The words “acute” and “ambulatory” might make the uninitiated think of triangles and ambulances, but these descriptors actually revolve around an important distinction in healthcare. If you’re considering a nursing career, it’s good to have a better understanding of the differences—and what they could mean for you in practice as a nurse.
If you’re looking to get up to speed on the differences between acute care versus ambulatory care, you’re in the right place. Read on to learn more about the basic differentiators between these types of care and what that means for the nursing professionals in these settings.
What is acute care, and what is ambulatory care?
Simply put, acute care 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.
Usually, patients in acute care settings are dealing with more severe or life-threatening conditions, while ambulatory care focuses on less dire—but still important—patient care.
The line between the two can get blurry, though. For instance, an “urgent care” clinic is still considered an ambulatory setting even though it receives patients with possibly life-threatening symptoms. Patients don’t always know whether what ails them is an acute issue or a longer-term concern when they first walk through that door. That means nurses and healthcare providers in ambulatory settings need to understand when it’s time to escalate and direct a patient to a facility that’s better equipped to tend to a patient’s acute health issues.
While there are some settings with the potential for overlap between acute and ambulatory care, there are still important general distinctions in the competencies required of nursing staff in these roles.
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. However, that’s a big understatement when it comes to where nurses can apply themselves.
Your typical TV medical drama most likely showcases an acute care setting. This environment includes places like the intensive care unit, emergency room or cardiology units in hospitals. 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, schools and even patient homes. Brook describes these settings as professional and busy but generally pleasant and lower stress.
“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 some 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.
What is working in acute care like?
This can be tough to answer broadly, as there are distinctions between different acute care nursing units. That said, there are some aspects that tend to be consistent in these roles.
One is the overall patient load. High-acuity patients typically need more consistent, focused care, as their condition can change rapidly, which means healthcare providers aim to have nurses care for relatively fewer patients.
Because patient status can change so rapidly, acute care nurses often need to make quick—and consequential—decisions while still adhering to hospital protocols and physician orders. Some environments, like the emergency room, can get hectic during times with unexpectedly high patient loads, so the ability to triage and prioritize care becomes much more important for nurses in these settings.
Additionally, they advocate for individual patients within their system but usually have limited contact with third parties like insurance companies, social services or community groups.
What is working in ambulatory care like?
Nurses in an ambulatory care setting make recommendations for care plans primarily determined by the patient or the patient’s family. The nurses in this setting may not always 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.
What traits are needed in acute care versus ambulatory care?
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, these nurses need some interdisciplinary 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 take the next step toward becoming a nurse. Check out our article “How to Become a Nurse: A Beginner’s Guide” to learn how to start your nursing career.
