Vanderbilt University Medical Center Nocturnist Nurse Practitioner/Physician Assistant - Internal Medicine (Acute NP) in Nashville, Tennessee

Nocturnist Nurse Practitioner/Physician Assistant - Internal Medicine (Acute NP)

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Please note this is a nocturnist position; employee will be expected to work overnight.

The Advanced Practice Professional, APP (including either PA or NP) within the acute care hospital setting works in collaboration with, and is an integral member of, a multidisciplinary health care team. The APP functions primarily as a Hospitalist in an inpatient setting, managing the care of acute/complex chronically ill patients. The APP is typically on a service aligned team cross-covering and managing the patient care from step down to discharge. The APP has a strong foundation in evidenced based practice/education and provides an environment of safe quality care. The APP demonstrates an advanced level of medical and nursing knowledge, clinical and technical competence, sound clinical judgment, professional communication skills, timely and compliant documentation, and is responsible for professional development and competency validation.

Highlights of the Role:

  • 12 shifts per month

  • flexible scheduling

  • Nice call room

  • Occasional admissions

  • Census of 30-50 per night

Key Functions and Expected Performances:

  1. Assessment of Health Status

a. Performs and documents in the medical record a complete history and physical examination for acute and complex chronically ill patients.

b. Orders and collects data using appropriate assessment techniques, relevant supporting diagnostic information and diagnostic procedures where indicated.

c. The APP 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.

d. 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.

e. Coordinates daily rounds with the Attending physician teams, presents 24 hour patient report, collaborates in plan of care, and cross-covers assigned patient population throughout the night.

  1. Diagnosis

a. Collaborates with interdisciplinary health care team in making diagnoses of acute and complex chronic conditions.

b. Manages diagnostic tests through ordering, interpretation, performance, and supervision.

c. Formulates differential diagnoses by priority.

d. Diagnoses complications and orders appropriate interventions

  1. Formulates Plan of Care

a. Identifies expected outcomes from diagnosis, and formulates and documents a plan of care to address complex acute and chronic health care needs.

b. Utilizes evidenced based practice guidelines or protocols in an individualized, dynamic plan of care that can be applied across the continuum.

  1. Implements and modifies plan of care

a. Prescribes diagnostic strategies and therapeutic interventions including pharmacologic, non-pharmacologic and surgical, needed to achieve expected outcomes.

b. Manages further diagnostic tests through ordering, interpretation, performance, and supervision.

c. May perform advanced procedures consistent with privileges and competency validation including minor suturing, complex wound management, line and tube placements and removals.

  1. Communication and Collaboration

a. Maintains ongoing communication and collaboration with interdisciplinary health care team.

b. Facilitates and communicates with patient, family and staff to promote continuity of care across the inpatient and outpatient continuum of care.

  1. Documentation

a. 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)

b. Documentation is timely, meets acute care compliance standards and captures patient acuity.

  1. Professional Practice

a. Demonstrates Professional Practice behaviors including: preceptor/mentoring, education and instruction of students, nursing staff, nurses, graduates and novice APPs.

b. Seeks opportunities for active engagement in research and the analysis of evidenced based practice.

c. Actively participates in Grand Rounds, APN council meetings, faculty and unit meetings, MM&I presentations.

Maintains CEUs, and membership in a professional organization

Our Nursing Philosophy:

We believe highly skilled and specialized nursing care is essential to Vanderbilt University Medical Center’s mission of quality in patient care, education and research. We believe nursing is an applied art and science focused on helping people, families and communities reach excellent health and well-being.

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Learn more about VUMC Nursing:

  • Nursing Careers : http://www.vumcnursingcareers.com/index.html

  • Benefits : http://www.vumcnursingcareers.com/benefits.html

  • Our Nursing Philosophy : http://www.vumcnursingcareers.com/philosophy.html

  • Our Nursing Leadership : http://www.vumcnursingcareers.com/leadership.html

  • Shared Governance : http://www.vumcnursingcareers.com/shared-governance.html

  • Education & Professional Development : http://www.vumcnursingcareers.com/professional-development.html

  • Life In Nashville : http://www.vumcnursingcareers.com/nashville.html

  • VUMC Nursing : http://www.mc.vanderbilt.edu/root/vumc.php?site=vanderbilt-nursing

Master's Degree (or equivalent experience) and < 1 year experience. 12 months of nursing experience preferred; Inpatient acute care advanced practice nursing experience desirable.

Licensure, Certification, and/or Registration (LCR):

  • Registered Nurse Required

Additional Qualification Information:

  • Prefer National Specialty Board Certification, TN APN certificate/certificate of fitness to prescribe, eligible for DEA

Physical Requirements/Strengths needed & Physical Demands:

Movement

  • Occasional: Sitting: Remaining in seated position

  • Occasional: Standing: Remaining on one's feet without moving.

  • Occasional: Walking: Moving about on foot.

  • Occasional: Lifting under 35 lbs: Raising and lowering objects under 35 lbs from one level to another

  • Occasional: Push/Pull: Exerting force to move objects away from or toward.

  • Occasional: Bending/Stooping: Trunk bending downward and forward by bending spine at waist requiring full use of lower extremities and back muscles

  • Occasional: Crawling:Moving about on hands and knees or hands and feet.

  • Occasional: Reaching below shoulders: Extending arms in any direction below shoulders.

  • Occasional: Handling: Seizing, holding, grasping, turning or otherwise working with hand or hands.

Sensory

  • Occasional: Vision: Clarity of near vision at 20 inches or less and far vision at 20 feet or more with depth perception, peripheral vision, color vision.

  • Frequent: Noise: May include exposure to occupational noise levels which equal or exceed an 8-hr time-weighted average of 85 decibels, requiring enrollment in VUMC's Hearing Conservation Program which includes training, use of hearing protection, and periodic audiometry.

  • Continuous: Communication: Expressing or exchanging written/verbal/electronic information.

Environmental Conditions

  • Occasional: Chemicals and Gasses: Medications, cleaning chemicals, oxygen, other medical gases used in work area.

  • Occasional: Pathogens: Risk of exposure to bloodborne pathogens and other contagious illnesses.

  • Occasional: Radiation: May be exposed to occupational radiation, requiring enrollment in VUMC's Radiation Safety Program which includes training, use of personal protective equipment with lead shielding, and personal dose monitoring.

  • Occasional: Climate: Ability to withstand exposure to atmospheric extremes including heat, cold, humidity, and barometric pressure changes.

Job Other Nursing Services

Organization: Internal Medicine 104366

Title: Nocturnist Nurse Practitioner/Physician Assistant - Internal Medicine (Acute NP)

Location: TN-Nashville-Medical Center East (MCE) - North Tower

Requisition ID: 1803116