Nurse Practitioner or Physician Assistant - Pediatric Abdominal Transplant Surgery

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Nurse Practitioner or Physician Assistant

Duke University Hospital

The Duke Pediatric Abdominal Transplant Surgery Advanced Practice Provider (NP or PA) provides direct patient care services for medically and surgically ill pediatric (aged 0-21 years) patients on an intensive care, intermediate and/or step-down unit or in the transplant and hepatology clinics in collaboration with residents and surgeons. There may be rare occasions for which it would be appropriate for a CPNP to provide care for a patient beyond the age of 21 for a limited/specified period of time.

Patient population includes but is not limited to both pre and post transplantation, intestinal rehabilitation, and bowel management. 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. The APP contributes to excellence in patient care, research, teaching, and provides leadership in the organization.

• In collaboration with the attending of service 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 APP colleagues, 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, APP, resident and/or intern at the end of the shift.

• Assess educational needs of the patient-care staff and provide one‑on‑one as well as formal education as needed.
• Assess educational needs of the patients/families and provide culturally‑sensitive patient/family education interventions as indicated. Use non‑technical language when educating patients and families. Document all education in patients' medical record.
• Implement and evaluate appropriate educational programs for DUHS patient care staff and other healthcare providers as appropriate.
• Role model and precept healthcare learners through contractual agreements.

• Utilize current research and evidence‑based decision‑making in all clinical practice.
• Incorporate clinical research findings in the development and…