NP Full-time
University of Miami Health System

Advanced Practice Registered Nurse - Medicine, Nephrology - Full Time

apartment University of Miami Health System location_on, US
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Current Employees:

If you are a current Staff, Faculty or Temporary employee at the University of Miami, please click here to log in to Workday to use the internal application process. To learn how to apply for a faculty or staff position using the Career worklet, please review this tip sheet.

CORE JOB SUMMARY   

The Advanced Practice Registered Nurse (“APRN”) delivers patient-family centered care in a culturally competent and compassionate manner, utilizing and promoting evidence-based standards of quality, safety, and service while ensuring population-specific patient care. The APRN provides and directs hands-on care to patients, practicing within the Scope of Practice of the Florida Board of Nursing requirements, standards of care, and institutional policies and procedures. Within this role, the APRN performs all steps of the care process and monitors the quality of care provided. The APRN demonstrates expertise and mastery towards patient care, providing care within the philosophy, mission, and objectives of the health system. The APRN delivers care that supports the UHealth mission to be a state-of-the-art academic medical center by participating in transforming patient care through innovative research.  

 

CORE JOB FUNCTIONS  

Caring Science   

Provides overall care with loving kindness. Uses creative problem-solving to meet the individual needs and requests of patients. Helps support the hope and faith of patients cared for. Is responsive to patient readiness to learn when they are taught something new. Is respectful of individual patient spiritual beliefs and practices. Creates an environment for the patient that helps them heal physically and spiritually. Establishes a helping-trusting relationship with the patients during their treatment period. Responds to each patient as a whole person, helping to care for their needs and concerns. Encourages patients to speak honestly about their feelings, no matter what their feelings are.  

Leadership 

Contributes concise, constructive feedback in the provision of care to other staff and leadership. Assumes responsibility and delegates to appropriate personnel and follows up to ensure completion. Serves as a clinical role model, mentor, and/or preceptor. Teaches others, suggests process improvements, provides evidence-based practice suggestions, coaches others to improve, support changes, and recognizes contribution of others. 

Participates and/or leads committees and task forces as they advance in expertise.  

 

Establishes Therapeutic and Trusting Relationships 

Creates and maintains a climate conducive to healing through being present to the patient and family. leads and collaborates with the care team in identifying and managing discomforts; providing emotional support and information; guiding the patient and family through phases of illness and recovery/passage to death in accordance with the patient's goals and culture. Mobilizes the patient's strengths and abilities towards participation in recovery and control over plan of care. 

Diagnostic and  Monitoring Functions 

Obtains accurate and relevant assessment data and interprets the data as normal vs. abnormal. Determines diagnosis. Modifies patient treatment plans as indicated by patients’ responses and conditions and collaborates with physicians and other team members. 

Plans and Implements Therapeutic Interventions 

Collaborates with the patient, family, and members of health care team to develop an individualized plan of care including discharge planning. Implements medical interventions safely. Performs appropriate patient tests and safely administers medications within the scope of practice. Administers and maintains accurate records related to medications and treatments as per regulatory bodies, policies, and procedures. Evaluates effectiveness of interventions and monitors patient for adverse responses and side effects. 

Utilizes available technology platforms for telehealth encounters. Initiates and leads the development of policies, procedures, protocols standards of care; examines and questions treatment to determine if they are within best practice.  

Teaching and Coaching: Patient and Staff Teaching 

Assesses a patient's and family's learning needs and readiness to learn. Teaches needed information for self-care and illness management and prevention. Adjusts information and expectations based on responses from patient, developmental levels, physiological and psychological condition, and cultural variations while addressing and meeting the needs of any language barriers that may be present.  

Effective Management of Rapidly Changing Situations 

Rapidly grasps problem situations and responds quickly and appropriately. Identifies the need for and activates emergency protocols.  Serves as a transformational leader in assisting others to adapt to changing work demands and environment. Anticipates possible problems and assists leadership in the development of contingency plans.  

Monitors and Ensures Quality Healthcare Practices 

Monitors own practices and assists in monitoring and evaluating others for practices related to patient and employee safety and compliance to standards and policies. Looks for opportunities for continual improvement in patient care and the work environment. Adheres to University, departmental and unit-level policies and procedures and safeguards University assets. Participates in activities such as, leading an Evidence-based Practice/Performance Improvement project and/or a nursing theory-based, methodologic approach to develop/submit a research proposal for Institutional Review Board (IRB). 

