Nurse Practitioner Hospitalist

Description

The Nurse Practitioner (NP) in the hospital setting will work under the direct supervision of the staff physicians at Tyler Holmes Memorial Hospital (THMH). The NP will be responsible for providing primary care services as deemed appropriate and acceptable by the attending physician, including assessing and managing patients at THMH following established standards and policies. Tyler Holmes Memorial Hospital is a Critical Access Hospital that admits Acute Care and Swing Bed patients. 

Essential Job Functions for Acute Care and Swing Bed Patients 

The Nurse Practitioner will be expected to be involved in the care of all patient admitted to Tyler Holmes Memorial Hospital with the supervision of the attending physician. The attending physician will establish and give direction to the NP on their expectations of the NP's involvement in the care of the patient. These patients will be either Acute Care, Observation or Swing Bed.

• The NP will make daily rounds on each Acute Care patient and review their chart prior to physician arriving on the floor (if feasible) for their morning rounds. Be prepared to discuss and confer with the attending physician their assessment and together develop a plan of treatment.
• Write notes and any needed orders daily on each acute patient.
• Review charts of each Swing Bed patient daily and round on the Swing Bed patients at least weekly and daily if needed. Document at least weekly, but more often as needed to document changes or significant findings or treatment concerns. Confer with attending physician as needed. 
• Be available to make rounds with the physician at their request and be prepared to discuss patient's plan of treatment. This time will be used for discussion and education for the Nurse Practitioner.
• Complete History and Physical on any new patients admitted to the floor that Nurse Practitioner is involved in their case unless Attending Physician or Emergency Department Physician completed the documentation.
• Write orders for any changes in plan of treatment as discussed with the attending physician regarding labs, diagnostic studies, medications, or therapies in appropriate and timely manner daily.
• Monitor patient's condition and evaluate labs, diagnostic test results, any other discipline's progress notes (i.e. PT, OT, ST, RT, Wound Care and RD) daily and notify attending physician of any changes throughout the day.
• Communicate with the nursing staff and all other disciplines involved in the patients care regarding Plan of Treatment providing new, revised and cancelled orders as needed while keeping the attending physician apprised of any new developments or changes that occur with their patients.
• Attend weekly Swing Bed meetings with all team members and discuss patient care and potential discharge planning.
• Be involved in the Discharge Planning of their patient. Discuss discharges with their patients and work closely with the Social Worker on referring patient to community resources or medical specialists as appropriate for counseling or specialized diagnosis or treatment. This includes assessing each patient for possible Swing Bed Placement and making recommendations for admission if indicated.
• Complete the Discharge Summary for each patient in which the Nurse Practitioner has been involved in their care, unless otherwise directed by the attending physician. The Discharge Summary will be done using the approved format for Tyler Holmes Memorial Hospital.
• The Nurse Practitioner will take the lead in the process of transferring patients to another facility if the transfer is approved by the attending physician. The NP will be expected to give direction and guidance to the nursing staff that will be facilitating the transfer. The NP will be available to speak to the accepting facility and or provider if needed. 
• Work with the Swing Bed Coordinator on all referrals that may be considered for admission to THMH Swing Bed. This process will include the Swing Bed Coordinator preparing a detailed synopsis of each referral and a verbal report on the conditions and needs of the referral. The NP will make the preliminary decision on accepting the patient based on the findings. The admitting physician will have the final decision on accepting or declining the patient.

Collaborate with a physician whose practice is compatible

• Implement a Quality Assurance/Quality Improvement Program.
• It consists of a sample of charts that represent 10% or 20 charts, whichever is less, of patients seen by the NP each month.
• Maintain a log of charts reviewed which included the identifier for the patients chart, reviewer name, and date of review.
• Meet face to face with a collaborating physician at least biweekly and possible more often if the need arises for the purpose of quality assurance.

Requirements

• Follow established policies, procedures and objectives, continuous quality improvement, improvement and safety objectives, environmental and/or infection control standards. 
• Provide excellent services and care to all of our patients in a professional manner. Maintain confidentiality according to all HIPPA guidelines at all times. 
• Participate in performance improvement teams, attend any required departmental meetings and maintain professional knowledge through continuing medical education. 
• In collaboration with the administration at THMH, develop educational materials and programs as needed for staff and patients.

Working Conditions 

• May involve exposure to communicable disease and other conditions common in medical facilities. 
• Will be required to wear appropriate Personal Protective Equipment such as gown, gloves, shoe and hair covering, mask, goggles or face shield.
• Work schedule will be Monday through Friday with 8 hours in each work day. Most days will be 7:00 a.m. to 3:00 p.m. However, from time to time, depending on patient needs, the NP may be required to stay longer. It should also be noted that if the NP initiates a treatment or an order for a patient, the nursing staff may need to reach the NP after hours to follow up. The NP may hand off to the Emergency Room physician if needed, but a detailed report should be verbally delivered before the NP leaves the building. 
• NP will give a report to the ER physician on Friday afternoons on each Acute patient and any Swing Bed patient that may need to be seen over the weekend. Make sure they are aware of any test results that are pending that may need their attention. 

Minimum Qualifications/Requirements 

Physical and Mental 

• Must have the analytical ability to evaluate problems and come to appropriate conclusions.
• Must use best judgement and discretion.
• Must have the ability to communicate effectively with peers, staff members, patients and others and to document using appropriate vocabulary, grammar and word usage.
• Must have the ability to respond and react immediately to visual observation and in emergency situations.
• Must have the ability to respond and react immediately with unimpeded auditory perception of verbal/vocal instructions and auditory auscultation such as codes or emergency situations.

Education and Experience

• Current licensure as a registered nurse in the state of Mississippi.
• Successful completion of nurse practitioner certification
• Current DEA license
• Current PALs certification
• Current ACLS certification
• Successfully complete and submit to HR 40 hours of continuing education, including 10 hours specific to controlled substances every 2 years. Primary Collaborating physician should approve 20 of the CEU hours.