Standard Competencies in Ambulatory Care: An Urgent Need

The ambulatory setting presents unique challenges for leadership and staff transitioning from other care areas, such as the inpatient environment. Nurses and support staff newly entering the world of ambulatory care may experience challenges acclimating to their new roles as they shift from an environment that provides focused care to achieve a safe discharge to one that focuses on holistic prevention and treatment over long periods. Inpatient hospital care relies on many protocols, orders, and guidelines and a multidisciplinary team of physicians, pharmacists, dieticians, and rehabilitation support to progress the patient through their illness or injury during their hospital admission. Nurses in ambulatory care have increased responsibility and autonomy in patient care. New challenges are encountered, for example, transportation to appointments, socioeconomic challenges, immediate resource needs, and patient support for future success in their own environment. In these situations, the ambulatory nurse is an immediate caregiver and a case manager, providing direct patient care for a short period, but following up over a longer period, in some cases, years. [.