Nurse Practitioner (NP) or Physician Assistant (PA) for Heart Center Surgical ICU

  • Mass General Brigham
  • MGH Main Campus 55 Fruit Street Boston 02114
  • Apr 28, 2023
Full time Nurse Practitioner (NP)

Job Description

Under general supervision and direction of the Cardiac Surgeons, and in accordance with the rules and regulations of Massachusetts governing Nurse Practitioner’s practice, the Nurse Practitioner (NP) will be responsible for the care of patients on the Cardiac Surgical Service, primarily those patients that are admitted to the Cardiac Surgery Service. The NP will participate in daily rounds with nurses, other Advanced Practice staff, residents and multidisciplinary caregivers; perform bedside diagnostic and therapeutic procedures, participate in the development and implementation of care plans, coordinate tests and consultations, implement treatment plans, communicate with referring physicians, perform patient education, and prepare patients for discharge, all while keeping Surgeons  updated as required. Maintains open lines of communication between Cardiac Surgeons, Residents, Fellows, PAs, Nursing Staff, Cardiologists, VAD NP Coordinator, and patients/families. Promotes a collaborative relationship and effort between the medical staff and professional nurses toward continuity of patient care and efficient use of resources.  Serves as a role model for professional nursing practice.

 

 

UNIVERSAL DUTIES AND RESPONSIBILITIES: 

 

1.0      Provides direct care to a select patient population in collaboration with the physician.

1.1              Performs and records the patient history and physical exam and discusses findings with the physician.

1.2              Utilizes advanced nursing knowledge to identify, prevent or solve complex and/or recurring patient care problems.

1.3              Follows and manages patients (in collaboration with MD) enhancing continuity of care.

1.4              Performs (oversees/assures completion of) specialized procedures particular to the select population mutually agreed upon with collaborating physician.

1.5              Performs medically delegated aspects of patient care as agreed upon by nursing and medical administrators according to practice guidelines.

1.6              Collaborates with unit staff and physicians to facilitate a comprehensive plan of care and coordinate resources.

1.7              Writes orders which are in accordance with current guidelines.

1.8              Maintains and practices in accordance with practitioner guidelines per state and hospital               regulations

2.0      Provides consultation to Nurses, Advanced Practice staff and Physicians.

2.1              Serves as a resource to staff in area(s) of expertise.

2.2              Serves on appropriate intra and interdepartmental committees.

3.0        Participates in the development of formal and informal educational programs for the unit-based nursing staff.

3.1              Develops educational programs within area of expertise.

3.2              Collaborates with unit staff, Clinical Educators, Clinical Nurse Specialists, Staff Specialists and other health care professionals to meet staff and patient educational needs.

4.0              Monitors patient outcomes in accordance with defined standards of patient care.

4.1              Collaborates with nurse managers, clinical nurses and medical staff to plan, implement and evaluate pertinent change in practice and health care delivery.

4.2              Identifies system-wide factors contributing to undesirable outcomes, such as complications, increased length of stay and overutilization of services.

4.3              Facilitates patient movement through the system and efficient use of resources through interdepartmental collaboration.

5.0              Supports research efforts to advance knowledge and to promote research-based practice.

5.1              Evaluates own practice and program effectiveness.

5.2              Identifies pertinent nursing and health delivery problems for investigation.

5.3              Evaluates current research findings for clinical specialty and determines applicability to unit practice.

5.4              Assists nursing and medical colleagues in research efforts.

5.5              Conducts own research.

6.0              Responsible for own professional growth and maintenance of required credentials.

6.1              Maintains the standards and educational requirements specific to the position and licensure.

6.2              Identifies own learning needs and goals.

6.3              Takes responsibilities for leadership and participation on committees and task forces of the DON and the hospital.

6.4              Maintains and updates clinical knowledge and skills based on current health care practice/research.

7.0              Participates in MGH and Partners quality initiatives and/or hospital committees as assigned

 

 

Job Requirements

ROLE-SPECIFIC DUTIES AND RESPONSIBILITIES: 

 

Cardiac Surgery Intensive Care Unit:

 

1.0              Assists with postoperative management of Cardiac Surgery patients. Under the direction of the surgeons, executes a wide range of management plans for patients.

2.0              Writes daily notes on all patients and discusses the care of each patient with the CSICU attending or surgeon and other consult service(s) involved with the care of that patient.

3.0              Performs basic and advanced cardiac life support procedures as necessary and directs these efforts.

4.0              Attends daily rounds.  Also rounds independently.

5.0              Obtains consultations from other services.

6.0              Receives patient admissions from the Operating Room, Cath Lab, ED, or other hospital units.

7.0              Arranges for transfers to the step down unit or other units to include hospital course summaries, transfer orders, and transfer notes.

8.0              Renews medications, transfer orders and general orders.

9.0              Performs appropriate evaluation of all patients on a daily basis. Medications, treatments, labs and consults will be ordered as needed. Discussion of the care of the individual patient will be made directly with the intensivist, Attending Surgeon, resident, Cardiologist or other consult service that is involved with the care of that patient.

10.0          Cardiac Care of the postoperative patients in the CSICU includes:

10.1          Initiating pacing with external pacemaker systems, atrial and/or ventricular, in patients with existing pacing wires for treatment of bradycardia, hypotension or arrhythmia suppression

10.2          Skin wire insertion in patients who require pacing but in whom the existing bipolar wires do not function properly

10.3          Changing milliamp output, sensitivities, and/or polarities of the pacing system

10.4          Placing central lines, pulmonary artery catheters, chest tubes, or arterial lines

10.5          Removal of chest tubes, drains, epicardial pacing wires, central lines

10.6          Applying and/or changing wound VAC

10.7          Management of ECMO, VAD, heart transplant, and lung transplant patients.

10.8          Familiarity with CVVH, Mechanical Circulatory Support (intraaortic balloon pumps, ventricular assist devices, & ECMO), pulmonary arterial catheters, arterial catheters, and mechanical ventilation.

11.0          Liaison with VAD Coordinator, Transplant Coordinator, CSICU Nursing Director, and Heart Failure team

12.0          Develops and implements routine instructions for patient discharge.

13.0          Participates in Cardiac Surgery Service and Department of Surgery educational meetings with students and residents assigned to the surgical services.

14.0          Assists with ongoing clinical research through follow-up of patients currently involved in clinical trials.

15.0          Assists in current clinical research and pursues independent clinical research.

 

 

 

QUALIFICATIONS:

 

1.0              Current licensure in the Commonwealth of Massachusetts as a registered nurse in the expanded role. 

2.0              Master’s Degree in Nursing. 

3.0              National certification in acute care advanced practice nursing.

 

 

SKILLS/ ABILITIES/ COMPETENCIES REQUIRED: 

 

1.0              Professional knowledge: Clinical, healthcare management with knowledge to enable effective interactions and communication with clinicians, administrators and other professionals.

2.0              Time Management: Exceptional organizational skills and ability to prioritize effectively and complete tasks; Flexibility to handle multiple tasks and deadline pressures. 

3.0              Clinical leadership: Highly motivated, independent and capable of performing in a complex environment; Strong sense of initiative and perseverance to carry through to completion of tasks; Demonstrates forthrightness and integrity. 

4.0              Interpersonal/communication:  Excellent interpersonal, written and oral communication, and public speaking skills; Good command of English language, including medical and scientific terminology.

5.0              Information Systems/Technology Skills:  Exceptional computer skills (including Windows operating systems, word processing, database, electronic mail, Internet, spreadsheets, and other office management systems).  

6.0              Quality Assurance: Skills to work efficiently and effectively and strive to do so in all aspects of position; Effective project management skills and attention to detail.

7.0              Critical Thinking/Decision Making:  Ability to appropriately evaluate all aspects of a situation and to independently make appropriate and timely decisions. 

8.0              Collaboration: Ability to coordinate among diverse constituents, both inside MGH and in the community.

9.0              Discretion and Confidentiality:  Ability to handle sensitive and confidential matters discreetly and to ensure confidentiality guidelines are maintained by staff. 

10.0          Safety/Compliance:  Knowledge in aspects of safety applicable to position; Knowledge of and compliance with institutional, Joint Commision, HIPAA, and other regulatory bodies’ standards.

 

 

TRAINING & ORIENTATION

 

1.0       Training will be tailored to the individuals experience level but will include a minimum of two months orientation.

2.0       Orientation will be provided primarily by the Advanced Practice staff and will include all necessary aspects of patient care specific to area of  practice.

 

 

WORKING CONDITIONS:

 

Normal clinical conditions in a variety of hospital settings to include inpatient, clinic, and operating room.

 

May require attendance at meetings outside of regularly scheduled hours.

 

Rotating work schedule assigned by work location.  Position may includes night, weekend, & holiday coverage for inpatient responsibilities.  

 

 

SUPERVISORY RESPONSIBILITY: 

 

No direct supervisory responsibilities

 

 

 QUALIFICATIONS:

 

1.0              Current licensure in the Commonwealth of Massachusetts as a registered nurse in the expanded role. 

2.0              Master’s Degree in Nursing. 

3.0              National certification in acute care advanced practice nursing.

 

 

SKILLS/ ABILITIES/ COMPETENCIES REQUIRED: 

 

1.0              Professional knowledge: Clinical, healthcare management with knowledge to enable effective interactions and communication with clinicians, administrators and other professionals.

2.0              Time Management: Exceptional organizational skills and ability to prioritize effectively and complete tasks; Flexibility to handle multiple tasks and deadline pressures. 

3.0              Clinical leadership: Highly motivated, independent and capable of performing in a complex environment; Strong sense of initiative and perseverance to carry through to completion of tasks; Demonstrates forthrightness and integrity. 

4.0              Interpersonal/communication:  Excellent interpersonal, written and oral communication, and public speaking skills; Good command of English language, including medical and scientific terminology.

5.0              Information Systems/Technology Skills:  Exceptional computer skills (including Windows operating systems, word processing, database, electronic mail, Internet, spreadsheets, and other office management systems).  

6.0              Quality Assurance: Skills to work efficiently and effectively and strive to do so in all aspects of position; Effective project management skills and attention to detail.

7.0              Critical Thinking/Decision Making:  Ability to appropriately evaluate all aspects of a situation and to independently make appropriate and timely decisions. 

8.0              Collaboration: Ability to coordinate among diverse constituents, both inside MGH and in the community.

9.0              Discretion and Confidentiality:  Ability to handle sensitive and confidential matters discreetly and to ensure confidentiality guidelines are maintained by staff. 

10.0          Safety/Compliance:  Knowledge in aspects of safety applicable to position; Knowledge of and compliance with institutional, Joint Commision, HIPAA, and other regulatory bodies’ standards.

 

 

TRAINING & ORIENTATION

 

1.0       Training will be tailored to the individuals experience level but will include a minimum of two months orientation.

2.0       Orientation will be provided primarily by the Advanced Practice staff and will include all necessary aspects of patient care specific to area of  practice.

 

 

WORKING CONDITIONS:

 

Normal clinical conditions in a variety of hospital settings to include inpatient, clinic, and operating room.

 

May require attendance at meetings outside of regularly scheduled hours.

 

Rotating work schedule assigned by work location.  Position may includes night, weekend, & holiday coverage for inpatient responsibilities.  

 

 

SUPERVISORY RESPONSIBILITY: 

 

No direct supervisory responsibilities