Nurse Practitioner or Physician Assistant

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About Duke University Hospital

Pursue your passion for caring with Duke University Hospital in Durham, North Carolina, which is consistently ranked among the best in the United States. The largest of the four Duke Healthhospitals with 1062 patient beds, it features comprehensive diagnostic and therapeutic facilities, including a regional emergency/trauma center, an endo-surgery center, and more.

Duke University Hospital

Center for Advanced Practice

Job Description 

Nurse Practitioner or Physician Assistant – Pediatric Cardiothoracic Surgery

Job Location – Duke University Hospital, Children’s Hospital

Job Summary

The Duke Hospital Pediatric Cardiothoracic Surgery (CT surgery) Advanced Practice Provider (APP) provides /coordinates clinical practice for congenital cardiovascular patients. In conjunction with the Pediatric Cardiovascular and CT Surgery teams, the APP provides medical services to patients both inpatient and outpatient by collecting and documenting patient data, conducting or ordering diagnostic and therapeutic procedures, providing direct patient care services, ordering and scheduling laboratory and imaging studies, participating in surgical consultations, assisting in the operating room or on Ex-OR cases, and entering STS data. The APP contributes to excellence in patient care, research, teaching, and provides leadership to the organization.

The APP will be utilized in the management of congenital heart disease patients at Duke University Health System in the operating room and the inpatient and outpatient setting.   Practice locations include inpatient units at Duke Hospital and outpatient clinics at the Children’s Health Center. 

Job Duties and Responsibilities

Clinical Expert

• In collaboration with attending(s) and/or fellow/residents, round daily on patients to assess, diagnose, plan treatment, set priorities and realistic outcomes, and evaluate the effectiveness and cost efficiency of patient care.
• Provide and coordinate clinical care for service specific patients through established protocols and under the supervising physician or back up physician who is either on site or available by pager.
• Collaborate with the residents, fellows, attending, other APP colleagues, nurses, and other staff to formulate treatment plans and monitor patient progress.
• Perform procedures specific to the work environment after demonstrated competency and within the guidelines of scope of practice and credentialing protocols.
• Assess patients for change in status and institute appropriate interventions. Initiate emergency interventions in an effort to stabilize the patient
• Postoperative stabilization and management.
• Develop patient care pathways, protocols and guidelines for the management of specific problems in conjunction with physicians and other members of the health care team.
• Analyze clinical practice patterns to provide the best medical care and to increase effectiveness and efficiency.
• Communicate verbally and in writing all pertinent patient information to supervising MD, nursing staff, patient resource manager, home health agency, and other relevant healthcare providers.
• Document in the patients’ medical record all relevant data including but not limited to results of diagnostic tests; laboratory results; patients’ condition and response to therapies/interventions; communications with supervising MD.
• Utilize prescriptive privileges only for identified patient population.
• Prescriptive authority for prescribing, ordering, and or administering drugs; including (but not limited to) schedule II, III, IV, and V drugs and necessary medical devices.
• Role model competence in all nurse practitioner / physician assistant advanced skills.
• Give daily handoff to appropriate attending, APP, fellow, resident and/or intern at the end of the shift.
• Provide evidence base clinical care to pediatric patients cared for by the division of PCCM
• Gather pertinent information systematically and skillfully from all sources:  History, diagnostic tests, comprehensive physical exams, behavioral and developmental assessments.
• Bill appropriately for all APP services.

Educator:

• Assess educational needs of the patient-care staff and provide one-on-one as well as formal education as needed.
• Assess educational needs of the patients / families and provide culturally-sensitive patient/family education interventions as indicated.  Use non-technical language when educating patients and families.  Document all education in patients’ medical record.
• Implement and evaluate appropriate educational programs for DUHS patient care staff and other healthcare providers as appropriate.
• Role model and precept healthcare learners through contractual agreements.

Research Utilization and Investigation:

• Utilize current research and evidence-based decision-making in all clinical practice.
• Incorporate clinical research findings in the development and implementation of standards of care.
• Support IRB approved clinical research/trials though a variety of activities including but not limited to: obtaining consent; ordering diagnostic tests; recording laboratory & diagnostic results; administering therapeutic interventions; and reporting patient outcomes including toxicities or adverse events.
• Participate in interdisciplinary quality improvement and/or research activities.
• Participate in measuring and documenting outcomes.
• Identify potential areas for research

Consultant:

• Provide expertise and resource information to other healthcare providers, patients and families, and the community at large related to pediatric diseases, procedures, interventions, and conditions.
• Implement and evaluate appropriate educational programs for referring MDs
• Develop, implement and evaluate standards of care/practice guidelines/policies and procedures/care maps/protocols within area of specialization.
• Develop programs and projects in areas of expertise to facilitate the attainment of the goals and objectives of the Duke University Hospital and Duke University Health System.

Professional Leadership and Development:

• Role model advanced practice professionalism through conduct, communication, dress, leadership, ethical decision-making, critical thinking and problem solving skills.
• Participate in at least one professional organization.
• Demonstrate responsibility for professional practice through active participation in the CAP, and professional organizations.  Meet Continuing Education requirements as designated by the NC Medical Board and/or NC Nursing Board.  Maintain professional certification.
• Enhance the body of knowledge in area of specialization through written publications, oral presentations, posters, continuing education, etc.
• Maintain all professional requirements for licensure and certification
• Attend educational conferences such as Heart Center Surgical conference, cardiology lectures, and neurodevelopmental rounds
• When caring for adults with congenital heart disease, plan for situations beyond expertise, consult with and refer to other health care providers as appropriate. 

Job Eligibility Requirements

Education

NP:         Graduate of accredited MSN or DNP Acute Care Pediatric Nurse Practitioner program

PA:         Graduate of ARC accredited Master’s degree or Doctoral Degree Physician Assistant Program

Certification

NP:         PNP-AC and RN First Assist (RNFA) Certification is required

PA:         PA-C

Licensure  

NP:        Current uninhibited RN license issued by or recognized by the NCBON with authorization to practice as an NP.

PA:           Current uninhibited license issued by the NCMB with authorization to practice as a PA.

Experience

Prior experience as a Nurse Practitioner/Physician Assistant in a pediatric acute care clinical setting strongly preferred with preference for a cardiac-specific background but new graduates are welcome to apply. Prior OR experience required.

Life support:

       BLS required

       PALS required

       Recommended: ACLS

Physical and mental requirements:

• Able to clearly articulate scope of practice, and practices within those guidelines as a Nurse Practitioner / Physician Assistant in the state of North Carolina and within the Duke University Health System.
• Able to independently seek out resources and work collaboratively to solve complex problems
• Able to communicate clearly with patients, families, visitors, healthcare team, physicians, administrators, leadership, and others.
• Able to use sensory and cognitive functions to process and prioritize information, perform health assessments, treatment, and follow-up.
• Able to use fine motor skills
• Able to record activities, document assessments & interventions; prepare reports and presentations
• Able to use computer and learn new software programs
• Able to provide leadership in clinical area of expertise and in meeting organizational goals
• Able to navigate the Hospital and DUHS to provide clinical expertise to specific patient populations
• Able to withstand prolonged standing and walking with the ability to move or lift at least fifty pounds
• Able to remain focused and organized
• Able to work collaboratively with all levels of personnel

Job Hours

Primary hours will five 8-hour days throughout Monday-Friday. No call and no nights or weekends. Hours will vary in support of the clinical service needs.