Job Description:

Principal Duties and Responsibilities:

Function

1. Receive and triage telephone request for information, appointments and/or medication renewals. Make

appropriate and timely decision regarding the patient's compliant and/or request utilizing clinical knowledge and

skill to extract pertinent data.

2. Identify, coordinate and delegate as necessary, appropriate health care professional to facilitate delivery of

care. Provide appropriate and timely communication with the attending physician.

3. Provides thorough and accurate documentation in the medical record by documentation of all pertinent data, therapeutic interventions, patient responses and any medical/surgical procedures.

4. Perform routine bedside procedures and order tests and procedures as indicated.

5. Communicate immediately to attending physicians any gross abnormalities in patient lab levels or test results.

6. Round on Hepatobiliary and Liver Transplant patients on a daily basis as assigned by the attending surgeons

and in coordination with the Transplant Fellow and Surgical resident.

7. Admission history and physical exams; discharge summaries

8. Manages and communicates information through various processes which include but are not limited to the use

of computers, telephone systems, direct and indirect observations and documents in the medical record.

9. Actively involve the patient and family as appropriate in implementing the plan of care. Prioritize care needs

and ensures the appropriate availability and accessibility of treatment for the patient.

10. Develop and initiate the plan of care by collaborating with physician, other health care professionals and

family members. Provides counseling and education to both the patient and the family. Ensures treatment plan

is individualized based on the patient and family’s level of understanding.

11. Participates in grand rounds as necessary to assure continuity of quality care.

12. Documents as indicated in the department database.

13. Complete history and physicals, daily notes and discharges summaries on assigned impatients. Differentiates

normal results from abnormal findings.

14. Obtain detailed history and performs baseline and interval health examinations. Completes medical histories,

physical assessment and differentiates normal results from abnormal findings. Identify wellness and risk

factors; communicating relevant data via dictation and/or provide complete, accurate written documentation in

the patient's medical record.

15. Collaboratively perform biopsies or line placements as indicated by the attending and the needs of the patients.

16. During the admissions process, develop and initiate the plan of care by collaborating with physicians and other

healthcare professionals and family members.

17. Complete history and physicals, daily notes and discharges summaries on assigned inpatients. Differentiates

normal results from abnormal findings.

18. Assist in the maintenance of the Cardiothoracic Computer Database by appropriate data entry.

19. Perform routine health examinatins through baseline histories, review of symptoms and complete medical

histories and physical examinatins. Differentiate normal results from abnormal findings.

20. Completes a quarterly review with the supervising physician on a timely basis.

21. Ensures summaries include complete examinations, office visits, telephone conversations and testing requests

22. Utilize physical assessment skills on an ongoing basis to identify, communicate and document patient

problems. Recognizes changes in mental and physical condition. Implement appropriate action based on

assessment to ensure patient safety, well being and satisfaction.

23. Formulates desired outcomes specific to the individual patient problem/diagnosis and specifies interventions as

appropriate. Prescribe, in collaboration with or at the direction of the attending physician, medications specific

to the patients' diagnosis and level of medication tolerance and in accordance with Lahey Clinic policies and

procedures.

24. Obtain detailed history and performs comprehensive physical examinations. Completes medical histories,

physical assessment and differentiates normal results from abnormal findings. Identify wellness and risk

factors: communicating relevent data via dictation and/or provide complete, accurate written documentation in

the patients medical record. Obtains consents for total joint surgery and implements the study materials.

25. Follow through on achievement or failure of obtaining the desired outcomes and provide timely communication

to attending physician.

26. Ensures treatment plan is individualized based on the patient and family needs.

27. Complies with all policies and procedures as set forth by Lahey Clinic and all state and federal regulations.

28. Ensures summaries include complete examinations, office visits, telephone conversations and testing request.

29. Assist in the operating room as requested.

30. Review of the plan of care on an ongoing basis and revise the plan as necessary per patients progress or lack

there of. In conjunction with the attending physician, research medical protocols to determine an appropriate

change in care plan.

31. Provides complete and accurate documentation in the patient's medical record.

32. Anticipates potential emergency situations and perform appropriate treatment/intervention measures.

Perform a variety of routine procedures to expedite patients' response to plan of care.

33. All documentation is completed in a timely manner per Lahey Clinic policy.

34. Determine and order necessary laboratory and diagnostic tests. Perform and interpret various diagnostic tests

including blood tests, MRI, CT scans, EKGs etc. Assists patients in areas other than the primary specialty including, but not limited to, recognizing the patients' mental and physical conditions and initiates appropriate assistance from other health care professionals.

35. Identify and manage specified acute illness i.e., URI, UTI, vaginitis, etc.

36. Operating room participation, including: saphenous vein harvesting; wound closure; first and second assisting

on cardiac; pulmonary; and esophageal procedures.

37. Determine and order necessary lab and diagnostic tests.

38. Formulates desired outcomes specific to the individual patient problem/diagnosis and specifies interventions as

appropriate.

39. Order and adjust medications in conjunction with attending physicians.

40. Manages and communicates information through various processes which include but are not limited to use of

computers, telephone systems, direct and indirect observation and documents in the medical record.

