The Certified Registered Nurse Practitioner (CRNP) or Physician Assistant (PA) functions in an advanced care role in a collaborative practice agreement with and under the direction of the employed DCH Cardiac Surgeon within the West Alabama Cardiac Surgery clinic. The CRNP/PA plans, coordinates, and directs quality, compassionate care by maintaining standards of professional practice and creating positive therapeutic relationships with patients/families. Provides evaluations to patients based on pre-established guidelines and in collaboration with the Cardiac Surgeon. Provides leadership to other clinic team members by articulating and delegating expected standards of care.

1. Completes a health history and screening assessment in order to evaluate the age appropriate physical, psychosocial, educational, and environmental needs of patients/family in a systematic manner. Specific ages: as defined by scope of service.
2. Requests and evaluates pertinent diagnostic studies as needed in order to develop a plan of care that meets approved standards of practice in accordance with established protocols and in collaboration with Cardiac Surgeon as appropriate.
3. Performs a wide range of medical and surgical procedures under physician supervision and instruction and in accordance with the scope of practice. These include, but not limited to, surgical first assist, endoscopic vein and radial artery harvesting, the insertion of central venous lines and vein graphs.
4. Rounds on patients as assigned, consults with Cardiac Surgeon on the patient’s plan of care, and documents all patient encounters, records observations, interventions, and actions in a medically appropriate manner on the patient’s medical record.
5. Writes appropriate prescriptions and administers medications according to standard protocols and in collaboration with supervising cardiac surgeon instructions.
6. Provides patient assessment services including performing H&P’s.
7. Works in collaboration with other health care providers and collaborating/agreement physicians.
8. Participates in Cardiology Performance Improvement Program, other hospital quality programs, and QA initiatives including any clinic based quality programs or improvement efforts.
9. Teaches, supervises and counsels patients/family regarding educational needs appropriate to plan of care.
10. Plans, provides and documents patient/family education based on physical, behavioral, psychological, developmental, and age-rated factors, after identifying barriers to learning.
11. Assists in performance improvement (PI) activities by serving on PI teams as warranted, assisting with PI measures and supporting and implementing changes necessary for improvement.
12. Performs initial and annual competency per job class.
13. In coordination with the RN, verifies and amends medication list in medical record as appropriate.
14. Participates in a call rotation for afterhours call.

DCH Standards:

• Maintains performance, patient and employee satisfaction and financial standards as outlined in the performance evaluation.
• Performs compliance requirements as outlined in the Employee Handbook
• Must adhere to the DCH Behavioral Standards including creating positive relationships with patients/families, coworkers, colleagues and with self.
• Performs essential job functions in a manner that ensures the safety of patients, visitors and employees.
• Identifies and reduces unsafe practices that may result in harm to patients, visitors and employees.
• Recognizes and takes appropriate action to reduce risks and hazards to promote safety for patients, visitors and employees.
• Requires use of electronic mail, time and attendance software, learning management software and intranet.
• Must adhere to all DCH Health System policies and procedures.
• All other duties as assigned.

Education and Training:

1. Must be a graduate of an approved Nurse Practitioner or Physician Assistant program.
2. Active license by the State of Alabama Board of Medical Examiners to practice as a Physician Assistant; or have an active license by Alabama Board of Nursing to practice as a Nurse Practitioner.
3. If Nurse Practitioner, have completed appropriate RN First Assist certification course.
4. Maintain an active collaboration agreement with a DCH employed Cardiothoracic surgeon.

Experience: A minimum of (2) two years of experience preferred. Must be able to read, write legibly, speak, and comprehend English.

WORKING CONDITIONS

Physical: Ability to tolerate prolonged periods of standing and walking. Ability to lift and carry 50 pounds with frequent lifting and/or carrying of objects weighing up to 25 lbs. Is able to push stretcher/wheelchair with average adult patient. Is able to do frequent stooping and on occasion crouching, crawling or kneeling. Ability to reach reasonable distances in any direction. Ability to run in emergency situations. Must be able to move fingers in a coordinated manner. Must have ability to feel and perceive temperature, texture, shape and size with fingertips.

Physical presence onsite is essential.  Hearing and vision must be normal or corrected to within normal range. Able to perform the duties with or without reasonable accommodation.

Environmental:  Includes exposure to human body fluids, disease, infection, lab chemicals and hazardous materials and/or cleaning solutions. Requires wearing common protective or safety equipment.

Psychological:  Includes demonstrating leadership skills, delegating to team members, addressing conflict, communicating with all types of personalities, and being responsible for outcomes/results.

SIGNATURES