Nurse Practitioner / Physician Assistant, Liver Transplant

Liver Transplant APP

This position is eligible for our Student Loan Assistance Program. You may receive up to $9,600 which will be applied directly to your student loan account.

This benefit is for eligible positions as outlined in our program guidelines.

At Lucile Packard Children's Hospital Stanford, we know world-renowned care begins with world-class caring. That's why we combine advanced technologies and breakthrough discoveries with family-centered care. It's why we provide our caregivers with continuing education and state-of-the-art facilities, like the newly remodeled Lucile Packard Children's Hospital Stanford. And it's why we need caring, committed people on our team - like you. Join us on our mission to heal humanity, one child and family at a time.

Responsible for management of inpatient liver and intestinal transplant patients. Provides direct patient care, evaluation and medical management of patients on acute care and intensive care units. Provides ongoing continuity of care for transplant patients and assists with transition of care from inpatient to outpatient provider teams. Responsible for daily pre rounding, rounding, lab review, immunosuppression management, completing orders, consultations, and documentation for all inpatient liver and intestinal transplant patients. Leads the multidisciplinary team on rounds. Responsible for inpatient consultations for transplant on other service lines. Primary point of contact for patients and families admitted to the hospital under the transplant service. Primary point of contact for nursing staff. Responsible for admissions, transfers, and discharging patients from the inpatient liver and intestinal transplant service. Responsible for holding the pager for the transplant service during daytime hours when on service. Responsible for responding to communications in a respectful and timely manner and escalating acute care concerns for patients. Participates in patient care conferences, pathology conferences, radiology conferences, and departmental education. Works collaboratively with other APPs on the liver and intestinal transplant service to provide patient care coverage. Actively communicates with other APPs on the liver and intestinal transplant service, attending staff, support staff and resident/fellow staff. Provides education regarding liver and intestinal transplantation to nursing staff, students, residents. Able to see patients in outpatient transplant clinics in independent and shared visits with Hepatology and Surgery attendings. Responsible for documentation and care management for outpatient transplant patients. This position includes the ability to work in both inpatient and outpatient clinical settings. This position requires weekend and holiday coverage.

The Advanced Practice Provider (APP) positions are part of a collaborative team consisting of Attending Physicians, Fellows, and a team of advanced practice providers both NPs and PAs. The APP team is highly respected, we are seen as the go to team for the attendings. We actively participate in the education of fellows and visiting residents. Responsibilities for this role include: receiving sign-out from overnight team. Pre-rounding on assigned patients, developing a plan of care for the day for that patient, present patients on rounds, write a daily note, you will be responsible for implementing the plan agreed upon on during rounds and responding to any issues raised by the nurses during the course of the day. The advanced practice provider is credentialed to perform the following procedures: intubation, central line placement, arterial line placement, chest tube insertion, PD drain placement, chest tube removal, pacing wire removal.

The Nurse Practitioner functions under the general Nurse Practitioner Standardized Process Protocol approved by the Interdisciplinary Practice Committee (IDPC). The Nurse Practitioner provides routine care and management of the patient with acute and chronic complaints, in collaboration with the supervising physician and through implementation of standardized procedures. Specific functions pertaining to the Service, Clinic or Department are established by the Nurse Practitioner and the supervising physician(s), and approved by the appropriate medical and nursing administrators, the IDPC, and the Stanford Hospital and Clinics (SHC) Medical Executive Board and Board of Directors.

The Physician Assistant functions under the general Physician Assistant Role Description approved by the Interdisciplinary Practice Committee (IDPC). Specific functions pertaining to the Service, Clinic or Department are established by the Physician Assistant and his or her supervising physician(s), and approved by the appropriate medical and nursing administrators, the IDPC, and the Stanford Hospital and Clinics (SHC) Medical Board and Board of Directors.

