Schedule: The PA/NP schedule may require long workdays while maintaining a goal of 40 hours/week on average. PA/NPs may be required to cover weekends, holidays and sick call on a rotational basis.

The Cardiovascular Medicine Physician Assistant/Nurse Practitioner is a core member of the BWFH Department of Medicine and key constituent of the cardiology division and BWFH cardiology inpatient and consult teams. The PA/NP is primarily responsible for serving as the responding clinician for patients on the inpatient cardiology service and for performing inpatient cardiology consults. Candidates for the position should have a strong interest in acute care cardiology and, ideally, experience and training in clinical cardiology. The cardiology PA/NP will report to the BWFH APP and Physician Division Chiefs of Cardiology but will work very closely with the BWFH/BWH cardiology attending physicians to develop all necessary clinical skills in a highly collaborative and supportive environment.

PRINCIPA/NPL DUTIES AND RESPONSIBILITIES:

The PA/NP works closely with the cardiology physicians, inpatient physicians and advanced practice professionals, residents and nursing staff to develop and coordinate a plan of care designed to meet the physical, psychological and social needs of patients and their families. Strong interpersonal, organizational and communication skills are required. Knowledge of current literature, guidelines and a commitment to continued learning are also required. The mission, vision and core values of the Brigham and Women's/Faulkner Hospital (BWFH) are incorporated into all areas of practice. The BWFH cardiology PA/NP will also be an integral partner with the other BWFH advanced practice professionals.

As a member of the BWFH Cardiology Division, the PA/NP shall be responsible for the following duties:

* Closely collaborate with the cardiology inpatient attending physician to evaluate new and follow-up cardiology admissions and cardiology consults at BWFH

* Participate in daily patient cardiology rounds to monitor patient care and formulate treatment plans in collaboration with the inpatient cardiology attending

* Write initial H+P, consult and / or daily progress notes

* Follow through on team recommendations for patient management in partnership with nursing staff

* Occasionally assist the cardiology attending physician with supervising cardiology testing and procedures, including exercise and pharmacologic stress testing, cardioversion, and trans-esophageal echocardiograms

* Interpret appropriate laboratory testing and other special examinations as requested

* Serve as a resource to the BWFH care teams for patient care issues

* Prepare succinct and accurate sign-out to facilitate the smooth transition of patient care to another cardiology covering APP or physician

* Weekday and some holiday & weekend coverage; no night coverage

General Duties
Work collaboratively and function as an efficient member of the BWFH cardiology division

* Assist in the coordination of care for patients with the primary care teams and other sub-specialists involved in the care of patients

* Provide education to patients and families

* Document in the medical record as appropriate and communicate observations/findings with attending physicians

* Monitor environment of care and comply with regulatory agency standards

* Ensure that his or her clinical practice is consistent with physician assistant and or APRN policies, procedures and standards

* Participate in QA/QI projects as appropriate

Supervisory/Managerial Responsibilities (Y/N): N

Includes Budgetary Responsibilities (Y/N): N

SKILLS/COMPETENCIES REQUIRED: Must be realistic, objective, measurable and related to principal duties described above.

* Staff adheres to all C.A.R.E. Standards

Medical Knowledge
Medical knowledge includes an understanding of pathophysiology, patient presentation, differential diagnosis, patient management, surgical principles, health promotion and disease prevention. The PA/NP must demonstrate core knowledge about established and evolving biomedical and clinical sciences and the application of this knowledge to patient care in their area of practice. In addition, the PA/NP is expected to demonstrate an investigatory and analytic thinking approach to clinical situations.

The PA/NP is expected to:

• Understand etiologies, risk factors, underlying pathologic process, and epidemiology for medical conditions
• Identify signs and symptoms of medical conditions
• Select and interpret appropriate diagnostic or lab studies
• Manage general medical and surgical conditions to include understanding the indications, agents and other relevant treatment modalities
• Identify the appropriate site of care for presenting conditions, including identifying emergent cases and those requiring referral or admission
• Identify appropriate interventions for prevention of conditions
• Identify the appropriate methods to detect conditions in an asymptomatic individual
• Differentiate between the normal and the abnormal in anatomic, physiological, laboratory findings and other diagnostic data
• Appropriately use history and physical findings and diagnostic studies to formulate a differential diagnosis
• Demonstrate proficiency with BWFH computer systems as needed to independently perform daily tasks such as order entry, EMAR, lab tests and results, incident reporting etc.
• Consistently provide high quality and timely documentation including consult notes and progress notes.

Abilities required

• Must be energetic, quality driven and have proven ability to be a productive member of a cohesive team of peers, dedicated to providing optimum patient care.
• Must exercise the highest degree of professional judgment under the direct supervision and guidance of a licensed physician.
• Must maintain a professional attitude towards patients and exercise such mature independent originality in solving problems not covered by existing guidelines, within legal limits, to meet the needs of the patients.
• Must maintain a professional attitude towards patients at all times and an excellent and collegial working relationship with other personnel involved in patient care.
• Must demonstrate understanding of procedures, policies and documentation required to ensure compliance with hospital standards of care.

For PA's

• Must have successfully completed a Graduate Level, accredited Physician Assistant Program approved by AMA Board of Approval and Certification of PA programs.
• Must have 4 years of college level education and baccalaureate degree or equivalent. (BS/MS joint programs are also acceptable; BS with PA certificates are acceptable for graduates before 1995).
• Board Certification by the National Commission on Certification of PA/NPs is required.

For APRN's

• Completion of a master's or post master's degree in acute care, adult or family NP program accredited by the Commission on Collegiate Nursing Education (CCNE) or the National League for Nursing Accrediting Commission (NLNAC)
• Current certification by the American Nurses Credentialing Center or an equivalent body.
• Current active licensure to practice in the expanded role in the state of Massachusetts.

LICENSES, CERTIFICATIONS, and/or REGISTRATIONS

• NCCPA/NP certified
• License as a Physician Assistant in Massachusetts
• Maintain current DEA and Massachusetts Controlled Substance Licenses
• Complete 100 hours of CME according to national and state regulations during each 2 year period of employment.
• NP must have current Massachusetts Registered Nurse Licensure/ Advanced Practice
• NP Certification in Basic Life Support for Healthcare Providers required
• NP must maintain updated continuing education requirement for certification and licensure
• Maintain current ACLS certification
• Complete BWFH Professionalism Program within 3 months of date of hire.
• Complete BWFH Procedural Sedation Training, if determined necessary.

EXPERIENCE:

• One year of relevant full time experience as a PA/NP in this specialty, preferred.
• Other previous Hands on patient care experience may be considered at the discretion of the Medical Director.