Advanced Practice Provider - Pulmonary & Critical Care - Days / Nights

VCU Health System's Internal Medicine - Pulmonary / Critical Care is seeking a full time Nurse Practitioner or Physician Assistant (Advanced Practice Provider (APP) located in the Medical Respiratory ICU (MRICU). Advanced provider skills and judgment are necessary for this position. The APP will function as an essential member of a multidisciplinary team to provide ongoing medical critical care consultative services and / or direct patient care to critically ill adult inpatients including patients with acute and chronic respiratory failure and / or critically ill or complex medical patients. Hours will include days, evenings, nights, weekends and holidays.

Responsibilities : Ability to make autonomous clinical judgments and independently implement management plans with minimal physician supervision. Manage patients with acute and chronic respiratory failure, pulmonary diseases (including but not limited to : management of mechanical ventilation, tracheostomies, infections, and obstructive lung disease), ordering and interpretation of diagnostic tests and procedures, and managing other critically ill patients in an ICU setting (including but not limited to : septic shock, hemorrhagic shock, liver failure, renal failure, acute respiratory failure, and multiple organ failure). Demonstrate ability to work within a multidisciplinary team (physicians, nurses, RT, RD, Pharm D etc...) to consult on and care for critically ill patients on a medical ICU service.

The Nurse Practitioner job demonstrates a high level of expertise in the assessment, diagnosis, and treatment of the complex responses of individuals, families, or communities to actual or potential health problems, prevention of illness and injury, maintenance of wellness, and provision of comfort. This role assists the health care team with the prevention of illness and injury, maintenance of wellness, and provision of comfort.

The Nurse Practitioner job continues to perform many of the same interventions used in basic nursing practice. The difference in this practice relates to a greater depth and breadth of knowledge, a greater degree of synthesis of data, and complexity of skills and intervention. ANA's Scope and Standards of Advanced Practice Registered Nursing (1996).

Essential Job Functions

Performance Expectation : Pertains to Staff in Licensed Nursing Positions ONLY

Employee must complete 15 contact hours of Continuing Nursing Education during this evaluation cycle.

Failure to achieve the required number of contact hours will result in the employee ineligible to receive an overall performance rating above "Fully Meets".

Performance Expectation : Expert Coaching & Guidance

The APN-Practitioner is a strong proponent of coaching and guidance as evidenced by :

Planning and implementing steps to resolve problems affecting patient care quality and evaluates results.

Role modeling patient advocacy.

Challenging and adapting systems to maximize the benefits of patient care.

Demonstrates advanced assessment skills in assessment, management of disease, and treatment-related side effects.

Recommending goals and interventions for medical and nursing plan of care plans based on current literature.

Promoting individual involvement and development of others.

Demonstrating expert knowledge to coordinate patient care across the continuum of services : inpatient, ambulatory, and home health through the patient's trajectory of illness.

Developing and evaluating educational materials and teaching interventions for staff, patients / caregivers, and the community.

Fostering skill development of others

Assessment, diagnosis, and monitoring to improve the skills of students and staff.

Mentoring the APN's role in the health system to promote quality patient outcomes.

Performance Expectation : Consultation

The APN-Practitioner maintains a therapeutic relationship with the patients, caregivers, and staff throughout the health care continuum.

Consultation and support is evidenced by :

The ability to organize and facilitate patient support groups as needed.

Serving as a liaison, translator and negotiator for staff, patients and families.

Utilizing experiences and resources to staff regarding routine and unusual therapeutic interventions.

Promoting teamwork through effective communication and feedback to team members.

Recognizes team as integral to individual effectiveness and quality patient outcomes.

Identifying unit, departmental / regional and hospital issues.

Suggests changes in an effort to connect system problems.

Functions as a consultant in the multi-disciplinary team.

Performance Expectation : Research Skills

The APN-Practitioner participates in clinical practices for a population of patients based on the application of clinical research findings and evidence-based practices as evidenced by :

Identifying areas of need for nursing or medical research.

Actively seeks / participates in and / or monitors this research.

Utilizing current research to develop, implement and evaluate critical paths and standards of care for identified patient populations.

Incorporating research findings into practice.

Contributing to the profession through participation in research, publications, consultation and / or educational activities.

Performance Expectation : Clinical & Professional Leadership

The APN-Practitioner works with colleagues and or professional organizations in the advancement of clinical practice and fosters professional leadership behaviors as evidenced by :

Consistently using nurse / patient relationship to positively affect the health care experience and promote adaptation to changing health status.

Utilizing the Performance Improvement Process to address clinical practice and system changes within the organization.

Seeking out opportunities for professional growth through organizational affiliations and certification in specialty area.

Demonstrating mastery of nursing care of specialty populations.

Expert documentation reflecting holistic and interdisciplinary patient care.

Initiating and participating in departmental / specialty educational endeavors.

Case managing identified target populations and diseases.

