Critical Care Nurse Practitioner/Physician Assistant - Duke EM Clinical Evaluation Unit
- Durham, NC
- Permanent
- Full-time
- The nation's first Physician Assistant Program was created at Duke in 1965 and is consistently ranked No. 1 in the country.
- The Duke School of Nursing is consistently ranked as one of the top nursing schools and their MSN and DNP programs offers eight advanced practice registered nurse majors and specialty certifications, as well as post master's certificates and certification alignment programs.
- Commitment to ongoing learning for APPs through annual CME funding and access to high-quality Duke CME offerings including APP Grand Rounds and a professional advancement program. APPs are leaders in multiple arenas within Duke.
- Duke offers APPs opportunities to practice within team based integrative care in a tremendous variety of specialties. APPs are expected to work to top of scope in order to contribute to Duke's missions which include clinical practice, education, and research.
- Practice locations can include Duke Health's three hospitals or over 140 primary care and specialty care clinics throughout North Carolina.
- In collaboration with the attending physician(s), provide direct clinical services for critically ill patients according to the established protocols and utilizing evidence-based clinical practice in the Clinical Evaluation Unit.
- Perform detailed histories and physical exams on patients placed in observation.
- Develop, initiate, and manage individualized treatment plans for a broad range of acute and subacute conditions.
- Order, interpret, and act on diagnostic studies including labs, imaging, and EKGs.
- Initiate appropriate therapeutic interventions including medications, IV fluids, respiratory therapies, wound care, and other procedures within scope of practice.
- Monitor and reassess patient status throughout their observation stay to ensure clinical stability and progress toward discharge goals.
- Make timely decisions regarding patient disposition, coordinate specialty consultations, and facilitate transitions of care.
- Communicate effectively with patients and families regarding diagnosis, treatment plans, expectations, and follow-up.
- Document all clinical encounters and updates in the electronic medical record.
- Complete required admission, progress, and discharge notes in accordance with departmental protocols.
- Support the operational goals of the ED and hospital by managing observation patients efficiently.
- Assist in identifying barriers to timely discharge and proactively work to resolve them.
- Help ensure appropriate use of observation status in compliance with regulatory guidelines.
- Adhere to evidence-based clinical pathways, protocols, and institutional guidelines.
- Participate in ongoing quality improvement initiatives, case reviews, and morbidity & mortality discussions.
- Promote a culture of safety, respect, and accountability within the unit.
- Stay current with developments in emergency and observation medicine through CME, journal review, and departmental education sessions.
- Support orientation and mentoring of new APPs, residents, and students rotating through the observation unit.
- Seek opportunities to contribute to operational improvements, academic projects, or protocol development.
- Nurse Practitioners: Work requires completion of an accredited Nurse Practitioner program, with a Master's degree in Nursing. Critical Care / Acute Care NP Master's or completion of ACNP/CCNP post-Master's program strongly preferred.
- Physician Assistants: Completion of an accredited Physician Assistant program. A Bachelor's degree required; Master's degree strongly preferred.
- BLS required.
- ACLS required within 3 months of hire
- Nurse Practitioners: Must have current or compact RN licensure in the state of North Carolina. BLS required. National certification as a NP required prior to employment. Certification as an Acute Care or Critical Care Nurse Practitioner strongly preferred.
- Physician Assistants: Must be licensed in the state of NC, and be certified as a Physician Assistant by the National Commission on Certification of Physician Assistants.
- Candidates must have at least 1 year of advanced practice emergency medicine, observation, or critical care experience. Completion of a residency/fellowship in emergency medicine, observation, or critical care preferred.
- Nurse Practitioners: 1 year of experience as a nurse practitioner in an emergency medicine, observation, or critical care setting required.
- Physician Assistants: 1 year of experience as a physician assistant in emergency medicine, observation, or critical care setting required.