Critical Care Advanced Practice Provider

Critical Care APP Intensivist

Job Summary

The Critical Care Advanced Practice Provider (APP) is a member of the intensive care team and his/her primary responsibility is the management of a caseload of critically ill complex (multi-organ) patients in an intensive care setting. The APP is under the direct supervision of the ICU supervising physician or designated back-up physicians. The APP performs physical exams, collects and documents data, conducts approved diagnostic and therapeutic procedures, orders and schedules laboratory studies and professional consultations, prescribes appropriate interventions and medications, and provides direct patient care services in a specific ICU. The APP contributes to excellence in patient care, research, teaching, consulting, and provides leadership to the organization and to the APP profession.

Job Hours

Rotating 12 hours shifts, includes dayshift, nightshift, weekends and holidays.  Fourteen (14) shifts per month.

Job Duties and Responsibilities

• Provide direct clinical services for critically ill adult patients with multi-organ trauma or multi-system disease /failure, according to established protocols
• Utilize evidence-based clinical practice standards under the supervision of the ICU supervising physician.
• Obtain patient health histories and complete physical examinations.
• Document findings, noting pertinent normal and abnormal findings.
• Order and interpret appropriate diagnostic and laboratory tests.
• Explain the necessity, preparation, nature and anticipated effects of procedure(s) to patients, patient's family, staff, and healthcare learners .
• Perform approved therapeutic or diagnostic procedures based upon patient's clinical status.
• Document patient preparation and response to procedure(s).
• Formulate and implement treatment plan for acute illness management in collaboration with the designated primary supervising physician and/or attending back-up physician(s).
• Document in medical records and appropriate narrative summaries.
• Utilize prescriptive privileges as allowed by NC licensure.
• Document all prescriptions in patient's medical record.
• Assess patient for change in status and institute appropriate interventions.
• Initiate necessary emergency interventions to stabilize patient.
• Provide family-centered care by communicating with the family regarding the changing health care needs of their family member.
• Assess family adaptation, coping skills and the need for crisis or other intervention.
• 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 documenting and reporting patient outcomes including toxicities or adverse events.
• Perform and participate in quality/performance improvement activities and clinical research.
• Serve as a clinical expert and leadership consultant to members of the healthcare team and to the larger community.
• Participate in and support accreditation, compliance, and regulatory activities of the organization.
• Identify educational needs of the family and participate in teaching opportunities.
• Assess educational needs, plan, provide, and evaluate educational programs for nursing staff, interdisciplinary healthcare team, and community.
• Precept physician assistant students and other new healthcare learners.
• Participate in the development, review, and evaluation of critical care medical management practice protocols within legal guidelines incompliance with DUHS policies.
• Role model professionalism through conduct, appearance, communication, mutual respect, leadership, ethical decision-making, critical thinking, and problem-solving skills.
• Demonstrate responsibility for professional practice through active participation in professional organizations and continuing education.
• Enhance the body of knowledge to the APP profession or other areas of specialization through exchange of ideas and knowledge in professional organizations, oral presentations, posters, research activities, and written publications.

Job Eligibility Requirements

Education

PA:        Graduate of ARC accredited Master’s Degree or DSc Physician Assistant Program preferred

NP:        Graduate of an accredited MSN or DNP Acute Care Nurse Practitioner Program for adults

Certification

PA         PA-C

NP         AGACNP or ACNP

License                                   

PA:        Current and unrestricted Medical License issued by NCMB with authorization to practice as PA

NP:        Current and unrestricted RN License issued by or recognized by the NCBON with authorization to practice as NP

Both:    Federal and State DEA prescriptive authorization

Experience

PA         1+ year critical care PA experience preferred but will consider new grad with relevant PA electives or clinical background

NP         1+ year critical care NP experience preferred but will consider new grad with 2+ years’ critical care RN experience

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

Rotating 12 hours shifts, includes dayshift, nightshift, weekends and holidays.  Fourteen (14) shifts per month.

Duke aspires to create a community built on collaboration, innovation, creativity, and belonging. Our collective success depends on the robust exchange of ideas—an exchange that is best when the rich diversity of our perspectives, backgrounds, and experiences flourishes. To achieve this exchange, it is essential that all members of the community feel secure and welcome, that the contributions of all individuals are respected, and that all voices are heard. All members of our community have a responsibility to uphold these values.

Essential Physical Job Functions: