Advanced Practice Provider, Orlando Regional Medical Center - Critical Care Management

• Possess specialized skill and knowledge unique to the ICU setting in which they practice (Medical, Surgical, Neurosurgical, Cardiovascular, etc)
• Provides direct clinical services for critically ill patients according to established protocols and utilizes evidence-based clinical practice standards.
• Obtains comprehensive and focused history and physician exam on critically ill patients
• Responsible for evaluating critically ill complex (multi-organ failure) patients in the ICU and step down units by synthesizing data, physical exam and pertinent medical history to assess clinical scenario and prescribe appropriate interventions and medications.
• Uses clinical judgment and evidence based medicine to order and schedule appropriate laboratory and radiographic studies.
• Works with supervising physician to determine and place appropriate specialty consultations.
• Evaluates critically ill patients in the ICU and step down units by synthesizing data, physical exam and pertinent medical history to assess clinical scenario and prescribe appropriate interventions and medications.
• Works in collaboration with supervising and consulting physicians to formulate and implement plan for management of critical ill patients.
• Performs complex procedures in the diagnosis and treatment of medical and surgical problems (including but not limited to: Central venous catheter placement, arterial catheter placement, chest tube placement, lumbar puncture, thoracentesis, paracentesis, endotracheal intubation, therapeutic bronchoscopy –i.e removal of secretions and BAL.)
• Performs advanced cardiac life support. In a medical emergency, the nurse practitioner will act on behalf of the supervising medical staff member to maintain life support until a licensed physician arrives to manage the patient.
• Removes catheters, drains, sutures and staples.
• Interprets arterial blood gas report and appropriate management of invasive and noninvasive modes of mechanical ventilation.
• Assesses need for vasoactive medication and places appropriate order sets and titration parameters.
• Interpretation of invasive and noninvasive hemodynamic monitoring, waveforms and EKG and institutes appropriate

• Operates with the highest degree of independence in provision of patient care services with minimal physician supervision and generally in a highly specialized area
• Performs emergent lifesaving procedures in cases such cardiac arrest, respiratory arrest, massive hemorrhage, or similar catastrophe.
• Performs preliminary daily rounds independently and daily multidisciplinary rounds (i.e., attending physicians, fellows, pharmacist, dietician, respiratory therapist)
• Assesses patient for changes in status and capable of instituting appropriate interventions in sub-acute, acute and emergent situations.
• Notifies attending physician about unusual or unexpected events or problems requiring direct physician consultation.
• Initiates necessary emergent interventions to stabilize acutely deteriorating patients.
• Prescribes medication using evidence based medicine, clinical judgment and plan of care as discussed in rounds as agent for supervision physician.
• Writes and/or dictates concise thorough patient progress notes, consult notes, history and physical notes and clinical resumes.
• Documents the preparation, procedure, outcome and complications of therapeutic and diagnostic procedures performed.
• Explains the necessity, preparation, nature and anticipated effects of procedures or tests to patients, patient’s family and staff.
• Provides family-centered care by communicating with family regarding the changing health care status of their family member.
• Provides family education as needed and works to answer or address family’s questions or concerns.
• Assesses family adaptation, coping skills and need for crisis or other intervention.
• Utilizes current research and evidence based medicine approach in all clinical practice.

• Graduate of accredited nurse practitioner program with a Master’s Degree and completion of a board certification if graduated after July 2006. New hires and Team Members placed in this job after May 1, 2021 must obtain acute care certification.

• Graduate of accredited physician assistant program.
• New hires and Team Members placed in this job after May 1, 2021 must obtain acute care or critical care fellowship program.

• ARNP license in the state of Florida.
• Maintains current ACLS and BLS.
• Fundamental Critical Care Support (FCCS) Certificate, or obtain the FCCS certification within 6 months of hire if preapproved by the Physician Director of Critical Care Services

• Current licensure in State of Florida renewed every two years.
• Maintains current ACLS and BLS.
• Fundamental Critical Care Support (FCCS) Certificate, or obtain the FCCS certification within 6 months of hire if preapproved by the Physician Director of Critical Care Services

• If graduated before July 2006, and without certification, must have 2 years experience as a nurse practitioner in a critical care APP role

• Two (2) years of critical care experience in an APP role, a fellowship may substitute for the required experience.

Orlando Health