Organization and Work Role Functions. Priorities Management and Delegation 

Integrates multiple requests and work expectations by setting priorities, delegating tasks appropriately, and seeking assistance as needed. Contributes to team building through participation in unit programs and meetings.  

Contributes to positive morale, using constructive and effective conflict resolution skills. Learns and utilizes the available technology for communication, documentation, and locating information regarding unusual clinical situations, diagnosis, and treatments.  

Contributes to the knowledge and skill of other members of Advanced practice through one or more activities such as formal or informal teaching, participation in Shared Governance groups, professional publications and/or presentations. 

 

Education 

Attains and maintains knowledge and competence that reflects current advanced nursing practice for assigned patient population through professional development activities.  Demonstrates an advanced level of competency in practice. Engages in activities such as membership or leadership of a workshop or specialty continuing education course; serving as resource/super-user/specialist/support; teaches specialty competency development and proctor skill validation  

Communication 

Communicates plan of care in a timely manner to patient and family, as well as the appropriate team members, ensuring compliance with all regulatory guidelines (i.e., HIPAA). Uses best practices for transition of patient care.  

Meets diverse communication needs of patients with Limited English Proficiency (LEP).  

Professional Practice Evaluation 

Evaluates Advanced practice in relation to professional practice standards and guidelines, relevant statues, rules, and regulations. Provides focused constructive feedback and guidance with loving kindness to peers in a manner that provides growth and maintains self-esteem. 

Participates in shared governance, following the ANA Code of Ethics to elevate the professional, integrating the professional practice model and relationship- based care, delivery model into their practice. Integrates the Magnet Model components into practice. 

Critical Thinking 

Incorporates protocols and standards of care into daily practice. Uses sound judgement, decision making criteria, and available resources for drawing conclusions and taking required action. Applies evidence-based practices, approaches and solves problems with a global perspective using creativity and flexibility.  

 

This list of duties and responsibilities is not intended to be all-inclusive and may be expanded to include other duties or responsibilities, as necessary. 

 

CORE QUALIFICATIONS  

 

Education: 

  • Masters or Doctorate in Nursing (APRN) or Masters in Physician Assistant Studies from an accredited program. 

Certification and Licensing: 

  • Current board certification as an Acute Care nurse practitioner by an accredited APRN certifying body required 

  • Valid State of Florida required 

  • BLS – Basic Life Support certification required 

  • Must have a National Provider Identifier (NPI), or obtain an NPI, prior to employment start date and meet current Medicare requirements for billing 

Experience: 

  • Minimum of 1 year of relevant experience. 

                                                                  

Knowledge, Skills and Attitudes: 

  • Strong, effective communication skills with patients, families, and clinical team for innovative patient care and trust   

  • Ability to collaborate with peers in the best interest of the patient to provide consistent quality of care   

  • Ability to adapt and exhibit flexibility to handle new, different, or changing environments   

  • Demonstrates strong time management skills to prioritize, triage, and act proactivity  

  • Ability to uphold professional ethics and maintain patient confidentiality   

  • Knowledgeable on all aspects of patient care including assessing, planning, coordinating, monitoring and evaluating the patients’ progress through continuum of care 

 

Department Specific Functions  

The APRN is responsible for assessing physical and psychosocial status of patients in an outpatient clinic setting by means of interview, health history, physical examination, and diagnostic studies. Assist physicians in performing and documenting medical procedures, up to and including blood drawing, vital signs, nursing assessments, and history and physicals. The incumbent will spend up to 8 half days per week in outpatient Nephrology clinics. APRN will manage ambulatory patients with chronic kidney disease, create and carry out treatment plans, educate about medication use, diet restrictions, and renal replacement choices, and collaborate with consultants. APRN will be expected to cover outpatient dialysis service, as needed. In addition, the APRN will rotate as necessary in our UHealth Tower and Jackson Memorial Hospital inpatient dialysis units managing patients with end-stage kidney disease who are supported with hemodialysis, report findings to and discuss management with the supervising physician until deemed independent and provide education to patients.  

 

Seeking an Advanced Practice Provider (Nurse Practitioner or Physician Assistant) to join the Nephrology team providing care primarily in the outpatient hemodialysis setting, with flexibility to assist with inpatient nephrology coverage at Jackson Memorial Hospital or UMH as needed. This role supports seamless continuity of care between the dialysis unit, CKD clinic, and hospital, maintaining a balanced and collaborative workflow. 

 

  • Manage outpatient dialysis patients (minimum 3 visits per patient per month) and collaborate with the multidisciplinary dialysis team. 