41. Anticipate and intervene potential problems/complications before they occur and initiates protocols and

therapeutic measures in collaboration with the physician and according to established standards of practice.

42. Identify and manage urgent care i.e., superficial wounds and laceratins, burns, sprains, minor fractures, etc.

43. Perioperative technical procedures, including but not limited to:changing of pulmonary artery, central venous

pressure, triple lumen, and double lumen catheters

b) removal of chest tubes

c) insertion and changing of arterial lines

d) removal of intra aortic balloon pumps

e) removal of temporary epicardial pacing wires

f) insertion of nasogastric tubes

g) emergency endotracheal intubation

44. Meets all guidelines for continuing educaton/recertification for continued practice in the Orthopaedic Surgery

Department.

45. Postoperative patient care (ICU, Step-down unit, and floor)

These duties would include, but are not limited to:

a) Recognition of disturbance in the normal postoperative course recovery following open heart, pulmonary,

and esophageal surgery

b) Recognition and management of postoperative hemodynamic abnormalities including hypertension and

hypotension. This would include the interpretation of hypodynamic data and the use of pressor and inotropic

agents.

c) Recognition and management of arrhythmias, including the use of anti-arrhythmic drugs and the use of an

external cardioverter/defibrillator.

d) The use of an external pacemaker and epicardial pacing wires.

e) Acquisition of information for daily rounds, as determined by the attending surgical staff, and presentation of

this data on each patient.

f) Writing of daily progress notes and orders, under supervision of Chief Resident and/or attending staff

g) Arrange inter service consultation

46. Review test results and act in an expedious manner to correct any abnormal findings.

47. Prescribe, in collaboration with or at the direction of the attending physician, medications specific to the

patient's diagnosis and level of medication tolerance.

48. Monitor and manage stabilized patients with chronic diseases i.e., hypertension, diabetes, thyroid, etc.

49. Review plan of care on an ongoing basis and revise the plan as necessary per patient's progress or lack

thereof. In conjunction with the attending physician, research medical protocols to determine an appropriate

change in care plan.

50. Make appropriate and timely decisions regarding patient complaint and or request utilizing clinical knowlege

and skill to extract pertinent date.

51. Respond to and assist in the treatment of patients requiring emergency care.

52. Write prescriptions and medication orders; dispense sample medications and administer injections and

immunizations under established guidelines.

53. Initiates appropriate assistance from other healthcare professionals as required.

54. Actively involve the patient and family as appropriate in the implementing of the plan of care. Prioritizes care

needs and ensures the appropriate availability and accessibility of treatment for the patient.

55. Provide post operative and post procedure care by removing sutures as indicated and performing wound care.

56. Make referrals to outside health care specialists and provide halth care management for HMO and PPO

members; initiate written referrals to insurance companies as necessary.

57. Educate and actively involve patient and family members in post surgical care.

58. Assist with completion and/or review completed forms i.e.; office visit and lab encounter forms, insurance and disability, worker's compensation, etc. and provide necessary signatures. Provide direction to medical records staff regarding completion of forms and APS release.

59. Identify, coordinate and delegate, as necessary, appropriate healthcare professionals to facilitate the delivery of

care.

60. Teach and counsel patients in preventive health care i.e.; basic nutrition, specialized diets, obesity, smoking,

exercise, sexuality, etc.

61. Assist discharged hospital patients with home treatment preparation and provide education to family members

responsible for providing home patient care.

62. Follow through on an achievement or lack thereof based on outcome evaluation. Provide appropriate and

timely communication with attending physician.

63. Perform minor surgical procedures and provide follow-care i.e.; suturing/suture removal, dressing changes,etc.

in accordance with past training

64. Perform routine procedures i.e., collections of specimens for culture and vaginal or microscopic examination

including PAP smears as well as blood, urine and stool specimens.

65. Provides thorough and accurate documentation in the medical record by documenting all pertinent data,

therapeutic interventions, patient responses and any medical/surgical procedures.

66. Ensure summaries include complete examinations, office vistits, telephone conversations and testing requests.

67. Perform and interpret a variety of diagnostic tests including but not limited to timed vital capacity, audiograms,

pulmonary function tests, tympanometry, visual acuity, electrocardiograms, and skin test.

68. Manages and communicates information through various processes which include but are not limited to the use

of computers, telephone systems, direct and indirect observations and documents in the medical record.

69. Conduct house calls as deemed necessary

70. Communicate relevant patient data via dictation and/or provide complete written documentation in the medical

records including summaries of examinations, office visits, progress notes, telephone conversations,

procedures and tests; maintain patient confidentiality.

71. Adhere to patient care standards as defined by collaborating physician and Medical Director.

72. Attend regularly scheduled provider meetings and serve on committees in order to develop and assist with

planning, developing, implementing and monitoring new or revised clinical programs within group practice.

73. Participate in ongoing educational programs for NP's or PA's; maintain professional development through

organizational and community resources, conferences, workshops, etc.; maintain BCLS certification.

74. Maintain collaborative working relationships with all levels of staff.

75. Provide on-call coverage on designated weekends and holidays, based on a rotation; treat acute care patients

in the office and triage in collaboration with on-call physician.

76. Maintain established departmental policies and procedures, objectives, qual