Nurse Practitioner or Physician Assistant - Inpatient Pain Mngt Service

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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 Inpatient Pain Service Advanced Practice Provider (NP or PA-C) provides direct patient care services to patients admitted to Duke University Hospital or within Duke Clinics for all age groups (adult and occasionally pediatrics) in collaboration with the attending physician, fellows, resident and APPs. The NP or PA performs physical exams, collects and documents data, conducts diagnostic and therapeutic procedures, orders and schedules laboratory studies and professional consultations, prescribes appropriate interventions and medications, coordinates the care and discharge of patients, may assist in the operating room and provides direct patient care services.  The Nurse Practitioner or Physician Assistant contributes to excellence in patient care, research, teaching and provides leadership in the organization.  This position has no operating room responsibilities.

Procedures performed by IPS APP Team:

• Epidural Removal
• Peripheral Nerve Catheter Removal
• Pain Catheter Repair
• Bolus via CADD Pump
• Bolus Epidural Catheter with Fentanyl
• Attach and manage the Nimbus Pump
• Change Dressing over Pain Cather Site

Job Duties and Responsibilities include but are not limited to the following:

• In collaboration with attending surgeon(s) and/or 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 hospitalist supervising physician or back up physician who is either on site or available by pager.
• Collaborate with the chief resident, residents, fellows, attending other NP/PA colleague’s nurses, and patient resource managers 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 until physician support arrives.
• 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 so as 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, resident and/or intern at the end of the shift

Job Eligibility Requirements

Education

NP:        Graduate of accredited Nurse Practitioner program, acute care preferred but will consider other adult NPs in conjunction with relevant experience.

PA:        Graduate of ARC accredited Physician Assistant program

Certification

NP:        ACNP or AGACNP preferred, will consider AGNP and FNP with relevant experience

PA:        PA-C

Licensure  

NP:        Current unrestricted RN license issued by or recognized by the NCBON with approval to practice as a NP.

PA:        Current unrestricted medical license issued by the NCMB with approval to practice as PA.

Both:     Federal and State DEA prescriptive authority

Experience

Experience in medical/surgical management as an advanced practice provider for at a minimum of 1 years is preferred, but not required.

Physical and mental requirements:

• Able to clearly articulate scope of practice, and practices within those guidelines as a Nurse Practitioner / Physician Assistant
• 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

This position covers NIGHT shift only, working 12-hour shifts (6pm-6am, Monday – Saturday). Schedule is made in collaboration with other APP team members. Some weekend and holiday coverage is required.

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.