Advanced Practice Provider - Pediatrics Neurosurgery

Position Summary

Department: Arnold Palmer Hospital - Pediatrics Neurosurgery 

Position Type: Inpatient 

Orlando Health Arnold Palmer Hospital for Children provides comprehensive care to pediatric patients across a wide range of specialties. The Pediatric Neurosurgery team is seeking a full-time Advanced Practice Provider (APP) to join its collaborative and multidisciplinary team. This role includes inpatient, outpatient, surgical, and trauma call coverage to meet the needs of pediatric neurosurgical patients.

Position Summary:

The Pediatric Neurosurgery APP works in close collaboration with supervising physicians and APP colleagues to co-manage pediatric neurosurgical patients across various care settings. Responsibilities include inpatient management, outpatient clinic visits, surgical first-assist duties, and trauma call coverage. Care is delivered according to established practice guidelines and evidence-based standards to ensure high-quality outcomes.

Responsibilities

Inpatient Coverage

APP conducts daily rounds, writes progress notes, admissions, consults, and discharge summaries. They complete pre-admissions and history and physicals for surgical patients, serve as the first point of contact for nursing questions, and respond to floor, emergency room, and trauma consults. The APP communicates care plans to the medical service, enters daily charge notes, educates patients and families at discharge, arranges follow-up appointments, and writes prescriptions. Bedside procedures performed include shunt reprogramming, shunt and reservoir taps, ventricular taps, and insertion or removal of external ventricular drains (EVDs) and intracranial pressure (ICP) monitors.

Operating Room Coverage

APP prepares and positions patients for surgery, ensures necessary equipment and surgical navigation systems are ready, and follows neurosurgical bundle protocols. They assist in surgery, demonstrating proficiency in knot tying, multilayer closures, skin closures, and removal of fixation pins. Postoperative responsibilities include applying dressings and head wraps, writing admission orders and notes, completing medication reconciliation, and transporting patients to the post-anesthesia care unit (PACU) or intensive care unit (ICU). The APP performs postoperative exams, reviews diagnostic studies and lab results, and ensures proper function of EVDs, lumbar drains, and ICP monitors. They remain available for bedside procedures and assist with other clinical roles as needed.

Outpatient Coverage

Manage the daily APP clinic, which encompasses annual follow-ups, new patient visits, and postoperative exams. The APP rotates through specialty clinics such as Head Shape, Spina Bifida, Spasticity, Brachial Plexus, Neuro-oncology, and satellite clinics. They are available for walk-ins and same-day appointments, conduct peer-to-peer reviews, respond to patient calls, write letters of medical necessity, and review labs and imaging. The APP coordinates pre-admissions and schedules pre-surgical stealth imaging. Outpatient procedures include baclofen pump refills and reprogramming, shunt reprogramming and taps, and wound care.

Night and Weekend Coverage

Trauma call is provided on a rotating basis with other APPs, including overnight and weekend shifts. Coverage includes weekdays from 4:00 PM to 7:00 AM and weekends from Friday 7:00 AM to Monday 7:00 AM. The APP is expected to respond in person for urgent consults, admissions, and surgical cases. They serve as the first call for nursing questions, consults, parent calls, and emergency and trauma evaluations. Additional compensation is provided for weekend and night coverage. Restricted call coverage may be implemented in the future based on clinical needs.

Quality Improvement, Research & Education

Each APP is expected to participate in a quality improvement initiative, research project, or educational activity with guidance from supervising physicians or senior APPs. Educational responsibilities include attending Tumor Board and Epilepsy Conference, participating in quarterly Journal Club, and attending at least one neurosurgical CME conference annually.

Operations

Operational duties include attending neurosurgical provider meetings, staff meetings, and neuroscience department meetings. APPs are encouraged to participate in surgical department meetings, Surgical PIPS reviews, and APP council meetings.

Paid Time Off (PTO)

Requests for PTO must be made at least 30 days in advance according to OH policy. However, operational needs may require additional notice. PTO requests are granted on a first come first serve basis.

Holiday Coverage

Holiday coverage is rotated equally among APPs and includes four minor holidays—Easter, Memorial Day, July 4th, and Labor Day—and three major holidays—Thanksgiving, Christmas, and New Year’s.

Work Hours

The schedule requires seven APPs to provide 24/7 coverage. Weekday operations require four APPs to cover the operating room, clinic, inpatient care, and a float role. Night shifts and weekend coverage are rotated among the team.

Qualifications

Education/Training

Candidates must be graduates of an accredited Physician Assistant program or hold an MSN or DNP from an accredited nursing school. APRNs must have Acute Care Certification. RNFA certification is not required but preferred.

Experience

Preferred qualifications include two years of experience in pediatric or general surgery. Neurosurgical experience is a plus but not required. Fellowship training in Surgery, Critical Care, Trauma, or Emergency Medicine is desirable

Licensure/Certification

Applicants must hold a current Florida PA or APRN license with prescriptive authority. National certification through NCCPA (for PAs) or the appropriate APRN board is required. Current certifications in BLS, ACLS, and PALS are also required.