  • Conduct a ½-day CKD clinic weekly for chronic kidney disease management. 

  • Assess and manage volume status, vascular access, anemia, bone-mineral balance, and medication 

  • adjustments. 

  • Provide inpatient nephrology week and weekend coverage at JMH/UMH as needed  

  • Recognizes deviations from normal in the physical assessment. Works in collaboration with a physician in formulating treatment plans for health problems and follow-up.  

  • Writes prescriptions for medication, blood products based upon laboratory results, routine diagnostic and follow-up studies, therapeutic measures, diet, and post-discharge care in accordance with written practice protocols.  

  • Participates in and facilitates clinical research protocols and coordinates patient care with research staff.  

  • Obtains complete medical history and physical examinations without supervision by the physician.  

  • See patients in follow up in between dialysis treatments and post procedure as necessary 

  • Initiate and Maintain orders as per protocol 

  • Orders appropriate laboratory tests according to practice guidelines.  

  • Develops, implements, and evaluates a plan of care that is appropriate for the patient and family.  

  • Actively participates in quality assurance programs and peer review activities. 

  • Responsible for providing assistance to physicians in the care and treatment of patients.  

  • Provides medical support to staff, triaging and implementing care in a knowledgeable and skillful manner, as evidenced by team feedback and documentation in medical records.  

  • Assess severity of patient's condition, determining and directing patients to appropriate medical providers.  

  • Requests prior authorizations and provides peer-to-peer reviews with insurance carriers in support of patients’ medications 

  • Consents patients for procedures, and places orders for procedures  

  • Maintain EMR inbox and close encounters in a timely fashion according to UMMG guidelines. 

 

APRN inpatient job description 

  • The APRN will see alone all ESRD consults with the exception of PD patients  

  • Fellow and APRN should sign out guarded status patients every day at 5pm to the night float fellow via text or phone call.   

  • APRN to cover fellow when at clinic, if needed.  

  • The APRN will carry an APRN ESRD phone from 8am to 5pm.  

  • Inpatient job description is based on service needs; APRNs are exempt staff, not hourly. 

  • For inpatient daily responsibilities, APRN is to arrive no later than 8am and leave at 5pm or unless service dictates otherwise. 

  • Fellows on the consult service, will forward their phones from 11:45am to 1 pm on Monday, Thursday and Fridays to the APRN of the hospitals they are assigned to. Either Jackson Memorial or UHT/ 

  • Daily huddle at 11:30am between APRN and fellow to bring up to date about calls/new consults/follow up questions via text or phone call.   

  • Whoever is holding phone should text the other teams if they get a new consult.   

  • It is the responsibility of the ARNP to find coverage when going on vacation or absent leaves by another APRN for both inpatient and outpatient activities, ex. answer calls from patients followed in outpatient clinics, covering inpatient services, and covering outpatient dialysis services APRN should declare vacations 2 or 3?  months ahead of time and assigned coverage and cancel their PM clinic.   

  • APRN inpatient coverage during sick days, the APRN should email the APRN lead (MD supervisor and Elias Fernandez, APRN, and Sr. Clinical Practice Manager) and the faculty on service to have the teams find coverage.  

  • It is expected that APRNs will have at least 75% participation in our noon teaching conferences.  

  • APRNs will be evaluated by their clinic patients using the Ganey consumer experience survey; group and individual data will be shared monthly.  

  • APRNs are expected to see consults until 5 PM even during clinic days. 

  • Provide inpatient nephrology week and weekend coverage at JMH/UMH as needed 

The University of Miami offers competitive salaries and a comprehensive benefits package including medical, dental, tuition remission and more.

UHealth-University of Miami Health System, South Florida's only university-based health system, provides leading-edge patient care powered by the ground breaking research and medical education at the Miller School of Medicine. As an academic medical center, we are proud to serve South Florida, Latin America and the Caribbean. Our physicians represent more than 100 specialties and sub-specialties, and have more than one million patient encounters each year. Our tradition of excellence has earned worldwide recognition for outstanding teaching, research and patient care. We're the challenge you've been looking for.

The University of Miami is an Equal Opportunity Employer - Females/Minorities/Protected Veterans/Individuals with Disabilities are encouraged to apply. Applicants and employees are protected from discrimination based on certain categories protected by Federal law. Click here for additional information.

