Nurse Practitioner or Physician Assistant - Orthopedic Surgery Hospitalist

At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together.

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 Orthopedic Advanced Practice Provider (APP) provides direct patient care services to Orthopedic patients for the adult patient population in collaboration with the attending physicians, fellows, residents and other APPs.  The APP 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 care, and provides direct patient care services. The APP contributes to excellence in patient care, research, teaching, and provides leadership to the organization.

•             95% inpatient floor coverage, up to 5% of clinical effort in clinic (ortho trauma patient population only)

•             Potential operating room responsibilities (total knee/hip cases including primary and revision)

•             No on-call responsibilities

•             Includes adult patient populations covering all Orthopedic sub-services patient including total joint, trauma, tumor, sports, foot & ankle, etc.

Job Duties and Responsibilities

• 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 backup physician who is either on-site or available by pager.
• Collaborate with the chief resident, residents, fellows, attendings, other NP/PA colleagues, nurses, and patient resource managers to formulate treatment plans and monitor patient progress.
• Order and interpret appropriate diagnostic and laboratory tests.
• Perform procedures specific to the work environment after demonstrating competency and within the guidelines of the scope of practice and credentialing protocols. Document patient preparation and response to procedure(s).    Procedures (include but are not limited to):
  • Wound care including wound vac management
  • Operating room assisting
  • Intra-articular injection
  • Casting/splint management

• Assess patients for change in status and institute appropriate interventions.  Initiate emergency interventions to stabilize the patient until 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 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 patient’s medical record all relevant data including but not limited to results of diagnostic tests; laboratory results; patients’ condition and response to therapies/interventions; and communications with the supervising MD.
• Utilize prescriptive privileges for identified patient populations.
• 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 the appropriate provider at the end of the shift
• Provide family-centered care by communicating with the family regarding the changing healthcare 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.
• Identify the 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 APP students and other new healthcare learners.
• Participate in the development, review, and evaluation of medical management practice protocols within legal guidelines in compliance 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 the exchange of ideas and knowledge in professional organizations, oral presentations, posters, research activities, and written publications.

Job Eligibility Requirements

Education

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

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

Certification

PA:         PA-C

NP:         Adult providers, e.g., FNP, ACNP, AGACNP, AGNP, etc. 

License

PA:         Current unrestricted medical license issued by NCMB with authorization to practice as PA

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

Both:     Federal and State DEA prescriptive authorization

Experience

• Strongly prefer candidate with 1+ year Orthopedic APP 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 teams, physicians, administrators, leadership, and others.
• Able to use sensory and cognitive functions to process and prioritize information, and 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 a computer and learn new software programs.
• Able to provide leadership in clinical areas 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 is a FULL TIME, SALARIED POSITION with primarily 12-hour shifts (14 shifts / month)

• This includes occasional weekend, holiday and rare nighttime coverage (on average 9 Sunday nights per year).
• Schedule may be modified by the clinical or leadership team to fit clinical needs of the service.
• No on-call responsibilities

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.