Site: The Brigham and Women's Hospital, Inc.
Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham.
Job Summary
Under the supervision of the Orthopedic Department Chief, Vice President, Senior Director of Advanced Practice Providers (APPs), Senior APP Manager and Inpatient APP Lead, the Nurse Practitioner (CNP) or Physician Assistant (PA-C) will function as Responding Clinician and be responsible for the care of the Orthopedic patient population comprised of seven subspecialities in the inpatient setting at BWH.
Responding Clinicians are responsible for all aspects of patient care for the patients on their daily assignment, which include: (a) admitting patients from the ED, clinic, or front door (completes admission note and orders); (b) acute postoperative care and symptom management; (c) care of the non-operative patient (daily exam, note and billing if appropriate); (d) coordination of care with all disciplines involved in the care of the patient during the patient’s hospital stay; (e) responding to patient emergencies and (f) performing consults (carry ED and inpatient pager). The APP: documents patient history and physical examinations; orders labs, tests, diagnostic imaging, and procedures; diagnoses new medical conditions during the hospital stay and treat those various conditions; prescribes medications; writes progress notes and bills when applicable; coordinates consultations with multiple disciplines; implements postop care and symptom management in accordance with surgeons’ treatment plans; and completes discharge summaries in a timely fashion.
Discharge planning is an essential responsibility to assist with the hospital’s capacity issues and metric of decreasing patient length of stay. This requires pre-planning and daily communication with multiple interdisciplinary team members (all specialty consults, case management, OT, PT, PCP/referring physicians) as well as those involved in the transition of care (home care companies for abx, VACs, VNA or rehabs/acute and SNF).
The APP has a significant role relative to patient/family education to reinforce surgeons’ postop plans and participates in many patient/family meetings.
The APP will practice in accordance with federal and MA state regulations, as well as standards set forth by their respective NP or PA Academy and National Commission on Certification and Credentialing. All APPs are vetted by the MGB/MGH Credentialing Center and receive hospital privileges, including first assist (PA or RNFA, NPFA), within the scope of practice of an APP.
The appropriate candidate will have successfully completed an accredited graduate level physician assistant or nurse practitioner program (Master’s degree).
· Certification by the National Commission on Certification of Physician Assistants (NCCPA), r American Academy Nurse Practitioners (AANP) or American Nurses Credentialing Center (ANCC) ANA must be obtained prior to employment.
· Must hold a current valid MA license for PA or NP practice.
· Must have a current DEA registration and Massachusetts Controlled Substance Registration.
· Must complete all required CME according to national and state regulations for NPs and PAs.
· Qualified in all basic (BLS) and advanced cardiac life support (ACLS) standards.
Additional Job Details (if applicable)
- Provide direct care, counseling, and teaching to the orthopedic patient population in the inpatient, operative, and/or procedural setting.
- Act as responding clinician for an assigned daily patient census, average 10-12.
- Inpatient APPs will evaluate the daily census and provide cross coverage to support services with a high census and/or to cover for colleague vacations, FMLAs, sick calls.
- Perform history and physical examinations.
- Consistently provides high quality and timely documentation updating plan of care in the chart.
- Write admission notes for patients admitted via the ED, clinic or front door if not already done by a resident/fellow.
- Complete event notes when they occur.
- Write progress notes on non-operative patients and bills accordingly.
- Complete ortho pass postop note if First Assist in the OR.
- Complete discharge summaries in a timely manner and preps charts for weekend discharges.
- Order, interpret, and evaluate appropriate laboratory and diagnostic tests.
- Develop appropriate plans of care and follow-up based on the outcomes of diagnostic, laboratory, and physical examination findings.
- Order medications and write prescriptions according to organizational and regulatory policies and procedures.
- Respond to emergent patient issues (chest pain, SOB, wound dehiscence, syncope, falls, social-behavioral issues, codes)
- Perform bedside procedures as appropriate to the patient population.
- Function as first assist (PA or RNFA/NPFA) in the operating room or procedural areas only if truly first assist and all services have adequate coverage.
- Performs consults (ED and inpatient)
- Practice cost effective medicine in an efficient manner, maximizing available resources.
- Discusses patient data with other physicians and professionals as appropriate in a multidisciplinary setting.
- Demonstrate expert clinical judgment skills to function in an independent role.
- Additional duties and responsibilities as required by the department/division in the environment of an ever-changing health care system.
- Demonstrate professional collaborative and interpersonal skills with inpatient Orthopedic APP colleagues to effectively function as a team.
- Demonstrate professional collaborative and interpersonal skills with consultative relationships and other multidisciplinary providers.
- Follow all designated prescriptive practices and monitoring requirements with the designated supervising physician and administrative report.
- Participate in departmental (decrease LOS) and organizational committees and programs (HRO rounds) as appropriate and attend all required meetings, in-services, and professional annual trainings and vaccinations.
- Maintains superior interpersonal and communication skills as a member of the healthcare team to collaborate effectively with patients, families, staff, and community health workers.
- Remains actively involved in continuing education with a commitment to self and departmental growth.
- Adheres to all established safety policies, procedures, and precautions; identifies potential or actual unsafe situations in the environment and takes measures to rectify the situation.
- Demonstrates understanding of procedures, policies, and documentation required to ensure compliance with hospital standards of care.
- Discusses challenges/barriers to daily practice and creates innovative strategies to enhance patient discharge and or improve care through all phases of the patient’s surgical journey.
- Contributes to Improving the quality of care of our orthopaedic population (innovative clinical prac