Nurse Practitioner or Physician Assistant - Emergency Department

STATEMENT OF PURPOSE

The purpose of the Emergency Department Nurse Practitioner / Physician Assistant position is to provide safe, timely, compassionate, and evidence-based care to patients presenting to the Emergency Department across the lifespan. The Nurse Practitioner functions as an integral member of the Emergency Department team, working collaboratively with emergency physicians, nurses, ancillary services, EMS, and other healthcare professionals to evaluate, diagnose, treat, and appropriately disposition patients.

This is a full time, benefited position working 80 hours per two week pay-period.  Hours are Monday-Friday with variable hours.  

JOB FUNCTIONS

Quality

• Performs comprehensive patient evaluations including detailed history, physical examination, assessment, and diagnosis; initiates, reviews, and revises treatment plans.
• Demonstrates knowledge of growth and development across the lifespan and provides age-appropriate care.
• Orders or transmits orders for laboratory, radiology, therapeutic, and other diagnostic studies; arranges admissions and completes required medical record documentation.
• Ensures legible, timely, and compliant documentation that meets coding and reimbursement standards.
• Practice in accordance with current evidence-based standards, hospital policies, regulatory requirements, and professional standards.
• Participates in performance improvement initiatives.
• Assists in development, revision, and implementation of department policies and procedures.
• Attends designated meetings, drills, and in-service programs.
• Maintains required certifications and completes annual competency evaluations.
• Follows disaster procedures, standard precautions, aseptic techniques, infection control and isolation guidelines; investigates and reports incidents per risk management policy.

Service

• Perform comprehensive and focused histories and physical examinations.
• Perform medical screening examinations and determine the patient's presenting level of acuity.
• Develop differential diagnoses and appropriate diagnostic and treatment plans.
• Recognize and respond appropriately to changes in patient condition.
• Diagnose and manage acute and chronic conditions presenting in the Emergency Department within the provider's scope of practice.
• Order, interpret, and act upon laboratory, radiologic, cardiac, and other diagnostic results.
• Initiate appropriate medications, treatments, and interventions.
• Reassess patients and modify treatment plans based on clinical response.
• Participate in trauma activations and other emergency response protocols.
• Provide timely evaluation and treatment to support efficient Emergency Department operations.
• Manage appropriate patients independently while collaborating with the emergency physician for complex or high-acuity presentations.
• Facilitate appropriate disposition, including discharge, observation, admission, consultation, or transfer.

People

• Communicate effectively with inpatient services, specialists, receiving facilities, and EMS.
• Work collaboratively with emergency physicians, nurses, paramedics, technicians, laboratory, radiology, respiratory therapy, pharmacy, surgery, and other healthcare professionals.
• Participate in interdisciplinary communication and handoffs.
• Maintain effective communication with the Emergency Department leadership team regarding patient care, operational concerns, and quality issues.
• Support a culture of teamwork, respect, accountability, continuous improvement, and patient-centered care.
• Attends mandatory education and contributes to a culture of clinical excellence and accountability.

Finance

• Complete accurate and timely documentation to support appropriate coding, billing, reimbursement, and regulatory requirements.
• Support efficient Emergency Department throughput while maintaining patient safety and quality of care.

Growth

• Identify opportunities to improve patient flow, reduce unnecessary delays, and increase appropriate utilization of Emergency Department resources.
• Collaborate with Emergency Department leadership and medical staff to identify opportunities for service expansion and improved patient access.
• Build strong working relationships with EMS, primary care, specialty services, community healthcare organizations, and referral partners.
• Promote positive patient experiences that support patient confidence in JRMC's Emergency Department and healthcare services.
• Participate in community education, outreach, and healthcare initiatives as appropriate.
• Maintain current knowledge of emerging practices, technologies, and models of emergency care that may improve services at JRMC.

QUALIFICATIONS/REQUIREMENTS FOR THIS POSITION:

