Nurse Practitioner or Physician Assistant - Vascular Surgery Hospitalist

At Duke Health, we're 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 Healthhospitals 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 Vascular Surgery Hospitalist Advanced Practice Provider (NP or PA-C) provides direct patient care services for surgically and medically ill vascular surgery patients in Duke Hospital, the DMP or in the clinic in collaboration with physicians. The NP or PA 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, may assist in the operating room and provides direct patient care services. The Nurse Practitioner or Physician Assistant contributes to excellence in patient care, research, education and provides leadership in the organization. Job Duties and Responsibilities

• In collaboration with attending surgeon(s) and/or 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 hospitalist supervising physician or back up physician who is either on site or available by pager.
• Collaborate with the chief resident, residents, fellows, attending other NP/PA colleague?s nurses, and patient resource managers 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 until physician support arrives.
• 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 so as 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, resident and/or intern at the end of the shift

The NP/PA may order and/or perform the following procedures:

• Patient history and perform physical exam
• Patient discharges
• Laboratory, radiology, and/or diagnostic procedures/tests
• Interpretation of laboratory, radiographic and diagnostic tests
• Critical thinking skills
• EKG interpretation
• Suture / Staple removal
• Application of dressings, bandages, NPWT
• Simple debridement
• Manage and insert cantor tubes, NG tubes
• Manage support devices, including (but not limited to) hemovac, JP drains, arterial lines, NPWT/Wound Vacs
• Removal of superficial foreign bodies
• Application of dressings and bandages.
• Inhalation therapy or medications to alleviate the distress of dyspnea or shortness of breath.
• Venipuncture for blood sampling
• Blood sampling via central venous lines, including:

• • Administration of infusion therapy/ oral medications including: but not limited to
  • Anticoagulants
  • Analgesics, Narcotics, including Patient Controlled Analgesia
  • Antibiotics
  • Antifungals
  • Antivirals
  • Antiarrhythmic
  • Antihypertensive
  • Immunosuppressant
  • IV Fluids
  • Electrolytes
  • Benzodiazepines
  • Muscle relaxants
  • Local anesthetics
  • Blood products - Packed Red Blood Cells and / or Platelets

Other related duties to include education, research utilization and investigation, consultations and leadership are expected from APPs in this position. Job Eligibility Requirements Education PA: Graduate of ARC accredited Physician Assistant Program. Master?s or Doctoral degree strongly preferred. NP: Graduate of an accredited MSN or DNP Acute Care / Critical Care Nurse Practitioner program. Certification PA: PA-C NP: ACNP or AGACNP is REQUIRED. Licensure PA: Current unrestricted medical license issued by 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 Prescriptive Authority Experience: 1 or more years APP experience in a similar setting is preferred but not required OR AN EQUIVALENT COMBINATION OF RELEVANT EDUCATION AND/OR EXPERIENCE Physical and mental requirements :

• Able to clearly articulate scope of practice, and practices within those guidelines as a Nurse Practitioner / Physician Assistant in the state of 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, healthcare 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 & interventions; prepare reports and presentations;
• Able to use 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 12-hour shifts providing daytime coverage Monday - Saturday (1 weekend per month on average).

• Fourteen shifts per month (or an equivalent of shifts and paid time off)
• 5:00am-5:00pm shift

Schedule may be changed by administrative or clinical leadership to meet department needs.

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 on the 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.

As a world-class academic and health care system, Duke Health strives to transform medicine and health locally and globally through innovative scientific research, rapid translation of breakthrough discoveries, educating future clinical and scientific leaders, advocating and practicing evidence-based medicine to improve community health, and leading efforts to eliminate health inequalities.

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