A Day in the Life of an Acute Care Nurse Practitioner

Welcome to “A Day in the Life of an Acute Care Nurse Practitioner (ACNP).” ACNPs can work in various medical sub-specialties such as organ transplant (kidney transplant groups), advanced surgery (cardiothoracic surgery), critical care (cardiac, trauma, neuro, or burn ICUs), and emergency departments. Being an Acute Care Nurse Practitioner (ACNP) is a fast-paced and fulfilling role. Each day brings something different—balancing hospital rounds, performing procedures, managing clinic patients, and working closely with physicians and care teams.

In this post we’ll explore the day in the life of an ACNP working in critical care in the pulmonology subspecialty.

Morning: ICU Rounds and Hands-On Care

The day kicks off early—around 6:30 AM. The Acute Care Nurse Practitioner starts by reviewing labs, imaging, and charts to get up to speed. By 7:00 AM, it’s time for ICU rounds with the intensivist and the rest of the team.

During rounds, the ACNP helps present cases, updates treatment plans, and makes real-time decisions. They might coordinate sedation and pain control, manage fluid balance, and adjust oxygenation and ventilation strategies. They interpret diagnostic tests like chest X-rays, CT scans, and arterial blood gases to guide treatment. In some cases, they manage ECMO or initiate advanced support systems. They oversee airway management, including intubation, mechanical ventilation, and ventilator adjustments for conditions like ARDS, pneumonia, or COPD.

Procedures often follow. Intubations, central lines, and thoracentesis are part of the daily rhythm—always done in coordination with or under the supervision of the attending physician. Safety and precision are key. Their work blends high-level clinical skill, collaboration, and compassion to stabilize and support the most critically ill patients.

Late Morning: Medical-Surgical Consults

After the ICU, it’s off to the med-surg floors to consult on patients with pulmonary concerns—things like pneumonia, pulmonary embolism, or interstitial lung disease.

Here, the Acute Care Nurse Practitioner assesses, orders diagnostics like CT scans, adjusts oxygen therapy, and starts treatments like anticoagulants. Patient education is also a big part of the role—like teaching a newly diagnosed asthma patient how to use an inhaler or avoid triggers.

Afternoon: Outpatient Clinic Visits

In the afternoon, the setting changes again as the Acute Care Nurse Practitioner heads to the outpatient pulmonary clinic. Patients here may be dealing with chronic conditions such as asthma, sleep apnea, or COPD. They may also see patients post hospilizations or procedures.

A typical visit might involve reviewing a patient’s peak flow results, tweaking inhaler prescriptions, or discussing why they’re not feeling improvement. The ACNP might also order a sleep study or interpret pulmonary function tests.

They also ensure seamless care—coordinating with primary care providers, arranging home oxygen if needed, and connecting patients with pulmonary rehab programs.

Always a Team Effort

Throughout the day, collaboration is constant. The Acute Care Nurse Practitioner works closely with their supervising physician, especially on complex cases. Regular check-ins help keep care plans aligned and ensure professional development continues.

The Challenges

The job isn’t without its tough moments. Managing critical cases in the ICU can be emotionally heavy—especially when dealing with end-of-life care or delivering hard news.

Time is always tight, and switching gears from high-intensity ICU cases to clinic visits requires focus and flexibility. Plus, with evolving guidelines and documentation systems, staying organized and up to date is essential.

Even within a strong team, there can be moments of differing opinions, making communication skills and professionalism crucial.

The Rewards

Despite the challenges, the rewards are deeply fulfilling. There’s nothing like seeing a former ICU patient walk in for a follow-up, healthy and on the road to recovery.

Being a trusted provider during someone’s most vulnerable moments is powerful. And building long-term relationships in the clinic allows for personalized care and real connection.

The role also offers constant growth—whether it’s performing procedures, interpreting complex results, or making clinical decisions that save lives. Each day brings opportunities to make a real difference.

Final Thoughts

Working as an Acute Care Nurse Practitioner in pulmonary and critical care means wearing many hats—clinician, educator, collaborator, and advocate. From the ICU to the clinic, this role is essential to helping patients through some of their most challenging health journeys. It’s fast-paced, hands-on, and above all—deeply impactful.

Explore Further

For those aspiring to become Acute Care Nurse Practitioners or seeking more information about the profession, we recommend visiting American Association of Nurse Practitioners and Pediatric Nursing Board of Certification for valuable resources and information.