Surgery, Advanced Practice Provider - Surgical First Assist

The Thoracic Surgery Advanced Practice Provider (APP) delivers comprehensive perioperative and longitudinal care to adult thoracic surgery patients in inpatient, outpatient, and procedural settings. This role functions as an integral member of the cardiovascular and thoracic surgery team, providing advanced surgical first assisting skills, clinical assessment, diagnosis, treatment, and care coordination for patients undergoing thoracic surgical interventions. The APP reports to the APP Manager and works closely with thoracic surgeons, anesthesiologists, intensivists, bedside nurses, pharmacists, and care management teams. Responsibilities span preoperative evaluation, intraoperative and postoperative management, rounding, procedures, patient education, and transitions of care. The APP contributes to quality, safety, throughput, and patient experience while practicing at the top of license under applicable Texas regulations and evidence-based protocols.

Responsibilities

Provides Advanced Surgical First Assisting Support (45%)
Directly supports surgeons during surgical procedures

Opening and closing surgical incisions

Surgical first assisting

Manages Perioperative and Postoperative Care (25%)
Performs comprehensive history and physical examinations across the perioperative continuum

Conducts pre-operative risk assessments and surgical readiness evaluations.

Performs daily inpatient rounds including ICU and step-down units.

Manages post-operative complications such as bleeding, wound complications, infection

Collaborates with the Multidisciplinary Care Team

Coordinates discharge planning and follow-up care plans

Prescribes medications and therapeutic interventions per scope and protocols.

Communicates patient status and plans during handoffs and interdisciplinary rounds.

Participates in clinical pathway development and standardization efforts.

Performs Invasive and Bedside Procedures (5%)
Performs bedside procedures such as thoracentesis, chest tube management, and bronchoscopy assistance.

Performs advanced wound care procedures such as intrathoracic negative pressure dressing changes

Provides Outpatient Management in Clinic and Virtual Visit Settings (15%)
Performs comprehensive assessments of new and established thoracic patients

Orders, interprets, and responds to diagnostic studies.

Conducts pre-operative risk assessments and surgical readiness evaluations

Prescribes medications and therapies in accordance with department protocols.

Coordinates progression of care and readiness for discharge.

Documents and Communicates Clinical Information (5%)
Completes timely, accurate, and compliant documentation in the electronic medical record.

Communicates clinical updates to patients, families, and referring providers.

Ensures documentation supports quality outcomes, billing, and compliance standards.

Supports Quality, Safety, and Regulatory Compliance (5%)
Adheres to evidence-based practices, clinical guidelines, and organizational policies.

Identifies opportunities for quality improvement and patient safety initiatives.

Participates in morbidity and mortality reviews, peer review, and quality improvement projects

Participates in peer review, morbidity and mortality reviews, and audits.

Marginal or Periodic Functions:
Participates in community outreach, education, or professional development activities

Assists with orientation and mentorship of new APPs, residents, or trainees

Assists with development or revision of thoracic surgical pathways and protocols

Contributes to research, scholarly projects, or clinical trials as applicable

Serves on departmental or system-wide committees or task forces

Performs other related duties as assigned.

KNOWLEDGE/SKILLS/ABILITIES

Applies advanced surgical first assisting skills during procedures

Proficient

With endoscopic and robotic surgeries

Demonstrates procedural competence and clinical judgment in complex cases

Procedural proficiency with thoracentesis and chest tube thoracostomy

Applies advanced thoracic and surgical clinical knowledge in patient care

Uses evidence-based guidelines to inform treatment decisions

Clinical Judgment

Recognizes subtle changes in patient condition and intervenes appropriately

Balances risks and benefits of interventions in high-acuity settings

Escalates care when clinical thresholds are exceeded

Collaboration

Engages effectively with physicians, nurses, and ancillary staff

Facilitates smooth handoffs across care settings

Builds trust and rapport within high-performing clinical teams

Composure

Performs effectively and functions calmly during high-stress scenarios, emergencies or rapid clinical deterioration

Maintains professionalism in emotionally charged patient or family interactions

Models calm decision-making in high-pressure environments

Patient Focus

Communicates diagnoses, procedures, and care plans clearly and empathetically

Advocates for patient needs and preferences

Supports patient experience and satisfaction goals

Learning on the Fly

Integrates new surgical, procedural and clinical protocols and technologies

Seeks feedback to enhance clinical performance

Adapts to evolving surgical techniques and care models

EDUCATION & EXPERIENCEMinimum Qualifications:

Master’s degree in Nursing or Physician Assistant Studies

Licensed Advanced Practice Registered Nurse (APRN) with National Assistant at Surgery Certification (NASC) and Prescriptive Authority or Physician Assistant with Prescriptive Authority

Minimum 2 years of relevant clinical experience in surgery

Relevant education or experience may be substituted where appropriate

Preferred Qualifications:

Master’s or Doctoral degree with surgical focus

2+ years of thoracic surgery experience

Prior experience in a tertiary or academic medical center

LICENSES, REGISTRATIONS OR CERTIFICATIONSRequired:Current Texas Acute Care Nurse Practitioner (AGACNP) certification with National Assistant at Surgery Certification (NASC)

or PA license

National certification (ANCC/AANP for NP or NCCPA for PA)

Advanced Cardiac Life Support (ACLS)

Preferred:

Acute Care Nurse Practitioner (AGACNP) certification

Advanced Trauma Life Support (ATLS)

Thoracic-specific continuing education or certification

Salary Range:
$133,000+ depending on qualifications

WORKING ENVIRONMENT/EQUIPMENTStandard office equipment

Repetitive use of a keyboard

May be exposed to such occupational hazards as communicable diseases, blood borne pathogens, ionizing and non-ionizing radiation, hazardous medications and disoriented or combative patients, or others.

Important

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