Nocturnal Physician Assistant, Critical Care- Full time

When you join the growing BILH team, you're not just taking a job, you’re making a difference in people’s lives. The ICU PA serves as the primary overnight critical care provider in collaboration with the attending intensivist, hospitalists, emergency physicians, nursing staff, respiratory therapists, and specialty consultants.

The PA is responsible for the assessment, treatment, stabilization, and ongoing management of critically ill patients in the Intensive Care Unit. The position provides dedicated overnight ICU coverage and serves as a key resource for rapid response events, deteriorating patients, ICU admissions, and critical care procedures.

This role is expected to improve clinical support during off-hours, enhance patient safety, support ED throughput, reduce ICU transfers, and contribute to the development of overnight critical care and airway management capabilities.

Schedule:

Twelve-hour overnight shifts (7:00 PM – 7:00 AM).
Rotating weekends and holidays.
Three APP FTEs will provide 365-day overnight ICU coverage.
Collaborative schedule designed to support physician intensivists and hospital medicine services.

Why BID Milton:

Beth Israel Deaconess Hospital–Milton is a member of Beth Israel Lahey Health and is expanding its critical care capabilities to better serve the South Shore community. The ICU expansion initiative supports increased patient retention, improved access to critical care services, enhanced support for surgical programs, and stronger integration within the BILH network.

Join a collaborative team committed to delivering exceptional critical care close to home while helping shape the future of critical care services at BID Milton.

Job Description:

DUTIES AND RESPONSIBILITIES:

Professional

• Demonstrates collaborative efforts with health team members such as nurses, respiratory therapy, social workers, infection control staff, etc.
• Demonstrates compassion, professionalism and commitment to excellent patient care.
• Demonstrates compliance to the hospital’s Code of Conduct and Employee Standards of Behavior.
• Must be able to work with autonomy within Massachusetts law under direction of supervising physician.

Clinical

• Performs comprehensive and problem focused history and physical exams (where indicated) critical care patients admitted through the Emergency Department and on those held for observation , initiates appropriate lab, radiology tests or other special tests required for evaluation of illness, and scrutinizes lab data on new and former patients and hospital admissions to establish a record of the patient's current health status and to develop a working diagnosis and treatment plan, with direct review by a physician.
• Assist with triage decisions regarding ICU admission and transfer
• Performs and interprets, at least to the point of recognizing deviations from normal, common laboratory, radiologic, cardio graphic and other routine diagnostic procedures used to identify pathophysiologic processes, as privileged.
• Interprets and correlates subjective and objective data to formulate a differential diagnosis and establishes a working diagnosis.
• Formulates a treatment plan for medical problems within scope of practice.
• Writes initial orders in coordination with the attending physician.
• Implements therapeutic intervention for specific conditions, when appropriate.
• Exercises judgment on problems requiring consultation, referral, or evaluation by the supervising physician or other health care professionals.
• Performs routine procedures such as injections, immunizations, suturing and wound care, managing simple conditions produced by infection or trauma, as well as taking initiative in performing evaluation and therapeutic procedures in response to life-threatening situations, as privileged.
• Performs specialized procedures (as requested and under the direction of an attending physician), including blood draws, designated IV starts, lumbar puncture, central venous line placement, arterial line placement, chest tube insertions, thoracentesis, paracentesis, foley catheter insertion +/- bladder irrigation, endotracheal intubation, management of mechanical ventilation, as well as other specific procedures in the Emergency Department and on the inpatient units, with demonstrated competency and the approved delineation of privileges.
• Provides information and answers routine questions of patients regarding their disease, including preventive health maintenance topics such as diet, weight, smoking and topics related to medical specialty, with basic recommendations.
• Educates patients regarding their disease, treatments, related drug and treatment side effects and hazards.
• Assists with record keeping, completes appropriate patient medical chart, transcribes lab data and routine correspondence, as directed and reviewed by physician.
• Refers patients to physicians as appropriate for consultation or for specialized health resources and treatment.
• Participates in rounds in ICU patients as required, upon arrival for duty.
• Responds to all Codes and Rapid Responses
• Assists Emergency Department physicians in cases of Critical Carel consultation in the Emergency Department, in the evaluation of trauma victims in the ED, and with procedures within the PAs scope of practice.
• Evaluates and manages the acute care needs of BID Milton patients in concert with the attending physician.
• Oversees the management of mechanical ventilation with supervision from Anesthesia, Pulmonary and/or Critical Care physicians.
• Ensures continuity of care by serving as a liaison between patient and other members of the multi-disciplinary care team or with other specialty areas as necessary.
• Facilitates appropriate length of stay, transfers, discharge planning and compliance with regulatory standards for inpatient management.
• Participates in quality monitoring through the review of records and treatment plans for patient outcomes on a periodic basis to ensure quality care.
• May serve as clinical preceptor for PA students and other health professionals.

