clinically indicated.

·         Monitor completion of optimization interventions prior to surgery.

·         Document findings and communicate recommendations to relevant stakeholders.

Educational and Clinical Leadership Responsibilities

The NP participates in the clinical education of Student Registered Nurse Anesthetists (SRNAs).

Responsibilities include:

·         Supervise and mentor up to two SRNAs during non-anesthetizing clinical activities.

·         Facilitate SRNA participation in patient assessments, care planning, documentation, and interdisciplinary communication.

·         Provide clinical instruction and feedback during ICU rounds, acute pain consultations, and PACU activities.

·         Support the educational mission of the anesthesia department while maintaining compliance with accreditation standards.

·         Collaborate with anesthesia leadership to promote a positive learning environment.

Supervision of SRNAs during direct anesthesia care remains the responsibility of CRNAs and anesthesiologists in accordance with accreditation requirements.

Education and Experience

Required

·         Master's or Doctoral degree from an accredited Nurse Practitioner program.

·         Current Nurse Practitioner licensure in the state of practice.

·         Acute Care Nurse Practitioner (ACNP) or Adult-Gerontology Acute Care Nurse Practitioner (AGACNP) certification.

·         Current DEA registration (if applicable).

·         Current BLS and ACLS certification.

·         Minimum of two years of critical care, perioperative, or acute care experience preferred.

·         Strong clinical assessment and communication skills.

Preferred

·         Experience in critical care medicine, anesthesia, perioperative services, or pain management.

·         Familiarity with ICU patient management and perioperative optimization.

·         Experience working within multidisciplinary healthcare teams.

·         Teaching or precepting experience.

Reporting Structure

The Acute Care Nurse Practitioner reports to Supervising Anesthesiologist and works under the clinical oversight of a designated anesthesiologist. The NP collaborates closely with anesthesiologists, CRNAs, SRNAs, surgeons, intensivists, PACU staff, and hospital leadership.

Work Environment

This position functions within a hospital-based anesthesia practice and includes responsibilities in:

·         Intensive Care Units (ICU)

·         Preoperative assessment environments

·         Post-Anesthesia Care Units (PACU)

·         Inpatient units

·         Procedural and perioperative care areas

Mission of the Role

To improve perioperative patient outcomes through proactive patient optimization, timely acute pain management, efficient post-operative care coordination, and collaborative support of anesthesia services while contributing to education, quality improvement, and operational excellence.