The Nurse Practitioner/Physician Assistant functions as an independent healthcare provider who, working collaboratively within a multidisciplinary health team, is responsible for providing comprehensive care to both well and ill patients in both the inpatient and outpatient setting. This position requires working weekends and holidays. He/she demonstrates a high degree of clinical expertise in working with patients with acute and chronic illnesses commonly encountered in Hepatobiliary Pancreatic Surgery. He/she is responsible for assessment, diagnosis, treatment, management, education, health promotion and care coordination for patients and families with acute and chronic health needs. The NP/PA practices as a member of the Hepatobiliary Pancreatic Surgery provider team. This position may participate in weekly GI tumor board conferences as available. The Nurse Practitioner/Physician Assistant demonstrates an advanced level of medical/nursing clinical knowledge, communication and interdisciplinary collaboration, professionalism and systems-based practice. He/she works with administrative, nursing, physician, and university faculty to assure safe, effective, quality patient care and to promote Advocate Health educational and research missions.
The Nurse Practitioner/Physician Assistant will provide care within his/her scope of practice as outlined by applicable state law, licensing, regulations, institutional policy and practice agreements. The Nurse Practitioner/Physician Assistant is eligible to begin practice after he/she is credentialed and privileged by Advocate Health and Clinics Medical Staff. Active hospital privileges will be required and to maintain employment within this practice. The Nurse Practitioner/Physician Assistant will need to be credentialed and obtain and maintain professional privileges required for employment within this department.
Outside of minimum work requirement, he/she will be eligible for excess pay for additional shifts worked, per Advocate Health policy, Paid Time Off, and performance incentive bonuses. Each year, he/she will have $2500 and a total of 40 hours of CME.
Major Responsibilities
Clinical Knowledge
- Demonstrates knowledge of etiologies, risk factors, pathophysiology, presentation and epidemiology of medical conditions.
- Performs history and physical exams of patients that are accurate, complete, concise, relevant and appropriate for age, gender and clinical problem.
- Orders appropriate diagnostic studies and correctly interprets the results.
- Utilizes critical thinking to synthesize and analyze collected data.
- Develops, implements, evaluates and alters the care plan as needed.
- Manages general medical and surgical conditions based on knowledge of the indications, contraindications, side effects, interactions and adverse reactions of pharmacologic agents and other relevant treatment modalities.
- Counsels and educates patients and families.
- Demonstrates proficiency in procedural skills pertinent to practice area.
- Maintains accurate, complete, concise and timely documentation in the electronic medical record.
Patient Care
- Provides care that is patient and family centered, compassionate, appropriate and effective for the promotion of health, prevention of illness and treatment of disease throughout the lifespan.
- Facilitates consistent, coordinated care and clear communication among all members of the healthcare team.
- Incorporates the patient and family in care planning and treatment across settings.
- Serves as an advocate for patients and families in navigating the health care system.
Practice Based Learning and Clinical Improvement
- Demonstrates insight into own strengths, limitations and knowledge deficits.
- Demonstrates initiative to meet identified learning needs using multiple resources.
- Actively participates in self-evaluation by seeking and utilizing guidance and constructive feedback in a professional manner.
- Continuously seeks opportunities for clinical advancement and knowledge and skill attainment.
Communication and Interdisciplinary Collaboration
- Communicates and collaborates effectively with physicians, other health professionals and health related agencies.
- Works effectively with multidisciplinary team members.
- Promotes mutual respect and trust working within a team model.
- Communicates effectively with patients and families, incorporating gender, age, culture, race, religion, disabilities and sexual orientation.
Professionalism
- Follows ethical principles regarding patient confidentiality, informed consent and unanticipated adverse outcomes.
- Demonstrates the highest level of accountability for professional practice.
- Participates in education of students and other health care professionals.
- Maintains effectiveness where circumstances and priorities are changing. Is flexible, resilient and change oriented.
