Under the supervision and direction of the designated supervising physician, and in accordance with the rules and regulations of Massachusetts governing Nurse Practitioner (NP) practice, the NP supports the inpatient Neurosurgical Service. The neurosurgical NP will work directly with the clinical faculty and residents to provide quality patient care and medical services as it relates to all phases of neurological surgery for comprehensive management of brain, spinal cord and peripheral nerve diseases and disorders. Reports to the collaborating neurosurgeon.
PRINCIPAL DUTIES AND RESPONSIBILITIES:
1. Order Writing
1.1 Orders for all situations covered by protocols are written and signed by the NP including his/her title.
1.2 Orders for situations not covered by protocols are first discussed with an appropriate physician involved in the patient's care and written by the NP and including the physician's name.
2. Preoperative Patient Care (Inpatient)
2.1 Elicit a detailed and accurate history, perform an appropriate physical examination, record and present pertinent data in a manner meaningful to the physician.
2.2 Perform and prescribe routine laboratory and related studies, medications, and consultations standard for the Neurosurgical Service. Admission and preoperative orders will be entered into Order Entry and signed by the NP. The admission orders will include routine laboratory tests, consultations and continuing medications, which the patient had been taking prior to admission.
3. Postoperative Patient Care
3.1 The NP will alternate with a junior surgical resident and additional Nurse Practitioners and/or Physician Assistants in the management of neurosurgical patients. Under advisement of a resident or an attending physician, they will prescribe/order prn medications, treatments, routine labs, and consults.
3.2 Perform suture removals and wound checks on as needed basis.
3.3 They are to be qualified to:
insert ventriculostomies or ICP bolts under the direct supervision of a physician
discontinue ventriculostomies or ICP bolts
3.4 Neurosurgical Care
To assist in implementation of the treatment plan as formulated by the attending neurosurgeon. It is expected that the NP will contribute to the assessment of the patient, respond appropriately to the clinical situation with good clinical judgment, and, with the attending and resident staff, develop and implement the clinical care plan, within the scope of the practice.
Participate in daily rounding on the inpatient neurosurgical units through multidisciplinary collaboration.
Assist in facilitating patient movement through the system, particularly as it relates to the admission and discharge process.
Independent performance of evaluative and treatment procedures essential to provide an appropriate response to life threatening emergency situations per Neurosurgical Service guidelines.
To assist in the education of the patient regarding his/her illness, surgical procedure, and care
To assist in the education of staff (e.g., other nursing staff and caregivers) regarding the surgical procedure and post-operative care, according to the standards of good clinical practice, the requests of the attending surgeon, and the needs of the individual patient.
Minimum of Master's Degree in Nursing (MSN) and previous experience in an academic medical environment preferred.
Ideally have 3-5 years of prior related experience in the Advanced Practice role in Neurosurgery, Orthopedics, or other surgical sub-specialty. Neuroscience experience preferred.
For NPs, will consider 1-3 years NP experience with RN experience in acute care setting.
Critical care experience and/or clinical nursing experience preferred.
Hold current certification as an Acute Care Nurse Practitioner or Adult Nurse Practitioner.
Hold current valid Massachusetts nursing license.
Hold a current valid Federal DEA certificate.
Hold a current valid State Controlled Substance Certificate in the Commonwealth of Massachusetts.
ACLS provider trained.
SKILLS/ ABILITIES/ COMPETENCIES REQUIRED:
Requires independent judgment.
Ability to work well under pressure.
Broad knowledge of medical environment and academically oriented surgical practice.
Ability to exercise the highest degree of professional judgment under the direction and guidance of a licensed physician.
May maintain variable work schedule depending on departmental needs to provide patient care (evening, holidays, and weekends); coverage would involve a rotating schedule with other Advanced Practice Provider (APP) team members.
Qualified in all basic and advanced cardiac life support standards as established by the American Heart Association.
Knowledge of bedside and operating room procedures and priorities.
Maintain a professional demeanor towards patients and co-workers at all times, as well as maintain good working relationships with other personnel involved with patient care activities. It is expected that the NP will function as an effective member of the care team, in association with the attending surgeon and resident staff, and other APP's. This should be made manifest by a professional attitude, a willingness to work as a member of the care team, and being supportive and helpful to other members of the team as needed.
Possess the maturity, self-confidence, and ability to follow complex patient management plans as directed by the attending surgeon.
Eligible for state and federally controlled substances registration.
Is knowledgeable and compliant in all hospital, State and Federal regulatory requirements, including hospital policy and procedures (where applicable to the performance of the job), Joint Commission on Accreditation of Healthcare Organizations (JCAHO), and Health Insurance Portability and Accountability Act of 1996 (HIPAA).
Work will be performed primarily in an inpatient hospital setting. The work may require the lifting of heavy objects and patients, as well as exposure to potentially infective material. Work requires contact with needles and other sharp instruments. Prolonged standing can be expected. Walking to and from the patient care units can be expected.
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