Nurse Practitioner/Physician Assist.:Cardiology-Echocardiogram (49368)

  • Job Type: Full Time
  • FTE/Bi-Weekly Hours: 1.0/80
  • Shift: Days
  • Hours in Shift: 8
  • Location: Palo Alto, CA
  • Req: 49368

Job Description

Nurse Practitioner (NP): The Nurse Practitioner functions under the general Nurse Practitioner Standardized Process Protocol approved by the Interdisciplinary Practice Committee (IDPC). The Nurse Practitioner provides routine care and management of the patient with acute and chronic complaints, in collaboration with the supervising physician and through implementation of standardized procedures. Specific functions pertaining to the Service, Clinic or Department are established by the Nurse Practitioner and the supervising physician(s), and approved by the appropriate medical and nursing administrators, the IDPC, and the Stanford Hospital and Clinics (SHC) Medical Executive Board and Board of Directors.
Physician Assistant (PA): The Physician Assistant functions under the general Physician Assistant Role Description approved by the Interdisciplinary Practice Committee (IDPC). Specific functions pertaining to the Service, Clinic or Department are established by the Physician Assistant and his or her supervising physician(s), and approved by the appropriate medical and nursing administrators, the IDPC, and the Stanford Hospital and Clinics (SHC) Medical Board and Board of Directors.

I.

Essential Functions



· Evaluates and treats patients with acute, chronic complaints and health maintenance concerns

· Obtains complete histories and performs pertinent physical exams with assessment of normal and abnormal findings on new and return patients

· Performs or requests and evaluates diagnostic studies

· Administers, orders, furnishes and/or prescribes medications

· Orders and collects specimens for routine laboratory tests, screening procedures and therapeutic procedures, including blood and blood products

· Orders physical therapy, occupational therapy, respiratory therapy, radiology examinations and nursing services

· Performs designated procedures after demonstrated competency

· Obtains informed consent

· Initiates arrangements for hospital admissions and discharges

· Effectively communicates and interacts with patients, families, staff and members of the community from diverse backgrounds

· Recognizes situations which require the immediate attention of a physician, and initiates life-saving procedures when necessary

· Facilitates the coordination of inpatient and outpatient care and services

· Facilitates collaboration between providers and coordination of community resources

· Provides and coordinates patient teaching and counseling.

Cardiology-Echocardiography Specific Job Description.
The Hospital based Cardiology APP will practice in collaboration with the supervising physician and perform and supervise stress tests/stress echocardiogram, and TEE procedures for Stanford inpatients and outpatients. The Cardiology/echo APP will serve as a liaison and a resource for multidisciplinary health care team members, patients, and families and will utilize expertise in the delivery of whole-person care.
Stress Tests
1. Cognitive experiences:
Exposure to and understanding of normal and abnormal resting and exertional physiology of the cardiovascular and pulmonary systems.
Exposure to clinical exercise testing principles
Exposure to EKG interpretation during both rest and exertion
2. Practical experiences:

Previous time spent in a clinical exercise testing lab, either working independently or under supervision, during academic training or after graduation. Physicians and non-physicians should meet level 1 Core Cardiology Training Symposium standard for conducting exercise testing, requiring a minimum of 200 tests. A minimum of 50 tests should be performed to maintain competency

3. Skills and Abilities
Screens patients for the appropriate indication, type of test, and contraindications. Assesses patient history, symptoms, and signs that suggest increased risk so that the appropriate level of medical supervision is provided

Recognizes appropriate termination criteria for the clinical exercise test.

Recognizes when the baseline signs and symptoms indicate the clinical exercise test is not warranted
Effectively communicates with the patient about the reason for testing; obtains informed consent; selects appropriate exercise testing procedures; and prepares patient for the exercise test

Operates/maintains all clinical exercise testing equipment independently

Appropriately interprets exercise testing data and generates appropriate reports, the parameters of which are defined by the medical director.


