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Nurse Practitioner/Physician Assistant- Critical Care- FT Nights- VUMC|
JOB CODE INFORMATION:
- Title: Nurse Practitioner, Acute
- Job Code: 6628
- Title: Nurse Practitioner, Acute
- Job Code: 6628
The nurse practitioner (NP) within the acute care hospital setting works in collaboration with, and is an integral member of, a multidisciplinary health care team. The NP functions primarily as a hospitalist in an inpatient setting, managing the care of acute/complex chronically ill patients. The NP is typically on a service aligned team managing the patient care from step down to discharge. The NP may have responsibilities for same patient population during follow up outpatient visits. The NP has a strong foundation in evidenced based practice/education and provides an environment of safe quality care. The NP demonstrates an advanced level of medical and nursing knowledge, clinical/technical competence, sound clinical judgment, professional communication skills, timely and compliant documentation, and is responsible for professional development and competency validation.
- Assessment of Health Status
- Performs and documents in the medical record a complete history and physical examination for acute and complex chronically ill patients.
- Orders and collects data using appropriate assessment techniques, relevant supporting diagnostic information and diagnostic procedures where indicated.
- The nurse practitioner may serve as the first responder for both nursing and house staff in the event of patient status changes, orders, and in situations requiring procedural and resuscitative interventions.
- Assesses for risks associated with the care of the acute and complex chronically ill patient including: medication side effects, immobility, impaired nutrition, fluid and electrolyte imbalance, immunocompetence, invasive interventions and diagnostic procedures.
- Coordinates daily rounds with the Attending physician teams, presents 24 hour patient report, collaborates in plan of care, and follows assigned patient population throughout the day.
- Collaborates with interdisciplinary health care team in making diagnoses of acute and complex chronic conditions.
- Manages diagnostic tests through ordering, interpretation, performance, and supervision.
- Formulates differential diagnoses by priority.
- Diagnoses complications and orders appropriate interventions
- Formulates Plan of Care
- Identifies expected outcomes from diagnosis, and formulates and documents a plan of care to address complex acute and chronic health care needs.
- Utilizes evidenced based practice guidelines or protocols in an individualized, dynamic plan of care that can be applied across the continuum.
- Implements and modifies plan of care
- Prescribes diagnostic strategies and therapeutic interventions both pharmacologic, non-pharmacologic and surgical, needed to achieve expected outcomes.
- Manages further diagnostic tests through ordering, interpretation, performance, and supervision.
- May perform advanced procedures consistent with privileges and competency validation including minor suturing, complex wound management, line and tube placements and removals.
- Communication and Collaboration
- Maintains ongoing communication and collaboration with interdisciplinary health care team .
- Facilitates and communicates with patient, family and staff to promote continuity of care across the inpatient and outpatient continuum of care.
- Documents/dictates key components of patient's progress via daily progress note, transfer, and discharge summary , and or clinic note where applicable. (h&p, daily progress notes, plan of care, problem lists, procedure notes, acute event note, discharge summaries, in medical record per specific patient unit or service, death summary)
- Documentation is timely, meets acute care compliance standards and captures patient acuity.
- Professional Practice
- Demonstrates Professional Practice behaviors including: preceptor/mentoring, education and instruction of students, nursing staff, nurses, graduate and novice nurse practitioners.
- Seeks opportunities for active engagement in research and the analysis of evidenced based practice.
- Actively participates in Grand Rounds, APN council meetings, faculty and unit meetings, M&M presentations.
- Maintains CEUs, and membership in a professional organization.
Qualifications & Requirements
Master's Degree (or equivalent experience) and < 1 year experience. 12 months of nursing experience preferred; Inpatient acute care advanced practice nursing experience desirable.
Licensure, Certification, and/or Registration (LCR):
- Registered Nurse Required
Additional Qualification Information:
- Prefer National Specialty Board Certification, TN APN certificate/certificate of fitness to prescribe, eligible for DEA
Physical Requirements/Strengths needed & Physical Demands:
- Occasional: Sitting: Remaining in seated position
- Occasional: Standing: Remaining on one's feet without moving.
- Occasional: Walking: Moving about on foot.
- Occasional: Lifting under 35 lbs: Raising and lowering objects under 35 lbs from one level to another
- Occasional: Push/Pull: Exerting force to move objects away from or toward.
- Occasional: Bending/Stooping: Trunk bending downward and forward by bending spine at waist requiring full use of lower extremities and back muscles
- Occasional: Crawling:Moving about on hands and knees or hands and feet.
- Occasional: Reaching below shoulders: Extending arms in any direction below shoulders.
- Occasional: Handling: Seizing, holding, grasping, turning or otherwise working with hand or hands.
- Occasional: Vision: Clarity of near vision at 20 inches or less and far vision at 20 feet or more with depth perception, peripheral vision, color vision.
- Frequent: Noise: May include exposure to occupational noise levels which equal or exceed an 8-hr time-weighted average of 85 decibels, requiring enrollment in VUMC's Hearing Conservation Program which includes training, use of hearing protection, and periodic audiometry.
- Continuous: Communication: Expressing or exchanging written/verbal/electronic information.
- Occasional: Chemicals and Gasses: Medications, cleaning chemicals, oxygen, other medical gases used in work area.
- Occasional: Pathogens: Risk of exposure to bloodborne pathogens and other contagious illnesses.
- Occasional: Radiation: May be exposed to occupational radiation, requiring enrollment in VUMC's Radiation Safety Program which includes training, use of personal protective equipment with lead shielding, and personal dose monitoring.
- Occasional: Climate: Ability to withstand exposure to atmospheric extremes including heat, cold, humidity, and barometric pressure changes.
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