{"schemaVersion":"1.0","exportedAt":"2026-05-15T12:38:27.899Z","occupation":{"soc":"29-1141.01","title":"Acute Care Nurses","group":"Healthcare Practitioners & Technical","sector":"62","jobZone":4,"jobZoneInferred":false},"framework":{"version":"v.26.05","description":"","contextCovered":"This framework covers acute care nursing practice across medical-surgical, telemetry, step-down, and intensive care hospital units, from supervised entry-level clinical performance through executive leadership of nursing systems and policy.","levels":{"emerging":{"label":"Emerging","statements":["Patient health status data — collect and document using established protocols under direct RN supervision in an acute care unit.","Illness explanations and treatment overviews — communicate to patients and family members using approved scripts and visual aids under charge nurse guidance.","Electronic health record entries — input assessment results, medications, and intervention notes accurately under direct supervision in a hospital documentation system.","Basic cardiac life support (BLS) procedures — perform according to certification standards under direct supervision during supervised clinical rotations in an acute care setting.","Vital signs and physiological measurements — obtain and report to supervising nurses using standard monitoring equipment on a medical-surgical floor.","Intravenous infusion setups — assist with preparation and initiation under the direct oversight of an experienced RN in an acute care environment.","Electrocardiogram tracings — recognize normal sinus rhythm and flag obvious abnormalities for senior nurse review in a monitored inpatient unit.","Medical software and electronic mail tools — use to retrieve patient records and communicate care updates under the direction of unit leadership.","Acute patient deterioration indicators — identify early warning signs and escalate immediately to supervising clinical staff in a telemetry or step-down unit.","Standard precaution and safety protocols — apply consistently when handling blood products and intravenous lines under supervision in an acute hospital environment."]},"developing":{"label":"Developing","statements":["Acute and chronic condition assessments — conduct systematically using physiological and technology-derived data with moderate oversight in a general acute care unit.","Patient and family illness discussions — facilitate independently, tailoring communication to health literacy levels encountered on a busy medical-surgical floor.","Advanced cardiac life support (ACLS) interventions — execute competently during code situations with minimal prompting in an acute or critical care environment.","Invasive device management — set up, operate, and monitor catheters, gastrointestinal tubes, and central lines with routine supervision in an ICU or step-down unit.","Blood and blood product transfusions — administer and monitor for adverse reactions, adjusting infusion rates according to protocol in an acute inpatient setting.","EKG rhythm strips — interpret common arrhythmias and initiate appropriate nursing responses with limited guidance in a cardiac monitoring unit.","Complex patient care documentation — complete assessment findings, patient responses, and treatment changes accurately and promptly in an electronic health record system.","Radiograph findings — review and identify common abnormalities relevant to nursing care decisions, consulting with physicians as needed in an acute hospital environment.","Time-sensitive clinical priorities — coordinate across multiple patients simultaneously using structured time management strategies on a high-acuity nursing floor.","Mechanical ventilator settings — monitor and report parameter changes to the respiratory therapy and medical team in a critical care or post-surgical unit."]},"proficient":{"label":"Proficient","statements":["Rapid physiological deterioration — diagnose acute and chronic conditions independently and initiate life-stabilizing interventions before physician arrival in a critical care environment.","Comprehensive urgent and emergent health assessments — perform autonomously integrating clinical intuition, monitoring technology, and laboratory data across diverse patient populations in a tertiary acute care center.","Full scope emergency procedures — lead BLS and ACLS responses, directing code team roles and communicating clinical status to physicians during high-stakes resuscitation events.","Tracheotomy and colostomy equipment, mechanical ventilators, and central line systems — manage the full lifecycle of setup, troubleshooting, and optimization without supervision in an ICU setting.","Adverse transfusion reactions — recognize, intervene, and document complex cases autonomously, escalating appropriately within hospital transfusion management protocols.","Diagnostic imaging and EKG interpretation — analyze findings independently to inform urgent nursing care decisions and collaborate with the interdisciplinary team in an acute hospital setting.","Non-routine patient and family counseling — navigate sensitive illness disclosures, treatment conflicts, and emotional crises using advanced therapeutic communication skills in an acute care context.","Clinical documentation integrity — ensure accuracy, completeness, and regulatory compliance of patient records across an assigned caseload using enterprise-level health information systems.","Complex problem-solving in deteriorating patients — apply deductive and inductive reasoning to synthesize ambiguous clinical data and determine priority interventions in a fast-paced acute care unit.","Multidisciplinary care coordination — lead daily patient-centered rounds, aligning nursing, pharmacy, therapy, and social work efforts in a high-acuity hospital environment."]},"advanced":{"label":"Advanced","statements":["Unit-wide clinical standards — develop, implement, and evaluate evidence-based nursing protocols that govern acute care practice across an entire inpatient department or system.","Staff competency development — design and lead simulation-based training programs for BLS, ACLS, and invasive device management, elevating the skill level of nursing teams across a hospital system.","Organizational patient safety strategy — lead root-cause analyses and quality improvement initiatives in response to adverse events, influencing policy at the department or executive level.","Emerging clinical technology adoption — evaluate, pilot, and champion new monitoring systems and medical software implementations, guiding acute care teams through workflow transitions.","Complex ethical and clinical dilemmas — guide multidisciplinary teams and families through end-of-life decisions, treatment conflicts, and resource allocation challenges at an organizational level.","Nurse mentorship pipelines — establish structured preceptorship and career-progression frameworks that retain and advance clinical talent within an acute care institution.","Cross-departmental coordination — lead hospital-wide responses to surge events, mass casualty incidents, or infectious outbreaks, applying systems evaluation skills to optimize patient flow and staffing.","Regulatory compliance and accreditation readiness — oversee documentation practices, audit outcomes, and corrective action plans to maintain Joint Commission or equivalent standards across nursing units.","Clinical learning strategies — direct continuing education curricula and evidence-based practice initiatives that translate current research into measurable improvements in acute care patient outcomes.","Strategic resource planning — advise hospital leadership on staffing models, budget allocation, and technology investments required to sustain high-quality acute nursing care at an enterprise scale."]}}},"sources":{"onet":"v30.2 (CC BY 4.0)","crosswalk":"https://skillscrosswalk.com","generator":"LER.me"},"attribution":"© EBSCOed"}