NURSE PRACTITIONER III -SPINE CENTER

Evaluates, examines, diagnose, and treats patients in collaboration with their supervising and or substitute supervising physician according to established guidelines and protocols. Maintains and promotes the well-being of the patient through preventative healthcare and guidance. Provide care in the hospital setting. May include weekends and shift work.

Core Essential Functions:

• Regular, consistent, on-site, and timely attendance.
• Manages the physical and psychological problems of the patient.
  • Identifies normal and abnormal findings.
  • Implements an individualized plan of treatment, reassess and revises plan as needed.
  • Evaluates the physical and emotional responses to medications and treatments.
  • Prescribes immunizations per recommended schedules.
  • Seeks appropriate consultation.
• Communicates effectively with the physician and other healthcare providers to achieve desired outcomes and assure a continuous flow of patient care.
  • Initiates and maintains the Problem/Medication list at each encounter.
  • Complies with completeness, accuracy, and timeliness of documentation at each encounter.
  • Assesses the patient and facilitates consultation when indicated.
  • Directs patients to appropriate level of care and communicates all pertinent information.
  • Assists in identifying and utilizing resources and/or social agencies for further treatment or rehabilitation.
• Demonstrates Leadership by utilizing the concepts inherent to the practice of the professional nurse.
  • Demonstrates an ability to solve problems independently utilizing critical thinking skills and seeks assistance from immediate supervisor when appropriate.
  • Delegates patient care appropriately.
  • Maintains accountability for actions taken.
  • Effectively functions as a resource person.
  • Acts as a patient advocate.
  • Performs effectively in the role of preceptor/mentor to new hires and /or students.
  • Assists in maintaining / decreasing organizational/department costs.
  • Completes all competency requirements annually.
• Provides for patient safety in compliance with hospital and physician practices policies.
  • Adheres to infection control processes, including standard precautions, to reduce the risk of acquiring or transmitting infections.
  • Utilizes two forms of patient identification before implementing any form of patient care.
  • Practices all National Patient Safety Goals.
  • Uses LEAN principles.
• Assists in the department's compliance with all regulatory agencies.
  • Participates in continuous survey readiness for inspections and survey's.
  • Participates in the non-punitive medication reporting system.
  • Ensures accountability for narcotics per regulatory/organizational policies.
  • Participates in office fire, safety, utility, hazard, and disaster drills as required.

“Ability to perform the Essential Functions on the Physical Conditions chart; and the ability to perform the Essential Functions on the Working Conditions chart (see attached charts)”

Specialty Essential Functions:

• Performs procedures, assists in surgery, and provides care to the surgical patient as per established guidelines (when applicable).
  • Positions patients and assists surgeon in the operating room.
  • Preps and drapes the patient as per established guidelines.
  • Assists in surgery by performing tasks defined by the surgeon.
  • Assists and maintains sterile techniques through procedures.
  • Per supervising physician's direction performs skin closures as directed.
  • Monitors patients until clinically stable unless requested by the surgeon to perform other duties.
  • Performs suture removal, and dressing changes as per supervising physician's directions.
  • Be available for call from home to assist in emergency surgeries.
• Directs and provides appropriate Pre and Post-operative care (when applicable).
  • Performs history and physicals as designated by the physician. Identifies normal and abnormal findings and reports to the physician in a timely manner.
  • Provides preoperative teaching to patients and or families.
  • Performs patient rounds ensuring accurate assessment, review of labs and diagnostic procedures, and reports overall progress to supervising physician.
  • Orders appropriate testing per established guidelines and as outlined by supervising physician.
  • Documentation supports a review of lab/diagnostic results, is reflective of all required history and physical assessment elements.
  • Communicates with supervising physician in a timely manner regarding changes in the patient's progress, status, or critical test results.
  • Prepares for and develops discharge planning in conjunction with supervising physician.
  • Dictates discharge summaries timely and appropriate.
  • Provides counseling and instruction to patients and or families as appropriate.
• Performs clinical responsibilities in a manner that maximizes patient care and outcomes.
  • Assumes appropriate code team role during emergency situations and responds effectively.
  • Facilitates timely treatment of abnormal labs or other relevant findings.
  • Develops workflow patterns to facilitate patient transfers or discharges.
  • Participates in outcome management and Press Ganey scores.
• In collaboration with the physician: Interviews, evaluates and assesses patients in the clinic setting. Provides recommendations for treatment.
  • Evaluates patient's current status providing recommendations for ongoing treatment. Assesses for alternate levels of care as necessary
  • Adjusts medication as indicated
  • Provides patient/family education regarding medication, rationale for use and possible side effects
• Collaborates with the supervising physician and or substitute supervising physician and members of the treatment team to achieve desired outcomes and to assure continuous flow of patient care.
  • Alerts the treatment team to any significant changes in the patient's status
  • Within prescribed time frames reviews treatment goals and objectives with patients making modifications as appropriate
  • Communicates pertinent information timely and efficiently to the supervising or substitute supervising physician
• Documents in the medical record.
  • Records patient's current mental status
  • Documents all screenings and assessments performed
  • Records medication changes, prescriptions written and samples provided
  • Documents patient's complaints, concerns and questions as appropriate
  • Documents any/all telephone contact with patients, families, pharmacists or physicians
  • Records beginning and end times of each session
  • Signs and dates all documentation
• Demonstrates leadership by utilizing the concepts inherent to the practice of a professional physician assistant.
  • Demonstrates an ability to problem solve independently utilizing critical thinking skills and seeks assistance from immediate supervisor when appropriate
  • Maintains accountability for actions taken
  • Effectively functions as a resource person
  • Acts as a patient advocate
  • Performs effectively in the role of preceptor/mentor to new hire/students
• Participates in Performance Improvement activities designed to enhance the quality of patient care, customer service, or practice efficiencies.
  • Identifies initiatives to improve patient outcomes and satisfaction
  • Assists in chart review/audits as needed for performance improvement data collection
  • Supports initiatives implemented to improve patient outcomes and or efficiencies
• Provides for patient safety in compliance with hospital and or physician practice policies.
  • Adheres to infection control processes, including standard precautions, to reduce the risk of acquiring or transmitting infections
  • Utilizes two forms of patient identification before implementing any form of patient care
  • Practices the National Patient Safety Goals
• Performs procedures, assists in surgery, and provides care to the patient as per established guidelines(when applicable)
  • Positions patients and assists surgeon in the operating room.
  • Preps and drapes the patient as per established guidelines.
  • Assists in surgery by performing tasks defined by the surgeon.
  • Assists and maintains sterile techniques through procedures.
  • Per supervising physician's direction performs skin closures as directed.
  • Monitors patients until clinically stable unless requested by the surgeon to perform other duties.
  • Performs suture removal, and dressing changes as per supervising physician's directions.
  • Be available for call from home to assist in emergency surgeries.
• Directs and provides appropriate Pre and Post operative care (when applicable).
  • Performs history and physicals as designated by the physician. Identifies normal and abnormal findings and reports to the physician in a timely manner.
  • Provides preoperative teaching to patients and or families.
  • Performs patient rounds ensuring accurate assessment, review of labs and diagnostic procedures, and reports overall progress to supervising physician.
  • Orders appropriate testing per established guidelines and as outlined by supervising physician.
  • Documentation supports a review of lab/diagnostic results, is reflective of all required history and physical assessment elements.
  • Communicates with supervising physician in a timely manner regarding changes in the patient's progress, status, or critical test results.
  • Prepares for and develops discharge planning in conjunction with supervising physician.
  • Dictates discharge summaries timely and appropriate.
  • Provides counseling and instruction to patients and or families as appropriate.

