Job Description

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. The largest of the four Duke Healthhospitals with 1062 patient beds, it features comprehensive diagnostic and therapeutic facilities, including a regional emergency/trauma center, an endo-surgery center, and more.

Duke Nursing Highlights:

• Duke University Health System is designated as a Magnet organization
• Nurses from each hospital are consistently recognized each year as North Carolina's Great 100 Nurses.
• Duke University Health System was awarded the American Board of Nursing Specialties Award for Nursing Certification Advocacy for being strong advocates of specialty nursing certification.
• Duke University Health System has 6000 + registered nurses
• Quality of Life: Living in the Triangle!
• Relocation Assistance (based on eligibility)

Duke University Hospital

Center for Advanced Practice

Special Infant Care Clinic and Pediatric Cardiac Neurodevelopment Clinic Advanced Practice Provider (APP)

Nurse Practitioner or Physician Assistant

Job Location

Duke University Hospital

This Pediatric Nurse Practitioner (PNP)/Physician Assistant (PA) will provide direct patient care services for infants and toddlers who are graduates of the Neonatal Intensive Care Unit (NICU) and those with congenital heart disease who have been discharged from the Pediatric Cardiac Intensive Care Unit (PCICU). These children have complex health conditions impacting growth and development and the PNP/PA will perform medical management and developmental assessments as a Nurse Practitioner/Physician Assistant for infants managed in the Special Infant Care Clinic (SICC) and Pediatric Cardiac Neurodevelopmental Clinic (PCNC). The Nurse Practitioner/Physician Assistant will perform physical exams, collect and document data, conduct diagnostic and therapeutic procedures, order and schedule laboratory studies and sub-specialty referrals, prescribe appropriate interventions and medications, and provide overall care coordination services. The PNP/PA will contribute to excellence in patient care, research, teaching, and provide leadership in the program.

The Pediatric Nurse Practitioner (PNP)/Physician Assistant (PA) may also perform inpatient consults on infants from the pediatric wards who have discharge planning needs and will be following up in SICC or PCNC, such as those needing be discharged home with NG tubes. In this role, the Nurse Practitioner/Physician Assistant performs a thorough chart review, physical exam, and provides recommendations to the inpatient team to support the infant’s feeding or development and management related to their transition from hospital to home.

Job Duties and Responsibilities

Clinical Expert

• Collaborate with attending physician(s) and healthcare team to assess, diagnose, plan, set priorities and realistic outcomes, and evaluate the effectiveness and cost efficiency of patient care.

• Provide /coordinate clinical practice for infants being followed by PCNC/SICC in the Duke Children’s Health Center, Duke Hospital, Lenox Baker Children’s Hospital, or Duke Pediatric Clinics through established protocols and under the supervision of the attending physician who is either on site or available by pager.

• In collaboration with attending, provide patient assessment, diagnosis, plan treatment, set priorities and realistic outcomes, and evaluate the effectiveness and cost efficiency of patient care;
• Provide evidence-based clinical care by actively engaging in review of literature.
• May order and/or perform the following procedures:

1. 1. Patient history and perform physical exam
   2. Laboratory, radiology, and/or diagnostic procedures/tests
   3. Interpretation of laboratory, radiographic and diagnostic tests
   4. Suture / Staple removal
   5. Application of dressings, bandages manage NG tubes, G tubes, GJ tubes
   6. Removal of superficial foreign bodies
   7. Bladder catheterization
   8. Venipuncture for blood sampling

g. Inhalation therapy or medications to alleviate the distress of dyspnea or shortness of breath.

h. Cauterization of granulation tissue surrounding G-tube site

i. Removal of G-tube when no longer indicated

• Assess patients for change in status and institute appropriate interventions. Initiate emergency interventions in an effort to stabilize the patient until physician support arrives.
• Communicate verbally and in writing all pertinent patient information to supervising MD, referring MD, nursing staff, home health, hospice agency, and other relevant healthcare providers.
• Document in patients’ chart all relevant data including but not limited to results of diagnostic tests; laboratory results; patients’ condition and response to therapies/interventions; communications with supervising MD.
• Participate in Transitions home program by enrolling patients and tending to home app program and sharing pager responsibility. PNP/PA will also assist with post-discharge 1 week follow-up phone calls and/or video visits.
• Provide leadership and coordination of care and services for the PCNC and SICC clinics.

