Advanced Practice Provider - Critical Care

ST. CHARLES HEALTH SYSTEM

JOB DESCRIPTION

TITLE: ICU Advanced Practice Provider (APP)

REPORTS TO POSITION: ICU Medical Director

DEPARTMENT: Critical Care

DATE LAST REVIEWED: November, 2025

OUR VISION: Creating America's healthiest community, together

OUR MISSION: In the spirit of love and compassion, better health, better care, better value

OUR VALUES: Accountability, Caring and Teamwork

DEPARTMENTAL SUMMARY: St. Charles Bend operates a 24-bed multi-disciplinary care unit as part of level II trauma hospital with 24/7 trauma coverage and full-time neurosurgical and cardiac surgical coverage. The prospective candidate should be comfortable providing care for general medical, neurologic and neurosurgical patients, cardiac and cardiac surgical patients and surgical sub-specialty patients. The Bend ICU is staffed 24/7 with a board-certified critical care physician. Every patient in the ICU has a physician responsible for their care and has access to variety of specialized physicians for consult on a patient's condition.


POSITION OVERVIEW: The Advanced Practice Providers (APPs) work as part of the Critical Care team. They work under the direction and supervision of the attending intensivist and facilitate care of ICU patients from admission to discharge, in collaboration with the attending physician. The APP will discuss and update the Intensivist on duty with significant changes in the patient's condition, new test results, and will attend Team rounds daily. New admissions will be discussed collaboratively with the Intensivist to develop a Plan of Care.


This is NOT an independent practice model for APPs and at all times a patient's plan of care and actual care should reflect the informed judgment of the Attending Intensivist.

Each APP should have a strong foundation in evidenced based practice and ensuring an environment of safe, quality care. They should also demonstrate an advanced level of medical knowledge, clinical/technical competence, solid clinical decision making, critical thinking skills, professional communication skills, timely and complete documentation, and are responsible for personal and professional development with competency validation.

APPs provide quality patient and family centered care as a member of the health care team in accordance with SCHS mission, philosophy, policies, and procedures; They provide specialty medical care within defined scope of practice under the supervision of a licensed physician, are responsible for daily patient flow in the ICU setting, and use critical skills to make appropriate patient health assessments and that should align with the physician's plan of care. APPs do not directly manage any other caregivers.

Work schedule: APP will work at least one hundred fifty-six (156) shifts per reconciliation year for a full-time exempt employee and will be prorated for any FTE that is established below a full-time status.


Provider Practice Location: Provider will render the Professional Services at such SCHS Facilities as may be directed by St. Charles Health System, and at such other facilities and locations as may be established by SCHS from time to time. It is anticipated that the primary work locations will be as follows:

Practice Locations:

St. Charles ICU - 2500 NE Neff RD Bend, OR

ESSENTIAL FUNCTIONS AND DUTIES: (May perform additional duties of similar complexity within SCHS as required or assigned)

Clinical Expectations:

• Round on every patient in ICU with the ICU care team (ICU physician, pharmacy, RNs, dietitian, etc)
• Document a comprehensive list of changes to each day's plan of care
• Update hospital course progression/daily and significant events in the "Care Coordination Note"
• Keep "Problem List" updated (only have current problems in active problem list)
• Ensure labs/imaging ordered for that day or the future (i.e. next morning's labs) when appropriate
• Place orders while on rounds (i.e. medications, labs, imaging, communication orders)
• Consult specialists
• Be able to answer critical and non-critical patient questions from RN/RT/staff and place orders when necessary
• Teach staff and families about treatment plans
• Facilitate family meetings and goals of care, in collaboration with the attending physician
• Participate in multidisciplinary rounds
• Take Histories and Review of Systems from ICU patients/families, performs physical exams
• Review outside records, completes full H&P's, orders appropriate diagnostic studies and coordinates among providers.
• Write H&Ps, Consults, progress notes, discharge summaries on ICU patients
• Sign death certificates
• Evaluate each emergency department consults for admission and place admission orders with each admission to ICU, in collaboration with attending physician
• Perform procedures (i.e. central lines, arterial lines, etc) that are consistent with medical staff privileges and individual capabilities
• Discharge patients from ICU while providing discharge orders, summary, medications and prescriptions, proper follow up
• Transfer patients and call "sign out" to hospitalists when a patient transfers out of ICU to the medical floor, PCU, etc.
• Update sign out patient list daily under "Pulmonary sign outs" drive → "ICU sign out" and print for night ICU physician
• Call patient families daily with updates on patient care and answer family questions
• Clinical preceptor for PA and NP students rotating through the ICU
• Provide targeted assessment and evaluation, including diagnostic impression and functional status on presenting problem(s).
• Examine, diagnose, and treat acute and chronic medical conditions.in collaboration with the Attending Intensivist
• Effectively utilize team-based care model, leveraging expertise of all members of multi-disciplinary team.
• Share knowledge with other team members and patients both formally (in-services, consult responses) and informally (hallway conversations).
• Collaborate in education with residents and medical students.
• Monitor effectiveness of plan of care.
• Educate patients and families on diagnoses and treatment plans.
• Collaborate and/or consults with physicians and other health care providers as appropriate.
• Help to provide ICU care in collaboration with the attending Critical Care Physician Intensivist: including daily rounds, fielding post-operative patients/admits/transfers, and continuous medical management.

