NP/PA - Pulmonary CC | Int Med-Pulmonary

Wake Forest Baptist Health
Job Title: NP/PA - Pulmonary CC
Job ID: 4451
Full/Part Time: Full-Time
Regular/Temporary: Regular
Job Category: Physician and Faculty
Winston-Salem, NCPhysician and Faculty, Medical, Healthcare10/1/2013Job DescriptionNurse PractitionerSupervising MD: Alexander Sy, MD FCCP, FACP, FASMI. Scope of Practice and Practice Location:The advanced practice nurse (APN) in the Medical ICU (MICU), in collaboration with critical care attending physicians and other medical personnel; clinically manage...

Job Description


Job Description

Nurse Practitioner/ Physician Assistant- MICU/ IMCU

Supervising MD/ Director of MICU: Peter Morris, MD

Director of IMCU: Michael Young, MD

Qualifications and schedule :

Advanced degree with MSN in nurse practitioner in Acute Care, Adult/Geriatric, or Family Practitioner (with critical care experience either as NP or Critical Care Nurse). Also, applicant should be certified by the ANCC and licensed as NP by the NC Nursing Board.

Advanced degree with a master's degree (MS) in physician assistant studies licensed as physician assistant by the NC Medical Board.

The qualified mid-level practitioner (NP/PA) will work an average of 14 twelve hour shifts every 5 week period.

Scope of Practice and Practice Location:

The advanced practice nurse (APN) and or Physician assistant (PA) in the Medical ICU (MICU)and Intermediate Care Unit (IMCU), in collaboration with critical care attending physicians and other medical personnel; clinically manage patients in the MICU and IMCU. Responsibilities include physical assessment, management of a broad range of critical illnesses, perform and assist with insertion of commonly utilized vascular catheters for venous access, dialysis, arterial monitoring and airway maintenance, coordination of clinical care between intensivist team, multiple consulting teams and hospital services, documentation of care provided, teaching and counseling patients and families including preparing patients/families for discharge from the ICU/IMCU, and serving as a clinical and educational resource for all disciplines of the ICU/ IMCU staff including nursing, respiratory therapy, pharmacy, physical therapy and nutrition services. When necessary, the APN/PA will also provide some emergency support to the residents and interns of the house staff-based ICU/IMCU team.

The practice location is Wake Forest Baptist Medical Center MICU and IMCU.

General Practice Privileges:

  1. Those clinical privileges that are granted to all PA/NP's at WFBMC. (WFBMC credentialing is kept in the physician services office and is reviewed annually.)
  2. Provide direct care to adult MICU/IMCU patients through the following functions:
  3. Assessment of patients, obtaining patient histories, performing physical examinations and ongoing data collection.
  4. Coordination and documentation of in-hospital care.
  5. Performance of approved diagnostic and therapeutic procedures.
  6. Initiate referrals/ consults to other health care providers and/or consult supervising MD for further definitive therapy
  7. Participate in rounds with Supervising Physician and Medical Critical Care team. Supervision and availability will occur onsite as well as by telephone connection for definitive decision making. Medical interventions will be performed with the direct knowledge of supervising and back-up physicians. Minimum standards for patient care throughout the continuum of hospitalization will be discussed but will be specifically focused on the patient's care in the intensive care unit.
  8. Life-threatening circumstances and emergency situations will be managed in accordance with hospital protocols as well as national standards and practice guidelines while in telephone consultation with supervising physician.
  9. Establish diagnoses commonly encountered in MICU/IMCU patients. These include, but are not limited to:
  • Arrhythmias
  • Fluid/Electrolyte Imbalances
  • Hyper/hypotension
  • Hyper/hypoglycemia
  • Drug Overdose/toxicity
  • Pneumonia
  • GI Emergencies (Bleeding, pancreatitis)
  • Infection/Sepsis
  • Respiratory Failure – acute & chronic
  • Renal Failure – acute & chronic
  1. Management of all diagnoses will be in accordance with hospital protocols, and using appropriate guidance provided by evidence-based guidelines implemented at Wake Forest Baptist Medical Center and under the guidance of supervising and backup physicians.
  2. Order and interpret laboratory tests including, but not limited to:
  • CBC
  • CMP
  • Electrolytes not covered in BMP
  • Coagulation studies
  • Urinalysis
  • Urine Cultures
  • Arterial Blood Gases
  • Blood Cultures
  • Type & Cross
  • Drug Levels: Vanc, Dig, Gent, etc.
  • Endocrine assessments
  • Organ anti-rejection drug levels
  • Hepatic Function tests

12. Order and interpret diagnostic studies including, but not limited to:

  • EKG
  • CXR

13. In collaboration with attending physician

  • Echocardiograms
  • Vascular studies
  • Insertion of endotracheal tubes, central venous catheters (CVC and PICC) and arterial catheters using standard techniques including ultrasound guidance when appropriate.
  • Computed Tomography
  • Magnetic Resonance Imaging

14. Order the following therapeutic measures consistent with the agreed plan of care including, but not limited to:

  • Diet adjustment
  • Activity
  • Vital sign monitoring
  • Intake and output monitoring
  • Wound care
  • Anti-embolic stocking/DVT prophylaxis
  • Nasal/orogastric tube placement/feeding tube placements
  • Perform the following therapeutic measures consistent with the agreed upon plan of care including, but not limited to:
  • Chest tube removal
  • Removal of central lines
  • Patient/family education
  • Placement of indwelling arterial catheters
  • Placement of central venous access catheters
  • Emergent intubation, only in times that mask ventilation has failed or is not emergently available and in-house physician support is not immediately available
  • Emergent tension pneumothorax relief with needle decompression
  • Ventilator management
  • CPR according to ACLS protocols

15. Order consultations consistent with the agreed plan of care including, but not limited to:

  • Arrhythmia/electrophysiology
  • Cardiac rehabilitation
  • Cardiology
  • Care management/Home health
  • Dental
  • Dermatology
  • Endocrine
  • ENT
  • General Surgery
  • Gastroenterology
  • Infectious Disease
  • Neurology
  • Ophthalmology
  • Pain
  • Physical Therapy
  • Occupational Therapy
  • Psychiatry
  • Pulmonary/Critical Care
  • Plastic surgery
  • Nephrology
  • Recreational therapy
  • Urology
  • Vascular surgery

16. The following medications may be initiated, altered, monitored or discontinued by the APN in accordance with education and written resources and in consultation with supervising physician, cardiothoracic surgery fellows and attendings including, but not limited to:

  • Analgesics
  • Antacids
  • Anti-anxiety medications
  • Anti-arrhythmics
  • Anti-biotics
  • Anti-coagulants
  • Anti-convulsants
  • Anti-flatulents
  • Anti-fungal agents
  • Antihistamines and decongestants
  • Anti-hypertensives
  • Anti-inflammatory agents
  • Anti-platelet agents
  • Anti-reflux medications
  • Benzodiazepines
  • Bronchodilators
  • Calcium channel blockers
  • Calcium supplements
  • Coagulant medications
  • Diuretics
  • GI laxatives/ stimulants/ bulk agents
  • Histamine blockers
  • Hypoglycemic agents
  • Hyperglycemic agents
  • Inotropic agents
  • Immunosuppressive agents (consult physician and/or transplant coordinator)
  • Intravenous solutions including total parent
  • eral nutrition and lipids
  • Mineral and electrolyte supplementation
  • Oral or nebulized bronchodilators
  • Oral or inhaled steroids
  • Organ anti-rejection medications
  • Optic anti-inflammatory/anti-biotic agents
  • Potassium supplements
  • Proton pump inhibitor medications
  • Oxygen
  • Schedule II, IIN, III, IIIN, IV, V controlled substances
  • Sedative medications
  • Thrombolytic agents (consult physician)
  • Thyroid hormone replacement
  • Topical anti-inflammatory agents
  • Vasodilators
  • Vasopressors
  • Vitamins and mineral supplementations

To apply for this position, please click on the "Apply Now" button on this page. You must complete the application process and then submit your application by clicking on the "Submit" button located at the bottom of the page titled "Submit Online Application". You will receive the following message once you hit the submit button: "You have successfully submitted your job application".

Computers are available for applying within the lobby of the Human Resources Department located at 1920 West First Street, (on the corner of Miller and First Street) Winston-Salem, North Carolina 27104. You may also call our office for assistance at (336) 716-7580. Office hours are Monday-Friday, 8:00am-5:00pm.

If you are an individual with a disability and need reasonable accommodation to participate in the application process, please contact the Office of Physician and Faculty Recruitment by phone (336) 716-7580 or email at facultyjobs@wakehealth.edu.

It is the policy of Wake Forest Baptist Medical Center to administer all educational and employment activities without discrimination because of race, sex, age, religion, national origin, disability, sexual orientation or veteran status (except where sex is a bona fide occupational qualification or a statutory requirement) in accordance with all local, state, national laws, executive orders, regulations, and guidelines.



Quick Reference

Physician and Faculty Recruitment

Phone 336-716-7580
Fax 336-716-1206

Email
facultyjobs
@wakehealth.edu

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