Nurse Practitioner (0.50 FTE) - Oncology

Navajo Preference Employment Act

In accordance with Navajo Nation and federal law, TCRHCC has implemented an Affirmative Action Plan pursuant to the Navajo Preference in Employment Act.  Pursuant to this Plan and corresponding TCRHCC Policy, applicants who meet the necessary qualifications for this position and (1) are enrolled members of the Navajo Nation, Hopi Tribe, or San Juan Southern Paiute Tribe will be given preference in hiring and employment for this position, (2) are legally married to enrolled members of the Navajo Nation, Hopi Tribe, or San Juan Southern Paiute Tribe and meet residency requirements will be given secondary preference, and (3) are enrolled members of other federally-recognized American Indian Tribes will be given tertiary preference.
Overview

POSITION SUMMARY

This position is a midlevel advanced practice professional who practices under the supervision of the physician to provide direct patient care, patient and family education, psychological support, and survivorship planning from the time of diagnosis throughout the continuum of cancer care. The scope of practice includes performing comprehensive assessments and physical examinations, ordering and interpreting diagnostic laboratory tests, performing invasive procedures, prescribing medications and treatments, ordering chemotherapy and biotherapy regimens, and conducting health screening and providing patient and family education. The incumbent will serve as an educator, consultant, and liaison to healthcare providers caring for the patients across the continuum of care, which includes inpatient and outpatient services.

Qualifications

NECESSARY QUALIFICATIONS

Education:

Master of Science in Nursing

Licensure/Certification:

• Must possess a valid, current, full, and unrestricted license to practice as a nurse practitioner in any state within the United States, District of Columbia, or the Commonwealth of Puerto Rico
• Certification by the American Association of Nurse Practitioners (AANP)
• Must maintain a current and valid Advanced Cardiac Life Support (ACLS) by the American Heart Association (AHA)
• Must maintain a current and valid Basic Life Support (BLS) certification by the American Heart Association (AHA)
• Must earn the credential of Advanced Oncology Certified Nurse Practitioner (AOCNP) from the Oncology Nursing Certification Corporation (ONCC) within one (1) year of hire date

Credentialing:

Must meet additional requirements for credentialing and privileging for membership to the Medical Staff

Experience:

Four (4) years of successful Nurse Practitioner evaluating and treating patients in adult primary care

Other Skills and Abilities:

A record of satisfactory performance in all prior and current employment as evidenced by positive employment references from previous and current employers.  All employment references must address and indicate success in each one of the following areas:

• Strong networking and relationship skills with demonstrated ability to work with staff, physicians, patients, and the community
• Experience and knowledge in the management of the physiologic and psychological effects of illness and subsequent treatment
• Basic understanding of Medical Oncology, Radiation Oncology, Oncology Nursing, Oncology Social Work, Cancer Registry data collection, interpretation and reporting
• Ability to work effectively in a culturally diverse environment and support the specific populations served in Oncology Services
• High motivated, self-directed individual with a demonstrated understanding of nursing care in ambulatory service delivery
• Reliable and dependable; reports to work as scheduled without excessive absences
• Responds effectively to sensitive inquiries or complaints
• Completion of and above-satisfactory scores on all job interviews, demonstrating to the satisfaction of the interviewees and TCRHCC that the applicant can perform the essential functions of the job
• Successful completion of and positive results from all background and reference checks, including positive employment references from authorized representatives of past and current employers demonstrating to the satisfaction of TCRHCC a record of satisfactory performance and that the applicant can perform the essential functions of the job
• Successful completion of fingerprint clearance requirements, physical examinations, and other screenings indicating that the applicant is qualified to be employed by TCRHCC and demonstrating to the satisfaction of TCRHCC that the applicant can perform the essential functions of the job
• Submission of all required employment-related documents, applications, resumes, references, and other required information free of false, misleading or incomplete information, as determined by TCRHCC

MENTAL AND PHYSICAL EFFORT

The physical and mental demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

Physical:

