Critical Care Nurse Practitioner or Physician Assistant - Cardiothoracic Step Down Unit

Critical Care Nurse Practitioner or Physician Assistant – Cardiothoracic Step Down Unit At Duke Health, we are driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together. About Duke University Hospital Pursue your passion for caring with Duke University Hospital in Durham, North Carolina, which is consistently ranked among the best in the United States. The largest of the four Duke Health hospitals with 1,062 patient beds, it features comprehensive diagnostic and therapeutic facilities, including a regional emergency/trauma center, an endo-surgery center, and more. Job Location Duke University Hospital Heart Center Job Summary The Duke University Hospital Cardiothoracic (CT) Surgery Step‑Down Unit (SDU) Advanced Practice Provider (APP) provides direct patient care services for complex critically ill Cardiothoracic Surgery and Advanced Heart Failure patients in collaboration with and under the supervision of the cardiothoracic surgeon(s) and medical director of the CT SDU. The APP 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. Job Duties and Responsibilities Provide and coordinate clinical care for cardiothoracic step‑down surgery patients at Duke Hospital, primarily in the Cardiothoracic Step‑down setting but also throughout Duke Hospital and clinic via established protocols and under the supervision of the cardiothoracic surgeon or backup supervising physician who is either on site or available by pager (including the OR, PACU, Step‑down units, all inpatient units, ER, and clinic setting). In collaboration with attending cardiothoracic surgeon(s) round daily on patients to assess, diagnose, plan treatment, set priorities and realistic outcomes, and evaluate the effectiveness and cost efficiency of cardiothoracic patient care. Collaborate with residents, fellows and attendings to formulate treatment plans and monitor patient progress. Assess patients for change in status and institute appropriate interventions, initiating emergency interventions to stabilize the patient until physician support arrives. Conduct preoperative evaluation, including (but not limited to) establishing diagnosis and baseline status. Provide 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 to provide the best medical care and 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 health care providers. Document in the patient’s chart 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 populations. Maintain 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. Act as a role model for competence in all nurse practitioner/physician assistant advanced skills. Job Eligibility Requirements Education PA: Graduate of an ARC‑accredited Physician Assistant (PA) program. Master’s degree or Doctoral required. NP: Graduate of an accredited MSN or DNP Acute Care Nurse Practitioner (NP) program for adult care. Certification PA: PA‑C. NP: ACNP or AGACNP. Licensure PA: Current unrestricted medical license issued by the NCMB with authorization to practice as a PA. NP: Current unrestricted RN license issued by or recognized by the NCBON with authorization to practice as an NP. Both: Federal and State DEA with unrestricted prescriptive authority. Experience PA: One year’s experience as a PA in a relevant clinical area preferred. NP: One-year NP experience or 2+ years RN experience in a cardiovascular or cardiothoracic surgery unit is preferred. * Will consider a new graduate with prior CTICU/CVICU or CTSD RN experience. Physical and Mental Requirements Able to clearly articulate scope of practice and practice within those guidelines as a Nurse Practitioner / Physician Assistant in North Carolina and within the Duke University Health System. Able to independently seek out resources and work collaboratively to solve complex problems. Able to communicate clearly with patients, families, visitors, health care 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 and interventions; prepare reports and presentations. Able to use a 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: fourteen (12) hour shifts per month, rotating shifts, 7 days per week including holidays. Duke is an Equal Opportunity Employer committed to providing employment opportunity without regard to an individual's age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex (including pregnancy and pregnancy‑related conditions), sexual orientation, military status, or other protected categories. Essential Physical Job Functions Certain jobs at Duke University and Duke University Health System may include essential job functions that require specific physical and/or mental abilities. Additional information and a provision for requests for reasonable accommodation will be provided by each hiring department. #J-18808-Ljbffr Duke Clinical Research Institute