- Welcomes and participates in opportunities to advance the mission of Advocate Health through service, scholarship, science and social responsibility.
- Participates in organizational and departmental meetings, educational opportunities, committees and workgroups as necessary.
Systems Based Practice
- Considers cost effectiveness and risk/benefit analysis when making decisions about patient care.
- Uses evidenced-based medicine to systematically analyze and improve patient care practices.
- Participates in quality initiative/performance activities.
- Participates in development, evaluates and implements standards of care within area of specialization (policies, protocols, etc).
Roles And Responsibilities Specific To Area Of Clinical Practice
Outpatient Specific Responsibilities
- Participate in pancreatic cyst clinic, follow up for non-operative drain management, post-operative care and management of postoperative complications.
- Conduct comprehensive or episodic health history and physical exam of patients with acute, chronic and/or potential health problems, including follow up for post-operative care and management of postoperative complications.
- Order appropriate diagnostic laboratory and imaging tests pertinent to active health problem(s).
- Establish medical diagnosis.
- Medical Management within the parameters set in the Collaborative Practice Agreement:
- Prescribe appropriate medications pertinent to active health problems.
- Order therapeutic interventions as appropriate for pertinent health problems.
- Perform wound and drain care, including removal of drains as appropriate.
- Provide counseling and education to the patient and family regarding active health problems.
- Initiate outpatient referrals as appropriate.
- Document the encounter in the electronic medical record and assure follow up plan.
- Provide appropriate direction to clinic staff regarding patient care issues.
- Orders to be instituted at the bedside (ie: staple removal, drain removal, etc).
- Follow-up plan.
- Ordering of lab work and/or other diagnostic tests.
- Other patient needs within the scope of practice for the clinic staff.
- Communicate effectively with referring health care providers
- Communicate collaboratively with other health care providers who are participating in the care of each patient as it relates to the active health problems managed by HPB Surgery.
- Be available to address outpatient needs for our patients by addressing calls/questions in collaboration with the clinic staff.
- Perform peer-to-peer reviews as necessary.
Inpatient Specific Responsibilities
- Perform inpatient consultations and round on established patients daily.
- Perform comprehensive H&Ps for new patients and episodic histories for established inpatients.
- Review and interpret diagnostic tests.
- Order additional tests as appropriate.
- Order therapeutic interventions as appropriate.
- Perform bedside care, including wound and drain care, in accordance with the collaborative practice agreement.
- Facilitate patient discharges in collaboration with case management, charge nurse, bedside nurse, physicians/APPs from other services involved in the patient’s care, and any other hospital staff involved in the care.
- Attend interdisciplinary rounds each weekday.
Procedures
- Common procedures performed on HPB Surgery
- Wound Care
- I&D
- Drain removal
Position Qualifications
- Education Requirements:
- Graduation from an accredited Adult Gerontology Acute Care NP or PA program.
- A master's degree is required.
- Licensure/Certification
- Current license to practice as a NP or PA in North Carolina.
- PA: Certification from the National Commission on Certification of Physician Assistants preferred. Current or pending CAQ certification preferred.
- NP: Certification from the American Nurses Credentialing Center or The American Association of Critical Care Nurses required.
- Current prescriptive privileges and DEA license required.
- Work Experience
- Must have at least 1 year of experience as an APP
- Preference will be given to applicants with experience in Hepatobiliary Surgery
- Experience in a surgical practice preferred.
- BLS for healthcare provider from AHA required.
- Demonstrates appropriate critical thinking and interpersonal skills when working in a fast-paced, high acuity work environment. Able to perform thorough history and physical assessment. Also, able to evaluate, assess, and monitor other co-morbid medical conditions.
Minimum Work Requirements
- Current MWR:
- Five days per week, 8-hour shifts. Mix of clinic and inpatient hospital coverage.
- One weekend per month on- call for possible weekend coverage
- The minimum work standard is subject to change to meet the needs of the practice.