APP - Atrium Health Urology- LCI

Overview

The Nurse Practitioner/Physician Assistant functions as an independent healthcare provider who, working in collaboration with collaboratively within a multidisciplinary health team, is responsible for providing comprehensive care to both well healthy and ill patients in the outpatient/inpatient setting. . He/she demonstrates a high degree of clinical expertise in working with patients with acute and chronic illnesses commonly encountered in Urology. He/she is responsible for assessment, diagnosis, treatment, management, education, health promotion and care coordination for patients and families with acute and chronic health needs. The NP/PA practices as a member of the Department of Urology provider team. This position will participate in weekly urology academic conferences. The Nurse Practitioner/Physician Assistant demonstrates an advanced level of medical/nursing clinical knowledge, communication and interdisciplinary collaboration, professionalism and systems-based practice. He/she works with administrative, nursing, physician, and faculty to assure safe, effective, quality patient care and to promote Atrium Health educational and research missions. 

The Nurse Practitioner/Physician Assistant will provide care within his/her scope of practice as outlined by applicable state law, licensing, regulations, institutional policy and practice agreements. The Nurse Practitioner/Physician Assistant is eligible to begin practice after he/she is credentialed and privileged by Atrium Health and Clinics Medical Staff. Active hospital privileges will be required to begin and to maintain employment within this Department. The Nurse Practitioner/Physician Assistant will need to be credentialed and obtain and maintain professional privileges required for employment within this department. 

Major Responsibilities:

Clinical Knowledge 

• Demonstrates knowledge of etiologies, risk factors, pathophysiology, presentation and epidemiology of medical conditions. 
• Performs history and physical assessments of patients that are accurate, complete, concise, relevant and appropriate for age, gender and clinical problem. 
• Orders appropriate diagnostic studies and correctly interprets the results. 
• Utilizes critical thinking to synthesize and analyze collected data. 
• Develops, implements, evaluates and alters the plan of care as needed. 
• Manages general medical and surgical conditions based on knowledge of the indications, contraindications, side effects, interactions and adverse reactions of pharmacologic agents and other relevant treatment modalities. 
• Counsels and educates patients and families. 
• Demonstrates proficiency in procedural skills pertinent to practice area. 
• Maintains accurate, complete, concise and timely documentation in the electronic medical record. 

Patient Care 

• Provides care that is patient and family centered, compassionate, appropriate and effective for the promotion of health, prevention of illness and treatment of disease throughout the lifespan. 
• Facilitates consistent, coordinated care and clear communication among all members of the healthcare team. 
• Incorporates the patient and family in care planning and treatment across settings. 
• Serves as an advocate for patients and families in navigating the health care system. 

Practice Based Learning and Clinical Improvement 

• Demonstrates insight into own strengths, limitations and knowledge deficits. 
• Demonstrates initiative to meet identified learning needs using multiple resources. 
• Actively participates in self-evaluation by seeking and utilizing guidance and constructive feedback in a professional manner. 
• Continuously seeks opportunities for clinical advancement and knowledge and skill attainment. 

Communication and Interdisciplinary Collaboration 

• Communicates and collaborates effectively with physicians, other health professionals and health related agencies. 
• Works effectively with multidisciplinary team members. 
• Promotes mutual respect and trust working within a team model. 
• Communicates effectively with patients and families, incorporating gender, age, culture, race, religion, disabilities and sexual orientation. 

Professionalism 

• Follows ethical principles regarding patient confidentiality, informed consent and unanticipated adverse outcomes. 
• Demonstrates the highest level of accountability for professional practice. 
• Participates in education of students and other health care professionals. 
• Maintains effectiveness where circumstances and priorities are changing. Is flexible, resilient and change oriented. 
• Welcomes and participates in opportunities to advance the mission of Atrium Health through service, scholarship, science and social responsibility. 
• Participates in organizational and departmental meetings, educational opportunities, committees and workgroups as necessary. 

Systems Based Practice 

• Considers cost effectiveness and risk/benefit analysis when making decisions about patient care. 
• Uses evidenced-based medicine to systematically analyze and improve patient care practices. 
• Participates in quality initiative/performance activities. 
• Participates in development, evaluates and implements standards of care within area of specialization (policies, protocols, etc). 

Position Description:

• Urology Department 
• Inpatient/Outpatient setting 
• No Night Call required 
• Rotating Holiday schedule
• Every 4th weekend 
• Occasional Night Shifts 
• Eligible for overtime, differential pay, PTO and Performance incentive bonuses 
• $2500/5 days of CME 

Roles and responsibilities specific to area of clinical practice: 

Outpatient Specific Responsibilities

• Conduct comprehensive or episodic health history and physical assessment of patients with acute, chronic and/or potential health problems. 
• Establish medical diagnosis. 
• Provide medical management. 
• Accurately and appropriately transcribe or execute standing orders at the direction of the supervising physician. Write specific orders within the limits of the practice agreement/scope of practice. 
• Discuss proposed surgical procedures with attendant risks and potential complications to obtain proper patient informed consent. 
• See patients in follow-up for routine post-operative care and manage complications related to surgery. 
• Provide appropriate direction to clinic staff regarding patient care issues. 
• Communicate effectively with referring health care providers. 

Inpatient Specific Responsibilities 

• Perform daytime hospital consultations and rounding on established patients 
• Potential to assist in the Operating Room.
• Potential for limited number of overnight call shifts (anticipated to cover first call 7 nights a month). 
• Perform bedside procedures (ie: cystoscopy, difficulty catheter placement, etc)

Procedures:

Performs routine clinical procedures independently as outlined in practice agreements/scope of practice including, but not limited to, the following: 

- Catheter insertion 

- Catheter changes 

- Complex bladder irrigation 

- Cystoscopy with foreign body removal 

- Cystoscopy with complex foley catheter placement 

- Prostate transrectal ultrasound 

- Prostate transrectal ultrasound with biopsy 

- Interstim interrogation 

- Tibial Nerve stimulation 

- Urethral dilation 

- Bedside Incision and Drainage 

- Suturing 

- Pessary fitting and placement 

- Chemotherapy bladder instillation 

- Potential for additional procedures independently as outlined in the collaborative practice agreement/scope of practice while under the direction and supervision of the responsible physician 

Position Qualifications: 

• Graduation from an accredited NP or PA program. Current license to practice as a NP or PA in North Carolina. Current prescriptive privileges and DEA license required. BLS for healthcare provider from AHA required.  
• Nurse practitioners are required to have a master’s degree or doctorate in nursing practice. Certification as an Acute Care NP will be required. Certification must be from a nationally recognized certifying body.  
• Physician Assistants with certification from the National Commission on Certification of Physician Assistants preferred.
• +1 years of experience preferred  
• Demonstrates appropriate critical thinking and interpersonal skills when working in a fast paced, high acuity work environment. Able to perform thorough history and physical assessment. Also, able to evaluate, assess, and monitor other co-morbid medical conditions secondary to mental illness.  
• NC/SC Licensure