Emergency Medicine-Nurse Practitioner/Physician Assistant-36 Hours

Completes thorough evaluations of pediatric patients (from neonates to adolescents and young adults) with increasing independence. Recommends broad evaluation based on prioritized focused differential
diagnosis. Interprets clinical significance of diagnostic study results. Collaborates care with the supervising physician and inter-professional team. Develops an interdisciplinary management plan for common and typical diagnoses. Continues to develop competencies in core procedures. 

Medical knowledge

• Clinical knowledge. With increasing independence, applies an intermediate-level of medical knowledge to common and typical scenarios, incorporating some literature to support care.
• Diagnostic Evaluation. Recommends broad evaluation based on prioritized focused differential diagnosis. Interprets clinical significance of diagnostic study results.

Patient History. Gathers, filters, prioritizes, and synthesizes patient history to develop a differential diagnosis in real-time for uncomplicated or typical presentations.

Patient care

• Clinical reasoning. Organizes clinical facts (e.g., history, exam, tests, consultations, etc.) to compare and contrast diagnoses being considered, resulting in a prioritized differential diagnosis.
• Organize and prioritize patient care. Organizes and prioritizes the simultaneous care of multiple patients with efficiency.
• Patient management. Develops an interdisciplinary management plan for common and typical diagnoses.

Procedures as defined by clinical department. Applies increasing competency in array of core procedures. Please reference the “APP Procedures Listing” for those relevant to the Medical Specialty.

Interpersonal and Communication

• Patient and family centered communication. Establishes a culturally competent and therapeutic relationship with patients/families. Communicates with sensitivity and compassion. Elicits patient/family values and incorporates awareness of these in communications with patient/family and in patient care. Acknowledges uncertainty and conflict and escalates to more experienced APPs, etc., as appropriate.
• Interpersonal and team communication. Formulates specific questions for consultation with supervising physician and tailors communication strategies as appropriate to promote collaborative practice. Uses bi-directional communication within the inter-professional team.
• Communication within Health Care System. Concisely documents updated, prioritized, diagnostic and therapeutic reasoning in the patient record. Aligns type of communication with message to be delivered (e.g., direct and indirect) based on urgency and complexity.

Practice–based learning and improvement

• Evidence-based and informed practice. Critically analyzes data and evidence (from literature), integrated with patient preference, and applies to the care of patients.
• Reflective practice and commitment to personal growth. Proactively seeks feedback. Designs and implements a learning plan, incorporating feedback and performance data. 

Professionalism

• Performs responsibilities in a thorough and timely manner, maintaining composure in increasingly complex or stressful situations. Proactively seeks guidance in new or especially difficult circumstances.
• Constructively highlights to lead/manager concerns that impact the cohesiveness and well-being of the team. Proactively presents viable solutions for discussion.

System-based practice

• System navigation for patient centered care-coordination of care. Coordinates inter-professional patient-centered care among different disciplines and specialties actively assisting families in navigating the health care system.
• Population and community health. Uses local and regional resources to effectively meet the needs and reduce health disparities of a patient population and community.
• Organizational View. Increasingly aware of one’s role and impact on the broader patient care team as it relates to patient care, systems and processes.

Minimum education (degree/type of degree). 

• Advanced Practice Nurse Practitioner: Graduate degree in nursing accredited by one of the national certifying bodies in nursing. (Or, on or before December 31, 2004, completion of an advanced nurse practitioner program recognized by a national certifying body for certification as a nurse practitioner.) 

Or…

• Physician Assistant: Graduation from a physician assistant program accredited, at the time of graduation, by the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA).

Minimum experience (minimum years & type of experience): At least 2 years of APP experience.
Preferred education & experience: n/a
 

                                                                                     License and/or Certification

Required:

At time of hire and maintenance at time of appointment or privilege approval:

• Current State of Connecticut (Pediatric) Advanced Practice Registered Nurse (APRN) licensure. OR
• Certified by the National Commission on Certification of Physician Assistants, Inc. (NCCPA). Current State of Connecticut Physician Assistant licensure.

Additionally:

• Depending on privileges for role, Basic Life Support (BLS) and/or Pediatric Advanced Life Support (PALS) certification may be required.
• Depending on privileges for role, federal DEA and CT controlled substance registration may be required. 
• Please reference the document: “APP: Certifications by Specialty.”

                                                                Knowledge, Skills, and Abilities

• Medical knowledge and procedures: 
  • Medical knowledge sufficient to navigate barriers, begin identifying outliers, and adapt plan of care for common and typical scenarios with increasing independence. 
  • Competent in performing core procedures of the department, while increasing in efficiency and their application.
• Communication: 
  • Exemplary written and verbal communication skills with the ability to modify communication strategy/method for the audience and circumstance. 
  • Highly organized in the presentation of essential information. 
  • Ability to tactfully and proactively address concerns and propose solutions.
• Interpersonal: 
  • Ability to maintain composure in increasingly complex or stressful situations and to proactively seek guidance when encountering new or more challenging situations. 
• Professionalism, Organizational view:
  • Demonstrates accountability for own work and for patient care. 
  • Demonstrates increasing understanding of one’s own role within the larger team.