Location: Chapel Hill, North Carolina
Advanced Practice Registered Nurses / Physician Assistants
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An Advanced Practice Provider (APP) functions as part of the interdisciplinary healthcare team in accordance with privileges approved by the credentialing committee to provide high quality, cost effective care to patients within the APPs scope of practice in collaboration with a supervising physician. The APP reflects the mission, vision, and values of the organization, and complies with all relevant policies, procedures, guidelines and other regulatory and accreditation standards.
The incumbent of this position functions as a Neonatal Nurse Practitioner (NNP) delivering critical care medical management in the Newborn Critical Care Center (NCCC) based at the North Carolina Children's Hospital and the delivery rooms of the North Carolina Women's Hospital, components of the UNC Hospitals. The practitioner works in a multi-disciplinary, academic environment and interacts at all professional levels (including students, residents, fellows, and faculty and staff) of medical, surgical, nursing, respiratory therapy, and other medical allied health professionals.
The practitioner has responsibility for complete daily medical management of a caseload of critically ill newborn infants including: delivery room resuscitation, initial stabilization, mechanical ventilation, parenteral drug administration, emergency management, acute and continuous medical care of the infant and communication with the infant's family. At all times care will be provided through independent utilization of approved protocols and procedures and under the supervision of attending neonatologists of the Division of Neonatal-Perinatal Medicine.
1. Clinical- Obtains relevant health and medical history, performs thorough physical assessment, reviews and interprets pertinent diagnostic tests/results. Develops appropriate differential diagnoses. Develops and implements treatment plans including prescribing/ordering of appropriate evidence-based pharmacological agents consistent with departmental guidelines and privileging, and schedules appropriate follow-up management. Actively incorporates evidence-based hospital initiatives to improve patient care. Conducts preventive health screening based on age, history and patient needs. Maintains clear comprehensive yet concise records of all aspects of patient care. Maintains essential knowledge of general disease and pathologic processes. Maintains extensive knowledge of their specialty literature including awareness of developing areas. Consistently derives correct diagnoses through synthesis of clinical data and proper selection and interpretation of diagnostic studies. Develops comprehensive differential diagnoses for patients. Revises the plan of care to meet the changing needs of the patient. Prioritizes work and assists staff to provide prompt and efficient client flow. Consistently maintains high productivity according to identified standards. Leads/participates in projects to improve productivity. Appropriately performs medical procedures consistent with departmental guidelines, privileging, and clinical roles/responsibilities.
2. Education- Appropriately and professionally educates clients and/or families regarding medical condition, treatment, and follow-up. Collaborates with clinicians, staff, and students to promote continuity and patient/family centered care. Develops educational materials based on learning needs of clinicians, staff, and students. Provide education/instruction to physicians, housestaff, nursing, ancillaries and/or students. Actively recognizes and participates in identification and achievement of self-learning needs. Attends education programs based on identified learning needs.
3. Leadership- Provides instruction to physicians, housestaff, nursing, ancillaries and/or students including but not limited to precepting, shadowing, lectures, training classes, CE, rounds, morning report, and or staff meetings. Participates in community/network outreach programs. Develops/leads community/network outreach programs. Demonstrates both an understanding of the contexts and system in which healthcare is provided and the ability to apply this knowledge to improve and optimize health care delivery. Leads/participates in systems improvements.
4. Professionalism- Interacts with patients and families in a respectful, courteous and timely fashion using appropriate communication for the patient and situation. Interacts collaboratively with coworkers, other team members and staff in a respectful, courteous, and timely fashion appropriate to patient care needs and situations. Responds quickly to meet customer needs and resolve problems. Accepts responsibility for outcomes of one?s work. Shares responsibility for overall workload with team members.
5. Quality/Research- Engages in daily continuous quality improvement by identifying and implementing processes for improvement. Consults with management in assessment, problem-solving, decision-making, and evaluating clinical/system issues and models of care. Leads interdisciplinary teams to provide integrated delivery of patient care services. Initiates and revises protocol(s) or guideline(s) to reflect evidence-based changes in care management Works to influence policy-making bodies to improve patient care. Develops new clinical programs or services within the department/unit/clinic to improve patient care.
