Duke University
Critical Care Nurse Practitioner or Physician Assistant - Medical ICU (MICU)
Duke University, Durham, North Carolina, United States, 27703
At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together.
About Duke University Hospital
Pursue your passion for caring with Duke University Hospital in Durham, North Carolina, which is consistently ranked among the best in the United States and is the number one hospital in North Carolina, according to U.S. News and World Report for 2023-2024. Duke University Hospital is the largest of Duke Health's three hospitals and features 1048 patient beds, 65 operating rooms, as well as comprehensive diagnostic and therapeutic facilities, including a regional emergency/trauma center, an endo-surgery center, and more.
Job Location - Duke University Hospital, Medical Intensive Care Unit
Job Summary
The Duke Hospital Medical Intensive Care Unit (MICU) Nurse Practitioner (NP)/Physician Assistant (PA) (NP/PA) provides direct patient care services for complex critically ill adult patients in the Medical Intensive Care setting in collaboration with and under the supervision of the MICU attending physicians. The NP/PA performs physical exams, collects and documents data, conducts diagnostic and therapeutic procedures, orders and schedules laboratory studies and professional consultations, prescribes appropriate interventions and medications, coordinates the care and discharge of patients, and provides direct patient care services. The NP / PA contributes to excellence in patient care, research, teaching, and provides leadership to the organization.
Job Duties and Responsibilities
Utilize assessment, diagnostic and clinical skills and knowledge in order to provide clinical care to patients during their admission. Perform necessary diagnostic and therapeutic procedures (within the scope of practice of the supervising physician). Conduct and obtain patient histories, perform physicals examination, monitor patient progress, order appropriate medications, laboratory studies and diagnostic procedures. Document the patient's course of treatment at the direction of the supervising physician: History/ Physical/Admissions Problem List and Plan of Care Daily Progress Note Procedure Note Interval Notes Discharge Summary Facilitate daily rounds in the unit. Collaborate with consulting services, physicians and nursing staffs in order to provide a longitudinal continuity of care Participate in meeting the educational requirements of students, medical residents, fellows and other members of the health care team Collaborate with the nurse manager in the identification of problems and their resolution in order to assure the providing of safe, cost effective patient care Assure proper charges have been posted and appropriate documentation provided Participate in quality improvement initiatives for the unit. May order and/or perform the following procedures: Patient history and perform physical exam Laboratory, radiology, and/or diagnostic procedures/tests Interpretation of laboratory, radiographic and diagnostic tests Intubation / Extubation and airway management Mechanical ventilation Flexible bronchoscopy for non-biopsy purposes in patients that already are intubated or have a tracheostomy Conscious / Moderate Sedation per protocol Chest tube insertion / removal Paracentesis Thoracentesis Evaluation of pleurovacs (chest tube drainage systems) Lumbar puncture Line placement for venous or arterial access: Peripheral arterial line placement Percutaneous central line placement Internal and external hemorrhage control Suture and staple removal Application of dressings, bandages, wound vacs Simple debridement Manage/Place Cortrak/NG tubes, G tubes, J tubes Manage support devices, including (but not limited to), JP drains, arterial lines, wound vac Bladder catheterization Drainage of superficial abcesses Venipuncture for blood sampling Blood sampling via central venous lines, including:
Temporary central catheters Tunneled catheters Implantable vascular access devices
Administration of infusion therapy, including:
IV fluids Analgesics, Narcotics, including Patient Controlled Analgesia Antibiotics Antifungals Antivirals Electrolytes Benzodiazepines Muscle relaxants Local anesthetics Blood products - Packed Red Blood Cells and / or Platelets Total parenteral nutrition Enteral nutrition
Job Eligibility Requirements
Education
PA: Graduate of ARC accredited Physician Assistant Program. Master's or Doctoral degree strongly preferred.
NP: Graduate of an accredited MSN or DNP Acute Care / Critical Care Nurse Practitioner program.
Certification
PA: PA-C
NP: ACNP or AGACNP only. (Acute Care Certification is REQUIRED.)
Licensure
PA: Current unrestricted medical license issued by NCMB with authorization to practice as a PA.
NP: Current unrestricted RN license issued by or recognized by the NCBON with authorization to practice as an NP.
Both: Federal and State Prescriptive Authority
Experience:
PA: One or more years as a Physician Assistant in a critical care setting is preferred but not required.
