Nurse Practitioner

Summary

Under the general supervision of the Director of Pediatrics and the Unit Chiefs (Child, Adolescent, Developmental Disabilities Unit [DDU]), the nurse practitioner uses an advanced level of clinical expertise to manage care and provide specialized services for patients and their families in our inpatient, outpatient and residential levels of care. The nurse practitioner uses established guidelines and collaborates with the physician and nursing staff to develop, implement, and/or evaluate a medical plan of care that integrates the medical and nursing disciplines.

The PNP by Rhode Island State Nurse Practice Act is an expanded role utilizing independent knowledge of physical assessment and management of health care and illness. The practice includes prescriptive privileges and collaboration with other licensed health care professionals (i.e., physicians, pharmacists, podiatrists, dentists and nurses). Brown University Health employees are expected to successfully role model the organization's values of Compassion, Accountability, Respect, and Excellence.

In addition to our values, all employees are expected to demonstrate the core Success Factors:
Instill Trust and Value Differences, Patient and Community Focus, and Collaborate.

• Collaborates with the physician and other health care professionals to develop and manage the plan of care.
• Obtains health histories and performs physical exams.
• Orders and performs diagnostic tests; analyzes and interprets results and, when appropriate, reports results to physician.
• Writes orders (must be co‑signed by the physician within 24 hours).
• Records this information on the medical record in a systematic manner, utilizing the problem‑oriented record format.
• Assists Unit Chief in completing medical record and oversees quality assurance of medical record under direction of chief.
• Diagnoses actual and potential health problems; collaborates with physician as appropriate in determining diagnosis.
• Evaluates the patient, as well as, the effectiveness, comprehensiveness and continuity of the intervention; when indicated, collaborates with physician or other health provider as necessary.
• Overall evaluation of the PMH‑NP work as a primary provider is accomplished through ongoing self evaluation, peer review and quality assurance programs, in accordance with the American Nurses Association standards pertaining to the scope of practice of the primary health care nurse practitioner.
• Evaluates the plan of care; assesses the need for modification and communicates this information to the physician and nursing staff as appropriate.
• Implements the plan of care in a safe and effective manner.
• Collaborates with the physician and other health professionals in continuing care and discharge planning.
• Assesses patient and family education needs; participates in patient and family teaching when appropriate; recommends referrals as needed.
• Serves as a consultant and educator to health care team members.
• Identifies and participates in clinical research as appropriate; applies research findings to practice.
• Maintains expertise and certification in clinical specialty; participates in and attends educational programs related to practice.
• Admits, transfers and discharges patients; obtains patient histories; performs physical exams; writes admission, transfer and discharge orders; completes inter‑agency referral forms.
• Develops a plan of care to include diagnostic tests, procedures, medications, patient education and hospital and community resources.
• Initiates, reviews and discontinues orders (co‑signed within 24 hours) for wound care and skin care, activity changes, monitoring, safety and protective measures, and medications.
• Initiates, consults and follows through with recommendations; orders appropriate laboratory tests (blood work, urinalysis, stool examinations, urine, sputum, blood, wound cultures and sensitivities).
• Orders diagnostic tests including general X‑rays, EKGs; consults with staff as needed for urgent referrals or inpatient admission.
• Liaisons with inpatient partial unit staff regarding patients in the inpatient program/partial program.
• Is responsible for the timely and…