Description

Nurse Practitioner or Physician Assistant

Outpatient Clinic position working Days only. No Weekends or On Call

Minimum 2 years of Internal Medicine or Rheumatology experience

JOB SUMMARY:

The specialty nurse practitioner (NP) in the ambulatory care setting works in collaboration with a multidisciplinary health care team. The specialty NP is generally service/physician aligned, managing a distinct patient population in the outpatient setting. The NP functioning primarily in a clinic setting may be required to perform some coordination of inpatient care and facilitate discharges/outpatient follow up. The specialty clinic NP has a strong foundation in evidenced based practice/education and is responsible for ensuring adherence to clinical pathways/protocols and ensures an environment of safe quality care. The NP demonstrates an advanced level of medical and nursing knowledge, clinical/technical competence, sound clinical judgment, professional communication skills, timely and compliant documentation, and responsible for professional development and competency validation.

KEY RESPONSIBILITIES:

• Assessment of Health Status
• Performs and documents in the medical record a complete history and physical examination for acute and complex chronically ill patients.
• Orders and collects data using appropriate assessment techniques, relevant supporting diagnostic information and diagnostic procedures where indicated.
• The nurse practitioner may serve as the first responder for both nursing and house staff in the event of patient status changes, orders, and in situations requiring procedural and resuscitative interventions.
• Assesses for risks associated with the care of the acute and complex chronically ill patient including medication side effects, immobility, impaired nutrition, fluid and electrolyte imbalance, immunocompetence, invasive interventions and diagnostic procedures.
• Coordinates daily clinic schedule with the attending physician team, presents patient report, collaborates in plan of care, and follows assigned patient population.
• Diagnosis
• Collaborates with interdisciplinary health care team in making diagnoses of acute and complex chronic conditions.
• Manages diagnostic tests through ordering, interpretation, performance, and supervision.
• Formulates differential diagnoses by priority.
• Diagnoses complications and orders appropriate interventions.
• Formulates Plan of Care
• Identifies expected outcomes from diagnosis, and formulates and documents a plan of care to address complex acute and chronic health care needs.
• Utilizes evidenced based practice guidelines or protocols in an individualized, dynamic plan of care that can be applied across the continuum.
• Implements and modifies plan of care
• Prescribes diagnostic strategies and therapeutic interventions both pharmacologic, non-pharmacologic, and surgical, needed to achieve expected outcomes.
• Manages further diagnostic tests through ordering, interpretation, performance, and supervision.
• May perform advanced procedures consistent with privileges and competency validation, including minor suturing, complex wound management, line and tube placements and removals.
• Communication and Collaboration
• Maintains ongoing communication and collaboration with interdisciplinary health care team.
• Facilitates and communicates with patient, family and staff to promote continuity of care across the outpatient continuum of care.
• Documentation
• Documents/dictates key components of patient's progress via daily progress note, transfer, and discharge summary, and/or clinic note where applicable. (h&p, daily progress notes, plan of care, problem lists, procedure notes, acute event note, discharge summaries in medical record per specific patient unit or service, death summary)
• Documentation is timely, meets critical care compliance standards and captures patient acuity.
• Professional Practice
• Demonstrates Professional Practice behaviors including: preceptor/mentoring, education and instruction of students, nursing staff, nurses, graduate and novice nurse practitioners,
• Seeks opportunities for active engagement in research and the analysis of evidenced based practice.
• Actively participates in Grand Rounds, APN council meetings, faculty and unit meetings, M&M presentations.
• Maintains CEUs, and membership in a professional organization.

View how Vanderbilt Health employees celebrate the difference they make every day:

Discover Vanderbilt University Medical Center:

Located in Nashville, Tennessee, and operating at a global crossroads of teaching, discovery and patient care, VUMC is a community of individuals who come to work each day with the simple aim of changing the world. It is a place where your expertise will be valued, your knowledge expanded and your abilities challenged. It is a place where your diversity - of culture, thinking, learning and leading - is sought and celebrated. It is a place where employees know they are part of something that is bigger than themselves, take exceptional pride in their work and never settle for what was good enough yesterday. Vanderbilt's mission is to advance health and wellness through preeminent programs in patient care, education, and research.

