Critical Care Nurse Practitioner or Physician Assistant - Cardiothoracic Step Down Unit

Critical Care Nurse Practitioner or Physician Assistant - Cardiothoracic Step Down Unit

Requisition Number: 269590

Regular or Temporary: Regular

Location: Duke University Hospital Heart Center, Durham, NC, 27710

Job Summary: The Duke University Hospital Cardiothoracic (CT) Surgery Step-Down Unit (SDU) Advanced Practice Provider (APP) provides direct patient care services for complex critically ill cardiothoracic surgery and advanced heart failure patients in collaboration with the cardiothoracic surgeon(s) and medical director of the CT SDU. 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 the care and discharge of patients, and provides direct patient care services.

• Provide / coordinate clinical care for cardiothoracic stepdown surgery patients at Duke Hospital, primarily in the Cardiothoracic Step-down setting but also throughout Duke Hospital and clinic via established protocols and under the supervision of the cardiothoracic surgeon or backup supervising physician available by pager (including the OR, PACU, Step-down units, all inpatient units, ER and clinic setting).
• In collaboration with attending cardiothoracic surgeon(s) round daily on patients to assess, diagnose, plan treatment, set priorities and realistic outcomes, and evaluate the effectiveness and cost efficiency of cardiothoracic patient care.
• Collaborate with residents, fellows and attendings to formulate treatment plans and monitor patient progress.
• Assess patients for change in status and institute appropriate interventions; initiate emergency interventions to stabilize the patient until physician support arrives.
• Preoperative evaluation; establishing diagnosis and baseline status.
• 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 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 health‑care providers.
• Document in the patient’s chart all relevant data including diagnostic test results, laboratory results, patient condition and response to therapies/interventions, and communications with supervising MD.
• Utilize prescriptive privileges only for identified patient populations.
• Prescriptive authority for prescribing, ordering, and/or administering drugs, including schedule II, III, IV, and V drugs and necessary medical devices.
• Model competence in all nurse practitioner/physician assistant advanced skills.

PA:
Graduate of an ARC-accredited Physician Assistant (PA) program. Master’s degree or Doctoral required.

NP:
Graduate of an accredited MSN or DNP Acute Care Nurse Practitioner (NP) program for adult care.

PA: PA‑C

NP: ACNP or AGACNP

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

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

Both:
Federal and State DEA with unrestricted prescriptive authority.

PA: 1 year’s experience as a PA in a relevant clinical area preferred.

NP: 1‑year NP experience or 2+ years RN experience in a cardiovascular or cardiothoracic surgery unit is preferred.

* Will consider a new graduate with prior CTICU/CVICU or CTSD RN experience.

• Able to clearly articulate scope of practice and practice within guidelines as a Nurse Practitioner / Physician Assistant in North Carolina.
• Able to independently seek resources and collaborate to solve complex problems.
• Able to communicate clearly with patients, families, visitors, health‑care team, physicians, administrators, leadership, and others.
• Able to use sensory and…