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

Duke University
June 13, 2023
Offerd Salary:Negotiation
Working address:N/A
Contract Type:Other
Working Time:Full time
Working type:N/A
Ref info:N/A

Duke University and Duke University Health System require all students, faculty and staff to receive the COVID-19 and influenza vaccines. After you have officially accepted a position at Duke, you may request a religious or medical accommodation.

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

Work Arrangement:

Requisition Number: 229721

Regular or Temporary: Regular


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


    NP: Graduate of accredited MSN or DNP Nurse Practitioner Program

    PA: Graduate of ARC accredited Physician Assistant Program


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

    PA: PA-C


    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.


    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.

    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.

    Nearest Major Market: Durham Nearest Secondary Market: Raleigh

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