The essential functions listed are typical examples of work performed by positions in this job classification. They are not designed to contain or be interpreted as a comprehensive inventory of all duties, tasks, and responsibilities. Employees may also perform other duties as assigned. Employees must abide by all Joint Commission Requirements including but not limited to sensitivity to cultural diversity, patient care, patient rights and ethical treatment, safety and security of physical environments, emergency management, teamwork, respect for others, participation in ongoing education and training, communication and adherence to safety and quality programs, sustaining compliance with National Patient Safety Goals, and licensure and health screenings. Must perform all duties and responsibilities in accordance with the hospital's policies and procedures, including its Service Standards and its Code of Conduct.

• An NP/PA may provide only those medical services which he/she is competent to perform, which are consistent with the NP/PA's education, training and experience, and which are performed in collaboration with a physician.
• An NP/PA shall consult with a physician regarding any task, procedure or diagnostic problem which the NP/PA determines exceeds his/her level of competence or shall refer such cases to a collaborating physician.
• Scope of Practice of the NP/PA:
• Evaluates and treats patients with acute, chronic complaints and health maintenance concerns related to specialty, according to written standardized procedures.
• Obtains complete histories and performs pertinent physical exams with assessment of normal and abnormal findings on new and return patients.
• Performs or requests and evaluates diagnostic studies as indicated upon evaluation of the patient.
• Administers, orders, furnishes and prescribes medications.
• Orders physical therapy, occupational therapy, respiratory therapy, radiology examinations and nursing services.
• Performs designated procedures after demonstrated competency, according to written standardized procedures where applicable.
• Obtains informed consent, as indicated.
• Initiates arrangements for hospital admissions and discharges and completes appropriate paperwork.
• As directed by the supervising physician, enrolls patients in investigational studies approved by the Investigational Review Board (IRB), and orders the necessary tests and medications.
• After appropriate training, assists the supervising physician in the operating room. The RN First Assistant directly assists the surgeon and practices under the supervision of the surgeon during the intraoperative phase. The RN First Assistant must adhere to standardized procedures and not concurrently function as a scrub nurse.
• Recognizes and considers age-specific needs of patients.
• Effectively communicates and interacts with patients, families, staff and members of the community from diverse backgrounds.
• Recognizes situations which require the immediate attention of a physician, and initiates life-saving procedures when necessary.
• Facilitates the coordination of inpatient and outpatient care and services as needed.
• Facilitates collaboration between providers and coordination of community resources.
• Ensures compliance with legal, regulatory and clinical policies and procedures.
• Participates in quality improvement initiatives.
• Provides and coordinates patient teaching and counseling.
• Other duties as assigned.
• Supervision:
• Supervision is provided by the supervising/sponsoring physician with clinical privileges at LPCH, or designated attending physicians in the Clinic, Service or Department. Standardized procedures, approved by the supervising physician(s) and the IDPC, are a mandatory mechanism of supervision. Other mechanisms of supervision used may be:
• Direct on-site, electronic or phone supervision by a supervising physician. A physician cannot supervise more than four (4) NP/PAs at one time.
• Chart screens on random charts by the supervising physician or designee.
• Chart audits on random charts as an integral part of selected quality improvement programs.
• Ongoing Professional Practice Evaluation (OPPE) through tracking of performance indicators.
• The NP/PA will receive a formal annual performance evaluation by the Lead Advanced Practice Provider (Lead APP), Director of Advanced Practice or supervising manager/director with input from the Lead APP, supervising physician(s) and/or physician delegates, APP peers and the supervising manager/director. Ongoing Professional Practice Evaluation (OPPE) also occurs through tracking of performance indicators.

Any combination of education and experience that would likely provide the required knowledge, skills and abilities as well as possession of any required licenses or certifications is qualifying.

Physician Assistant (PA): Bachelor's degree or above from an accredited college or university. Graduate of a PA program accredited by the Accreditation Review Commission on Education for the Physician Assistant, Inc.

Nurse Practitioner (NP): Master's or doctoral degree in nursing from an accredited college or university. Graduate of an NP program accredited by the National League of Nursing Accrediting Commission (NLNAC) or the