The nurse practitioner/physician assistant (NP/PA) within the acute care hospital setting works in collaboration with, and is an integral member of, a multidisciplinary health care team. The NP/PA functions primarily as a hospitalist in an inpatient setting, managing the care of acute/complex hematology and oncology chronically ill patients. The NP/PA will have some responsibility for the after hours clinic and infusion coverage. The NP/PA has a strong foundation in evidenced based practice/education and provides an environment of safe quality care. The NP/PA demonstrates an advanced level of clinical knowledge, clinical/technical competence, sound clinical judgment, professional communication skills, timely and compliant documentation, and is responsible for professional development and competency validation.
Key Functions and Expected Performances:
Assessment of Health Status
Performs and documents in the medical record a complete history and physical examination for acute and complex chronically ill patients.
Orders and collects data using appropriate assessment techniques, relevant supporting diagnostic information and diagnostic procedures where indicated.
The nurse practitioner may serve as the first responder for both nursing and house staff in the event of patient status changes, orders, and in situations requiring procedural and resuscitative interventions.
Assesses for risks associated with the care of the acute and complex chronically ill patient including: medication side effects, immobility, impaired nutrition, fluid and electrolyte imbalance, immunocompetence, invasive interventions and diagnostic procedures.
Coordinates daily rounds with the Attending physician teams, presents 24 hour patient report, collaborates in plan of care, and follows assigned patient population throughout the day.
Collaborates with interdisciplinary health care team in making diagnoses of acute and complex chronic conditions.
Manages diagnostic tests through ordering, interpretation, performance, and supervision.
Formulates differential diagnoses by priority.
Diagnoses complications and orders appropriate interventions.
Formulates Plan of Care
Identifies expected outcomes from diagnosis, and formulates and documents a plan of care to address complex acute and chronic health care needs.
Utilizes evidenced based practice guidelines or protocols in an individualized, dynamic plan of care that can be applied across the continuum.
Implements and modifies plan of care
Prescribes diagnostic strategies and therapeutic interventions both pharmacologic, non-pharmacologic and surgical, needed to achieve expected outcomes.
Manages further diagnostic tests through ordering, interpretation, performance, and supervision.
May perform advanced procedures consistent with privileges and competency validation including minor suturing, complex wound management, line and tube placements and removals.
Communication and Collaboration
Maintains ongoing communication and collaboration with interdisciplinary health care team.
Facilitates and communicates with patient, family and staff to promote continuity of care across the inpatient and outpatient continuum of care.
Documents/dictates key components of patient's progress via daily progress note, transfer, and discharge summary, and or clinic note where applicable. (h&p, daily progress notes, plan of care, problem lists, procedure notes, acute event note, discharge summaries, in medical record per specific patient unit or service, death summary)
Documentation is timely, meets acute care compliance standards and captures patient acuity.
Demonstrates Professional Practice behaviors including: preceptor/mentoring, education and instruction of clinician students.
Seeks opportunities for active engagement in research and the analysis of evidenced based practice.
Actively participates in Advanced Practice Council, APN council meetings, faculty and unit meetings, M&M presentations.
Maintains CMEs, and membership in a professional organization.
Vanderbilt University Medical Center is home to Vanderbilt University Hospital, The Monroe Carell Jr. Children’s Hospital at Vanderbilt, the Vanderbilt Psychiatric Hospital and the Vanderbilt Stallworth Rehabilitation Hospital. These hospitals experienced more than 61,000 inpatient admissions during fiscal year 2015. Vanderbilt’s adult and pediatric clinics treated nearly 2 million patients during this same period.
Vanderbilt University Hospital and the Monroe Carell Jr. Children’s Hospital at Vanderbilt are recognized again this year by U.S. News & World Report’s Best Hospitals as among the nation’s best with 18 nationally ranked specialties.
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