Paramedic – Emergency Department

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Duke Health Lake Norman Hospital

Pursue your passion for caring with Duke Health Lake Norman Hospital in Mooresville, North Carolina. The smallest of the four Duke Health hospitals at 123-beds, it offers a comprehensive range of medical services, including 24-hour emergency care, cardiology, orthopedics, women's services, and surgical specialties.

Duke Nursing Highlights:

• Duke University Health System is designated as a Magnet organization
• Nurses from each hospital are consistently recognized each year as North Carolina's Great 100 Nurses.
• Duke University Health System was awarded the American Board of Nursing Specialties Award for Nursing Certification Advocacy for being strong advocates of specialty nursing certification.
• Duke University Health System has 6000 + registered nurses
• Quality of Life: Living in the Triangle!
• Relocation Assistance (based on eligibility)

Occ Summary

The Paramedic functions as an integral member of the interdisciplinary healthcare team providing direct patient care. The Paramedic performs a variety of activities across various practices settings and patient populations in accordance with the Paramedic scope of practice as defined by the North Carolina Medical Board and with the approval of the practice setting Medical Director.

Work Performed

Responsible for providing direct patient care in accordance with the Paramedic scope of practice as defined by the North Carolina Medical Board under the medical oversight of the Medical Director of the practice setting where the individual will function. Assists clinical staff in the evaluation, treatment and care of patients. Obtains pertinent history and performs a physical examination. Performs technical procedures as delegated. Monitors patients and maintains records using patient monitoring system and electronic health records. Documents patients' status, delivery of care and evaluation of the patients' response to care according to specific procedures and established protocols. Documents and maintains an informative and accurate medical record to initiate charges for each patient treated. Communicates in a professional manner essential information to all appropriate members of the healthcare team to promote sharing of information throughout the continuum of care. Operates extensive medical and mechanical equipment in the hospital and transport environment. Ensures all medical equipment is functioning; restocks medical supplies as needed. Provides and maintains a safe and therapeutic environment for the patients, visitors, and staff. Properly disposes of and handles as applicable,sharps, soiled materials, and linens and disinfects area in accordance with policy and policy as applicable. Properly uses PPE when in contact with patients, soiled utility, hazardous materials in accordance with policy. Act as preceptor and support the development of other staff and formal learners. Participate in the identification of clinical or operational performance improvement opportunities and in performance improvement activities. Supports an environment of evidence-based practice/research/quality improvement initiatives Maintain certifications and clinical skills. Performs other related duties incidental to the work described herein. Level II - Life Flight Advanced Life Support Paramedic Complete vehicle inspection and documentation each shift and complete a road test of assigned ambulance(s). Responsible for minor repairs to the unit to include but not limited to: changing light bulbs, replenishing fluids, tightening nuts and bolts, inspecting tires, etc. Responsible for daily maintenance including fueling and cleaning of vehicle. Responsible for reporting minor and major repair needs to the site specific Fleet Safety Coordinator, Clinical Team Lead, and/or Program Manager. Responsible for assisting with patient care as requested to include loading and unloading, operation of commonly used equipment and providing family members information/directions to Duke. Responsible for providing direct patient care on ALS I, ALS II or BLS transports, not to exceed beyond the scope of The Paramedic as defined by the NCOEMS and approved by local medical direction, and documenting in the electronic medical record. Responsible for replenishing oxygen and medical supplies used during transport. Demonstrates safe driving skills and ability to use technology tocomplete missions safely. Assist with continuing education outreach programs and public relations events as assigned. Provide staffing coverage to all bases as needed. Assist units within Duke University Hospital when necessary. Level III - Life Flight Critical Care Paramedic Perform all responsibilities specified for Life Flight Level II. Obtain pertinent history and perform a physical examination based on comprehensive knowledge, advanced skills and sound professional judgement. Obtain historical data from an environmental survey, attending medical personnel, patient or significant other, and existing documentation. Complete a systematic, rapid primary assessment and a prioritized secondary survey. Analyze and assess available diagnostic data. Revise plan of care as new information becomes available. Provide care in a critical care environment utilizing appropriate, timely interventions, per program protocols, in a priority sequence within scope of practice not to exceed standards set by the North Carolina office of EMS (NCOEMS) and local medical direction. Utilize Advanced Skills prioritizing the patient's needs based on potential or actual needs. (I.e. intubation, Rapid Sequence Intubation, needle decompression of tension pneumothoraces, percutaneouscricothryoidotomy, placement of intraosseous and central line). Demonstrates proficient use of advanced and basic life support equipment and maintains contact with Medical Control when necessary for protocol deviation. Communicate essential information to all appropriate members of the healthcare team. Evaluate patient progress, analyze data, and modify the planning and implementation of care based on patient response throughout the transfer process. Communicate between referring and receiving healthcareprofessionals to ensure continuity of care. Act as a liaison between patients, families, referring healthcare professionals and DUHS staff. Plan, organize and maintain equipment and supplies for use before, during and after transport. Perform inventory of transport vehicle every shift with restocking after each transport. Plan for special equipment needs for each transport. (I.e. external pacemaker, intravenous infusion pumps, intra-aortic balloon pump, isolette, baby pod). Maintain equipment repair as needed. Performs intubations (nasal, endotracheal), RSI, and needle decompression of tension pneumothoraces, percutaneous cricothyroidotomy, central line placement (EJ), and intraosseous line placement. Provide and maintain a safe environment for fellow crewmembers, the patients, assisting agencies, and ancillary personnel. Formulate research studies as needed.

