Position Summary
Department: Critical Care Medicine
Locations: Horizon West Hospital in Winter Garden Florida
Shifts: Nights
Position Title: Advanced Practice Provider, APP, Nurse Practitioner, Physician Assistant, ARNP, NP, PA, PAC
Position Summary:Under the supervision of the physician, according to established practice guidelines and utilizing evidence-based clinical practice standards, provides inpatient management, consultations, and co-management of critically ill patients.
Responsibilities
- Possess specialized skill and knowledge unique to the ICU setting in which they practice (Medical, Surgical, Neurosurgical, Cardiovascular, etc)
- Provides direct clinical services for critically ill patients according to established protocols and utilizes evidence-based clinical practice standards.
- Obtains comprehensive and focused history and physician exam on critically ill patients
- Responsible for evaluating critically ill complex (multi-organ failure) patients in the ICU and step down units by synthesizing data, physical exam and pertinent medical history to assess clinical scenario and prescribe appropriate interventions and medications.
- Uses clinical judgment and evidence based medicine to order and schedule appropriate laboratory and radiographic studies.
- Works with supervising physician to determine and place appropriate specialty consultations.
- Evaluates critically ill patients in the ICU and step down units by synthesizing data, physical exam and pertinent medical history to assess clinical scenario and prescribe appropriate interventions and medications.
- Works in collaboration with supervising and consulting physicians to formulate and implement plan for management of critical ill patients.
- Performs complex procedures in the diagnosis and treatment of medical and surgical problems (including but not limited to: Central venous catheter placement, arterial catheter placement, chest tube placement, lumbar puncture, thoracentesis, paracentesis, endotracheal intubation, therapeutic bronchoscopy -i.e removal of secretions and BAL.)
- Performs advanced cardiac life support. In a medical emergency, the nurse practitioner will act on behalf of the supervising medical staff member to maintain life support until a licensed physician arrives to manage the patient.
- Removes catheters, drains, sutures and staples.
- Interprets arterial blood gas report and appropriate management of invasive and noninvasive modes of mechanical ventilation.
- Assesses need for vasoactive medication and places appropriate order sets and titration parameters.
- Interpretation of invasive and noninvasive hemodynamic monitoring, waveforms and EKG and institutes appropriate interventions.
- Interprets radiographic tests, including but not limited to CT scan, MRI and X-rays.
- Operates with the highest degree of independence in provision of patient care services with minimal physician supervision and generally in a highly specialized area
- Performs emergent lifesaving procedures in cases such cardiac arrest, respiratory arrest, massive hemorrhage, or similar catastrophe.
- Performs preliminary daily rounds independently and daily multidisciplinary rounds (i.e., attending physicians, fellows, pharmacist, dietician, respiratory therapist)
- Assesses patient for changes in status and capable of instituting appropriate interventions in sub-acute, acute and emergent situations.
- Notifies attending physician about unusual or unexpected events or problems requiring direct physician consultation.
- Initiates necessary emergent interventions to stabilize acutely deteriorating patients.
- Prescribes medication using evidence based medicine, clinical judgment and plan of care as discussed in rounds as agent for supervision physician.
- Writes and/or dictates concise thorough patient progress notes, consult notes, history and physical notes and clinical resumes.
- Documents the preparation, procedure, outcome and complications of therapeutic and diagnostic procedures performed.
- Explains the necessity, preparation, nature and anticipated effects of procedures or tests to patients, patient's family and staff.
- Provides family-centered care by communicating with family regarding the changing health care status of their family member.
- Provides family education as needed and works to answer or address family's questions or concerns.
- Assesses family adaptation, coping skills and need for crisis or other intervention.
- Utilizes current research and evidence based medicine approach in all clinical practice.
- Supports IRB approved clinical research/trials through a variety of activities including but not limited to: ordering diagnostic tests, prescreening patients, recording laboratory and diagnostic results, administering therapeutic interventions per trial protocols and documenting outcomes per hospital and trial protocols.
- Remains in compliance with national accreditation and state licensure
- Participates and supports accreditation, compliance, policies, procedures and regulatory activities.
- Embodies professionalism through conduct, appearance, communication, mutual respect, ethical decision making and leadership skills.
- Demonstrates responsibility for professional practice through active participation in professional organizations and continuing education.
- Contributes to excellence in patient care, research, teaching and consulting.
- Provides appropriate patient and family education.
- Maintains reasonably regular, punctual attendance consistent with Orlando Health policies, the ADA, FMLA and other federal, state and local standards.
- Maintains compliance with all Orlando Health policies and procedures.
- Participates in basic science and clinical research projects.
- Other duties as assigned.
Qualifications
Education/Training Nurse Practitioner
- MN or MSN or DNP or PhD or DNS degree in nursing.
Physician Assistant
- Graduate of accredited physician assistant program.
Licensure/Certification Nurse Practitioner
- APRN license in the state of Florida.
- After July 1, 2006, licensure applicants are required to have national advanced certification from an approved nursing specialty board.
- Maintains current BLS certification.
Physician Assistant
- Maintain current physician assistant licensure in State of Florida.
- Maintain current BLS/healthcare certification.
Experience - Two (2) years of Critical Care Advance Practice Provider experience required