VUMC Recent Accomplishments

Because we are committed to providing the best in patient care, education and research, we are proud of our recent accomplishments:
• US News & World Report: #1 Adult Hospital in Tennessee and metropolitan Nashville, named to the Best Hospitals Honor Roll of the top 20 adult hospitals, 10 nationally ranked adult specialty programs, with 3 specialties rated in the top 10 nationally, Monroe Carell Jr. Children's Hospital at Vanderbilt named as one of the Best Children's Hospital in the nation, with 10 out of 10 pediatric specialties nationally ranked.
• Healthcare's Most Wired: Among the nation's 100 "most-wired" hospitals and health systems for its efforts in innovative medical technology.
• Becker's Hospital Review: named as one of the "100 Great Hospitals in America", in the roster of 100 Hospitals and Health Systems with Great Oncology Programs and to its list of the 100 Hospitals with Great Heart Programs.
• The Leapfrog Group: One of only 10 children's hospitals in the to be named at Leapfrog Top Hospital.
• American Association for the Advancement of Science: The School of Medicine has 112 elected fellows
• Magnet Recognition Program: Received our third consecutive Magnet designations.
• National Academy of Medicine: 22 members, elected by their peers in recognition of outstanding achievement
• Human Rights Campaign Healthcare Equality Index: 6th year in a row that Vanderbilt University Medical Center was a Leader in LGBTQ Healthcare Equality.

BASIC QUALIFICATIONS (NP)

• Master's Degree (or equivalent experience) (Required)
• <1 year experience. 12 months of nursing experience preferred; Inpatient acute care nursing experience desirable. (Required)
• Registered Nurse (Required)
• Prefer National Specialty Board Certification, APN certificate/certificate of fitness to prescribe, eligible for DEA

or
BASIC QUALIFICATIONS (PA):

• Graduate of an approved discipline specific program (or equivalent experience) (Required)
• <1 year experience. 12 months of physician assistant experience preferred; Inpatient acute care advanced practice
• nursing experience desirable. (Required)
• Certified Physician Assistant (Within 3 months)
• Prefer National Specialty Board Certification, TN license through Board of Medical Examiners Committee on Physician

Assistants, Eligible for DEA within 3 months

Additional Qualification Information:

• Prefer National Specialty Board Certification, TN APN certificate/certificate of fitness to prescribe, eligible for DEA

Physical Requirements/Strengths needed & Physical Demands:

Movement

• Occasional: Sitting: Remaining in seated position
• Occasional: Standing: Remaining on one's feet without moving.
• Occasional: Walking: Moving about on foot.
• Occasional: Lifting under 35 lbs: Raising and lowering objects under 35 lbs from one level to another
• Occasional: Push/Pull: Exerting force to move objects away from or toward.
• Occasional: Bending/Stooping: Trunk bending downward and forward by bending spine at waist requiring full use of lower extremities and back muscles
• Occasional: Crawling:Moving about on hands and knees or hands and feet.
• Occasional: Reaching below shoulders: Extending arms in any direction below shoulders.
• Occasional: Handling: Seizing, holding, grasping, turning or otherwise working with hand or hands.

Sensory

• Occasional: Vision: Clarity of near vision at 20 inches or less and far vision at 20 feet or more with depth perception, peripheral vision, color vision.
• Frequent: Noise: May include exposure to occupational noise levels which equal or exceed an 8-hr time-weighted average of 85 decibels, requiring enrollment in VUMC's Hearing Conservation Program which includes training, use of hearing protection, and periodic audiometry.
• Continuous: Communication: Expressing or exchanging written/verbal/electronic information.

Environmental Conditions

• Occasional: Chemicals and Gasses: Medications, cleaning chemicals, oxygen, other medical gases used in work area.
• Occasional: Pathogens: Risk of exposure to bloodborne pathogens and other contagious illnesses.
• Occasional: Radiation: May be exposed to occupational radiation, requiring enrollment in VUMC's Radiation Safety Program which includes training, use of personal protective equipment with lead shielding, and personal dose monitoring.
• Occasional: Climate: Ability to withstand exposure to atmospheric extremes including heat, cold, humidity, and barometric pressure changes.