The nurse practitioner (NP) role has evolved since its inception in 1965. Initially focused on primary care, the role has expanded amid the changing health care environment and provider shortages to encompass a variety of specialties and settings, including hospital-based, critical care, and subspecialty fields. Many job satisfaction factors positively and negatively affect NPs, who are integral members of the health care team. A healthy work environment—one in which factors that positively influence job satisfaction are capitalized and negative factors are reduced—can increase job satisfaction and staff retention and can ultimately improve patient outcomes.

Almost 270 000 licensed NPs practice in the United States. Of these, approximately 42% have been granted hospital privileges. The majority are certified in an area of primary care; only 4.8% are certified in acute care.

The acute care NP (ACNP) role in adult critical care and...

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