Clinical Nurse Practitioner
About Steward Health Care System
Steward Health Care is the largest private, tax-paying physician-led health care network in the United States. Headquartered in Dallas, Texas, Steward operates 35 hospitals in the United States and the country of Malta that regularly receive top awards for quality and safety. The company employs approximately 42,000 health care professionals. The Steward network includes multiple urgent care centers and skilled nursing facilities, substantial behavioral health services, over 7,900 beds under management, and approximately 2.2 million full risk covered lives through the company's managed care and health insurance services.
Steward Medical Group (SMG), Inc. is Steward's multi-specialty group practice with over 4,500 employees including over 1,800 physicians and advanced practitioners. SMG operates approximately 450 practice locations throughout Massachusetts, Southern New Hampshire, Rhode Island, New Jersey, Pennsylvania, Ohio, Florida, Utah, Arizona, Texas, Louisiana, and Arkansas, and provides more than 4 million patient encounters per year.
St. Elizabeth’s Medical Center, a community-based academic teaching hospital, is seeking Advanced Practice Providers (PAs and NPs) with Critical Care experience for full time and per diem positions to staff a 28 bed ICU nightly from 7pm – 7am. The position can also include a smaller number of daytime shifts at Carney Hospital, also in Boston. Advanced Practice Providers will provide coverage of medical and surgical ICU patients with immediate supervision from eICU physicians. Duties will include assisting with admissions from the ER, floors, PACU and referring hospitals, assessing and managing decompensating patients, and performing needed procedures, specifically placement of central lines and arterial lines. St. Elizabeth’s serves as the tertiary care hospital for Steward’s Massachusetts hospitals and possesses all the clinical services compatible with that role.
- Licensed or license eligible nurse practitioner or physician assistant with at least one year of in-patient critical care experience.
- Have both Massachusetts MCR and Federal DEA or eligible for same.
- BLS and ACLS certification
- FCCS recommended but not required
Responsibilities and Duties
- Co-management of MICU and SICU patients with eICU attending back-up. Shifts will be overnight from 7 pm – 7am.
- Will round on patients and develop over-night care plan, follow-up on lab and imaging studies and order/adjust medication regimens including paralytic agents, vasoactive medications, and anti-arrhythmic agents. Also work with respiratory therapy on ventilator management.
- Will admit patients to the ICU from the emergency department, in-patient floor or in transfer.
- Will perform critical care consults and respond to rapid response and cardiac arrests in the in-patient setting.
- Independently perform procedures including central line and arterial line placement.
- Interpret EKGs and manage arrhythmias or ischemic events.
- When applicable will provide documentation including admission, progress, procedure, discharge, and transfer notes.
- Provide verbal and written morning sign-out to attendings and residents.
General Responsibilities/Essential Functions
- Provide superior customer service to internal and external clients, customers, and patients as referenced in the Service Excellence Standards.
- Build and maintain a detailed referring physician database.
- Ensure follow-up and update communication with referring physicians and patients via telephone and/or fax, email, or written correspondence.
- Ensure proper communication between the pulmonary medicine service and all other applicable staff including RNs, NP’s, PAs, house staff, fellows and attending physicians.
- Prepare and submit documentation in consultation with attending physicians and fellows to ensure financial reimbursement for NP/PA/MD encounters. This involves making sure that all applicable information is coordinated, available, and contains initial NP/PA documentation which is then made available to the attending MDs to maintain high quality patient care and reimbursement practices.
- Provide patient education. Participate in the educational training of medical residents, pulmonary medicine fellows, NP’s, PAs, nurses, and students.
- Participate in clinical research in the form of patient recruitment and data collection and management.
- Participate in journal club, divisional rounds, and mid-day educational conferences.
Qualifications and Skills
- Should have prior experience and/or credentialing in the following:
- Orogastric and Dobhoff tube placement.
- Ultrasound guided central line placement
- Arterial line placement