Nurse Practitioner/Physician Assistant - Relief Hospitalist

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Day - 08 Hour (United States of America)

Ready to join a growing and driven team of Advanced Practice Providers (APPs) in Inpatient Medicine?

Created in July 2021, the Med 7 Inpatient Service is staffed with a unique hybrid model involving collaborative care provided by both physicians and Advance Practice Providers (APP). The APPs on the Med 7 service are trained in Internal Medicine to manage the day-to-day care of hospitalized patients. This is an excellent opportunity for the right candidate to join a collaborative and supportive APP/MD team practice.

Responsibilities include complete/comprehensive history and physical examination, ordering and interpretation of diagnostic studies, and prescribing appropriate treatments in collaboration with the attending physician. Other responsibilities include consultation with specialist providers and other team members regarding findings/changes in patient condition, documentation of patient care/procedures per policy, and communication/education with patients and their families. APPs are also responsible for precepting and mentoring Stanford school of medicine Physician Assistant students.

Common diagnoses managed: Sepsis/Septic shock/Bacteremia, Cellulitis, UTI, Acute & chronic liver failure, Acute kidney injury/failure, COPD/asthma exacerbations, UGIB, Pancreatitis, ETOH withdrawal, DKA, AMS/Delirium, Anemia, Atrial Fibrillation, Syncope, Venous thromboembolism, and Electrolytes Abnormalities.

Orientation on Med 7 inpatient service is dependent on the experience of the employee and typically lasts between six and twelve weeks. Orientation is tailored to the employee and generally includes participation in team rounds, orientation to procedures, training on difficult conversations including goals of care, and cross training other APP specialty teams. 

The position is 100% clinical. The typical morning consists of pre-rounding on patients followed by rounds with the attending physician. In the afternoon, the APP carries out the plan of care for patients, consults with other services as indicated, admits, and discharges patients, and performs procedures.

Schedule

The schedule is made 2-3 months in advance and shifts are 7a-7p.

This is a Stanford Health Care job.

A Brief Overview

The Nurse Practitioner (NP) functions under this Nurse Practitioner Job Description approved by the Interdisciplinary Practice Committee (IDPC). The NP provides routine are and management of the patient with acute and chronic complaints, in collaboration with the supervising physician, and through implementation of standardized procedures. Specific functions pertaining to the Service, Clinic or Department are established by the NP and his/her supervising physician(s), and approved by the appropriate medical and nursing administrators, the IDPC, the Credentials & Privileges Committee, the Stanford Hospital and Clinics (SHC) Medical Executive Committee and the SHC Board Credentials, Policies and Procedures Committee.

This job description covers all classifications for NPs within the organization. All NPs must meet all elements of the Essential Functions, Qualifications, and Supervision. There is a voluntary Career Ladder for NPs who are interested in promotions for clinical expertise and contributions to the institution as well as the profession. Promotion is determined based on the Center for Advanced Practice Career Ladder Handbook. Here is a description of the various levels:

Job Attributes: LEVEL I LEVEL II LEVEL III

FLSA Status: Exempt Exempt Exempt

Job Code: 400077 400169 400170

Requirement:

