Advanced Practice Provider - Surgical Specialty - 0.8 FTE

Lancaster General Medical Grp - Lancaster, PA

Full-timeEstimated: $86,000 - $120,000 a year
SkillsBenefits
POSITION SUMMARY: Responsible for performing medical diagnosis and prescription of medical therapeutic or corrective measures in the adult neurosurgical setting, in collaboration with and under the direction of the physicians at Penn Medicine Lancaster General Health Physicians - NeuroScience & Spine Associates (LNSA). Serves as Surgical First Assist to LNSA neurosurgeons:.

ESSENTIAL FUNCTIONS: Qualified individuals must have the ability (with or without reasonable accommodation) to perform the following duties:

Obtain comprehensive health history: perform physical examination on new admissions and document/dictate in patient record.
Performs problem-focused exams on patients.

Perform and/or participate in rounds of hospitalized patients, including physical assessment, interpretation of diagnostic studies, interaction with nursing staff and documentation in medical record.
Order (verbal or written) common diagnostic studies, laboratory studies and pharmacologic treatment modalities according to written protocol in collaboration with the physician.
Order (verbal or written) pharmacologics if he/she has obtained prescriptive privileges as documented by a current collaborative practice agreement with a physician member of the LGH Medical and Dental Staff and a current letter of approval of prescriptive authority from the PA State Board of Nursing or PA Medical Board. The APP can only write for those pharmacologics identified on the collaborative agreement
No pharmacologic orders can be written by a APP while the patient is located in the Emergency Medicine Department unless the APP has prescriptive authority and the Emergency Department is specifically identified in the collaborative agreement as an approved site for prescribing pharmacologics.
If the APP does NOT have prescriptive privileges, all pharmacologic orders (including diagnostic studies utilizing dye or other pharmacologics) must be written by the APP in the medical record as a verbal order from the collaborating physician and cosigned by the collaborating physician within 24 hours.
In collaboration with the attending physician, assist in establishing diagnosis, formulating plan of care, evaluation of patient response, and revising plan of care.
Consult other physicians and members of the healthcare team and agencies in collaboration with the physician.
Dictate a consultation report only after the case has been presented to the physician and the collaborating physician has reviewed the chart and evaluated the patient. All dictated consults must state specifically that the physician saw and evaluated the patient and discussed the plan of care.
Facilitate the discharge process and dictate discharge summary.
Perform diagnostic and therapeutic functions within the scope of CRNP and PA practice as designated by clinical privileges and obtain informed consent as appropriate. A procedure note must be dictated for all clinical procedures for which the PA has privileges that require competency validation.
Discuss medical plan with patient/family. Serve as a liaison between physicians and patient/family as needed to enhance communication and understanding.
Provide support and clinical expertise to nursing personnel regarding complex patient care issues.
Participate in collaborative appraisal of his/her own practice with APP peers including mandatory compliance with peer review requirements.

PATIENT MANAGEMENT:
Follows-up on test results, response to treatments and medications, and consultant’s recommendations.
Suggests a diagnosis, formulates a plan of care, evaluates the response to the plan, and revises the plan as needed, collaborating with or referring to a physician.

Performs clinical procedures including, but not limited to:
Suturing and removal of sutures/skin staples
Serving as clinical first assistant in surgery
Halo management; wound care; cervical collar fitting, etc.
Initiates appropriate evaluation and management in emergency situations.
Assists the physicians in obtaining informed consent or informed refusal to treatment plan.
Initiates admission orders in collaboration with physicians.
Morning hospital rounds to assist surgeons with patient discharges.
Provides comprehensive preventative care and counseling regarding risk factor modification in areas such as diet, exercise, stress reduction, and smoking cessation.
Evaluates and manages patients with chronic pain conditions.
Documents all patient communications / medications prescribed, either by dictation in the patient medical record or in patient management computer system notes.
Evaluates patients following hospital admissions with regard to the established medical plan, making adjustments accordingly.
Identifies patient/family educational needs and, in collaboration with staff/office nurses, provides patient/family education. Provides pre- and post-operative education.
Acts as an advocate for the patient/family, encouraging participation in decision-making and care.
SECONDARY FUNCTIONS: The following duties are considered secondary to the primary duties listed above:
Provide for the educational needs of the patient/family through verbal and written teaching and development of educational materials.
Provide for the educational needs of the pre-hospital, nursing, physician staff by discussion, didactic sessions/presentations, trauma nurse course and development of educational materials and programs.
Provide for the educational needs of the community through verbal and written teaching and development of injury prevention and outreach materials.
Other duties as assigned.
JOB REQUIREMENTS

MINIMUM REQUIRED QUALIFICATIONS:
Current license as a Physician Assistant by PA Board of Medicine or Certified Nurse Practitioner with the American Association of Nurse Practitioners
Graduate of Accredited Physician Assistant or Certified Registered Nurse Practitioner training program.
A health care provider in good standing with Medicare, Medicaid, and other federal and state health insurance programs, i.e. not excluded from participation in Medicare, Medicaid or any other federal or state health insurance program.

PREFERRED QUALIFICATIONS:
Minimum one year experience as a Physician Assistant or Nurse Practitioner
Operating room experience