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

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.

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

Duke University Hospital Heart Center

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 and under the supervision of 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 step‑down surgery patients at Duke Hospital being followed primarily in the Cardiothoracic Step‑down setting but also throughout Duke Hospital and clinic through established protocols and under the supervision of the cardiothoracic surgeon or back‑up supervising physician who is either on site or 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. Initiates emergency interventions in an effort to stabilize the patient until physician support arrives.
• Preoperative evaluation; including (but not limited to) 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 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 patient’s 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 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 models 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.

• Federal and State DEA with unrestricted prescriptive authority

• PA: 1 year’s…