Knowledge, Skills and Abilities

Knowledge of and appropriate application Paramedic scope of practice Knowledge of professional theory, practice and procedure Ability to assess needs of acute and chronically ill patients and their families Ability to independently seek out resources and work collaboratively Ability to establish and maintain effective working relationships Ability to communicate clearly with patients, families, visitors, healthcare team, physicians, administrators, leadership and others Ability to use sensory and cognitive functions to process and prioritize information, treatment, and follow-up Ability to use fine motor skills Ability to record activities, document assessments, plan of care, interventions, evaluation and re-evaluation of patient status Ability to use computer and learn new software programs Able to document and communicate pertinent information using computer and/or paper documentation tools Ability to withstand prolonged standing and walking Ability to remain focused and organized Working knowledge of procedures and techniques involved in administering routine and special treatments to patients Working knowledge of infection control procedures and safety precautions Pre-employment Physical Capacity Testing Required Must Speak English in good, understandable terms Participate in own professional development by maintaining required competencies, identifying learning needs and seeking appropriate assistance or educational offerings. Critical thinking and ability to concentrate Must be able to respond quickly to changes in patient and/or unit conditions Level II and III: Operating knowledge of ambulance/fire truck or vehicle equivalent to the Duke Life Flight ambulances. Physical Requirements Work requires walking, standing, sitting, lifting, reaching, stooping, bending, knelling, crouching/squatting, balancing, and pulling. Ability to withstand prolonged standing and walking. Must be able to lift and support the weight up to 75 pounds in handling patients, medical equipment, and supplies. Intact sense of sight, hearing, smell, and touch. Finger dexterity. Bimanual Dexterity: Requiring the use of both hands. Life Flight: Level II: Vision must be 20/40 corrected. Successful completion of post offer job testing for physical fitness. Level III Meet Level II requirements Physically fit to allow for functional movement in an aircraft or ambulance and the ability to wear the Duke approved helmet. Max weight 240 pounds fully outfitted for air crew. Max height 6'4" for air crew-See Weight Standards policy The transport environment may be indoors or outdoors in any type of weather. The air ambulance (rotor wing or fixed wing) is noisy, may experience exhaust fumes. High and low frequency vibrations are present requiring hearing protection/helmet.

