Purpose of Position
The Nurse Practitioner and/or Physician Assistant ICU Swing is a member of the intensive care team and has as his/her primary responsibility is the management of a caseload of critically ill complex (multi-organ) patients in an intensive care setting as well as backup care of the cardiology patients in the ICU as well as backup to the Hospitalists team when needed. A team of effective Critical Care Nurse Practitioners/Physician Assistants will provide 24 x 7 coverage of the ICU service, building a common practice with his/her colleagues and with the supervising ICU physicians. Handoffs in the morning and evening by the Critical Care Practitioners on all patients on the ICU service will provide an opportunity for daily feedback and coordination of the team's practice. Daily multi-disciplinary rounds with the ICU physician on all patients allow the team to develop a unified strategy for protocolized care. The night coverage of the ICU service by the Critical Care Nurse Practitioners will be supported by existing on-site resources as well as a dedicated back-up ICU attending who would be available by phone or to provide hands-on care if necessary. The Critical Care Nurse Practitioner/Physician Assistants will be expected to perform triage responsibilities in the off hours to aid in ICU discharge/transfer planning. The Critical Care Nurse Practitioners/Physician Assistants' daily patient care workflow is under the supervision of the ICU physician or designated back-up physicians. The overall reporting of the CCAP is to the Chief of Critical Care, who will review and support scheduling models, education, and procedural training. In addition, the Critical Care Nurse Practitioners will be expected to contribute to development of ICU protocols and quality initiatives. Critical Care Nurse Practitioners/Physician Assistants will be expected to have excellent communication skills and will develop collaborative relationships with the intensivists, hospitalists, cardiologists, as well as with the ICU consultants. The Critical Care Nurse Practitioner/Physician Assistant contributes to excellence in patient care, research, teaching, consulting, and provides leadership to the organization and nursing profession.

Description
 Performs physical exams, collects and documents data, orders and schedules laboratory studies and professional consultations, makes and confirms diagnoses, prescribes appropriate interventions and medications, and provides direct patient care services under the general supervision of the supervising physician.
 Perform therapeutic or diagnostic procedures based upon patient clinical status to include performance of procedures to include central lines, arterial lines, temporary hemodialysis catheters, paracentesis, thoracentesis , pigtail catheters, intubation, cardioversion, and lumbar puncture .
 Explain the necessity, preparation, nature and anticipated effects of procedure(s) to patients, patient family, staff, and healthcare learners.
 Provide first contact for critical care consultations in select cases outside of the ICU service.
 Assess patient for change in status and institute appropriate interventions , compatible with their training, and initiate necessary emergency interventions to stabilize patient.
 Formulate and implement treatment plan for acute illness management in collaboration with the designated primary supervising physician and/or attending back-up physician(s)
 Document in medical records and appropriate narrative summaries. Bill as a practitioner when appropriate, per ICU service guidelines.
 Provide family-centered care by communicating with the family regarding the hanging health care needs of their family member. Assess family adaptation and coping.
 Back up coverage to the Cardiology team for patients in the ICU.
 When needed, assist the Hospitalists' team with cross-coverage and/or admissions.
 Other duties as assigned.

Qualifications
EDUCATION/EXPERIENCE/TRAINING (NP) :
 (MSN) - Master of Science in Nursing
 ( CNP ) - Currently licensed as a Certified Nurse Practitioner in the Commonwealth of Massachusetts
 (DEA) - US Department of Justice DEA Registration (required if prescribing)
 (ACLS) - Advanced Cardiac Life Support certification (obtain within 30 days of position start, offered within)
 Successful candidate must have critical care advanced practitioner experience
 Demonstrates the ability to be thoroughly trained to meet organizational standards
 Adept at communication with patients and staff
 Must be proficient in the placement and management of Vascular Access catheters including arterial catheters, and central venous catheters
 Must be able to perform basic Ventilator management

EDUCATION/EXPERIENCE/TRAINING (PA) :
 (MPAS) - Masters from a program accredited by the ARC-PA
 ( PA ) - Currently licensed as a Physician's Assistant in the Commonwealth of Massachusetts
 (DEA) - US Department of Justice DEA Registration (required if prescribing)
 (ACLS) - Advanced Cardiac Life Support certification (obtain within 30 days of position start, offered within)
 Successful candidate must have critical care advanced practitioner experience
 Demonstrates the ability to be thoroughly trained to meet organizational standards
 Adept at communication with patients and staff
 Must be proficient in the placement and management of Vascular Access catheters including arterial catheters, and central venous catheters
 Must be able to perform basic Ventilator management