Communication with Attending Surgeons

• Critical Care PAs will evaluate inpatients and ER consults and communicate with the appropriate attending physician by phone.
• Critical Care PAs will alert and inform a patient's attending physician (or coverage) as soon as possible in the event of any major change in the status of the patient, including: Instituting any major therapeutic intervention with a patient, except in emergencies, only in cooperation and consultation with the patient's attending physician. Not undertaking any significant change in the management of a patient (i.e., transfusions, change in medications, such as antibiotics in use), except in emergencies, without the knowledge and consent of the patient's attending physician. Instituting all medically appropriate measures in an emergency situation when the life of the patient is at risk. Notifying a attending physician in the event of the nighttime emergency department admission of the patient. Discussion with the Chief of Critical Care Medicine or designee of any problems that may arise with regard to physicians' duties and responsibilities.

Major therapeutic intervention can be instituted only in consultation and under the direction of the attending physician.

Performance Expectations

The successful candidate will:

• Provide high-quality critical care management.
• Improve overnight ICU responsiveness.
• Support reduction of ICU boarding in the Emergency Department.
• Assist in reducing ICU transfers related to capacity constraints.
• Enhance provider and nursing satisfaction.
• Contribute to airway management and critical care competency development.
• Support BID Milton's strategic ICU expansion initiative.

Reporting

• When signing out to day or evening PA/MD, face-to-face reporting is required, along with the completion of sign-out reports.

Medical Records

• Critical Care PAs are responsible for dictating & signing
• Discharge summaries and procedure notes, as authorized by attending physicians
• Daily progress notes Consultation notes as well as History and Physicals, as requested by attending physicians All verbal, telephone, and written orders ( verbal & telephone orders MUST be signed within 48 hours of original order )

Meetings/Grand Rounds

• Critical Care PAs are required to attend appropriate conferences, including Department of Medicine M & M's, Critical Care Committee, Patient Safety & Quality Committee, etc

General

• Employee maintains competencies (position specific and hospital-wide) required for the specific patient population served.
• Performs all duties in accordance with safety and other laws, rules, and regulations set forth by appropriate regulatory and government agencies and in accordance with established department and hospital policies and procedures.
• May be required to perform similar or related duties as may be necessary on an emergency basis or as designated by the Chief Medical Officer or supervisor.
• The nature of the tasks/responsibilities required of employees in this position will likely expose them to blood and body fluids. Employees will be oriented to and required to understand and follow the standard precautions for infection control.
• A summary list of tasks and procedures that may cause exposure to blood and body fluids is listed in the attached Physical Abilities Job Description. Also identified is the protective gear that is available.

QUALIFICATIONS:

Min Education:

• Bachelor’s degree and graduate of a Physician Assistant program accredited by the Commission on Accreditation of Allied Health Education Programs.

Min Experience:

• Minimum two (2) years postgraduate experience as a critical care, hospital medicine, emergency, surgical or equivalent acute care experience preferred. Procedural competency, ultrasound proficiency, airway management and mechanical ventilation experience, especially in a community hospital setting preferred.

License:

• Licensed by the Massachusetts Board of Physician Assistants.

Credentials:

• Must be approved by the Board of Directors BID-Milton.
• Must have and maintain current ACLS .

A Physical Abilities Job Description is a component of this Job Description.

The above statements are intended to describe the general nature and level of work being performed. This list is not to be construed, as an exhaustive list of all responsibilities, duties and skills required of personnel so classified.

Pay Range:

$55.16 - $89.34

The pay range listed for this position is the base hourly wage range the organization reasonably and in good faith expects to pay for this position at this time. Actual compensation is determined based on several factors, that may include seniority, education, training, relevant experience, relevant certifications, geography of work location, job responsibilities, or other applicable factors permissible by law. Compensation may exceed the base hourly rate depending on shift differentials, call pay, premium pay, overtime pay, and other additional pay practices, as applicable to the position and in accordance with the law.

As a health care organization, we have a responsibility to do everything in our power to care for and protect our patients, our colleagues and our communities. Beth Israel Lahey Health requires that all staff be vaccinated against influenza (flu) as a condition of employment.

More than 35,000 people working together. Nurses, doctors, technicians, therapists, researchers, teachers and more, making a difference in patients' lives. Your skill and compassion can make us even stronger.

Equal Opportunity Employer/Veterans/Disabled