Job DescriptionServes as a recognized leader and expert resource in diagnosing the full breadth of clinical presentations. Effectively navigates the most complex or ambiguous circumstances with pediatric patients (from neonates to adolescents and young adults) and their families. Facilitates the interdisciplinary care of patients. Teaches and mentors staff in area of expertise. Promotes the role of the team as contributors to the broader organization's overall effectiveness, well-being, and culture.
ResponsibilitiesMedical knowledge- Clinical knowledge. Applies breadth of medical knowledge that spans the continuum from simple to complex problems, incorporating evidence-based practice and current literature to support care. Teaches students and other less experienced APPs, providing education and oversight.
- Diagnostic Evaluation. Prioritizes and optimizes evaluation based on risks, benefits, indications, and alternatives to clarify the diagnosis(es). Interprets clinical significance of diagnostic study results while considering study limitations. Educates others about risks, benefits, indications, and alternatives to guide diagnostic decision-making. Teaches others to interpret clinically significant results and consider study limitations.
Patient History. Gathers, filters, prioritizes, and synthesizes patient history to develop a differential diagnosis in real-time for complicated or atypical presentations. Recognizes and probes subtle clues from patients and families; distinguishes nuances among diagnoses to efficiently drive further information gathering.
Patient care- Clinical reasoning. Role models and coaches others in the organization and integration of clinical facts (e.g., history, exam, tests, consultations, etc.) to develop prioritized differential diagnoses, including life threatening diagnoses, atypical presentations, and complex clinical presentations. Reappraises in real time to avoid diagnostic error.
- Organize and prioritize patient care. Serves as a role model and coach for patient care responsibilities. Organizes, prioritizes, and collaborates with others even when patient volume approaches the capacity of the individual or facility; anticipates and triages urgent and emergent issues.
- Patient management. Serves as a role model and coach for development of management plans for complicated and atypical diagnoses, with the ability to modify plans as necessary.
Procedures as defined by clinical department. Applies full competency in core procedures. Coaches and mentors others in the performance of procedures. Please reference the "APP Procedures Listing" for those relevant to the Medical Specialty.
Interpersonal and Communication- Patient and family centered communication. Mentors others in developing positive and culturally competent therapeutic relationships with patients/families, including those relationships involving ambiguity and/or conflict. Models and coaches others in patient and family centered communication. Elicits patient/family values and incorporates awareness of these in communications with patient/family and in patient care. Uses shared decision making with patient/family to make a personalized care plan.
- Interpersonal and team communication. Influences relationships with supervising physician(s) and referring providers that maximizes adherence to practice recommendations and fosters collaborative practice. Coaches others in effective communication within the inter-professional team.
- Communication within Health Care System. Models and coaches others in documenting diagnostic and therapeutic reasoning. Concisely documents updated, prioritized, diagnostic and therapeutic reasoning, including anticipatory (preventive) guidance, in the patient record. Identifies areas for preventive counseling. Aligns type of communication with message to be delivered (e.g., direct and indirect) based on urgency and complexity. Coaches others in written and verbal communication.
Practice-based learning and improvement- Evidence-based and informed practice. Critically appraises data and applies evidence, even in the face of uncertainty and conflicting evidence, to guide care tailored to the individual patient, including integrating patient preference. Coaches others to critically appraise and apply evidence for complex patients. Contributes to evidence-based practice based on program needs.
- Reflective practice and commitment to personal growth. Role models and coaches others in proactively seeking and incorporating feedback and performance data. Continues to expand clinical knowledge to deepen expertise and enhance role as department resource.
Professionalism- Models professional behavior and maintains composure in all circumstances. Coaches others when their behavior fails to meet professional expectations. Proactively seeks guidance in new or unusually difficult circumstances.
- Coaches and supports colleagues to optimize well-being at the team level. Constructively highlights to lead/manager concerns that impact the cohesiveness and well-being of the team. Proactively presents viable solutions for discussion.
System-based practice- System navigation for patient centered care-coordination of care. Coaches others in inter-professional, patient-centered care coordination among different disciplines and specialties actively assisting families in navigating the health care system. Provides leadership to sustain and optimize inter-professional patient-centered care.
- Population and community health. Adapts practice to provide for the needs of and reduce health disparities of a specific patient population.
- Organizational View. Promotes the role of the team as contributors to the broader organization's overall effectiveness, especially in relation to improving patient care, systems and processes, and the overall culture and well-being of the organization. Constructively and proactively addresses considerations of others related to the same.
QualificationsMinimum Education and Experience RequiredMinimum education (degree/type of degree).
- Advanced Practice Nurse Practitioner: Graduate degree in nursing accredited by one of the national certifying bodies in nursing. (Or, on or before December 31, 2004, completion of an advanced nurse practitioner program recognized by a national certifying body for certification as a nurse practitioner.)
Or...
- Physician Assistant: Graduation from a physician assistant program accredited, at the time of graduation, by the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA).
Minimum experience (minimum years & type of experience): At least 5 years of APP experience.
Preferred education & experience: n/a
License and/or CertificationRequired:
At time of hire and maintenance at time of appointment or privilege approval:
- Current State of Connecticut (Pediatric) Advanced Practice Registered Nurse (APRN) licensure. OR
- Certified by the National Commission on Certification of Physician Assistants, Inc. (NCCPA). Current State of Connecticut Physician Assistant licensure.
Additionally:
- Depending on privileges for role, Basic Life Support (BLS) and/or Pediatric Advanced Life Support (PALS) certification may be required.
- Depending on privileges for role, federal DEA and CT controlled substance registration may be required.
- Please reference the document: "APP: Certifications by Specialty."
Knowledge, Skills, and Abilities - Medical knowledge and procedures:
- Demonstrates an expertise in the depth and breadth of medical knowledge to effectively and independently attend to the most complex and nuanced of clinical presentations within appropriate authority.
- Ability to evaluate patient outcomes and implement new procedures and policies, as needed.
- Fully competent in performing the core procedures of the department and increasingly proficient at performing the most complex procedures.
- Communication:
- Exemplary written and verbal communication skills with the ability to modify communication strategy/method for the audience and circumstance.
- Highly organized in the presentation of essential information.
- Ability to tactfully and proactively address concerns and propose solutions.
- Interpersonal:
- Demonstrates leadership and an ability to garner the respect of others.
- Ability to maintain composure in complex and stressful situations and in the midst of ambiguity or uncertainty.
- Skilled at effectively and proactively engaging patients/families in developing a care plan.
- Ability to facilitate and coordinate care across all levels of professionals and specialties.
- Professionalism, Organizational view:
- Exemplifies leadership with a broader organizational view.
- Demonstrates a sense of accountability for the broader patient care team, especially for those mentored.
