Nurse Practitioner-Surgery-Cardiac

Nurse Practitioner

Kaweah Health is a publicly owned, community healthcare organization that provides comprehensive health services to the greater Visalia area in central California. With more than 5,000 employees, Kaweah Health provides state-of-the-art medicine and high-quality preventive services in our acute care hospital, specialized health centers and clinics. Our eight-campus healthcare district has 613 beds and offers comprehensive health services across a broad continuum of care.

The Nurse Practitioner is dedicated to enhancing the health and well-being of patients/families, nurses and the healthcare system by positively influencing patient outcomes utilizing evidence-based practice and promoting excellent bedside practice through collaboration, leadership and mentoring. Supports the Cardiothoracic Surgery program at Kaweah Health by providing and coordinating resources for inpatient, intraoperative, and outpatient care for patients being managed by this service.

Job Description

Qualifications

License/Certification Required:

CA Nurse Practitioner (NP) and CA Nurse Practitioner Furnishing Number

Drug Enforcement Administration (DEA) registration

CA RN license

BLS

ACLS

Preferred:

National Nurse Practitioner certification from American Academy of Nurse Practitioners (AANP) or American Nurses Credentialing Center (ANCC).

Completion of a recognized RNFA training program

Education

Preferred: MSN or DNP Experience Required: One year of recent RN specialty experience in an adult, critical care, or medical-surgical setting. Preferred: One year of recent practice as a Nurse Practitioner with an emphasis in adult assessment and management of medical and/or surgical conditions and/or clinical experience in Surgery-Cardiac or Cardiothoracic ICU setting. Knowledge/Skills/Abilities

Must complete credentialing through Medical Staff Interdisciplinary Practice Committee. Excellent written and oral communication skills and effective interpersonal relationships. Critical thinking, creative thinking, and creative skill in problem solving. Computer literate.

Job Responsibilities Essential

Uses knowledge and assessments of patients to design, implement and evaluate plans of patient care related to specialty area. Uses advanced theoretical and empirical knowledge of physiology, pathophysiology, pharmacology, and health assessment:

Manages populations with disease states and non-disease based etiologies to improve and to promote health care outcomes.

Collaborates with the interdisciplinary team on most complex patients within specialty area on a consistent basis.

Focuses on population health management across the care continuum.

Collaborates between the medical staff, nursing unit and ancillary departments to facilitate problem-solving. Designs, implements, and evaluates innovative individual and/or population-based programs of care to achieve high quality, cost-effective outcomes:

Provides relevant patient instruction and education.

Coordinates patient care including ordering, interpreting, and evaluating laboratory tests and radiographic studies to expedite treatment. Follows up on all abnormal findings.

Orders transfers within the hospital or to other facilities to the appropriate level of care.

Consults with medical staff, medical residents, nursing, case management, social work and clinical documentation staff as needed to meet documentation and throughput goals.

Completes history and physical or medical screening exam, discharge summary/instructions and provides patient prescriptions as indicated to enhance throughput.

Documents the necessary components in the medical record to meet documentation standards for the assigned DRG or APR-DRG, including appropriate patient status and level of care.

Documents and orders the necessary components to meet CMS, core measure and Value-Based purchasing requirements. Serves as a leader/consultant/mentor/change agent in advancing the practice of nursing among other nurses and across organizations to achieve outcomes:

Utilizes direct clinical practice to consult, educate, coach, and mentor staff nurses in achieving optimum patient outcomes.

Serves as a change agent in health care settings by developing high-quality health care standards, assisting in the implementation of standards, order sets, clinical pathways, and facilitating goal setting while measuring achievements, and evaluating outcomes. Advances nursing practice through innovative evidence-based interventions, best-practice guidelines, and modification of professional standards and organizational policies that direct the care of nursing personnel and other providers of healthcare to improve outcomes. Evaluates the standards of clinical practice with all appropriate disciplines in the specialty area:

Uses clinical inquiry and research in an advanced specialty area of practice.

Promotes use and understanding of evidence based practice.

Reviews standards of practice and national guidelines for specialty area to determine appropriateness and to reflect current nursing clinical practice. Leads multidisciplinary groups to facilitate collaboration with other disciplines in the attainment of outcomes across the continuum of care:

Performs consultative functions.

Provides clinical expertise and makes recommendations to physicians, other health care providers, patients, and health care organizations.

Attends appropriate Medical staff committees.

Completes and maintains appropriate procedural training for the population being served (i.e. Cardiac Stress Testing).

When performing RN-First Assist duties:

Assists on all cardiovascular surgical procedures as directed by the surgeon.

Functions as the first assistant at surgery in the general and obstetric surgical suites.

Assists the surgeon by providing intraoperative tissue retraction.

Assists with intraoperative hemostasis.

Assists with intraoperative tissue manipulation. Uses surgical instruments and suture material to manipulate tissue as directed by the surgeon.

Assists with intraoperative wound closure. Sutures tissue, using instruments and suture material as directed by the surgeon.

Preoperative- assists with: review of procedure prior to the case; opening and set up of the operating room suite; either preoperative counts or patient assessment as coordinated with the circulating RN; transfer of the patient to the OR bed; anesthesia induction if requested to do so by the circulating RN; and positioning the patient for the surgical procedure.

Interoperative- scrub in and assist in the draping of the patient; assist the surgeon within the parameters of standardized procedures; and assist in counts as needed.

Postoperative- assists with: the application of the patient's dressings; transfer from the OR bed; accompany the patient to the PACU if required; and clean up and turn over of the operating room.

Assists with specialty procedures including minimally invasive vein/arterial harvesting, closure of deep fascia layer, insertion of invasive monitoring lines and cardiac sternal wound closure.

When assisting with RN Circulator duties:

Assesses basic patient needs, including recognition of abnormal diagnostic data, and potential problems related to the proposed surgical intervention and communicates appropriate information to the physician and other members of the surgical team.

Provides the ability to modify assessment criteria based on the age of the patient, psychosocial and physical needs.

Implements patient's plan of care by evaluating patient's response to care. Organizes and adjusts assignments according to patient's needs.

Facilitates patient transfer to appropriate postoperative unit, ensuring patient safety and communication with receiving patient care staff.

Demonstrates understanding in use of patient care equipment and instrumentation. Responsible for knowledge of emergency equipment and supplies, including the crash cart, airway management cart, and the malignant hypothermia cart. Timely written referral of any malfunctioning or defective equipment.

Assures that all medications are administered properly 100% of the time, including IV's as prescribed by physician; knows actions, indications, precautions, adverse reactions, dosage and route of administration on all drugs before administering to the patient.

Maintains clear communication and rapport with patient/family as appropriate for setting. Gives and documents emotional support and keeps patient/family informed of progress.

Assures that patient's personal hygiene needs are met, immediate environment is clean and safe.

Maintains a current and complete medical record. Coordinates admission, transfer and discharge of patient with appropriate personnel and documents observations, assessment treatments and outcome as necessary.

Cardiac Cath Lab also responsible for:

Coordinates overall clinical program and ensures processes are in place to assure smooth operations and patient flow for the clinical activities of cardiology services specific to heart valve devices (TAVR).

Develops and implements required elements of an effective clinical program such as:

Develops methods to ensure prompt access to care.

Ensures processes are in place to provide coordinated patient flow across Physicians clinical sites.

Develops collaborative partnerships with inpatient and outpatient facilities implementing the heart valve device.

Develops & implements clinical guidelines.

Aligns EMR to support care delivery.

Facilitates establishment of clinical trial protocols at all sites in partnership with the Valve Consortium.

Provides program and clinical input