Level Characteristics

Knowledge of and appropriate application Paramedic scopeof practice Knowledge of professional theory, practice and procedure Ability to assess needs of acute and chronically ill patients and their families Ability to independently seek out resources and work collaboratively Ability to establish and maintain effective working relationships Ability to communicate clearly with patients, families, visitors, healthcare team, physicians, administrators, leadership and others Ability to use sensory and cognitive functions to process and prioritize information, treatment, and follow-up Ability to use fine motor skills Ability to record activities, document assessments, plan of care, interventions, evaluation and re-evaluation of patient status Ability to use computer and learn new software programs Able to document and communicate pertinent information using computer and/or paper documentation tools Ability to withstand prolonged standing and walking Ability to remain focused and organized Working knowledge of procedures and techniques involved in administering routine and special treatments to patients Working knowledge of infection control procedures and safety precautions Pre-employment Physical Capacity Testing Required Must Speak English in good, understandable terms Participate in own professional development by maintaining required competencies, identifying learning needs and seeking appropriate assistance or educational offerings. Critical thinking and ability to concentrate Must be able to respond quickly to changes in patient and/or unit conditions Level IIand III: Operating knowledge of ambulance/fire truck or vehicle equivalent to the Duke Life Flight ambulances. Physical Requirements Work requires walking, standing, sitting, lifting, reaching, stooping, bending, knelling, crouching/squatting, balancing,and pulling. Ability to withstand prolonged standing and walking. Must be able to lift and support the weight up to 75 pounds in handling patients, medical equipment, and supplies. Intact sense of sight, hearing, smell, and touch. Finger dexterity. Bimanual Dexterity: Requiring the use of both hands. Life Flight: Level II: Vision must be 20/40 corrected. Successful completion of post offer job testing for physical fitness. Level III Meet Level II requirements Physically fit to allow for functional movement in an aircraft or ambulance and the ability to wear the Duke approved helmet. Max weight 240 pounds fully outfitted for air crew. Max height 6'4" for air crew-See Weight Standards policy The transport environment may be indoors or outdoors in any type of weather. The air ambulance (rotor wing or fixed wing) is noisy, may experience exhaust fumes. High and low frequency vibrations are present requiring hearing protection/helmet.

Minimum Qualifications

Education

Successful completion of an NCOEMS approved Paramedic Course or a United States Department of Transportation (USDOT) centered course or similar approved Paramedic Course.

Experience

Level I - Paramedic One year experience in relevant clinical areas required, Paramedic experience preferred. Level II - Life Flight Advanced Life Support Paramedic One year ALS Paramedic experience required, preferred two to three years prehospital experience with a moderate call volume (>15,000 calls/year) 911 agency. Level III - Life Flight Critical Care Paramedic Minimum of three years and current ALS experience as a Paramedic in emergency setting with a moderate to high call volume 911 agency (20,000 to 35,000 calls/year) Obtain FP-C within 2 years of hire. Weight Standards policy

Degrees, Licensures, Certifications

Current certification as a North Carolina Paramedic required for all levels. Level I BLS, ACLS, and PALS required. (Must obtain within 6 months if working in a hospital based department) Current trauma course preferred: PHTLS, BTLS or ITLS Level II Applies to Life Flight Paramedic only BLS, ACLS, and PALS, required. ITLS (or PHTLS) preferred upon hire. If not, will need to acquire within the first year. Neonatal Resuscitation Provider required within 6 months of hire. North Carolina Emergency Vehicle Driver certification or comparable. Current Class C driver's license Current three (3) year driving history absent of violations Level III Applies to Life Flight Paramedic only Satisfy all requirements of Level II Neonatal Resuscitation Provider (NRP) required CCP-C or FP-C certification required. PHTLS certification required within 1 year of hire. Specialty certification, i.e., FP-C, or CCEMTP required within 2 years of hire date if Paramedic is new to SCT transport Obtain TPATC within 24 months of hire