NP: Three years minimum as a registered nurse, with minimum of one year experience as an Acute Care NP, preferably in an ICU setting.
OR AN EQUIVALENT COMBINATION OF RELEVANT EDUCATION AND/OR EXPERIENCE
Life support requirements :
BLS
ACLS
Physical and mental requirements:
Able to
clearly articulate scope of practice, and practices within those guidelines as a Nurse Practitioner / Physician Assistant in the state of North Carolina and within the Duke University Health System. Able to
independently seek out resources and work collaboratively to solve complex problems Able to
communicate clearly with patients, families, visitors, healthcare team, physicians, administrators, leadership, and others. Able to
use sensory and cognitive functions to process and prioritize information, perform health assessments, treatment, and follow-up. Able to
use fine motor skills Able to
record activities, document assessments & interventions; prepare reports and presentations; Able to
use computer and learn new software programs Able to
provide leadership in clinical area of expertise and in meeting organizational goals Able to
navigate the Hospital and DUHS to provide clinical expertise to specific patient populations Able to
withstand prolonged standing and walking with the ability to move or lift at least fifty pounds Able to
remain focused and organized Able to
work collaboratively with all levels of personnel
Job Hours
Rotating 12 hour shifts providing dayshift, nightshift, weekend and holiday coverage.
For .75FTE, APPs work an equivalent of
10.5
twelve-hour shifts per month.
Schedule may be changed by administrative or clinical leadership to meet department needs.
Duke is an Affirmative Action/Equal Opportunity Employer committed to providing employment opportunity without regard to an individual's age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex, sexual orientation, or veteran status.
Duke aspires to create a community built on collaboration, innovation, creativity, and belonging. Our collective success depends on the robust exchange of ideas-an exchange that is best when the rich diversity of our perspectives, backgrounds, and experiences flourishes. To achieve this exchange, it is essential that all members of the community feel secure and welcome, that the contributions of all individuals are respected, and that all voices are heard. All members of our community have a responsibility to uphold these values.
Essential Physical Job Functions: Certain jobs at Duke University and Duke University Health System may include essentialjob functions that require specific physical and/or mental abilities. Additional information and provision for requests for reasonable accommodation will be provided by each hiring department.
About Duke University Hospital
Pursue your passion for caring with Duke University Hospital in Durham, North Carolina, which is consistently ranked among the best in the United States and is the number one hospital in North Carolina, according to U.S. News and World Report for 2023-2024. Duke University Hospital is the largest of Duke Health's three hospitals and features 1048 patient beds, 65 operating rooms, as well as comprehensive diagnostic and therapeutic facilities, including a regional emergency/trauma center, an endo-surgery center, and more.
Job Location - Duke University Hospital, Medical Intensive Care Unit
Job Summary
The Duke Hospital Medical Intensive Care Unit (MICU) Nurse Practitioner (NP)/Physician Assistant (PA) (NP/PA) provides direct patient care services for complex critically ill adult patients in the Medical Intensive Care setting in collaboration with and under the supervision of the MICU attending physicians. The NP/PA performs physical exams, collects and documents data, conducts diagnostic and therapeutic procedures, orders and schedules laboratory studies and professional consultations, prescribes appropriate interventions and medications, coordinates the care and discharge of patients, and provides direct patient care services. The NP / PA contributes to excellence in patient care, research, teaching, and provides leadership to the organization.
