Inpatient APP - NP or PA for Duke Center for Brain and Spine Mets

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Inpatient APP - NP or PA for Duke Center for Brain and Spine Mets

Work Arrangement:

Requisition Number: 229721

Regular or Temporary: Regular

Location:

Durham, NC, US, 27710

Personnel Area: DUKE HOSPITAL

Date: May 10, 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.

Duke Nursing Highlights:

Duke University Health System is designated as a Magnet organization

Nurses from each hospital are consistently recognized each year as North Carolina's Great 100 Nurses.

Duke University Health System was awarded the American Board of Nursing Specialties Award for Nursing Certification Advocacy for being strong advocates of specialty nursing certification.

Duke University Health System has 6000 + registered nurses

Quality of Life: Living in the Triangle!

Relocation Assistance (based on eligibility)

Inpatient Advanced Practice Provider (APP) at Duke Center for Brain & Spine Metastasis (DCBSM)

Job Location - Duke Hospital and Cancer Center Main campus

Job Summary

The Duke Center for Brain and Spine Metastasis (DCBSM) Inpatient Advanced Practice Provider (APP) provides direct patient care services to patients with brain and/or spine metastases from a solid tumor in collaboration with the multidisciplinary team and under the supervision of the Medical Director of the DCBSM. The APP performs physical exams, collects and documents data, conducts diagnostic and therapeutic procedures, orders and schedules laboratory studies and professional consultations, prescribes appropriate interventions and medications, coordinates care and provides direct patient care services. The APP contributes to excellence in patient care, research, teaching, and provides leadership to the organization. This is a full time position in the Duke Center for Brain and Spine Metastasis and will have significant interaction with all members of the Duke Center for Brain and Spine Metastasis.

Job Duties and Responsibilities

Serve an inpatient medical oncology consulting role (either independently or in shared format with medical oncology fellow) for patients with brain and/or spine metastases from a solid tumor.

Obtain and document a comprehensive health history, physical and neurological exam for patients with a brain-metastatic solid tumor, spine- metastatic solid tumor or leptomeningeal disease.

Perform diagnostic coding for all brain/spine metastasis and leptomeningeal disease patients in Maestro for billing and tracking purposes

Assess and treat symptoms commonly seen in patients with a brain- metastatic solid tumor, spine-metastatic solid tumor or leptomeningeal disease (e.g., fatigue, pain, nausea, vomiting, headache, seizures) or for common signs and symptoms related to disease progression or recurrence

Conduct a pharmacologic assessment, including over-the-counter medications, prescription drugs, nutritional supplements, and other complementary, alternative, and integrative therapies, to identify any potential interactions with cancer therapeutics or surgery; consult with clinical pharmacist as necessary

Perform a comprehensive assessment of functional status and the impact on activities of daily living, including but not limited to the following domains: Psychological, Role, Social, Cognitive, and Physical; refer to appropriate support services

Assess for the presence of psychological comorbidities (e.g., anxiety/depression, substance use), past and present coping skills, and the psychosocial impact of the metastatic brain or spine tumor experience; identify psychiatric disorders and common psychiatric sequela of metastatic brain or spine tumors; anticipate management of these (pharmaceutical, CBT, therapeutic communication etc) and refer to adjunct staff neuro-psychology and psychiatry

Collaborate with the multidisciplinary team, patient, family, and caregivers to formulate a comprehensive plan of care for patients with a brain-metastatic solid tumor, spine-metastatic solid tumor, or leptomeningeal disease

Demonstrate awareness of appropriate clinical trials and research studies for which patients may be eligible and assists in recruiting patients as appropriate; help facilitate enrollment of inpatients with a brain- metastatic solid tumor, spine-metastatic solid tumor or leptomeningeal disease to tissue-based and/or therapeutic clinical trials.

Facilitate patient and family decision making regarding complex treatment; Coordinate palliative and end-of-life care in collaboration with patients, families, caregivers, and other members of the multidisciplinary healthcare team as necessary

Maintain outpatient clinic ½ day per week in the Duke Cancer Center Clinic as needed to assess and determine appropriate treatment plan for patients with a suspected metastatic cancer diagnosis of unknown primary.

Attend and present (when indicated) at weekly DCBSM Tumor Board and other meetings as necessary to ensure and promote the growth and development of DCBSM

Oversee DCBSM Tumor Board documentation, ensuring utilization of appropriate DCBSM dot phrases and flowsheet.

Work in collaboration with DCBSM nurse navigators and patient coordinators to obtain outside hospital records as needed and coordinate timely multi- disciplinary outpatient follow up upon discharge.

Make recommendations to consulting team regarding initial staging, or re- staging, of suspected primary disease process including imaging studies, biopsy planning, tumor markers and requests for appropriate molecular studies

Work in collaboration with the 9300 team and medical oncology fellows to streamline management/coordination of inpatient and/or outpatient follow- up care with neurosurgery and/or radiation oncology for patients with a brain-metastatic solid tumor, spine-metastatic solid tumor, or leptomeningeal disease.

Perform other related duties incidental to the work described herein.

Job Eligibility Requirements

Education/Training

NP: Graduate of accredited MSN or DNP Nurse Practitioner Program

PA: Graduate of ARC accredited Physician Assistant Program

Certification

NP: any NP certification for adult care, i.e., FNP, AGNP, ACNP, AGACNP, etc.

PA: PA-C

Licensure

NP: Current unrestricted RN license issued by the NCBON with authorization to practice as a NP

PA: Current unrestricted license issued by NCMB with authorization to practice as a PA.

Experience

Two year APP experience is preferred but not required.

Job H ours

Day Shift, 40 hours per week. Monday – Friday 7am – 3pm

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.

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