JOB LOCATION

Duke University Hospital

JOB SUMMARY

The Advanced Practice Provider (APP) is a Nurse Practitioner (NP) or Physician Assistant (PA) who provides direct patient care services and performs medical acts as a Nurse Practitioner or Physician Assistant, under the supervision of the supervisory physician to patients on the cardiology service. This position will work with cardiology patients and will rotate with all of the cardiology services including general cardiology, Electrophysiology (EP), Advanced Heart Failure (HF), Ventricular Assist Device (VAD) and the Heart Transplant teams. Areas of clinical work include: all Duke University Hospital inpatient units, Emergency Department, the Cardiovascular Short Stay Unit, and all Hospital based Cardiology clinics. NP or PA performs admission, physical exams, collects and documents data, conducts diagnostic and therapeutic procedures, orders and schedules laboratory studies and professional consultations, prescribes appropriate interventions and medications, coordinates the care and discharge of patients, and provides direct patient care services. The Cardiology APP contributes to excellence in patient care, research, teaching, and provides leadership to the organization

JOB DUTIES and RESPONSIBILTIES

• The ACNP/PA will evaluate new patients, consult and established patients on the cardiovascular service as well as diagnose, treat and manage common conditions in the cardiovascular patient population.
• Perform an appropriate history and physical exam on all assigned patients. The ACNP/PA will write progress notes; prepare patient workups and summaries noting pertinent positive and negative findings; a psychosocial history will be obtained relevant to patient care. The ACNP/PA will assume responsibility for developing therapeutic relationships with patients.

• Facilitate and order diagnostic studies including echocardiograms, cardiolite stress test, magnetic resonance imaging and cardiac catheterization if indicated, review with attending MD.

• Order and schedule laboratory studies and diagnostic procedures. Explain necessity, preparation, and nature and anticipated effects of scheduled diagnostic and therapeutic procedures to the patient and family.

• Work closely with the inpatient rounding teams including attendings, APP's, residents and Fellows to appropriately allocate workload based on daily census, clinical and operational needs.
• Assist in the training of new employees, students and fellow trainees, to the limits of competence, and actively participate in educational conferences.
• Discharge all assigned admitted/procedural/surgical patients, as directed by the Attending physician, including, but not limited to, dictating discharge summary, patient education, patient wound care instructions, and prescriptions and entering discharge orders.

• In collaboration with attending and/or residents, round daily on patients to assess, diagnose, plan treatment, set priorities and realistic outcomes, and evaluate the effectiveness and cost efficiency of patient care.
• Provide and coordinate clinical care for service specific patients through established protocols and under the hospitalist supervising physician or back up physician who is either on site or available by pager.
• Collaborate with the chief resident, residents, fellows, attending other NP/PA colleague's nurses, and patient resource managers to formulate treatment plans and monitor patient progress.
• Perform procedures specific to the work environment after demonstrated competency and within the guidelines of scope of practice and credentialing protocols.
• Analyze clinical practice patterns so as to provide the best medical care and to increase effectiveness and efficiency.
• Prescriptive authority for prescribing, ordering, and or administering drugs; including (but not limited to) schedule II, III, IV, and V drugs and necessary medical devices.
• Give daily handoff to appropriate attending, resident and/or intern at the end of the shift.

JOB ELIGIBILITY REQUIREMENTS

Education

PA: Graduate of ARC accredited Master's Degree or Doctoral Degree Physician Assistant program.

NP: Graduate of accredited MSN or DNP Acute Care Nurse Practitioner program for adult care.

Certification

PA: PA-C

NP: ACNP or AGACNP

Licensure

PA: Unrestricted medical license issued by NCMB with approval to practice as PA.

NP: Unrestricted RN licensure issued by or recognized by the NCBON with approval to practice as an NP.

Both: Federal and State DEA with full prescriptive authority

Experience

Strongly prefer candidate with at least one year of provider experience in cardiology setting, but will also consider a new or recent graduate with relevant nursing experience or clinical rotations.

Physical and mental requirements:

• Able to clearly articulate scope of practice, and practices within those guidelines as a Nurse Practitioner / Physician Assistant in the state of North Carolina and within the Duke University Health System.

• Able to independently seek out resources and work collaboratively to solve complex problems

• Able to communicate clearly with patients, families, visitors, healthcare team, physicians, administrators, leadership, and others.

• Able to use sensory and cognitive functions to process and prioritize information, perform health assessments, treatment, and follow-up.

• Able to use fine motor skills

• Able to record activities, document assessments & interventions; prepare reports and presentations;
• Able to use computer and learn new software programs
• Able to provide leadership in clinical area of expertise and in meeting organizational goals
• Able to navigate the Hospital and DUHS to provide clinical expertise to specific patient populations

• Able to withstand prolonged standing and walking with the ability to move or lift at least fifty pounds
• Able to remain focused and organized
• Able to work collaboratively with all levels of personnel

JOB HOURS

Primary hours will be 14 (fourteen) 12 (twelve) hour day shift a month covering Monday-Sunday (7 days a week) including holidays. Administrative or clinical leadership may change schedule to meet department needs.