Job Status:

Full time

Employee Type:

Staff

Pay Grade:

H15

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Current Employees: If you are a current Staff, Faculty or Temporary employee at the University of Miami, please click here to log in to Workday to use the internal application process. To learn how to apply for a faculty or staff position, please review this tip sheet . Up to $20,000 Sign On Bonus The University of Miami Uhealth Department of Ambulatory Nursing at Bascom Palmer in Miami has an exciting opportunity for an Advanced Practice Registered Nurse (APRN). The incumbent d elivers medical care to a wide variety of patients. The APRN is also e xamines and treats patients independently and in autonomous collaboration with other health care professionals. Ensures proper illness and injury care and disease prevention, diagnosis, treatment, and recovery. May prescribe medications and order diagnostic tests. Advises patients about continuing care. CORE JOB FUNCTIONS Performs and documents complete physical examinations and comprehensive health histories . Functions independently to perform age-appropriate history and physical for patients. Orders and interprets diagnostic and therapeutic tests relative to patient’s age-specific needs. Prescribes appropriate pharmacologic and non-pharmacologic treatment modalities Implements interventions to support the patient to regain or maintain physiologic stability . Assists with the provision of care in accordance with facility, state, and federal regulations. Monitors the effectiveness of interventions. Facilitates the patient’s transition within and between health care settings, e.g. admitting, transferring, and discharging patients. Collaborates with multidisciplinary team members by making appropriate referrals . Facilitates staff, patient and family decision making by providing educational tools. Adheres to University and unit-level policies and procedures and safeguards University assets. This list of duties and responsibilities is not intended to be all-inclusive and may be expanded to include other duties or responsibilities as necessary. CORE QUALIFICATIONS Education: Master’s d egree in relevant field Certification and Licensing: Valid State of Florida APRN License Experience: Minimum 2 years of relevant advanced practice nursing experience preferred Knowledge, Skills and Attitudes: Ability to exercise sound judgment in making critical decisions. Skill in completing assignments accurately and with attention to detail. Ability to analyze, organize and prioritize work under pressure while meeting deadlines. Ability to work independently and/or in a collaborative environment. Ability to communicate effectively in both oral and written form . Department Specific Functions OVERVIEW: The BPEI Consult Service provides initial evaluation and high - standard eye care outside ABLEC to patients admitted at JMH, Holtz Pediatric Hospital, Ryder Trauma Center, and UHealth facilities: UHealth Tower, Sylvester Cancer Center , and others : UHM/Sylvester Consults Initiation of the consult : Consult APRN carries the page for UMH facilities , responds to page in less than 30 min and proceeds with the consult in a timely manner. Timing : Routine consults less than 12 h. UMH ER consult less than 3 h. STAT consults less than 1 h. Escalation of the consult as needed: Optometry resident/Consult APRN , Fellow OD, Director of Consult Service, Ophthalmology specialty Medical Director (Ex: Retina, Cornea, Pediatrics, Glaucoma, Neuro, etc.) Medical Director BPEI. Consult visit: Consult APRN notifies optometry resident about consultation request for preliminary evaluation. Optometry resident will be available from 8.00am to 5.00pm on weekdays. Optometry resident proceeds with preliminary evaluation using the ca s e of instruments located at UHT pharmacy 4th floor. After preliminary evaluation optometry resident triage with Consult APRN and write a note in Epic, pending it for fellow evaluation and note signing. Consult APRN will exam patient: Adds addendum-documentation, signs attestation/encounter and update running list of UMH consult patients. The Consult APRN will escalate to appropriate service for additional evaluation if needed. Visit should be properly documented in EPIC and should include comments about discussion of the results with a patient or a next of kin, particularly in cases of poor visual prognosis. Assessment and Plan must be clearly documented, and HCP and nursing staff has to be informed about any critical decision. If discharged on the day of the consultation, have them open appointment slot at BP the same day. Inpatient psychiatry consults can be sent to BPEI ED and must have a sitter. UMH Instrument Case: Includes medications and instruments: Located at the 4th floor of UHT pharmacy. Optometric Resident and APRN will sign out case and return case to UHT Pharmacy. UHT Pharmacy will replace medication including expired medication. Non-functioning equipment will be reported by the Consult APRN for repair initiation/replacement. The case will be returned as orderly as it was received. Documentation of the visit: EPIC. Full note. Use smart phrases External photos should be included on the note Consent for any procedure to be performed including scrapping and testing. Instruction about follow up and calling back if any worsening Communication with HCP when radical procedures expected or needed Instruction upon discharge for FU. Signing Charts: Consult APRN will sign the chart