Emergency Behavorial Health Services APP / Nurse Pracitioner or Physician Assistant -/ Full Time

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Emergency Behavorial Health Services APP / Nurse Pracitioner or Physician

Assistant -/ Full Time

Work Arrangement:

Requisition Number: 236106

Regular or Temporary: Regular

Location:

Durham, NC, US, 27710

Personnel Area: DUKE HOSPITAL

Date: Aug 23, 2023

Duke University Hospital

Duke University Hospital is consistently rated as one of the best in the United States and is known around the world for its outstanding care and groundbreaking research. Duke University Hospital has 1,048 licensed inpatient beds and offers comprehensive diagnostic and therapeutic facilities, including a regional emergency/trauma center; a major surgery suite containing 65 operating rooms; an endo-surgery center; a separate hospital outpatient surgical department with nine operating rooms and an extensive diagnostic and interventional radiology area. For 2021-2022, U.S. News and World Report ranked Duke University Hospital nationally in 11 adult specialties: cancer, cardiology & heart surgery, diabetes & endocrinology, ear, nose & throat, gastroenterology & GI surgery, gynecology, neurology & neurosurgery, ophthalmology, orthopedics, pulmonology & lung surgery, and urology. Duke University Hospital is also ranked first in North Carolina and first in the Raleigh-Durham area.

In addition to its hospitals, Duke Health has an extensive, geographically dispersed network of outpatient facilities that include primary care offices, urgent care centers, multi-specialty clinics and outpatient surgery centers.

Emergency Behavioral health SERVICES Advanced Practice Provider (APP)

Nurse Practitioner or Physician Assistant

Job Location: Duke University Hospital Emergency Room

Job Summary

The Emergency Behavioral Health Services Advanced Practice Provider (APP) provides direct patient care services and performs medical acts as either a Nurse Practitioner (NP) or Physician Assistant (PA) under the supervision of the supervisory physician to patients requiring psychiatric evaluation and management in the Emergency Departments at Duke University Hospital and Duke Regional Hospital. The APP performs physical and mental health exams, collects and documents data, conducts diagnostic and therapeutic procedures, orders and schedules laboratory studies and professional consultations, prescribes appropriate interventions and medications, and provides direct patient care services. The APP contributes to excellence in patient care, research, and teaching, as well as provides leadership in the organization.

Job Duties and Responsibilities

Clinical Expert

Collaborate with Emergency Department attending physicians and residents, Psychiatry attending physicians and residents, 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 psychiatric patients at Duke Hospital and Duke Regional Hospital being followed in the Emergency Department through established protocols and under the supervision of the supervising physician who is either on site or available by pager

In collaboration with attending, round daily on patients to assess, diagnose, plan treatment, set priorities and realistic outcomes, and evaluate the effectiveness and cost efficiency of patient care:

Provide evidence-based clinical care

May order and/or perform the following procedures:

Patient history and perform a physical exam

Laboratory, radiology, and/or diagnostic procedures/tests

Interpretation of laboratory, radiographic, and diagnostic tests

Removal of superficial foreign bodies

Venipuncture for blood sampling

Prescribing Authority for the following:

Antidepressants

Antipsychotics, typical and atypical

Benzodiazepines

Non-benzodiazepine anxiolytics

Hypnotics

Mood stabilizers

Psychostimulants

Antiparkinsonian drugs

IV and oral antibiotics

Analgesics, to include both narcotic and narcotic agents

Antiepileptic agents

Oral antifungal agents

Muscle relaxants

Antiasthmatics

Antihistamines

Antitussives, expectorants

Anticoagulants

Antidiarrheals

Oral antidiabetics/insulin

Antiemetics

Antihypertensives

Antipyretics

Cardiovascular Drugs

Cholesterol lowering agents

Diuretics

Electrolyte replacements/Vitamins/IV fluids

Gastrointestinal drugs

Antiretroviral medications

Hormones and synthetic substitutes/oral contraceptives

Muscle relaxants

Osteoporosis meds

Smoking cessation meds

Thyroid meds

Tuberculosis meds (in latent TB/already established med regimen)

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, transfer facility, home health, and other relevant healthcare providers.

Document in patients' medical records 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.

Provide leadership and coordination of care and services for psychiatric patients in the Emergency Department.

Utilize prescriptive privileges for identified patient populations in accordance with DUH and NC Board of Nursing/NC Medical Board regulations.

Role model competence in advanced nursing skills.

Educator:

Assess the educational needs of the Duke nursing staff and healthcare team members and provide one-on-one as well as formal education as needed.

Role model and precept healthcare learners through contractual agreements.

Assess the 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 practices.

Incorporate clinical research finding in the development and implementation of standards of care.

Support IRB-approved clinical research/trials through 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.

Consultant:

Provide expertise and resource information to other healthcare providers, patients and families, and the community at large related to psychiatric/mental health diseases, recognition, and management.

Professional Leadership and Development :

Role model Advanced Clinical Practice through conduct, communication, dress, leadership, ethical decision-making, critical thinking, and problem-solving skills.

Demonstrate responsibility for professional practice through active participation in Emergency Department, Behavioral Health Services, CAP Department, and professional organizations.

Share clinical expertise, program accomplishments, and research findings with other professionals.

Maintain all professional requirements for licensure and certification.

Job Eligibility Requirements

Education

NP: Graduate of MSN or DNP Adult Psychiatric and Mental Health Nurse Practitioner Program

PA: Graduate of ARC accredited Master's Degree or DSc Physician Assistant program

Licensure

NP: Current unrestricted RN license issued by or recognized by NCBON with approval to practice as an NP.

PA: Current unrestricted medical license issued by the NCMB with approval to practice as PA.

Certification

NP: Adult Psychiatric Mental Health Nurse Practitioner - PMHNP

PA: PA-C, with added qualifications (CAQ) in Psychiatry, is preferred.

Experience

One (1) year experience as an NP/PA in a psychiatric capacity is strongly preferred.

Physical and mental requirements :

Able to clearly articulate the 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 teams, physicians, administrators, leadership, and others.

Able to use sensory and cognitive functions to process and prioritize information, and 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 a computer and learn new software programs

Able to provide leadership in clinical area of expertise and in meeting organizational goals

Able to navigate the Hospitals 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

Schedule

Night shift 7p-7a at Duke University Hospital ED. 14-shifts per month is considered FULL-TIME.

Duke is an Affirmative Action/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, sexual orientation, or veteran 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 essentialjob 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.

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