Job Duties and Responsibilities
Utilize assessment, diagnostic and clinical skills and knowledge in order to provide clinical care to patients during their admission. Perform necessary diagnostic and therapeutic procedures (within the scope of practice of the supervising physician). Conduct and obtain patient histories, perform physicals examination, monitor patient progress, order appropriate medications, laboratory studies and diagnostic procedures. Document the patient's course of treatment at the direction of the supervising physician: History/ Physical/Admissions Problem List and Plan of Care Daily Progress Note Procedure Note Interval Notes Discharge Summary Facilitate daily rounds in the unit. Collaborate with consulting services, physicians and nursing staffs in order to provide a longitudinal continuity of care Participate in meeting the educational requirements of students, medical residents, fellows and other members of the health care team Collaborate with the nurse manager in the identification of problems and their resolution in order to assure the providing of safe, cost effective patient care Assure proper charges have been posted and appropriate documentation provided Participate in quality improvement initiatives for the unit. May order and/or perform the following procedures: Patient history and perform physical exam Laboratory, radiology, and/or diagnostic procedures/tests Interpretation of laboratory, radiographic and diagnostic tests Intubation / Extubation and airway management Mechanical ventilation Flexible bronchoscopy for non-biopsy purposes in patients that already are intubated or have a tracheostomy Conscious / Moderate Sedation per protocol Chest tube insertion / removal Paracentesis Thoracentesis Evaluation of pleurovacs (chest tube drainage systems) Lumbar puncture Line placement for venous or arterial access: Peripheral arterial line placement Percutaneous central line placement Internal and external hemorrhage control Suture and staple removal Application of dressings, bandages, wound vacs Simple debridement Manage/Place Cortrak/NG tubes, G tubes, J tubes Manage support devices, including (but not limited to), JP drains, arterial lines, wound vac Bladder catheterization Drainage of superficial abcesses Venipuncture for blood sampling Blood sampling via central venous lines, including:
Temporary central catheters Tunneled catheters Implantable vascular access devices
Administration of infusion therapy, including:
IV fluids Analgesics, Narcotics, including Patient Controlled Analgesia Antibiotics Antifungals Antivirals Electrolytes Benzodiazepines Muscle relaxants Local anesthetics Blood products - Packed Red Blood Cells and / or Platelets Total parenteral nutrition Enteral nutrition
Job Eligibility Requirements
Education
PA: Graduate of ARC accredited Physician Assistant Program. Master's or Doctoral degree strongly preferred.
NP: Graduate of an accredited MSN or DNP Acute Care / Critical Care Nurse Practitioner program.
Certification
PA: PA-C
NP: ACNP or AGACNP only. (Acute Care Certification is REQUIRED.)
Licensure
PA: Current unrestricted medical license issued by NCMB with authorization to practice as a PA.
NP: Current unrestricted RN license issued by or recognized by the NCBON with authorization to practice as an NP.
Both: Federal and State Prescriptive Authority
Experience:
PA: One or more years as a Physician Assistant in a critical care setting is preferred but not required.
NP: Three years minimum as a registered nurse, with minimum of one year experience as an Acute Care NP, preferably in an ICU setting.
OR AN EQUIVALENT COMBINATION OF RELEVANT EDUCATION AND/OR EXPERIENCE
Life support requirements :
BLS
ACLS
Physical and mental requirements:
Able to
clearly articulate scope of practice, and practices within those guidelines as a Nurse Practitioner / Physician Assistant in the state of North Carolina and within the Duke University Health System. Able to
independently seek out resources and work collaboratively to solve complex problems Able to
communicate clearly with patients, families, visitors, healthcare team, physicians, administrators, leadership, and others. Able to
use sensory and cognitive functions to process and prioritize information, perform health assessments, treatment, and follow-up. Able to
use fine motor skills Able to
record activities, document assessments & interventions; prepare reports and presentations; Able to
use computer and learn new software programs Able to
provide leadership in clinical area of expertise and in meeting organizational goals Able to
navigate the Hospital and DUHS to provide clinical expertise to specific patient populations Able to
withstand prolonged standing and walking with the ability to move or lift at least fifty pounds Able to
remain focused and organized Able to
work collaboratively with all levels of personnel
Job Hours
Rotating 12 hour shifts providing dayshift, nightshift, weekend and holiday coverage.
For .75FTE, APPs work an equivalent of
10.5
twelve-hour shifts per month.
Schedule may be changed by administrative or clinical leadership to meet department needs.
Duke is an Affirmative Action/Equal Opportunity Employer committed to providing employment opportunity without regard to an individual's age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex, sexual orientation, or veteran status.
Duke aspires to create a community built on collaboration, innovation, creativity, and belonging. Our collective success depends on the robust exchange of ideas-an exchange that is best when the rich diversity of our perspectives, backgrounds, and experiences flourishes. To achieve this exchange, it is essential that all members of the community feel secure and welcome, that the contributions of all individuals are respected, and that all voices are heard. All members of our community have a responsibility to uphold these values.
Essential Physical Job Functions: Certain jobs at Duke University and Duke University Health System may include essentialjob functions that require specific physical and/or mental abilities. Additional information and provision for requests for reasonable accommodation will be provided by each hiring department.