APP Specialty-Cardiovascular Surgery Outpatient & Inpatient - Exempt

Advanced Practice Provider

The nurse practitioner will work in collaboration with a healthcare team to provide excellent patient care in a clinic and/or hospital setting. Responsibilities include, but are not limited to, assessment of patients, hospital rounding as needed, performing procedures consummate with training/experience with appropriate oversight, prescribing pharmacologic and non-pharmacologic therapy as indicated, and completion of clinical documentation. They will contribute to accomplishing and supporting the mission, vision, and values of WTMG Clinic. The APP models appropriate behavior to employees and provides leadership to the organization and nursing profession. Responsible for ensuring all core measures are met. If functioning in a surgical capacity, the APP, as defined by the American College of Surgeons, shall function as a first assistant who provides aid in exposure, hemostasis, and other technical functions, that will help the surgeon carry out a safe operation with optimal results for the patient. The APP performs, under direct supervision, intraoperative technically advanced functions as stated in the job functions or directed by the surgeon. The APP performs these functions during the operation, or in the clinic under the direction and supervision of the surgeon(s) and in accordance with hospital policy, appropriate laws and regulations and stated job functions. The incumbent will provide surgical evaluation, care and health education for adult and geriatric patients, as well as first assist services, if applicable. The APP will work under the general established supervision using protocols as required. Responsible for providing patient care for assigned shifts as scheduled full time or part time. Reporting is under the supervision of the Practice Manager, and physicians. Employee is subject to call back, and call coverage. They will contribute to the accomplishment and support of the mission, vision and values of the WMG Clinic.

Essential Job Functions:

• Provides medical services and health education to adult and geriatric patients under the direction of the supervising physician.
• Performs a complete physical exam, obtain a complete medical history and records findings. Orders appropriate laboratory and diagnostic procedures. Interprets and integrates data to determine preliminary diagnoses and therapeutic plan.
• Collaborates with the supervising physician in establishing/reviewing protocols for managing the needs of the patients.
• Orders, performs, and interprets necessary diagnostic and therapeutic procedures according to approved protocols developed with and under the direction of the supervising physician which may include but are not limited to, securing, records and evaluating the health, psychosocial and development history of patients, ordering laboratory and x-ray studies, carrying out prescription drug orders under protocols, management of common or chronic illnesses, referrals, etc. Documents the processes of nursing care delivery, and all other care delivery and procedures.
• Formulates and implements treatment plan for acute illness management in collaboration with the supervising physician.
• Administers or gives orders to nursing support to administer medications and injections in compliance with state law and clinical guidelines.
• Functions as patient advocate, explaining the necessity, preparation, nature and anticipated effects of procedure(s) to patients, family and staff. Conducts follow-up care, coordinates care with other health care providers, and makes referrals for continuity of care.
• Screens consults for appropriateness of referral, for co-morbid or social issues that would affect aspect of care. Coordinates post-acute care services.
• Ensure that appropriate outside studies are available at time of consultation.
• Demonstrates thorough knowledge of principles of asepsis ensuring that proper techniques and practices are maintained, in providing age-specific patient care.
• If position requires surgical participation:
• Preoperatively perform nursing assessments, educate the patient and offer emotional support. Evaluate the needs of the patient and the surgical team on a continuum, throughout the surgical encounter.
• Collaborating with the surgeon and other health care professionals for an optimal surgical outcome.
• Assisting the anesthesiologist when applicable.
• Assisting with patient positioning, skin preparation, and draping.
• Providing wound exposure by suctioning sponging, and retracting.
• During endoscopic procedures, may advance the rigid endoscope to provide optimal visualization under the direction of the operating surgeon.
• Providing hemostasis by applying hemostatic clamps, or clips, coagulating bleeding points and ligating bleeding vessels.
• Surgical wound closure under the direction of the surgeon; may facilitate the closure of the skin layer by proper handling of the tissue with forceps. Suturing fascia, subcutaneous, and skin tissues.
• Insertion of urethral catheters.
• Scrubs, gowns and gloves self for surgical procedures.
• Using and manipulating surgical instruments. Handles and uses instruments correctly and insures their proper functionality and storage.
• Actively participates in correct sponge, needle and instrument counts.
• Handling tissue appropriately to reduce the potential for injury. Participates in proper handling of all lab and tissue specimens according to established protocol.
• Assumes responsibility for proper handling of supplies.
• Selecting and applying the appropriate wound dressings.
• Providing assistance in securing drainage systems to tissue.
• Relieves on cases at or during change of shift, breaks, or meal times, following correct protocol, to ensure continuity of care.
• Has access and handling of medications deemed necessary for procedures in the operating room.
• Records progress of patient on Progress Notes, which will be countersigned by the physician in the hospital and independently in the clinic setting.
• May accept verbal orders from the physician, recording and then reading back to the physician for confirmation.
• May be responsible postoperatively for assisting in the safe delivery of the patient to the recovery room; communicating to the appropriate health care personnel and family members; performing follow-up care to evaluate the patient's condition; performing post-operative activities, which may include removing sutures, chest tubes, drains, and pacing wires; and participating in discharge planning and providing discharge instructions.
• Performs related responsibilities as required or directed, and remains on-site until the employee's assigned patient care duties have been completed.
• Be able to multi-task and prioritize workload in a fast-paced environment, lift and move patients as necessary, and work on a computer for sustained periods.
• Maintains accurate and complete medical records in a timely fashion.
• Practice the profession using evidence-based practices; standardized protocols and order sets; appropriate utilization of resources; and coordinator of care to achieve the most appropriate length of stay.
• Daily planning and coordinating care with all members of the health care team to assure maximum quality and efficiency, including daily coordination with the multi-disciplinary care team, including other team members, respiratory therapy, pharmacy, nursing, and various other departments of the hospital.
• Perform such other administrative and clinical duties related to the delivery of services as may be reasonably requested by the service from time to time.
• Demonstrates the AIDET skills with patients, families, and guests.
• Provide educational counseling that will enhance patient care and preventative knowledge.
• Contributes to a positive work climate and the overall team effort of the department.
• Responsible for supporting staff in providing quality nursing care and promoting quality outcomes.
• Support and guide a working environment that stays current with research and guidelines in the assigned area of specialty medicine.

Job Specifications:

Education:

• BSN and Master's Degree in Nursing with successful completion of a Nurse Practitioner Specialty or a Physician Assistant Program as approved by the state of Tennessee.

Licensure, Registration, and Certification:

• RN License, APN Certification for FNP;
• PA License; NCCPA Certification for Physician Assistant
• Current BLS required.
• Providers who require hospital privileges where ACLS is required by delineation of privileges, or who work in a clinic setting that requires ACLS, must maintain current Advanced Cardiac Life Support (ACLS) certification through the American Heart Association as a condition of employment.
• Current DEA license issued by the Drug Enforcement Agency
• Responsible for Continuing Education units annually

Experience:

• Two years of experience in a clinical setting.
• Prefer candidate with surgical practice experience, if applicable to position.

Knowledge, Skills, and Abilities:

• Function fully of the scope of practice, as determined by the educational program and national board certification, in conjunction with state licensure requirements.
• Demon