Valuing the patient / family right to receive quality cost effective care and facilitates this process.

Looked upon as a Role model self-leadership in own professional development : setting outcomes, seeking needed resources or learning, seeking and accepting feedback.

Serving as a preceptor for advanced practitioners / students / medical staff / nursing staff and others.

Performance Expectation : Collaboration

The APN Practitioner initiates referrals and coordinates the health care team to meet the patient / family needs by utilizing collaborative relationships between nursing and other disciplines as evidenced by :

Collaborating in development, implementation, communication, and monitoring of the multidisciplinary / interdisciplinary plan of care for complex patients.

Structuring multidisciplinary systems to facilitate these processes.

Working with others to promote health and present illness in patients, families, staff, and community.

Networking with payers and community resources to ensure quality outcomes.

Participating as a team leader / member in the provision of health care.

Interacting with professional colleagues (within / outside the facility) to provide comprehensive continuity of care.

Performance Expectation : Nurse Practitioner

The APN- Practitioner's instinctive grasp of clinical situations reflects comprehensive knowledge and experience as evidence by :

Assessing the health status of individuals through health histories, by performing physical examination, initiating screening, ordering or performing a diagnostic, and therapeutic intervention requiring skill and education beyond that of a registered nurse. Interpreting information obtained from history and physical and developing a treatment plan.

Formulating and prioritizing appropriate short-term and long-term therapeutic plans when indicated.

Plan of care incorporates the physical, spiritual, cultural, and psychosocial aspects of patients and families to promote optimum levels of health.

Management of patients in clinical specialty and other related disorders in individuals.

Focusing on health maintenance in clinical management of chronically ill patients.

Initiating emergency procedures as indicated.

Exploring strategies to decrease length of stay and resource consumption within specialty.

Utilizing clinical pathways to coordinate patient care across the full continuum of services : inpatient, ambulatory and home health, or through the patient's trajectory of illness.

Establishing priorities to meet the health needs of the individual, family or community.

Developing a treatment plan, establishing a mutually acceptable evidence based, cost effective plan of care to maximize health potential

Performance Expectation : Ethical Decision-making Skills

The APN-Practitioner adheres to ethical principles that reflect the standards of the organization and individual behaviors as evidenced by :

Incorporating the use of the nursing process and clinical judgment in ethical decision making.

Practicing the principles of ethics in decision making for patients.

Promoting the use of interdisciplinary collaborative processes to resolve ethical dilemmas.

Demonstrating appropriate use of skills of negotiation, mediation, collaboration, compromise, and accommodation to assist families struggling with ethical decisions.

Displaying the ability to examine patient's values that impact treatment decision-making preferences.

Recognition of patient rights as a foundation for ethical decisions.

Performance Expectation : Miscellaneous Responsibilities

Performs other duties as assigned and / or participates in special projects in order to support the mission of VCUHS and department.

Provides assistance to team members.

Accepts alternate assignments, as required, graciously.

Licensure, Certification, or Registration Requirements for Hire :

Current RN licensure in Virginia or eligible

License to practice as NP in the specialty area in the Commonwealth of Virginia

Prescriptive Authority when required

Licensure, Certification, or Registration Requirements for continued employment :

Current RN Licensure in Virginia Credentialing in accordance with medical staff by-laws for specific job title

License to practice as NP in the specialty area in the Commonwealth of Virginia

Prescriptive authority when required

Experience REQUIRED :

Minimum of two (2) years experience as a RN

Experience PREFERRED :

Academic health care experience

Two (2) years within the specialty practice area Advanced Practice Nursing Role or Clinical Leadership Role experience

Education / training REQUIRED :

Master's Degree in Nursing from an accredited program specific to area of practice

• Applicants with current advanced practice licensure may be within one semester of graduation from obtaining a MSN degree or higher, which must be completed within six months of hire to continue employment.

Education / training PREFERRED :

N / A

Independent action(s) required :

Clinical decision-making in collaboration with physicians and daily prioritization of activities.

The allocation of time spent in patient care and elsewhere is largely self-determined.

Supervisory responsibilities (if applicable) : N / A

Additional position requirements : N / A

Age Specific groups served :

As appropriate based on unit assignment.

Physical Requirements

(includes use of assistance devices as appropriate) :

Physical : Lifting 50-100 lbs.

Other : Exposure to potentially hazardous and infectious substances

Activities : Prolonged standing, Frequent bending, Walking (distance), Climbing (steps, ladder, other), Reaching (overhead, extensive, repetitive), Repetitive motion

Mental / Sensory : Strong recall, Reasoning, Problem solving, Hearing, Speak clearly, Write legibly, Reading, Logical thinking

Emotional : Fast pace environment, Steady pace, Able to handle multiple priorities, Frequent and intense customer interactions, Noisy environment, Able to adapt to frequent change

Rotating

EEO Employer / Disabled / Protected Veteran / 41 CFR 60-1.4.