Marginal Functions: Defined as duties that are not essential in nature and do not take a considerable amount of time to complete (less than 10%).

• Performs any and all other duties as assigned and appropriate.

Required Skills and Knowledge: Minimum level of education, skills and abilities necessary in performing the job.

Education:

• Graduate of accredited Nursing & Nurse Practitioner Program. Master's Degree in Nursing.

Certification / Licensure / Regulation:

• Current licensure to practice as a Registered Nurse in the State of Pennsylvania
• Current Certification as CRNP. Current Certification for Prescriptive Authority with DEA license.
• PA Act 153 Clearances (Act 34-PA Criminal Record Check from the PA State Police system, Act 33-PA Child Abuse History obtained through the Department of Public Welfare, Act 73-FBI Fingerprint screening within 2 weeks of hire in order to meet 30 days of hire or transfer position requirement).
• BLS Certification

Prior Experience:

• Related training/experience (preferably within the past five years)
• One-year medical/surgical experience

Other Skills and Abilities:

• none

Preferred Factor:

These are job related enhancements that are preferred or would benefit the performance outcome of the job but are not essential or required for the job to exist.

• DNP; prior CRNP experience

The above job descriptive information is intended to describe the general nature and level of work being performed by individuals assigned to this job. This is not intended to be an exhaustive list of all duties and responsibilities, as an employee may be assigned other duties other than described in this document.

Essential Working Conditions:

Working Conditions:

Never

• Extreme Cold
• Extreme Heat
• Heights
• Confined Spaces-Cramped Quarters (Labeled)
• Extreme Noise (> 85 dB)
• Mechanical Hazards
• Use of Vibrating Tools
• Operates Vehicle
• Operates Heavy Equipment
• Use of Lifting/Transfer Devices

Occasionally

• Rotates all shifts
• On Call
• Overtime (more than 8 hrs. /shift, 40 hours/week)

Frequently

• 8 hour shifts
• 10 - 12 hour shifts

Protective Equipment:

Never

• Head (hard hat)
• Hearing

Rarely

• Respirator-Breathing Equipment

Frequently

• Eye
• Hands
• Feet, Toes
• Body

Occupational Exposures:

Never

• Solvents
• Paints (direct use of)
• Dust (Sanding)
• Ethylene Oxide
• Cytotoxic Drugs (Chemo)
• Mists
• Wax Stripper (direct use of)
• Radiation
• Ionizing Radiation
• Lasers

Rarely

• Chemicals (direct use of)

Frequently

• Blood and Body Fluids

Constantly

• Latex (Rubber, erasers, balloons, gloves, rubber bands, etc.)

Essential Physical Conditions:

Physical Demands:

Never

• Climbing Ladders

Rarely

• Kneeling
• Squatting (Crouching)
• Pushing / Pulling

Occasionally

• Climbing Stairs
• Use of Forceful Hand Grasp
• Keyboard/Computer Operation
• Bending (Stooping)

Frequently

• Sitting
• Standing
• Walking
• Fine Finger Manipulation
• Hand / Arm Coordination

Sensory Requirements:

Frequently

• Feeling (Sensation)
• Color Vision

Constantly

• Seeing Near-with Acuity

Over Shoulder Work:

Occasionally

• Pulling or Pushing Objects Overhead
• Reaching Above Shoulder Level

Lifting: floor to standing position:

Never

• 20 - 29 pounds
• 30 - 49 pounds
• 50 pounds
• > 50 pounds

Rarely

• 10 - 19 pounds

Lifting: waist to shoulder level:

Never

• 20 - 29 pounds
• 30 - 49 pounds
• 50 pounds
• > 50 pounds

Rarely

• 10 - 19 pounds

Lifting: shoulder to overhead:

Never

• 20 - 29 pounds
• 30 - 49 pounds
• 50 pounds
• > 50 pounds

Rarely

• 10 - 19 pounds