Competency Evaluation in the Emergency Department Setting for the Family Nurse Practitioner Student

Currently, nurse practitioners (NP) work in a variety of settings. The optimal clinical setting emphasizes assessment of health states, management of common health problems, health education and promotion, and disease prevention common to individuals and families across the lifespan. The purpose of this presentation is to evaluate competencies in the setting of the emergency department for the family nurse practitioner (FNP) clinical experience. In addition, case studies with story telling will serve as examples of experiences.

The core competencies exist that outline essential behaviors that should be demonstrated within all specialty programs. Unique to primary care is diagnosis of health status. The FNP competencies supplement the core competencies for the primary care population of families across the lifespan. Conversely, the Acute Care Nurse Practitioner competencies incorporate complex monitoring and therapies, as well as invasive interventions and procedures to promote physiologic stability.

The Emergency Nurses Association has created competencies for the nurse practitioner in emergency care. What differs is the forensic emphasis along with the mandatory screening exam. There are also multiple procedural competencies unique to emergency care.

The competency that is necessary for practice in the primary care setting but is lacking in emergency care is health promotion and disease prevention. The FNP needs to provide continuity of care along with a partnership with individuals and families over time.

Since this is lacking in the emergency department, the FNP needs emphasis in the primary care setting with only supplemental experiences in the ED.  The recent document published by the Institutes of Medicine calls for transformational change in nursing education and practices. This includes the removal of practice barriers that inhibit NPs from practicing to the full extent of their education and training and serving in primary care roles. Clearly, to drive NP education competency evaluation needs to be ongoing.