LEVEL I: Entry level

LEVEL II: Meets Career Ladder criteria for NP II

LEVEL III: Meets Career Ladder criteria for NP III

Locations

Stanford Health Care

What you will do

• A. An NP may provide only those medical services which he/she is competent to perform, which are consistent with the NP’s education, training and experience, and which are performed under the supervision of a physician who is responsible for the patients cared for by that NP.
• B. An NP shall consult with a physician regarding any task, procedure or diagnostic problem which the NP determines exceeds his/her level of competence or shall refer such cases to a collaborating physician.
• C. Scope of Practice of the NP:
• Evaluates and treats patients with acute, chronic complaints and health maintenance concerns related to specialty, according to written standardized procedures. [see Appendix A: Assessment & Management of Patients]
• Obtains complete histories and performs pertinent physical exams with assessment of normal and abnormal findings on new and return patients, according to written standardized procedures. [see Appendix A Assessment & Management of Patients]
• Performs or requests and evaluates diagnostic studies as indicated upon evaluation of the patient, according to written standardized procedures. [see Appendix A: Assessment & Management of Patients]
• Administers, orders, furnishes and prescribes medications, according to written standardized procedures. [see Appendix B : Administering, Ordering, Furnishing or Prescribing of Drugs; Formulary Protocol]
• Orders and collects specimens for routine laboratory tests, screening procedures and therapeutic procedures, including blood and blood products.
• Orders physical therapy, occupational therapy, respiratory therapy, radiology examinations and nursing services.
• Performs designated procedures after demonstrated competency, according to written standardized procedures where applicable.
• Obtains informed consent, as indicated.
• Initiates arrangements for hospital admissions and discharges and completes appropriate paperwork.
• As directed by the supervising physician, enrolls patients in investigational studies approved by the Investigational Review Board (IRB), and orders the necessary tests and medications. [see Appendix B: Administering, Ordering, Furnishing or Prescribing of Drugs; Formulary Protocol] Medications that are not FDA-approved or are used for a non-FDA-approved indication (off-label use) require a patient-specific order in advance from the supervising physician.
• After appropriate training, assists the supervising physician in the operating room. The RN First Assistant directly assists the surgeon and practices under the supervision of the surgeon during the intraoperative phase. The RN First Assistant must adhere to standardized procedures and not concurrently function as a scrub nurse.
• Recognizes and considers age-specific needs of patients.
• Effectively communicates and interacts with patients, families, staff and members of the community from diverse backgrounds.
• Recognizes situations which require the immediate attention of a physician, and initiates life-saving procedures when necessary.
• Facilitates the coordination of inpatient and outpatient care and services as needed.
• Facilitates collaboration between providers and coordination of community resources.
• Ensures compliance with legal, regulatory and clinical policies and procedures.
• Participates in quality improvement initiatives.
• Provides and coordinates patient teaching and counseling.
• Other duties as assigned.

Education Qualifications

• Master’s or Doctoral degree in nursing from an accredited college or university.
• Note: NPs hired prior to March 1, 2012 are not subject to this educational requirement.
• Graduate of an NP program accredited by the National League of Nursing Accrediting Commission (NLNAC) or the Commission on Collegiate Nursing Education (CCNE).

Licenses and Certifications

• 1. Licensure as a Registered Nurse (RN) in the State of California.
• 2. Certification as a Nurse Practitioner (NP) in the State of California.
• 3. National Board Certification as a Nurse Practitioner (NP) from an agency accredited by the American Board of Nursing Specialties (ABNS).
• a. Note: All NPs hired after November 1, 2013 must be nationally certified upon hire.
• 4. Certification in Basic Life Support (BLS) from the American Heart Association (AHA).
• 5. Furnishing license issued by the Board of Registered Nursing (BRN).
• a. NPs with six (6) months or more experience shall obtain a current furnishing license within six (6) months of hire.
• 6. Additional board certification(s) may be required by certain specialties/departments.

These principles apply to ALL employees:

SHC Commitment to Providing an Exceptional Patient & Family Experience

Stanford Health Care sets a high standard for delivering value and an exceptional experience for our patients and families. Candidates for employment and existing employees must adopt and execute C-I-CARE standards for all of patients, families and towards each other. C-I-CARE is the foundation of Stanford’s patient-experience and represents a framework for patient-centered interactions. Simply put, we do what it takes to enable and empower patients and families to focus on health, healing and recovery.

You will do this by executing against our three experience pillars, from the patient and family’s perspective:

• Know Me: Anticipate my needs and status to deliver effective care
• Show Me the Way: Guide and prompt my actions to arrive at better outcomes and better health
• Coordinate for Me: Own the complexity of my care through coordination

Equal Opportunity Employer Stanford Health Care (SHC) strongly values diversity and is committed to equal opportunity and non-discrimination in all of its policies and practices, including the area of employment. Accordingly, SHC does not discriminate against any person on the basis of race, color, sex, sexual orientation or gender identity and/or expression, religion, age, national or ethnic origin, political beliefs, marital status, medical condition, genetic information, veteran status, or disability, or the perception of any of the above. People of all genders, members of all racial and ethnic groups, people with disabilities, and veterans are encouraged to apply. Qualified applicants with criminal convictions will be considered after an individualized assessment of the conviction and the job requirements.

Base Pay Scale: Generally starting at $94.35 - $125.03 per hour

The salary of the finalist selected for this role will be set based on a variety of factors, including but not limited to, internal equity, experience, education, specialty and training. This pay scale is not a promise of a particular wage.