Physician - Emergency Medicine

Travel Emergency Medicine Physician Opportunity

Services Needed:

• Board Certified Emergency, Internal or Family Medicine Physician
• Contractor physicians shall have recent (within the last 3 years) experience in the Urgent Care Clinic or Emergency Room.
• AHA BLS & ACLS
• Physician(s) assigned by the Contractor to perform the services covered by this contract shall have a current license to practice medicine in any State, Territory, or Commonwealth of the United States or the District of Columbia when services are performed onsite on VA property. All licenses held by the personnel working on this contract shall be full and unrestricted licenses.
• 2 Live Intubations- Either signed off by supervising Physician or OORAM certification by VA employee (required for submittal and re-credentialing, used only for rare and extreme situations)

Shift Hours:

• Current needs are for daytime weekend shifts 0815-2015
• Monday-Friday Daylight 0815-1615
• Monday-Friday Overnight (excluding Holidays) 1615-0815
• Saturday & Sunday (excluding Holidays) 0815-2015 & 2015-0815

Notes from Facility:

To clarify we have an Urgent care and not a true ED.

1. What is the ED nursing coverage (i.e. number of nurses and their shift schedules) at the Altoona VA? RNs are scheduled a variation of 8 and 12 hour shifts and there is always at least 2 RNs on duty.
2. Is there a respiratory therapist on site, and if so, what are their hours of coverage (and does RT cover both ED and the floor)? RTs are available during administrative hours and cover UCC and the floors. RNs give breathing treatments, RTs do not intubate but can assist with CPAP, BIPAP, vents (as we transfer them), ABGs. They are on call during nonadministrative hours for those services as well.
3. What airway equipment is available in the ED and on the floor? CPAP/Bipaps, we have a vent but not used as we would transfer those patients, glidescope in UCC.
4. Is there a bedside ultrasound in the ED, and if so, what model? We have one, not sure of model, but currently not using.
5. What radiology services are offered (US, XR, CT, MRI) and what are the hours for the radiology techs and the radiologist's coverage for formal reads? We have all services, although during nights, weekends, holidays may need to call tech in. MRI is limited due to one machine and does not offer STAT imaging. Radiologist is here during administrative hours. Teleradiology during off hours. We expect MODs to read xrays and not wait for TeleRadiologist during nonadministrative hours.
6. What are the hours of coverage for the nurse practitioner in the ED? 7am-3pm. 6am-6pm or 7am-7pm depending on day and NP assigned.
7. What are the hours of coverage for the nurse practitioner on the medical floor? Same as above
8. What are the hours during which the ED physician has to write admission orders and manage inpatients? The entire shift you are working. If an NP is still here, but has workload that prevents him/her from doing the admission, you are expected to do it. NPs typically manage the floor and community living center until they leave, but again, if something is preventing them from doing so, you are expected to assist. You will admit and manage from 7pm until 7am
9. What is the total inpatient bed capacity and what is the average daily census on the medical floor? We are certified for 11 beds, only 8 are open during construction, our census has been about 6-8
10. What is the general practice with patients that require a chest pain work-up (i.e. negative troponin but needs admission for serial troponins, cardiac monitoring and setup for stress test)? Are these patients advised to go to a higher acuity facility from the outset (like what many community urgent care centers do) or are they worked up in the ED and transferred (if so, what EMS service performs interfacility transfer and how does the transfer process generally work out)? I have experienced a lot of delays that negatively affected patient care when transferring to UPMC Altoona and so am curious about Altoona VA's experience with transfers. - We have high sensitivity troponins and repeat in 2 hours in the UCC, if negative, decision to send home vs admit, depending on heart score. However, this medical center can admit chest pain for serial troponins, cardiac monitoring, and cardiology consult. Stress testing is not typically done while inpatient, but can be planned. If it's let the person cannot stay here but is not having a STEMI, we would transfer to VA Pittsburgh. The process is to call and speak to their bed management, then the specialist, sometimes the hospitalist as well. We only transfer to UPMC for emergencies such as STEMI, Stroke, trauma, ICU level admissions, etc., otherwise Pitt VA for higher level of care.

Client Details:

Client Type Government - Federal Setting Emergency Room Address 2907 Pleasant Valley Boulevard City Altoona State PA Zip Code 16602 Unit Details Computer Charting System VISTA (CPRS)