1. Preparation & Training - Must be a graduate from a nurse practitioner training program approved by the Commission on Accreditation of Allied Health Education Programs (CAAHEP). Must have successfully completed the certifying examination of the National Commission on Certification of Nurse Practitioner. Must hold licensure/registration as required in the state of North Dakota. DEA certification required. Position is required to attend BLS, ACLS and Non-Violent Crisis Intervention (NCI)   training in the appropriate timeframe according to department orientation checklist. Preferred:  ATLS, TNCC / ATCN and Rural Emergency Medicine experience.
2. Work Experience - Prefer previous experience as a NP with preference for Emergency Department or Critical Care experience. The successful applicant must be able to demonstrate that during the past 12 months he or she has been actively involved in clinical practice as a nurse practitioner and has provided inpatient or outpatient services to a reasonable number of patients, which can be documented.
3. Attendance - Punctual and regular attendance is an essential responsibility of each employee at JRMC. Employee is expected to report to work as scheduled, on time and prepared to start working. Employee is also expected to remain at work for their entire work schedule. 
4. Analytical Ability - A high level of analytical ability is required in a variety of duties in order to gather and interpret complex data   and to find solutions to difficult problems. 
5. Independent Judgement - Must have critical thinking and organizational skills as well as strong oral and written communication skills.
6. Contact with Others - Demonstrates effective interpersonal skills in interactions with patients, staff and co-workers. Must demonstrate social sensitivity and the ability to communicate effectively in a professional manner.
7. Supervising the Work of Others - Required to plan, assign work to and check the work of others. Supervision is provided to RN.
8. Responsibility for Welfare of Others - High degree of contact with other employees that may result in minor discomfort and delay to patients and co-workers.
9. Mental/Visual Effort - Must be able to speak and write the English language in an understandable manner. Must demonstrate physical and emotional ability to meet agreed upon work schedule and performance standards required by the position. Required duties are such that concentrated attention must be applied on demand consistent with manual skill requirements in   situations that may at times be stressful. Visual acuity necessary for reading charts and working with medical devices or instruments; color perception necessary for interpreting testing procedures involving color comparisons and supplies.
10. Working Conditions - Works in a clean, well-lighted, heated, ventilated area. OSHA job classification: This position is defined as a Category I in which the employee does have exposure to blood borne pathogens and other potential infectious materials. Participates in and complies with JRMC Safety Management program. Position is subject to frequent interruptions. Work may be beyond normal working hours, on weekends and holidays. Position is subject to on-call after regular working hours. Risk of exposure to elements and hazards related to travel and work in satellite clinics. Must hold a current, unencumbered North Dakota driver's license. Working areas are clean and vented, but on occasion the position requires tasks that will expose individual to grinder dust.
11. Physical & Sensory Effort - Requires moderate to high levels of physical and sensory effort. The role involves prolonged periods of standing and walking during patient evaluations, procedures, and follow-up care. Frequent bending, stooping, reaching, and positioning of patients is required, particularly during patient assessments and different procedures performed in the Emergency Department. The provider must possess sufficient manual dexterity and fine motor skills to perform detailed assessment, interpretation of diagnostic results, and accurate documentation. Auditory acuity is necessary for effective communication with patients, families, and interdisciplinary team members. The role also requires the ability to respond   quickly in emergency situations, maintain focus for extended periods, and manage multiple clinical priorities in a fast-paced environment. Occasional lifting, repositioning, or assisting with patient transfers may be required, consistent with safe patient handling guidelines.
12.  Promotion - No formal line of promotion.
13. Background - A comprehensive background check will be conducted as a condition of employment for this role. 
14. Drug Screen - A urine drug screening is required for all positions and must be completed within 30 days of the date of hire.
15. Physical Requirement - These are physical requirements of the position that may be performed as part of daily duties. Inability to meet one or more of these physical requirements will not automatically disqualify a candidate or employee from the position. Upon request for reasonable accommodation, JRMC may be able to adjust or excuse one or more of these requirements, depending on the requirement, the essential functions to which it relates and the proposed accommodation.

Employee Requirements

• Visual Observation - Continuously
• Standing - Continuously
• Walking - Continuously
• Sitting - Occasionally
• Hands and Finger Dexterity - Continuously
• Reaching with Hands and Arms - Continuously
• Climbing - Rarely
• Stooping/Kneeling/Crouching/Crawling - Frequently
• Hearing/Listening - Continuously
• Tasting or Smelling - Occasionally
• Working Inside - Continuously
• Working Outside - Never
• Working in Extreme Heat - Never
• Working in Extreme Cold - Never
• Working with Hazardous Materials - Rarely
• Noise - Continuously
• Working in Dirt/Dust - Rarely
• Driving - Ocassionally

Lifting / Carrying / Pushing / Pulling:  

• Up to 10 pounds - Occasionally
• Up to 25 pounds - Occasionally
• Up to 50 pounds - Occasionally
• Up to 75 pounds - Occasionally
• Up to 100 pounds - Occasionally
• Over 100 pounds - Occasionally

Notice of AI Use in Job Application Review

As part of our commitment in creating a fair, efficient, and consistent hiring process we may use artificial intelligence (AI) to help our recruiting teams organize, summarize, and analyze information provided by candidates, including resumes, application responses, and other materials submitted during the application process.AI may be used to identify patterns, highlight relevant skills, and experience, and assist in comparing a candidate’s qualifications with the requirement of a specific role. These tools are to improve efficiency and consistency while supporting more informed hiring decisions, which will ultimately be made by the hiring team.