NURSE PRACTITIONER IV

Evaluates, examines, diagnose, and treats patients in collaboration with their supervising and or substitute supervising physician according to established guidelines and protocols. Maintains and promotes the well-being of the patient through preventative healthcare and guidance. Provides care in the outpatient setting only ? predominately Monday through Friday

1. Regular, consistent, on-site, and timely attendance.
2. Ensures that the assessment of the patient and the direct and indirect patient care delivered is in accordance with appropriate licensing board, hospital policies, procedures, and protocols, and all other professional standards of care.
a. Collects patient assessment data in a systematic manner, focusing on the physical, psychosocial, age, cultural, and spiritual needs of the patient.
b. Performs systematic physical exam and history of present illness.
c. Documents assessment data, history of present illness, and physical findings on the appropriate medical record within established time frame.
d. Involves the patient/family and other healthcare providers when appropriate.
3. Manages the physical and psychological problems of the patient.
a. Identifies normal and abnormal findings.
b. Implements an individualized plan of treatment, reassess and revises plan as needed.
c. Evaluates the physical and emotional responses to medications and treatments.
d. Prescribes immunizations per recommended schedules.
e. Seeks appropriate consultation.
4. Develops an educational process for the provision and coordination of patient care activities that promote and maintain health, foster self-care and improves outcomes.
a. Participates in the assessment of the patient’s readiness to learn, identifying the educational barriers and tailor the educational process to meet the needs of the patient/family.
b. Ensures the process include education about safe and effective use of medications, pain and managing pain, available resources, obtaining further care and their responsibility for their care.
c. Acquires and distributes educational resources tailored to the patient's needs.
d. Provides appropriate instruction and guidance regarding immunizations.
5. Communicates effectively with the physician and other healthcare providers to achieve desired outcomes and assure a continuous flow of patient care
a. Initiates and maintains the Problem/Medication list at each encounter.
b. Complies with completeness, accuracy, and timeliness of documentation at each encounter.
c. Assesses the patient and facilitates consultation when indicated.
d. Directs patient to appropriate level of care and communicates all pertinent information.
e. Assists in identifying and utilizing resources and/or social agencies for further treatment or rehabilitation.
6. Participates in Performance Improvement activities designed to enhance the quality of patient care, customer service, or practice efficiencies.
a. Identifies initiatives to improve patient outcomes, satisfaction, or efficiencies.
b. Assists in chart reviews/audits as needed for performance improvement data collection.
c. Supports initiatives implemented to improve patient outcomes and/or office efficiencies.
7. Demonstrates Leadership by utilizing the concepts inherent to the practice of the professional nurse.
a. Demonstrates an ability to solve problems independently utilizing critical thinking skills and seeks assistance from immediate supervisor when appropriate
b. Delegates patient care appropriately.
c. Maintains accountability for actions taken.
d. Effectively functions as a resource person.
e. Acts as a patient advocate.
f. Performs effectively in the role of preceptor/mentor to new hires and/or students.
g. Assists in maintaining/decreasing organizational/departmental costs.
h. Completes all competency requirements annually.
8. Provides for patient safety in compliance with hospital and physician practices policies.
a. Adheres to infection control processes, including standard precautions, to reduce the risk of acquiring or transmitting infections.
b. Utilizes two forms of patient identification before implementing any form of patient care.
c. Practices all National Patient Safety Goals.
9. Assists in the department's compliance with all regulatory agencies.
a. Participates in continuous survey readiness for inspections and surveys.
b. Participates in the non-punitive medication reporting system.
c. Ensures accountability for narcotics per regulatory/organizational policies.
d. Participates in office fire, safety, utility, hazard, and disaster drills as required.
“Ability to perform the Essential Functions on the Physical Conditions chart; and the ability to perform the Essential Functions on the Working Conditions chart (see attached charts)”


1. Performs procedures, assists in surgery, and provides care to the patient as per established guidelines.
a. Positions patients and assists surgeon in the operating room.
b. Preps and drapes the patient as per established guidelines.
c. Assists in surgery by performing tasks defined by the surgeon.
d. Assists and maintains sterile techniques through procedures.
e. Per supervising physician's direction performs skin closures as directed.
f. Monitors patients until clinically stable unless requested by the surgeon to perform other duties.
g. Performs suture removal, and dressing changes as per supervising physician's directions.
h. Be available for call from home to assist in emergency surgeries.
2. Directs and provides appropriate Pre and Post-operative care.
a. Performs history and physicals as designated by the physician. Identifies normal and abnormal findings and reports to the physician in a timely manner.
b. Provides preoperative teaching to patients and or families.
c. Performs patient rounds ensuring accurate assessment, review of labs and diagnostic procedures, and reports overall progress to supervising physician.
d. Orders appropriate testing per established guidelines and as outlined by supervising physician.
e. Documentation supports a review of lab/diagnostic results, is reflective of all required history and physical assessment elements.
f. Communicates with supervising physician in a timely manner regarding changes in the patient's progress, status, or critical test results.
g. Prepares for and develops discharge planning in conjunction with supervising physician.
h. Dictates discharge summaries timely and appropriate.
i. Provides counseling and instruction to patients and or families as appropriate.
3. Performs clinical responsibilities in a manner that maximizes patient care and outcomes.
a. Assumes appropriate code team role during emergency situations and responds effectively.
b. Facilitates timely treatment of abnormal labs or other relevant findings.
c. Develops workflow patterns to facilitate patient transfers or discharges.
d. Participates in outcome management and Press Ganey scores.
4. In collaboration with the physician: Interviews, evaluates and assesses patients in the clinic setting. Provides recommendations for treatment.
a. Evaluates patient's current status providing recommendations for ongoing treatment. Assesses for alternate levels of care as necessary
b. Adjusts medication as indicated
c. Provides patient/family education regarding medication, rationale for use and possible side effects
5. Collaborates with the supervising physician and or substitute supervising physician and members of the treatment team to achieve desired outcomes and to assure continuous flow of patient care.
a. Alerts the treatment team to any significant changes in the patient's status
b. Within prescribed time frames reviews treatment goals and objectives with patients making modifications as appropriate
c. Communicates pertinent information timely and efficiently to the supervising or substitute supervising physician
6. Documents in the medical record.
a. Records patient's current mental status
b. Documents all screenings and assessments performed
c. Records medication changes, prescriptions written and samples provided
d. Documents patient's complaints, concerns and questions as appropriate
e. Documents any/all telephone contact with patients, families, pharmacists or physicians
f. Records beginning and end times of each session
g. Signs and dates all documentation
7. Demonstrates leadership by utilizing the concepts inherent to the practice of a professional physician assistant.
a. Demonstrates an ability to problem solve independently utilizing critical thinking skills and seeks assistance from immediate supervisor when appropriate
b. Maintains accountability for actions taken
c. Effectively functions as a resource person
d. Acts as a patient advocate
e. Performs effectively in the role of preceptor/mentor to new hire/students
8. Participates in Performance Improvement activities designed to enhance the quality of patient care, customer service, or practice efficiencies.
a. Identifies initiatives to improve patient outcomes and satisfaction
b. Assists in chart review/audits as needed for performance improvement data collection
c. Supports initiatives implemented to improve patient outcomes and or efficiencies
9. Provides for patient safety in compliance with hospital and or physician practice policies.
a. Adheres to infection control processes, including standard precautions, to reduce the risk of acquiring or transmitting infections
b. Utilizes two forms of patient identification before implementing any form of patient care
c. Practices the National Patient Safety Goals

• 1-2 years cardiology experience preferred