in no more than 48h. APRN will assist in obtaining Informed Consent and necessary equipment for any bedside procedure including but not limited to testing, samples for microbiology or pathology, surgical procedures, transfer to BPEI for special treatment, among others. Running list of patients: Consult APRN is responsible to keep updated r unning list of patients in FU and recently discharged on EPIC. Active patients – patients requiring follow-up Completed patients - patients recently discharged Consult Service APRN will properly hand-off the active patients to evening /weekend Consult Fellow . Consult APRN will report monthly and as needed to the Consult Service Medical Director. JMH/Holtz/Ryder Consults Initiation of the consultation : Ophthalmology Resident carries the page r for Jackson facilities, responds to page r in less than 30 min and proceeds with the consultation in a timely manner. Timing : Routine consults less than 12 h ., ER consult ation less than 3 h. , STAT consults less than 1 h. Escalation of the consultation as needed: Op hthalmology resident/Consult APRN, Fellow OD, Director of Consult Service, Ophthalmology specialty Medical Director (Ex: Retina, Cornea, Pediatrics, Glaucoma, Neuro, etc.) Medical Director BPEI. Consult visit: Op hthalmology resident proceeds with preliminary evaluation using the case of instruments . After preliminary evaluation Ophthalmology resident triage with Consult APRN and write a note in Cerner , pending it for fellow evaluation and note signing. Consult APRN will exam patient: Adds addendum-documentation, signs attestation/encounter and update running list of Jackson consult patients. The Consult APRN will escalate to appropriate service for additional evaluation if needed. Visit should be properly documented in Cerner and should include comments about discussion of the results with a patient or a next of kin, particularly in cases of poor visual prognosis. Assessment and Plan must be clearly documented, and HCP and nursing staff has to be informed about any critical decision. If discharged on the day of the consultation, have them open appointment slot at BP the same day. Inpatient psychiatry consults can be sent to BPEI ED and must have a sitter. Jackson Instrument Case: Includes medications and instruments: Located at BPEI Emergency Room . Non-functioning equipment will be reported by the Consult APRN for repair initiation/replacement. Documentation of the visit: EPIC. Full note. Use smart phrases External photos should be included on the note Consent for any procedure to be performed including scrapping and testing. Instruction about follow up and calling back if any worsening Communication with HCP when radical procedures are expected or needed Instruction upon discharge for FU. Signing Charts: Consult APRN will sign the chart in no more than 48h. APRN will assist in obtaining Informed Consent and necessary equipment for any bedside procedure including but not limited to testing, samples for microbiology or pathology, surgical procedures, transfer to BPEI for special treatment, among others. Running list of patients: Consult APRN is responsible to keep updated r unning list of patients in FU and recently discharged on EPIC. Active patients – patients requiring follow-up Completed patients - patients recently discharged Consult Service APRN will properly hand-off the active patients to evening/weekend Consult Fellow . Consult APRN will report monthly and as needed to the Consult Service Medical Director. Transfer for special procedures at BPEI: APRN will facilitate transfer for special procedures at BPEI following Patient Transfer policy. ABLEH/BPEI Internal Transfer scheduling process To request a consult appointment , please email Physician Logistics at bplogistics@med.miami.edu and provide the following information: Patient Name and MRN Required imaging / procedures Provider Name Preferred appointment location, date, and time Patient mobility: walking, wheelchair, stretcher, etc. Relevant patient medical needs: telemetry, negative pressure, etc. Use of Telehealth in Consults : As appropriate , there will be escalating levels of involvement. Ophthalmology consultant review of the medical record and EMR consult note written. Ophthalmology consultant to the patient attending telephone consult and EMR consult note written. The ophthalmology telemedicine consultation will be facilitated by attending using EMR , using a video call for evaluation. Ophthalmology consultant bedside exam and EMR consult note written. The University of Miami offers competitive salaries and a comprehensive benefits package including medical, dental, tuition remission and more. UHealth-University of Miami Health System, South Florida's only university-based health system, provides leading-edge patient care powered by the ground breaking research and medical education at the Miller School of Medicine. As an academic medical center, we are proud to serve South Florida, Latin America and the Caribbean. Our physicians represent more than 100 specialties and sub-specialties, and have more than one million patient encounters each year. Our tradition of excellence has earned worldwide recognition for outstanding teaching, research and patient care. We're the challenge you've been looking for. The University of Miami is an Equal Opportunity Employer. Applicants and employees are protected from discrimination based on certain categories protected by Federal law. Job Status: Full time Employee Type: Staff