Nurse Practitioner / Physician Assistant, Adult Congenital Heart Disease — PALO ALTO, CA

Department Description

The Advanced Practice Provider (APP) will play an integral role in the Adult Congenital Heart Disease (ACHD) Program, a collaborative partnership between Stanford Health Care and Stanford Medicine Children's Health dedicated to providing comprehensive, lifelong care for adults with congenital heart disease throughout Northern California. This full-time position offers a unique opportunity to develop expertise in a rapidly growing and nationally recognized ACHD program while caring for patients across the continuum of care in both inpatient and outpatient settings.

The APP will participate in inpatient consultations, perioperative management, postoperative care, and care transitions, while also managing independent outpatient ACHD clinics focused on longitudinal follow-up, surveillance of congenital heart disease, disease progression, and cardiovascular risk reduction. Working alongside ACHD cardiologists, surgeons, and a multidisciplinary team, the APP will deliver evidence-based care, coordinate complex patient management, educate patients and families, and contribute to quality improvement and program growth”.

The position is scheduled for four 10-hour shifts per week with shared on-call responsibilities as part of a seven-day coverage model.

JOB SUMMARY

Nurse Practitioner (NP): The Nurse Practitioner functions under the general Nurse Practitioner Standardized Process Protocol approved by the Interdisciplinary Practice Committee (IDPC). The Nurse Practitioner provides routine care 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 Nurse Practitioner and the supervising physician(s), and approved by the appropriate medical and nursing administrators, the IDPC, and the Stanford Hospital and Clinics (SHC) Medical Executive Board and Board of Directors.

Physician Assistant (PA): The Physician Assistant functions under the general Physician Assistant Role Description approved by the Interdisciplinary Practice Committee (IDPC). Specific functions pertaining to the Service, Clinic or Department are established by the Physician Assistant and his or her supervising physician(s), and approved by the appropriate medical and nursing administrators, the IDPC, and the Stanford Hospital and Clinics (SHC) Medical Board and Board of Directors.

ESSENTIAL FUNCTIONS

Must perform all duties and responsibilities in accordance with the Service Standards of the Hospital (s).

A. An NP/PA may provide only those medical services which he/she is competent to perform, which are consistent with the NP/PA's education, training and experience, and which are performed in collaboration with a physician.

B. An NP/PA shall consult with a physician regarding any task, procedure or diagnostic problem which the NP/PA determines exceeds his/her level of competence or shall refer such cases to a collaborating physician.

C. Scope of Practice of the NP/PA:

• Evaluates and treats patients with acute, chronic complaints and health maintenance concerns related to specialty, according to written standardized procedures.
• Obtains complete histories and performs pertinent physical exams with assessment of normal and abnormal findings on new and return patients.
• Performs or requests and evaluates diagnostic studies as indicated upon evaluation of the patient.
• Administers, orders, furnishes and prescribes medications.
• 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.
• 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.

D. Supervision:

• Supervision is provided by the supervising/sponsoring physician with clinical privileges at LPCH, or designated attending physicians in the Clinic, Service or Department. Standardized procedures, approved by the supervising physician(s) and the IDPC, are a mandatory mechanism of supervision. Other mechanisms of supervision used may be:
• Direct on-site, electronic or phone supervision by a supervising physician. A physician cannot supervise more than four (4) NP/PAs at one time.
• Chart screens on random charts by the supervising physician or designee.
• Chart audits on random charts as an integral part of selected quality improvement programs.
• Ongoing Professional Practice Evaluation (OPPE) through tracking of performance indicators.
• The NP/PA will receive a formal annual performance evaluation by the Lead Advanced Practice Provider (Lead APP), Director of Advanced Practice or supervising manager/director with input from the Lead APP, supervising physician(s) and/or physician delegates, APP peers and the supervising manager/director. Ongoing Professional Practice Evaluation (OPPE) also occurs through tracking of performance indicators.

MINIMUM QUALIFICATIONS

Education

Physician Assistant (PA):

• Bachelor’s degree or above from an accredited college or university.
• Graduate of a PA program accredited by the Accreditation Review Commission on Education for the Physician Assistant, Inc.

Nurse Practitioner (NP):

• Master’s or doctoral degree in nursing from an accredited college or university.
• Graduate of an NP program accredited by the National League of Nursing Accrediting Commission (NLNAC) or the Commission on Collegiate Nursing Education (CCNE).

Licensure/Certification:

Physician Assistant (PA):

• Licensure as a Physician Assistant (PA) in the State of California.
• Certification as a Physician Assistant (PA) by the National Commission on Certification of Physician Assistants (NCCPA)
• Certification in Basic Life Support (BLS) from the American Heart Association (AHA)
• An individual Drug Enforcement Agency (DEA) license issued by the United States DEA for Schedule II-V controlled substances, required only if prescribing controlled substances to outpatients
• Additional board certification(s) may be required by certain services/departments.

Nurse Practitioner (NP):

• Licensure as a Registered Nurse (RN) in the State of California
• Certification as a Nurse Practitioner (NP) in the State of California
• National Board Certification as a Nurse Practitioner (NP) from an agency accredited by the American Board of Nursing Specialties (ABNS).

Note: New graduate NPs will be allotted six (6) months from their graduation date to obtain national board certification.

• Certification in Basic Life Support (BLS) from the American Heart Association (AHA).
• Furnishing license issued by the Board of Registered Nursing (BRN), required only if furnishing medications
• An individual Drug Enforcement Agency (DEA) license issued by the United States DEA for Schedule II-V controlled substances, required only if prescribing controlled substances to outpatients.
• Additional board certification(s) may be required by certain specialties/departments.

Physical Requirements and Working Conditions

Pay Range

Minimum to Midpoint Range (Hourly): $93.75 to $114.84