Critical Care Nurse Practitioner - Emergency Medicine Clinical Evaluation Unit

Duke Emergency Medicine Observation Highlights

Observation Medicine at Its Best. Deliver focused, protocol-driven, top-of-scope care to patients who need short-term treatment, monitoring, and clinical decision-making in a fast-paced observation environment.

High-Impact Clinical Variety. Manage diverse conditions requiring diagnostic clarification, risk stratification, and therapeutic optimization from chest pain and syncope to heart failure, infection, and complex care coordination.

Team-Based Observation Care Model. Work closely with emergency physicians, consultants, nurses, case management, and interdisciplinary teams in a collaborative academic environment designed for safe, efficient, and high-quality observation care.

Specialized Observation Training & Support. Benefit from structured onboarding, protocol education, simulation, ultrasound training, and ongoing mentorship to build expertise in observation medicine and short-stay clinical management.

Lead Innovation in Patient Flow & Access. Participate in protocol development, throughput optimization, quality initiatives, and system-level projects that improve access, reduce admissions, and enhance patient outcomes.

Mission-Driven, Outcomes-Focused Culture. Join a high-functioning advanced practice team committed to efficient care transitions, clinical excellence, and supporting one another while delivering the right care at the right time.

Job Location

Duke Hospital, 2301 Erwin Road, Durham, NC

Job Summary

Duke Emergency Medicine is seeking Critical Care Advanced Practice Providers to join our nationally recognized team at Duke University Hospital, a premier tertiary referral center and Level I Trauma Center serving patients across North Carolina and the surrounding region. Our state-of-the-art Emergency Department is designed to support high-acuity, high-impact care and includes:

• Five adult emergency care areas supporting diverse and complex patient populations.
• Advanced, in-department CT scanners, X-ray suites, and point of care ultrasound equipment for rapid access to diagnostics.
• A 24-bed Clinical Evaluation Unit (CEU) focused on efficient ED observation and enhancing patient flow.
• A dedicated 13-bed Pediatric Emergency Department.
• A 7,000-square-foot ambulance bay supporting high-volume EMS arrivals.

At Duke, our emergency medicine team is driven by a shared commitment to delivering exceptional, patient-centered care while advancing innovation, collaboration, and clinical excellence in every encounter.

Job Duties & Responsibilities

• In collaboration with the attending physician(s), provide direct clinical services for critically ill patients according to the established protocols and utilizing evidence-based clinical practice in the Clinical Evaluation Unit.
• Perform detailed histories and physical exams on patients placed in observation.
• Develop, initiate, and manage individualized treatment plans for a broad range of acute and subacute conditions.
• Order, interpret, and act on diagnostic studies including labs, imaging, and EKGs.
• Initiate appropriate therapeutic interventions including medications, IV fluids, respiratory therapies, wound care, and other procedures within scope of practice.
• Monitor and reassess patient status throughout their observation stay to ensure clinical stability and progress toward discharge goals.
• Make timely decisions regarding patient disposition, coordinate specialty consultations, and facilitate transitions of care.
• Communicate effectively with patients and families regarding diagnosis, treatment plans, expectations, and follow-up.
• Document all clinical encounters and updates in the electronic medical record.
• Complete required admission, progress, and discharge notes in accordance with departmental protocols.
• Support the operational goals of the ED and hospital by managing observation patients efficiently.
• Assist in identifying barriers to timely discharge and proactively work to resolve them.
• Help ensure appropriate use of observation status in compliance with regulatory guidelines.
• Adhere to evidence-based clinical pathways, protocols, and institutional guidelines.
• Participate in ongoing quality improvement initiatives, case reviews, and morbidity & mortality discussions.
• Promote a culture of safety, respect, and accountability within the unit.
• Stay current with developments in emergency and observation medicine through CME, journal review, and departmental education sessions.
• Support orientation and mentoring of new APPs, residents, and students rotating through the observation unit.
• Seek opportunities to contribute to operational improvements, academic projects, or protocol development.

Job Eligibility Requirements

Education

• Nurse Practitioners: Work requires completion of an accredited Nurse Practitioner program, with a Master's degree in Nursing. Critical Care / Acute Care NP Master's or completion of ACNP/CCNP post-Master's program strongly preferred.
• Physician Assistants: Completion of an accredited Physician Assistant program. A Bachelor's degree required; Master's degree strongly preferred.

Certification

• BLS/ACLS required.

License

• Nurse Practitioners: Must have current or compact RN licensure in the State of North Carolina. Must have a national certification as a Nurse Practitioner. Certification as an Acute Care or Critical Care Nurse Practitioner strongly preferred.
• Physician Assistants: Must be licensed as a Physician Assistant in the State of North Carolina. Must have active certification as a Physician Assistant by the National Commission on Certification of Physician Assistants (NCCPA). DEA licensure required.

Minimum Experience Requirements

• Nurse Practitioners: 1 year of experience as a nurse practitioner in an emergency medicine, observation, or critical care setting preferred.
• Physician Assistants: 1 year of experience as a physician assistant in emergency medicine, observation, or critical care setting preferred. Post-graduate training in emergency medicine, observation, or critical care preferred.

Job Hours: 12-hour rotating day/night shifts or nocturnist role available