Blog Posts


Clarifying the Role of the Emergency Nurse Practitioner

Posted on Mon, Nov 14, 2016
Clarifying the Role of the Emergency Nurse Practitioner

It's National Nurse Practitioner Week! Please take a moment to thank the NPs on your team this week.

By Jennifer Wilbeck, DNP, ACNP-BC, FNP-BC, FAANP

During ACEP16, I had the pleasure of sharing updates on the role of emergency nurse practitioners (ENPs) to the ACEP Board and key leaders from across the country.

Although I have been an ENP for 17 years, the opportunities supporting and advancing ENP practice have only recently begun to gain momentum. In large part, this is due to the creation of the American Academy of Emergency Nurse Practitioners (AAENP), which now offers a unified, national voice for ENPs across the country. Reflecting the diversity of our practice sites, the paths to the ENP role and our subsequent litany of certifications is at times confusing for those who hire and work with ENPs.

Not all nurse practitioners (NPs) have the same knowledge and skill sets. Education and clinical practice for NPs, along with practice qualifications, are based on academic preparation and certification in a specific patient population, not on prior nursing experience. In addition to educational preparation, the ENP scope of practice is based on state regulations and licensure, as well as institutional credentialing. ENPs must be prepared to provide primary care and acute resuscitation, plus manage complex, unstable conditions in patients of all ages. Until recently, no academic programs offered this specialty training. Congruent with emergency care, current ENP educational programs now build upon the family nurse practitioner (FNP) education to provide specialty knowledge across the lifespan.
To further clarify the ENP role, the AAENP now “promotes high-quality, evidence-based practice for nurse practitioners providing emergency care for patients of all ages and acuities in collaboration with an interdisciplinary team.” Recent accomplishments which help standardize the ENP role include:

Additionally, AAENP is working to standardize both graduate ENP and post-graduate ENP fellowships. Just like our collaborative approach to care in the ED, AAENP’s organizational efforts also are collaborative. Visit and email any board member or regional director to get involved.

Jennifer Wilbeck, DNP, FNP, ACNP, FAANP, is the immediate past chair of the American Academy of Emergency Nurse Practitioners and the specialty director of the Vanderbilt University School of Nursing ENP Program in Nashville. She practices at several middle Tennessee emergency departments managed by EmCare, including TriStar Spring Hill ER, TriStar Centennial Medical Center, Southern Hills Medical Center and TriStar Medical Center.


Tips to Boost Your Documentation Process: Changes in Physician Certification Effective Jan. 1, 2015

Posted on Wed, Jan 07, 2015
Tips to Boost Your Documentation Process: Changes in Physician Certification Effective Jan. 1, 2015

Good documentation is important for new physicians as well as veteran caregivers. While documenting can seem like a very straightforward skill, there are often “best practices” that can be utilized. As a hospitalist for EmCare at St. Petersburg General Hospital in St. Petersburg, FL I write a “weekly documentation tip” email to help physicians improve their clinical documentation. I also share these documentation strategies with the residents I teach.

by: Timothy N. Brundage, M.D., CCDs

Changes in Physician Certification Effective Jan. 1, 2015

An important reminder – as of Jan. 1, 2015, a separate physician certification will no longer be required under CMS guidelines.

CMS has finalized changes to physician certification requirements:

  • Physicians will no longer need to provide formal certification for inpatient admission unless the admission is expected to last 20 days or longer, or the case is an outlier
  • Inpatient admission orders will remain a requirement as a condition of payment under Medicare Part A
  • Physicians will need to certify high-cost outlier cases for medical necessity

These changes will make it much more important that documentation reflect medical necessity and how sick admitted patients in order to justify each inpatient admission. These changes are expected to improve hospital efficiency.

Timothy N. Brundage, M.D., CCDs is a Certified Clinical Documentation Specialist and Diplomate of the American Board of Internal Medicine.