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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 Job Summary 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 subspecialty 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 evidencebased clinical care by actively engaging in review of literature.

May order and/or perform the following procedures:

Patient history and perform physical exam

Laboratory, radiology, and/or diagnostic procedures/tests

Interpretation of laboratory, radiographic and diagnostic tests

Suture / Staple removal

Application of dressings, bandages manage NG tubes, G tubes, GJ tubes

Removal of superficial foreign bodies

Bladder catheterization

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 Gtube site i. Removal of Gtube 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 postdischarge 1 week followup 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 evidencebased practice.

Educator:

Assess educational needs of the Duke nursing staff and healthcare team members and provide oneonone 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 culturallysensitive patient/family interventions as indicated. Use nontechnical language when educating patients/families. Document educational interventions in the patient's medical record.

Research Utilization and Investigation:

Utilize current research and evidencebased decisionmaking 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 decisionmaking, critical thinking and problemsolving 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 (PNPPC or PNPAC acceptable)

PA:

PAC 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 followup.

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 MondayFriday 8am5pm.

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: MF, 95 pm (shared responsibility with other APP and ICC fellow) Schedule may be changed by administrative or clinical leadership to meet department needs Duke is an Equal Opportunity Employer committed to providing employment opportunity without regard to an individual's age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex (including pregnancy and pregnancy related conditions), sexual orientation or military status. Duke aspires to create a community built on collaboration, innovation, creativity, and belonging. Our collective success depends on the robust exchange of ideas—an exchange that is best when the rich diversity of our perspectives, backgrounds, and experiences flourishes. To achieve this exchange, it is essential that all members of the community feel secure and welcome, that the contributions of all individuals are respected, and that all voices are heard. All members of our community have a responsibility to uphold these values.

Essential Physical Job Functions:

Certain jobs at Duke University and Duke University Health System may include essential job functions that require specific physical and/or mental abilities. Additional information and provision for requests for reasonable accommodation will be provided by each hiring department.