Critical Care Nurse Practitioner or Physician Assistant - Cardiothoracic ICU (CTICU)

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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 Duke Health's four hospitals with 1062 patient beds, it features comprehensive diagnostic and therapeutic facilities, including a regional emergency/trauma center, an endo-surgery center, and more.

Job Location

Duke University Hospital

Job Summary

The Duke Hospital Cardiac Intensive Care Unit (CICU) Advanced Practice Provider (APP) provides direct patient care services for complex, critically ill patients in the intensive care setting. Care is provided through collaboration with the attending cardiologist and multidisciplinary team.  The APP performs physical exams, collects and documents data, performs diagnostic and therapeutic procedures, including A-lines, Central lines, orders laboratory studies, partners with consultants, prescribes appropriate interventions and medications, and coordinates patient care.  The CICU APP contributes to excellence in patient care, research, teaching, and provides leadership to the organization.

Job Duties and Responsibilities

• Provide /coordinate clinical care for cardiac patients at Duke Hospital, being followed primarily in the Cardiac Intensive Care Unit setting but also throughout Duke Hospital through established protocols and under the supervision of the cardiologist and/or back-up supervising physician who is either on site or available by pager.

• Patient rounding in collaboration with attending cardiologist/Fellow, rounds daily on patients to assess, diagnose, plan treatment, set priorities and realistic outcomes, and evaluate the effectiveness and cost efficiency of cardiac patient care
• Collaborate with the chief resident, residents, and fellows to formulate treatment plans and monitor patient progress.

• Perform procedures when indicated: full list will be shared upon request or at time of interview.
• Assess patients for change in status and institute appropriate interventions.  Initiates emergency interventions to stabilize the patient until physician support arrives.
• 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 the supervising MD, nursing staff, patient resource manager, home health agency, and other relevant healthcare providers.
• Document in the patients’ chart 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 the identified patient population.
• Role models competence in all nurse practitioner/physician assistant advanced skills.

Job Eligibility Requirements

Education

NP:       Graduate of an accredited MSN or DNP Acute Care Nurse Practitioner Program for Adult Critical Care.

PA:       Graduate of an ARC-accredited Master's or Doctoral Degree Physician Assistant Program

Certification

NP:       ACNP, AGACNP (no other APRN certifications will be considered)

PA:       PA-C

License

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

PA:       Unrestricted medical license issued by the NCMB with authorization to practice as a PA

Both:    Federal and State DEA with unrestricted prescriptive authority

Experience

• Rotation in a high-acuity ICU unit as a student is required
• Critical Care Fellowship Training preferred
• 1+ years’ APP experience in a high acuity CICU/Critical care setting is preferred

Physical and mental requirements:

• Able to clearly articulate the scope of practice and practices within those guidelines as an NP/PA in the state of North Carolina and within the Duke University Health System (DUHS)
• 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, and interventions; prepare reports and presentations.
• Able to use a computer and learn new software programs
• Able to provide leadership in the 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 be 12-hour rotational shifts / 7 days per week, including holidays.

A Permanent Nights option is also available.

Duke is an Equal Opportunity Employer committed to providing employment opportunity without regard to an individual's age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex (including pregnancy and pregnancy related conditions), sexual orientation or military status.

Duke aspires to create a community built on collaboration, innovation, creativity, and belonging. Our collective success depends onthe 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: Certain jobs at Duke University and Duke University Health System may include essential job functions that require specific physical and/or mental abilities. Additional information and provision for requests for reasonable accommodation will be provided by each hiring department.