Nurse Practitioner/Physician Assistant - Inpatient/Outpatient Internal Medicine Hospitalist - .9 FTE, Days (12HRS)

About the role

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Day - 12 Hour (United States of America)

Job Description Summary

Created in July 2021, the Med 7 Inpatient Service is staffed with a unique hybrid model involving collaborative care provided by both physicians and Advance Practice Providers (APP). The APPs on the Med 7 service are trained in Internal Medicine to manage the day-to-day care of hospitalized patients. This is an excellent opportunity for the right candidate to join a collaborative and supportive APP/MD team practice.

Responsibilities include complete/comprehensive history and physical examination, ordering and interpretation of diagnostic studies, and prescribing appropriate treatments in collaboration with the attending physician. Other responsibilities include consultation with specialist providers and other team members regarding findings/changes in patient condition, documentation of patient care/procedures per policy, and communication/education with patients and their families. APPs are also responsible for precepting and mentoring Stanford school of medicine Physician Assistant students.

Common diagnoses managed: Sepsis/Septic shock/Bacteremia, Cellulitis, UTI, Acute & chronic liver failure, Acute kidney injury/failure, COPD/asthma exacerbations, UGIB, Pancreatitis, ETOH withdrawal, DKA, AMS/Delirium, Anemia, Atrial Fibrillation, Syncope, Venous thromboembolism, and Electrolytes Abnormalities.

Orientation on Med 7 inpatient service is dependent on the experience of the employee and typically lasts between six and twelve weeks. Orientation is tailored to the employee and generally includes participation in team rounds, orientation to procedures, training on difficult conversations including goals of care, and cross training other APP specialty teams.

The position is 100% clinical. The typical morning consists of pre-rounding on patients followed by rounds with the attending physician. In the afternoon, the APP carries out the plan of care for patients, consults with other services as indicated, admits, and discharges patients, and performs procedures.

This is a Stanford Health Care job.

A Brief Overview

The Physician Assistant (PA) functions under this Physician Assistant Job Description approved by the Interdisciplinary Practice Committee (IDPC). Specific functions pertaining to the Service, Clinic or Department are established by the PA and his/her supervising physician(s), and approved by the appropriate medical and nursing administrators, the IDPC, the Credentials & Privileges Committee, the Stanford Hospital and Clinics (SHC) Medical Executive Committee and the SHC Board Credentials, Policies and Procedures Committee.

Locations

Stanford Health Care

What you will do

• Employees must abide by all Joint Commission requirements including, but not limited to, sensitivity to cultural diversity, patient care, patients' rights and ethical treatment, safety and security of physical environments, emergency management, teamwork, respect for others, participation in ongoing education and training, communication and adherence to safety and quality programs, sustaining compliance with National Patient Safety Goals, and licensure and health screenings.
• A. A PA may provide only those medical services which he/she is competent to perform, which are consistent with the PA's education, training and experience.
• B. A PA shall consult with a physician regarding any task, procedure or diagnostic problem which the PA determines exceeds his/her level of competence or shall refer such cases to a supervising physician.
• C. Scope of Practice of the PA:
• 1. Evaluates and treats patients with acute, chronic complaints and health maintenance concerns related to specialty.
• 2. Obtains complete histories and performs pertinent physical exams with assessment of normal and abnormal findings on new and return patients.
• 3. Performs or requests and evaluates diagnostic studies as indicated upon evaluation of the patient.
• Orders or furnishes medications under physician supervision, in accordance with the practice agreement, consistent with the PA's educational preparation and training, and upon completion of a California Physician Assistant Board approved controlled substance course.
• a. All PA's who are credentialed and privileged by April, 2021 who have not completed a controlled substance course must successfully complete the course by August 31, 2021 during which time patient specific approval of a medication order by a supervising physician is obtained, documented in the medical record, and is co-signed. [see Standardized Procedure: Administering, Ordering, Furnishing or Prescribing of Drugs; Formulary Protocol]
• 4. Orders and collects specimens for routine laboratory tests, screening procedures and therapeutic procedures, including blood and blood products.
• 5. Orders physical therapy, occupational therapy, respiratory therapy, radiology examinations and nursing services.
• 6. Performs designated procedures after demonstrated competency, according to written standardized procedures where applicable.
• 7. Obtains informed consent, as indicated.
• 8. Initiates arrangements for hospital admissions and discharges and completes appropriate paperwork.
• 9. As directed by the supervising physician, enrolls patients in investigational studies approved by the Investigational Review Board (IRB), and orders the necessary tests and medications. [see Standardized Procedure: Administering, Ordering, Furnishing or Prescribing of Drugs; Formulary Protocol] Medications that are not FDA-approved or are used for a non-FDA- approved indication (off-label use) require a patient-specific order in advance from the supervising physician.
• 10. After appropriate training, assists the supervising physician in the operating room (OR).
• a. Acts as first or second assistant under the supervision of an approved supervising physician.
• b. Performs surgical procedures in the personal presence of the supervising physician.
• 11. Recognizes and considers age-specific needs of patients.
• 12. Effectively communicates and interacts with patients, families, staff and members of the community from diverse backgrounds.
• 13. Recognizes situations which require the immediate attention of a physician, and initiates life-saving procedures when necessary.
• 14. Facilitates the coordination of inpatient and outpatient care and services as needed.
• 15. Facilitates collaboration between providers and coordination of community resources.
• 16. Ensures compliance with legal, regulatory and clinical policies and procedures.
• 17. Participates in quality improvement initiatives.
• 18. Provides and coordinates patient teaching and counseling.

Education Qualifications

• BACHELOR'S DEGREE IN NURSING FROM AN ACCREDITED UNIVERSITY.
• Note: PAs hired prior to July 1, 2012 are not subject to this educational requirement
• Graduate of a PA program accredited by the Accreditation Review Commission on Education for the Physician Assistant, Inc. B.

Licenses and Certifications

• PA - Physician Assistant State Licensure
• BLS - Basic Life Support
• DEA - Drug Enforcement Administration

These principles apply to ALL employees: SHC Commitment to Providing an Exceptional Patient & Family Experience

• Stanford Health Care sets a high standard for delivering value and an exceptional experience for our patients and families.
• Candidates for employment and existing employees must adopt and execute C-I-CARE standards for all of patients, families and towards each other.
• C-I-CARE is the foundation of Stanford's patient-experience and represents a framework for patient-centered interactions.
• Simply put, we do what it takes to enable and empower patients and families to focus on health, healing and recovery.

You will do this by executing against our three experience pillars, from the patient and family's perspective:

• Know Me: Anticipate my needs and status to deliver effective care
• Show Me the Way: Guide and prompt my actions to arrive at better outcomes and better health
• Coordinate for Me: Own the complexity of my care through coordination

Pay and benefits

Base Pay Scale: Generally starting at $91.68 - $121.48 per hour

The salary of the finalist selected for this role will be set based on a variety of factors, including but not limited to, internal equity, experience, education, specialty and training. This pay scale is not a promise of a particular wage.