6. The APP Manager, and/or Supervising Physician within the Division of Neonatal-Perinatal Medicine.
A. Evaluates, plans, manages, and implements direct medical patient care. Acquires patient history and performs physical examination. Establishes differential diagnosis and institutes diagnostic workup to confirm diagnosis. Assigns thermal environment, monitoring nutrition (enteral and parenteral), ventilatory assistance, and oxygen administration. Orders enteral and parenteral medications, including antibiotics and other antimicrobial agents, narcotics and sedatives, cardiovascular anti-arrhythmic medications, antiseizure agents, methylxanthines, inhaled medications, blood products, etc. Performs invasive procedures, including intubation, lumbar puncture, tube thoracostomy, insertion of umbilical artery and venous catheters, needle aspiration of body cavities, suprapubic bladder taps, arterial puncture for blood aspiration, transcutaneous placement of arterial and central venous catheters, exchange transfusions, etc. These will be performed on a cadre of critically ill infants in the NCCC under written protocols and the clinical supervision of neonatology attending staff. Coordinates care plan with Primary Nurse.
B. Writes orders for tests, procedures, and implementation and management of therapies in accord with standards.
C. Provides parents (and other family members) with information regarding the infant's physiologic/developmental status and needs and psychological support on a continuous basis that is congruent with the multi-disciplinary health care team objectives.
D. Communicates in verbal and written report (the latter in the medical daily record) information that relates to care planned and delivered to the patient.
E. Participates in the education of nursing staff, nurse practitioner students, medical residents, nursing medical students, and other in the planning for and performance of continuing education and research on the unit. Includes self-directed continuing re-education.
F. Assists the Medical Director, Head Nurses, Nurse Educator (s), and Discharge Coordinators in the development and evaluation of standards of care, unit objectives, patient care programs, and continuing education programs.
G. Assumes other duties and responsibilities that are appropriate to the position and area.
H. Exemplifies professional relations and demonstrates leadership within the Center. The above responsibilities are a general description of the level and nature of the work assigned to this classification and are not to be considered all-inclusive.
The above responsibilities are a general description of the level and nature of the work assigned to this classification and are not to be considered all-inclusive.
* Completion of an accredited graduate-level Advanced Practice Provider (APRN or PA) program.
- Prefer BSN in Nursing from an accredited School of Nursing and NAACOG (Nurse Association of the American College of Obstetrics and Gynecology) and certification as a Neonatal Nurse Practitioner. NAACOG NNP certification requires completion of a minimum nine-month course, which conforms to the American Nurse Association Guidelines for Short Courses for Perinatal Nurse Clinician; or successful completion of a Master's and/or Doctorate degree Neonatal Nurse Practitioner university-based program whose curriculum has been approved by the North Carolina Medical Board.
* Licensed as an Advanced Practice Provider (i.e., Nurse Practitioner, Physician Assistant, Clinical Pharmacist Practitioner, Certified Nurse Midwife, Certified Registered Nurse Anesthetist) in the state of North Carolina. Board certification if required by the Department.
Professional Experience Requirements:
- The incumbent must maintain a current North Carolina licensure as a Registered Professional Nurse (RN). The incumbent must also obtain certification from the National Certification Corporation (NCC) as a Neonatal Nurse Practitioner (NNP) and must continuously maintain licensure by the NC Boards of Nursing and Medicine as a NNP. Exceptions may be allowed for nurse practitioners approved prior to January 8, 1981 (see Subchapter 32E.003 of Regulations regarding Approval of Registered Nurse Performing Medical Acts).
* No prior experience required.
Knowledge/Skills/and Abilities Requirements:
- Prefer a minimum of two years of experience as an RN in a Level III Neonatal Intensive Care Unit
* Demonstrated clinical competency. Effective leadership skills. Strong interpersonal skills. Ability to work independently and collaboratively. Demonstrated written and verbal communication and strong analytical skills. Effective interaction to ensure the successful care of patients in the clinical setting. Documentation in the medical record to substantiate accurate billing.
- Expert neonatal clinical skills. Must be able to remain calm and functional and to continue leadership skills under stressful and critical life-threatening emergency situations.
The practitioner will normally work rotating 10-18 hour shifts to include weekend assignments and night call. An average of 40 hours/week duty time will be maintained over any given scheduling period. Working schedule may be changed as clinical needs dictate
LEVELS OF SUPERVISION REQUIRED
The practitioner should be able to function independently as defined in the job description
Legal Employer: STATE
Entity: UNC Medical Center
Organization Unit: UNC FP Peds Neonatology
Work Type: Full Time
Standard Hours Per Week: 40.00
Work Schedule: Variable
Location of Job: US:NC:Chapel Hill
Exempt From Overtime: Exempt: Yes