• Utilize prescriptive privileges for identified patient population and in accordance with DUH and NC Board of Nursing/NC Medical Board regulations.
• Role model competence in advance nursing skills and provides evidence-based practice.

Educator:

• Assess educational needs of the Duke nursing staff and healthcare team members and provide one-on-one as well as formal education as needed
• Implement and evaluate appropriate educational programs for nursing staff, MDs, and other healthcare providers as appropriate.
• Role model and precept healthcare learners through contractual agreements.
• Assess educational needs of patients/families and provide culturally-sensitive patient/family interventions as indicated. Use non-technical language when educating patients/families. Document educational interventions in the patient’s medical record.

Research Utilization and Investigation:

• Utilize current research and evidence-based decision-making in all clinical practice.
• Incorporate clinical research finding in the development and implementation of standards of care.
• Support IRB approved clinical research/trials though a variety of activities including but not limited to: obtaining consent; ordering diagnostic tests; recording laboratory & diagnostic results; administering therapeutic interventions; and reporting patient outcomes including toxicities or adverse events.

• Become a certified Neonatal Research Network neuro examiner, perform exams on research patients, and document findings on case report forms
• Participate in interdisciplinary quality improvement and/or research activities.
• Participate in measuring and documenting outcomes.

Consultant:

• Provide expertise and resource information to other healthcare providers, patients and families, and the community at large related to developmental, feeding, and growth needs of medically complex infants, procedures, interventions, and conditions.
• Implement and evaluate appropriate educational programs for referring MDs
• Develop, implement and evaluate standards of care/practice guidelines/policies and procedures/care maps/protocols within area of specialization.

• Develop programs and projects in areas of expertise to facilitate the attainment of the goals and objectives of the Duke University Hospital and Duke University Health System.

Professional Leadership and Development

• Role model Advanced Practice through conduct, communication, dress, leadership, ethical decision-making, critical thinking and problem-solving skills.
• Participate in at least one professional organization.
• Demonstrate responsibility for professional practice through active participation in Pediatric Department and professional organizations.
• Share clinical expertise, program accomplishments, and research findings with other professionals through written publications, oral presentations, posters, continuing education, etc.
• Maintain all professional requirements for licensure and certification.

Job Eligibility Requirements

Education

NP: Graduate of an accredited MSN or DNP Pediatric Nurse Practitioner program, Acute Care or Primary Care certification.

PA: Graduate of an ARC accredited Physician Assistant program.

Licensure

NP: Current unrestricted RN licensure issued by or recognized by the NCBON with authorization to practice as an NP

PA: Current unrestricted medical license issued by the NCMB with authorization to practice as a PA

Certification

NP: National certification as an NP (PNP-PC or PNP-AC acceptable)

PA: PA-C

Experience

Experience in pediatrics as an advanced practice provider for at a minimum of 1 year preferred. New graduates welcome to apply.

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

Primary hours will be Monday-Friday 8am-5pm.Schedule subject to change to meet clinical needs with approval from the Department of Pediatrics.

• Special Infant Care Clinic:
  • Tuesdays, 8 am -5 pm
  • Wednesday (virtual), 1 pm -5 pm
• Pediatric Cardiac Neurodevelopmental Clinic:
  • Thursday, 8 am -5 pm

• Can perform additional virtual evaluations as needed on Mondays and Friday.

• Inpatient SICC and PCNC consults/pager: M-F, 9-5 pm (shared responsibility with other APP and ICC fellow)

Schedule may be changed by administrative or clinical leadership to meet department needs