Pediatric Nurse Practitioner or Physician Assistant - Heart Center Fellowship

Pediatric Nurse Practitioner Or Physician Assistant - Pediatric Heart Center Fellowship

The Duke Pediatric Heart Center Advanced Practice Provider (NP or PA-C) Fellowship rotates through clinical settings in the pediatric heart center which includes inpatient and outpatient locations. There will be heavy emphasis in the pediatric cardiac intensive care unit (PCICU), PICU, and pediatric cardiac stepdown. The APP Heart Center fellow will work alongside APPs and MDs to provide direct patient care services for newborn congenital heart, surgical, and medically ill pediatric heart center patients from birth to young adults at Duke University Hospital or in the clinics in collaboration with APPs, cardiologists, and surgical physicians.

The APP Fellow 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 Fellow contributes to excellence in patient care, research, teaching, and learns to provide leadership in the organization.

Job duties and responsibilities include:

• Clinical expert: In collaboration with cardiology attendings, PCICU attendings, surgeon(s) and/or APPs, 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 residents, fellows, attending other NP/PA colleague's 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 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 APP, attending, resident and/or intern at the end of the shift.
• Educator: 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 pre and post-op/procedure 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.
• Research Utilization and Investigation: Utilize current research and evidence-based decision-making in all clinical practice.
• Incorporate clinical research findings in the development and implementation of standards of care.
• Support IRB approved clinical research/trials though a variety of activities including but not limited to obtaining consent, ordering diagnostic tests, recording laboratory & diagnostic results, administering therapeutic interventions, and reporting patient outcomes including toxicities or adverse events.
• Participate in interdisciplinary quality improvement and/or research activities.
• Participate in measuring and documenting outcomes.
• Consultant: Provide expertise and resource information to other healthcare providers, patients and families, and the community at large related to cardiothoracic diseases, procedures, interventions, and conditions.
• Implement and evaluate appropriate educational programs for referring MDs
• Develop, implement and evaluate standards of care/practice guidelines/policies and procedures/care maps/protocols within area of specialization.
• Develop programs and projects in areas of expertise to facilitate the attainment of the goals and objectives of the Duke University Hospital and Duke University Health System.
• Professional Leadership and Development : Role model advanced practice professionalism through conduct, communication, dress, leadership, ethical decision-making, critical thinking and problem-solving skills.
• Participate in at least one professional organization.
• Demonstrate responsibility for professional practice through active participation in the Cardiology department, CAP Department, and professional organizations.
• Meet Continuing Education requirements as designated by the NC Medical Board and/or NC Nursing Board.
• Maintain professional certification.
• Enhance the body of knowledge in area of specialization through written publications, oral presentations, posters, continuing education, etc.
• Maintain all professional requirements for licensure and certification
• Attend educational conferences regularly, morbidity and mortality conferences, code reviews, NP monthly meetings and attend twice a year adult congenital sessions.
• When caring for adult patients with congenital heart disease, plan for situations beyond expertise, consult with and refer to other health care providers as appropriate.

Job eligibility requirements include:

• Education (MUST GRADUATE BY DECEMBER 31, 2025) PA: Graduate of ARC accredited Physician Assistant Program, Masters or DMSc degree preferred NP: Graduate of accredited MSN or DNP Pediatric Acute Care Nurse Practitioner Program
• Certification PA: PA-C NP: PNP-AC
• License PA: Current unrestricted medical license issued by the NCMB with authorization to practice as PA NP: Current unrestricted RN license issued or recognized by the NCBON with authorization to practice as NP
• Both: Federal and State DEA with unrestrictive full prescriptive authority
• Experience: New PA or PNP-AC grads welcome to apply, no APP experience required
• Life support: BLS (required) PALS (required) ACLS (recommended)
• Physical and mental requirements: Able to clearly articulate scope of practice, and practices within those guidelines as a Nurse Practitioner / Physician Assistant Able to independently seek out resources and work collaboratively to solve complex problems Able to communicate clearly with patients, families, visitors, healthcare team, physicians, administrators, leadership, and others. Able to use sensory and cognitive functions to process and prioritize information, perform health assessments, treatment, and follow-up. Able to use fine motor skills Able to record activities, document assessments & interventions; prepare reports and presentations; Able to use computer and learn new software programs Able to provide leadership in clinical area of expertise and in meeting organizational goals Able to navigate the Hospital and DUHS to provide clinical expertise to specific patient populations Able to withstand prolonged standing and walking with the ability to move or lift at least fifty pounds Able to remain focused and organized Able to work collaboratively with all levels of personnel
• Job hours: Primary hours will be a minimum of 12 to a maximum of 13, 12-hour shifts every 4 weeks, covering 7 days a week including days, nights, weekends and holidays. Flexibility is required to meet clinical needs of the service.