SUPERVISION: Reports to Supervisor of the Hospital Extenders, primary sponsoring physician and collaborating Heart Center (THC) cardiologists on call for the practice.
SUPERVISORY RESPONSIBILITIES: None
HOURS EXPECTED: Various shift work will be coordinated in order to accommodate approximately 35-40 hours weekly. Coverage needed 24 hours daily.
Minimum Knowledge, Skills, Experience Required
Knowledge, Skills, & Abilities: Knowledge of the professional medical practice and care to administer, direct, and evaluate patient care. Knowledge of THC and hospital organizational policies, regulations, and procedures to administer patient care. Knowledge of medical equipment and instruments to administer patient care. Knowledge of common safety hazards and precautions to establish a safe work environment. Skill in applying and modifying the principles, methods, and techniques of medicine to provide ongoing patient care. Skill in taking medical history, assessing medical conditions, and interpreting findings. Skill in establishing and maintaining records, writing reports, and responding to correspondence. Skill in developing and maintaining quality assurance. Skill in establishing and maintaining effective working rapport with patients, medical staff, and the public. Ability to maintain quality control standards. Ability to react calmly and effectively in emergency situations. Ability to interpret, adapt, and apply guidelines and procedures. Ability to communicate clearly. Knowledge of organizational policies and procedures. Uphold effective work habits including, but not limited to, regular attendance, teamwork, initiative, dependability, and promptness.
SCHEDULING OF WORK DAYS: The schedule will be provided to the CRNP/PA on a monthly basis. An equitable holiday and vacation schedule will be coordinated for all CRNP/PAs in this position, whether their employment is full time or part time. Advance notice of intent to attend a continuing education program or take a vacation will be made known to the Supervisor or his designee to allow time for appropriate scheduling changes. Every reasonable effort will be made by CRNP/PAs in this position to accommodate emergency situations or illness on the part of any of CRNP/PAs.
TYPICAL PHYSICAL DEMANDS: Requires full range of body motion including handling and lifting patients, manual and finger dexterity, and eye-hand coordination. Requires standing and walking for prolonged periods of time. Occasionally lifts and carries items weighing up to 50 pounds. Requires normal visual acuity and hearing. Requires exposure to communicable diseases and body fluids. Requires working under stress in emergency situations and irregular hours.
TYPICAL WORKING CONDITIONS: Frequently exposure to communicable diseases, blood and body fluids, toxic substances, ionizing radiation, medicinal preparations, and other conditions common to a hospital environment.
Education: Graduate of an accredited Nurse Practitioner or Physician Assistant program.
EXPERIENCE: 5 years of cardiology experience preferred. Must maintain cardiac patient care expertise, which includes 12 lead EKG interpretations, advanced patient assessment and care planning skills, risk reduction, dictation and documentation skills, and evaluation and reassessment skills.
CERTIFICATE/LICENSE: Current Alabama CRNP or PA license. Current national certification. Maintain ACLS and BCLS certification
EVALUATION OF PERFORMANCE: Annual evaluation by the Supervisor with input by collaborating physicians, to be provided in writing to the CRNP/PA and discussed in individual meetings with the primary sponsoring physician and/or Supervisor and CRNP/PA. Opportunities for improvement will be written in collaboration between the Supervisor, the primary sponsoring physician and the nurse practitioner.
QUALITY ASSURANCE: Quality assurance will be an on-going process. This will done by evaluation of all patient charts by the primary sponsoring physician and/or any collaborating physician on a daily basis. Feedback to the nurse practitioner will be promptly provided. Any specific issues will be discussed personally by the physician and the nurse practitioner.
Key Responsibilities / Essential Functions
1. Respond quickly and assess emergencies until cardiologist arrives. Initiate and/or direct basic and advanced life support protocols until arrival of cardiologist.
2. Telephone triage - primarily with questions from hospital nurses and patients.
3. Work up admissions under the direction of the physician on call. Acts as scribe for physician in the following areas:
· Complete medical history and dictate as directed, facilitate, discharge 23hr observation patients
· Review all records
· Complete physical examination
· Record results in medical chart
· Make presumptive diagnoses
· Orders appropriate laboratory and diagnostic procedures
· Formulate therapeutic plan
· Collaborate with cardiologist on management issues
· Write prescriptions appropriate for patient’s diagnoses and medication needs at discharge
4. For Cardiac Short Stay Unit Services
· Assure that each cath and EP inpatient has a completed H & P for the following day
· Assist with and identify the educational proctoring needs of staff in CSSM.
· Assure that 23-hour observation patients are discharged in a timely manner. Provide discharge teaching, prescriptions, and coordinate care of cardiac short stay patients.
· Assess, evaluate and participate in the care of cardiac short stay patients with special emphasis on intervention when patients are not progressing as expected.
· Implement ACLS protocols in decompensated patients.
· Recommend initiation of track order sets in all ACS patients.
5. At shift change, update incoming cardiologist or nurse practitioner regarding patient activities during the hours covered by the off-going practitioner, including data, triage situations, etc.
6. Communicate with cardiologist in a timely manner with regard to all of the above. Promptly consult and relay any urgent, unusual, or critical situations.
7. Promote a harmonious health care team environment.
8. Participate in professional development activities; maintain professional affiliations and professional national certification.
9. Maintain patient confidentiality in compliance with The Heart Center, P.C., hospital, and HIPAA rules and regulations.
10. Perform related work as required.