Physician Assistant - Pediatric Cardiac Stepdown Unit

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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 Duke Health's four hospitals with 1062 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

Job Summary

The Duke Hospital Pediatric Critical Care Medicine Cardiac Stepdown Advanced Practice Provider (APP), including both Nurse Practitioner (NP) and / or Physician Assistant (PA), provides direct patient care services for critically ill pediatric patients aged 0-21 with acute, complex, and chronic illness across a variety of care settings. It is appropriate for the NP to provide care for an aging pediatric patient beyond the age of 21 with a pediatric condition for a limited period of time. Pediatric Cardiac Stepdown APPs will be a part of the Pediatric Critical Care Medicine team and will care for patients on the stepdown unit.

Utilizing acquired knowledge of physiology, pathophysiology and pharmacology, the PCCM APP exercises independent decision making in the assessment, diagnosis and development of the plan of care for patients on the PCCM service. In collaboration and consultation with the supervising physician, the PCCM APP contributes to excellence in patient care. As an advanced practice provider, the PCCM APP is additionally involved in education, consultation, research and leadership throughout the Duke Health System, organization and profession.

Job Duties and Responsibilities

Clinical Expert

• In collaboration with attending(s) and / or fellow / residents, round daily on patients to assess, diagnose, plan treatment, set priorities and realistic outcomes, and evaluate the effectiveness and cost efficiency of patient care.
• Provide and coordinate clinical care for service specific patients through established protocols and under the supervising physician or back up physician who is either on site or available by pager.
• Collaborate with the residents, fellows, attending, other APP colleagues, nurses, and other staff to formulate treatment plans and monitor patient progress.
• Perform procedures specific to the work environment after demonstrated competency and within the guidelines of scope of practice and credentialing protocols.
• Assess patients for change in status and institute appropriate interventions. Initiate emergency interventions in an effort to stabilize the patient
• 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 to 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 healthcare providers.
• Document in the patients' medical record 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 population.
• 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.
• Role model competence in all nurse practitioner / physician assistant advanced skills.
• Give daily handoff to appropriate attending, APP, fellow, resident and / or intern at the end of the shift.
• Provide evidence base clinical care to pediatric patients cared for by the division of PCCM
• Gather pertinent information systematically and skillfully from all sources : History, diagnostic tests, comprehensive physical exams, behavioral and developmental assessments.
• Bill appropriately for all APP services.

Educator :

Research Utilization and Investigation :

Consultant :

Professional Leadership and Development :

Job Eligibility Requirements

Education :

NP : Graduate of MSN or DNP Pediatric Acute Care Nurse Practitioner Program.

PA : Graduate of Master's or Doctoral Degree ARC accredited Physician Assistant program.

Licensure :

NP : Current unrestricted RN license issued by or recognized by the NCBON with approval to practice as an NP.

PA : Current unrestricted medical license issued by NCMB with approval to practice as a PA.

Certification :

NP : PNP-AC is required

PA : PA-C

Experience :

Prior experience as a Nurse Practitioner / Physician Assistant in a pediatric acute care clinical setting strongly preferred with preference for a cardiac-specific background. Registered Nurses with at least 2 years of ICU nursing experience preferred.

Physical and mental requirements

Job Hours

Rotating 12-hour shifts to provide day and night coverage 7 days a week including holidays. Schedule may be modified by the clinical or leadership team.

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 or military status.

Duke aspires to create a community built on collaboration, innovation, creativity, and belonging. Our collective success depends onthe robust exchange of ideas-an exchange that is best when the rich diversity of our perspectives, backgrounds, and experiences flourishes. To achieve this exchange, it is essential that all members of the community feel secure and welcome, that the contributions of all individuals are respected, and that all voices are heard. All members of our community have a responsibility to uphold these values.

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 provision for requests for reasonable accommodation will be provided by each hiring department.