Incumbent must be able to frequently (1/2 day) sit, bend, and twist; prolonged (3/4 workday) ability to stand, walk, maintain balance, and reach: and occasionally (less ¼ day) drive, kneel, crouch, and climb. Incumbent will need to be able to  to lift, push, and pull up to 10 lbs for prolonged periods is required, frequently up to 24 lbs; and occasionally over 100 lbs.  Sensory requirements for the position include prolonged ability for near, color vision, depth perception, hearing normal speech, and telephone use. Other sensory requirements the Incumbent must be able to frequently have far vision, see fine details, and hear overhead pages on loudspeaker. The Incumbent will need to utilize the ability of hand manipulation consisting of prolonged use of keyboards and frequent us of simple, firm, and fine manipulation. Must have both hand manipulation of continuous simple and firm grasping, fine manipulation, and frequent use of keyboards.

Mental:

This position will need to have the ability to manage the emotions of the patients, families, and caregivers who are dealing with a cancer diagnosis. The Incumbent may need to be able to frequently adapt to shift work; work alone; handle multiple priorities in stressful situations; cope with anger/fear/hostility of others in a calm way; and make decisions while under high pressure. Incumbent must be able to handle the regularly stresses of rural medicine with critically ill patients; must have a high degree of judgment and leadership in coordinating service continuance of patient care needs. Incumbent will need the prolonged ability to cope with a high level of stress; concentrate; handle a high degree of flexibility; and demonstrate a high degree of patience. This position also requires occasionally be ability to work in areas that are close and crowded, and potential managing altercations.

Environmental:

This position may frequently be exposed to chemicals; and extremes in temperature and humidity.  The Incumbent may occasionally be exposed to infectious diseases; dust, fumes, gases; hazardous moving equipment; unprotected heights; and loud noises.

Responsibilities

ESSENTIAL FUNCTIONS

1. Performs comprehensive history and physical examinations on patients with cancer to assess normal and abnormal findings and identifies differential diagnoses on established and new patients.
2. Interviews, assesses, and evaluates oncology and hematology patients receiving outpatient infusion and other therapies to determine their physical condition and orders initial diagnostic tests, collects specimens for routine laboratory tests, and performs screening and therapeutic procedures appropriate for the patient’s medical condition.
3. Writes orders for administration of blood products and chemotherapy agents under the direction and supervision of attending physician.
4. Orders consults for services such as physical therapy, occupational therapy, respiratory therapy, imaging studies, and nursing services; and writes referrals for consultations to radiation oncology, writes orders for vascular access device placement for chemotherapy, and arranges for procedures and biopsies with the surgery and interventional radiology services.
5. Formulates an evidence-based treatment plan according to the interpretation and evaluation of all patient data.
6. Collaborates with other healthcare team members involved in patient treatment to ensure continuity of care.
7. Initiates arrangements for hospital admissions and discharges patients as indicated by clinical status.
8. Manages the clinical course of patients with cancer with acute or chronic complaints and end-of-life and other health concerns.
9. Performs core clinical practice competencies specific to the patient population, and promotes, directs, evaluates, and manages safe patient care for patients being treated in the chemotherapy infusion area, and provides patient teaching and coordinates counseling.
10. Prescribes medications and administers orders as indicated by patients’ clinical status.
11. Serves as a cancer pain management resource to the medical center in both outpatient and inpatient settings.
12. Recognizes and initiates lifesaving procedures for oncologic emergencies and brings emergencies to the immediate attention of a physician.
13. Participates in the tumor board and clinical research studies as determined by the needs of the program and participates in staff development and in-service education as requested. 
14. Promotes and participates in the delivery of patient and family education on the cancer diagnosis, treatment, expected outcomes, and end-of-life issues such as do-not-resuscitate orders, healthcare proxies, and advance directives; and assists in the completion of patients’ disability and insurance forms as needed.
15. Ensure proper PPE is always worn while on duty including but not limited to, face mask, gloves, gown, isolation gown, NIOSH-approved N95 filtering facepiece respirator or higher, if available), and eye or face shield.
16. Complete all donning and doffing tasks in a safe acceptable method and discard of used PPE accordingly. (see CDC website for most current updates)
17. Complete task training for all routine cleaning and decontamination processes for all surfaces contaminated by a communicable disease to ensure a high level of patient, visitor, employee, and external customer satisfaction.
18. Performs other duties as assigned.