Administrative Expectations:

• Document all patient care within the Electronic Medical Record (EMR) and complete all necessary tasks in compliance with health system policies and regulatory agencies to ensure timely and accurate billing.
• Be familiar with the SCHS organization structure.
• Participate in provider meetings and assist in policy formation for SCMG and Physician's practice.
• Keep medical knowledge and skills current through regular CME activity. Must attest to having adequate (CME) to meet maintenance of board certification and compliance with MSO rules and continuing privileges without restriction.
• Keep all licenses and appropriate certifications current and unrestricted.
• Maintain active privileges at a St. Charles Health System hospital sufficient to permit performance of job duties.

Behavioral Expectations:

• Participate in creating a healing environment that supports all aspects of the care environment and the wholeness of each individual, patient and caregiver.
• Provide and maintain a safe environment for caregivers, patients and guests. Conduct all activities with the highest standards of professionalism and confidentiality.
• Deliver first-rate patient care in a manner that promotes goodwill, and is timely, efficient and accurate, and courteous.
• Educate, counsel, and assist patients and families regarding current health problems, health maintenance activities and preventive behaviors.
• Provide a therapeutic presence in service to others by purposefully responding to the needs of patients/customers in a caring way.
• This includes introducing oneself and stating your purpose, asking the patient their preferred name, spending time with the patient to determine their care goals, active listening, and using skillful communications (appropriate touch, eye contact, etc.).
• Comply with all applicable laws, regulations, policies and procedures, supporting the health system's corporate integrity efforts by acting in an ethical and appropriate manner, reporting known or suspected violations of applicable rules, and cooperating fully with all health system's investigations and proceeding
• It is expected that the APP will develop a plan of care in collaboration with the attending physician and will be responsible for updating the attending physician regarding a patient's progress and any anticipated change in that plan of care. This collaboration specifically includes updating the Attending Intensivist regarding changes in a patient's condition; new lab and imaging studies that result; and any communications from consultants.
• All admissions done by the APP should be staffed with the attending physician as soon as possible and all admitting orders should be reviewed at that time. Likewise, any changes in a patient's condition, diagnoses or orders should be communicated to the attending physician in a timely manner.
• The APP should have a deep understanding of feasible goals of care relative to any patient before engaging any patient or his/her family in conversations that address goals of care. These conversations should be cleared with the attending physician before they occur, allowing the attending physician to provide input, direct participation in, and/or opportunity to lead in those discussions

EDUCATION

Required:

• Graduation from an accredited Physician Assistant or Nurse Practitioner program.
• Physician Assistant requires NCCPA certification. Nurse Practitioner requires AANC certification.
• Complete annual fire/safety, etc. education in-services as required.
• Attend mandatory educational offerings as described in SCHS policies/procedures and/or as required by other regulatory bodies.
• Complete annual CME as required to maintain license and appropriate Board certification.
• Complete by assigned due date Computer Based Learning modules.

Preferred:

• N/A

LICENSURE/CERTIFICATION/REGISTRATION

Required:

• Unrestricted Physician Assistant and/or Nurse Practitioner licensure.
• Physician Assistant requires NCCPA certification. Nurse Practitioner requires AANC, NCC or AANP, AMCB certification.
• Unrestricted Federal DEA number.
• Unrestricted ability to participate in Medicare / Medicaid, or other federal or state governmental health care programs.
• Valid driver's license and the ability to meet SCHS driving requirements.
• Current BLS certification required.
• Current ACLS certification required.
• Current ATLS certification required
• Additional certifications may be required based on privileges granted to provider by Medical Staff Services at SCHS Inpatient locations.

Preferred:

• Oregon license as PA/FNP
• Federal DEA Number registered in Oregon

EXPERIENCE

Required:

• Two years' experience as an Advance Practice Provider of which at least one year should be in the practice specialty

Preferred:

• One year in Critical Care medicine.

PERSONAL PROTECTIVE EQUIPMENT

• Must be able to wear appropriate Personal Protective Equipment (PPE) required to perform the job safely.

GENERAL

• Must have excellent communication skills and ability to interact with a diverse population and professionally represent SCHS.
• Strong team working and collaborative skills.
• Ability to multi-task and work independently.
• Attention to detail.
• Excellent organizational skills, written and oral communication and customer service skills, particularly in dealing with stressful personal interactions.
• Intermediate to advanced proficiency with Electronic Medical Record systems.
• Intermediate in Microsoft applications (Word, Excel).

PHYSICAL REQUIREMENTS:

• Continually (75% or more): Use of clear and audible speaking voice and the ability to hear normal speech level.
• Frequently (50%): Sitting, standing, walking, lifting 1-10 pounds, keyboard operation.
• Occasionally (25%): Bending, climbing stairs, reaching overhead, carrying/pushing or pulling 1-10 pounds, grasping/squeezing.
• Rarely (10%): Stooping/kneeling/crouching, lifting, carrying, pushing or pulling 11-25 pounds, operation of a motor vehicle.
• Never (0%): Climbing ladder/step-stool, lifting/carrying/pushing or pulling 25-50 pounds, ability to hear whispered speech level.
• Exposure to Elemental Factors
• Never (0%): Heat, cold, wet/slippery area, noise, dust, vibration, chemical solution, uneven surface.
• Blood-Borne Pathogen (BBP) Exposure Category
• No Risk for Exposure to BBP

Schedule Weekly Hours:
40

Caregiver Type:
Regular

Shift:
Variable (United States of America)

Is Exempt Position?
Yes

Job Family:
NURSE PRACTITIONER or PHYSICIAN ASSISTANT

Scheduled Days of the Week:

Shift Start & End Time: