Inpatient Renal NP or PA

The APP works closely with the nephrology physicians, inpatient physicians and advanced practice professionals, residents and nursing staff to develop and coordinate a plan of care designed to meet the physical, psychological and social needs of patients and their families. Strong interpersonal, organizational and communication skills are required. Knowledge of current literature and a commitment to continued learning are also required. The mission, vision and core values of the Brigham and Women's/Faulkner Hospital (BWFH) are incorporated into all areas of practice. The BWFH nephrology APP will also be an integral partner with the other BWFH advanced practice professionals.

As a member of the BWFH Nephrology Division, the PA/NP shall be responsible for the following duties:

• inpatient nephrology

• consults and follow up visits, primarily seing patients with AKI/CKD/ESRD and assist with their renal replacement therapies (hemodialysis, peritoneal dialysis, CRRT)
• Write dialysis/Peritoneal dialysis or CRRT Orders
• Perform Inpatient PICC consults
• Other duties as needed.

General Duties
Work collaboratively and function as an efficient member of the BWFH nephrology division

• Assist in the coordination of care for patients with the primary care teams and other sub-specialists involved in the care of patients
• Provide education to patients and families
• Document in the medical record as appropriate and communicate observations and findings to the attending physicians
• Monitor environment of care and comply with regulatory agency standards
• Ensure that their clinical practice is consistent with advance practice policies, procedures and standards
• Participate in QA/QI projects as appropriate

SKILLS/COMPETENCIES REQUIRED:

• Staff adheres to all C.A.R.E. Standards

Medical Knowledge
Medical knowledge includes an understanding of pathophysiology, patient presentation, differential diagnosis, patient management, surgical principles, health promotion and disease prevention. The APP must demonstrate core knowledge about established and evolving biomedical and clinical sciences and the application of this knowledge to patient care in their area of practice. In addition, the APP is expected to demonstrate an investigatory and analytic thinking approach to clinical situations.

The PA/NP is expected to:

* Understand etiologies, risk factors, underlying pathologic process, and

epidemiology for medical conditions

* Identify signs and symptoms of medical conditions

* Select and interpret appropriate diagnostic or lab studies

* Manage general medical and surgical conditions to include understanding

the indications, agents and other relevant treatment modalities

* Identify the appropriate site of care for presenting conditions, including

identifying emergent cases and those requiring referral or admission

* Identify appropriate interventions for prevention of conditions

* Identify the appropriate methods to detect conditions in an asymptomatic

individual

* Differentiate between the normal and the abnormal in anatomic,

physiological, laboratory findings and other diagnostic data

* Appropriately use history and physical findings and diagnostic studies to

formulate a differential diagnosis

* Demonstrate proficiency with BWFH computer systems as needed to

independently perform daily tasks such as order entry, EMAR, lab tests and

results, incident reporting etc.

* Consistently provide high quality and timely documentation including consult

notes and progress notes.

Physical and mental abilities required

• Must be energetic, quality driven and have proven ability to be a productive member of a cohesive team of peers, dedicated to providing optimum patient care.
• Must exercise the highest degree of professional judgment under the direct supervision and guidance of a licensed physician.
• Must maintain a professional attitude towards patients and exercise such mature independent originality in solving problems not covered by existing guidelines, within legal limits, to meet the needs of the patients.
• Must maintain a professional attitude towards patients at all times and an excellent and collegial working relationship with other personnel involved in patient care.
• Must demonstrate understanding of procedures, policies and documentation required to ensure compliance with hospital standards of care.

EDUCATION:

For PA's

• Must have successfully completed a Graduate Level, accredited Physician Assistant Program approved by AMA Board of Approval and Certification of PA programs.
• Must have 4 years of college level education and baccalaureate degree or equivalent. (BS/MS joint programs are also acceptable; BS with PA certificates are acceptable for graduates before 1995).
• Board Certification by the National Commission on Certification of PA/NPs is required.

For APRN's

• Completion of a master's or post master's degree in acute care, adult or family NP program accredited by the Commission on Collegiate Nursing Education (CCNE) or the National League for Nursing Accrediting Commission (NLNAC)
• Current certification by the American Nurses Credentialing Center or an equivalent body.
• Current active licensure to practice in the expanded role in the state of Massachusetts.

LICENSES, CERTIFICATIONS, and/or REGISTRATIONS

• NCCPA/NP certified
• License as a Physician Assistant in Massachusetts
• Maintain current DEA and Massachusetts Controlled Substance Licenses
• Complete 100 hours of CME according to national and state regulations during each 2 year period of employment.
• NP must have current Massachusetts Registered Nurse Licensure/ Advanced Practice
• NP Certification in Basic Life Support for Healthcare Providers required
• NP must maintain updated continuing education requirement for certification and licensure
• Maintain current ACLS certification
• Complete BWFH Professionalism Program within 3 months of date of hire.
• Complete BWFH Procedural Sedation Training, if determined necessary.

EXPERIENCE:

• One year of relevant experience as a APP in this specialty, would be ideal but is not necessary.
• Other previous hands-on patient care experience may be considered at the discretion of the Medical Directors.

WORKING CONDITIONS:

The APP position on the team can be quite challenging, requiring both teamwork and individual initiative. A high level of patient care is required while working quickly and often multi-tasking. The APP schedule may require long workdays while maintaining a goal of 40 hours/week on average.