Responsibilities for Stress/TEE:

A. Review schedule for upcoming patients
a. Address medication hold, assess for GI or ENT issues (difficulty swallowing, hx of esophageal varices, ulcers) that would need to be addressed.
b. If unclear indication, retrieve records and or discuss with referring MD
B. The day of:
a. Obtain consent
b. Physical exam
c. H&P
d. Enter orders if necessary
e. Supervise all stress tests performed in the assigned area
f. Perform TEE with echo attending: pass the probe, manipulate probe to obtain images, remove the probe at the end of the case
g. Assess patient to ensure stable VS, ands rhythm
h. Ensure the patient is stable for discharge
i. Start report (for TEE)
C. For inpatients:
a. Help triage TEE requests
b. Obtain consent
c. Physical exam
d. H&P
e. Enter orders if necessary
f. Supervise all stress tests performed in the assigned area
g. Perform TEE with echo attending: pass the probe, manipulate probe to obtain images, remove the probe at the end of the case
h. Assess patient to ensure stable VS, ands rhythm
i. Ensure the patient is stable for discharge
j. Start report (for TEE)
Time designation
Review schedule for upcoming patients
k. Address medication hold, assess for GI or ENT issues (difficulty swallowing, hx of esophageal varices, ulcers) that would need to be addressed.
l. If unclear indication, retrieve records and or discuss with referring MD
D. The day of:
a. Obtain consent
b. Physical exam
c. H&P
d. Enter orders if necessary 5 min
e. Supervise all stress tests performed in the assigned area
f. Perform TEE with echo attending: pass the probe, manipulate probe to obtain images, remove the probe at the end of the case
g. Assess patient to ensure stable VS, ands rhythm
h. Ensure the patient is stable for discharge

E. Start report (Stress/ TEE)
For inpatients:
a. Help triage TEE requests
b. Obtain consent for all procedures performed in the area
c. Physical exam
d. H&P
e. Enter orders if necessary
f. Supervise all stress tests performed in the assigned area
g. Perform TEE with echo attending: pass the probe, manipulate probe to obtain images, remove the probe at the end of the case
h. Assess patient to ensure stable VS, ands rhythm
i. Ensure the patient is stable for discharge
j. Start report (preliminary Stress/ TEE)




Equal Opportunity Employer Stanford Health Care (SHC) strongly values diversity and is committed to equal opportunity and non-discrimination in all of its policies and practices, including the area of employment. Accordingly, SHC does not discriminate against any person on the basis of race, color, sex, sexual orientation or gender identity and/or expression, religion, age, national or ethnic origin, political beliefs, marital status, medical condition, genetic information, veteran status, or disability, or the perception of any of the above. People of all genders, members of all racial and ethnic groups, people with disabilities, and veterans are encouraged to apply. Qualified applicants with criminal convictions will be considered after an individualized assessment of the conviction and the job requirements.

Qualifications

o Physician Assistant (PA):

§ Licensure as a Physician Assistant (PA) in the State of California
§ Certification as a Physician Assistant (PA) by the National Commission on Certification of Physician Assistants (NCCPA)
§ Certification in Basic Life Support (BLS) from the American Heart Association (AHA)
§ An individual Drug Enforcement Agency (DEA) license issued by the United States DEA for Schedule II-V controlled substances, required only if prescribing controlled substances to outpatients

§ Additional board certification(s) may be required by certain services/departments.


o Nurse Practitioner (NP):

§ Licensure as a Registered Nurse (RN) in the State of California
§ Certification as a Nurse Practitioner (NP) in the State of California
§ National Board Certification as a Nurse Practitioner (NP) from an agency accredited by the American Board of Nursing Specialties (ABNS).
§ Certification in Basic Life Support (BLS) from the American Heart Association (AHA).
§ Furnishing license issued by the Board of Registered Nursing (BRN), required only if furnishing medications
An individual Drug Enforcement Agency (DEA) license issued by the United States DEA for Schedule II-V controlled substances, required only if prescribing controlled substances to outpatients.

Additional board certification(s) may be required by certain specialties/departments.

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