CH NURSE PRACTITIONER

Position Summary:
Provide direct and comprehensive primary, preventive, and therapeutic medical and nursing care in an outpatient primary care setting, in accordance with the regulations of the Arizona Board of Nursing and the Clinical Privileges document signed by the Chief Medical Officer.  This position will work on the Mobile Health Unit, delivering services directly within the communities serviced by Sage Memorial Hospital. The provider will consult as needed with Outpatient Department and Urgent Care physicians, and clinical notes and prescriptions will be co-signed by a physician unless independent prescribing authority has been granted by the Board of Nursing. The provider must comply with all Board of Nursing requirements, as well as Medical Staff Bylaws and the Rules and Regulations governing clinical practice.

This list of duties and responsibilities is illustrative only of the tasks performed by this position and is not all-inclusive.

Essential Duties & Responsibilities:
•    Assesses, plans and provides comprehensive and therapeutic medical care to individual geriatric, adult, adolescent, and patients and their families, specifically.
•    Take a complete health and developmental history from the patient and/or family member and perform a physical examination of the patient using palpation, percussion, auscultation, observation using appropriate diagnostic instruments. 
•    Order and/or perform screening and diagnostic tests and procedures (lab studies, x-rays, electrocardiograms, audiograms, pulmonary function tests, etc.). 
•    Interpret test results and analyzes all collected data, discriminates between normal and abnormal findings to identify all stages of serious physical, emotional or mental problems, and to prioritize health care needs, i.e., formulates a problem list.
•    Make diagnosis and decision concerning medical and nursing care needs of patients, formulate and implement plan of care which may involve various treatment modalities, prescribing medications, consultation with other health care providers, and referrals. 
•    Identify and manage both minor and serious acute and chronic illnesses (e.g., upper respiratory infections, venereal disease, hypertension, eye infections, tuberculosis, heart disease, nausea, angina, back pain, trauma, etc.) in accordance with established standards of medical care and approved clinical privileges. 
•    Provide surveillance of medical regimens for stabilized chronically ill persons recognizing when to refer the patient to physician or other health team members.
•    Perform minor surgical and invasive procedures, such as suture of lacerations not involving nerves or tendons, incision and drainage of abscesses, insertion and/or removal of Norplant capsules, toenail removal and skin biopsy. 
•    Give direct physical and psychological emergencies in the presence of illness or disability in order to maintain life, provide comfort, reduce stress and enhance coping ability.
•    Identify components of the nursing regimen that may be delegated to nursing and measures as appropriate, i.e., cardiac shock, hemorrhage or overdose/poisonings, seizures, and emergency obstetric delivery.
•    Provide health and preventive services to healthy individuals, including guidance in nutrition, illness prevention, accident prevention, growth and development.
•    Prescribe medications as delineated in the approved clinical privileges and in accordance with current DEA licensure for a variety of symptoms and illnesses. Monitors effectiveness of medications, adjusting dosages as appropriate to patient response to medications.
•    Evaluate medical aspects of the plan of care periodically recognizing the need for assessment by a physician or other health professional. 
•    Recommend appropriate follow-up to patients and staff, making referrals when necessary.
•    Assist in referral and medical management of patients requiring long term care.
•    Document data, patient assessment, and care plan in acceptable form in medical records.
•    Assess, plan and is involved in meeting the health needs of community and group health needs, taking into considerations socio-economic, epidemiological and cultural influences. 
•    Develop and conduct health education classes and/or specialty clinics such as immunization, nutrition, parenting, women's health, men's health, adolescent health, or employee health. 
•    Adapt educational material/methods to meet the audience/patient level of understanding. 
•    Teach and counsel patients and family on disease prevention and health maintenance techniques. 
•    Promote responsible behavior and implement plans to further' enhance patient/family understanding of medical problems.
•    Collaborate with other health care professionals to develop treatment protocols, standards of practice and policies. 
•    Participate in ongoing quality improvement activities, including audits, chart reviews, development of review criteria, development of plans for improving performance and evaluation of effectiveness of actions in improving performance.
•    Serve as a consultant and provides technical assistance to other health cate providers and staff.  
•    Develop and conduct formal education (i.e., in-service) programs hospital/clinic staff and other health care provides (i.e., CHR, EMT, school nurses) in community. 
•    Consult with other professionals regarding health care issues and complex medical problems. 
•    Serve as a preceptor for nurse practitioner students with clinical rotations in the clinic and community setting. 
•    Collaborate with community leaders to foster and promote a good relationship between the health care facility and the community.
•    Participate in problem identification, literature review, data collection and interpretation of results for studies and research, which will influence the improvement and/or change in patient care.
•    Review and critique current research, giving recommendation to medical staff for adapting current research results to medical practice.
•    Maintain and improve professional knowledge and skills by participating in seminars, accredited home study, in-service education and/or individualized preceptorship.
•    Meet and comply with standards of Navajo Health Foundation Personnel Manual. 
•    Maintain confidentiality at all times. 
•    Attend regular meetings of the Medical Staff Department including morning report, etc.
 

    Minimum Qualifications:
•    Master’s Degree in Nursing. 
•    Unrestricted Arizona Board of Nursing license as a Certified Nurse Practitioner.
•    Board certification through American Nurses Credentialing Center (ANCC) or American Academy of Nurse Practitioners (AANP) as a Nurse Practitioner.
•    Current DEA. 
•    Current BLS Certification.  ACLS certification will need to be obtained within 90 days of hire.
•    Valid Driver’s License.
•    Must be able to successfully pass the Employee Health Program requirements and background investigation.

    Knowledge, Abilities, Skills, and Certifications:
•    Knowledge of the wide range of professional nursing and nurse practitioner principles, concepts, practices and procedures applied in order to provide comprehensive and therapeutic health care to individuals and community groups. 
•    Knowledge of physical and psychosocial assessment and history taking skills (i.e., palpation, percussion, auscultation, listening and observation) in order to perform and complete physical examinations. 
•    Ability to interpret diagnostic tests and procedures and to analyze data in order to discriminate between normal and abnormal communicate results and to identify early stages of serious physical, emotional or psychological problems, make a diagnosis, and to implement modify treatment.
•    Ability to assess and treat both minor and serious illnesses and health states such as respiratory infections, lacerations fractures, pregnancy, urinary tract infections, trauma, etc.
•    Knowledge of prevention and health maintenance measures, disease control activities, and early identification of disease in order to provide health maintenance education to individuals and community groups.
•    Knowledge of and ability to treat chronic health problems as hypertension, diabetes, obesity, cardiovascular disease, substance abuse and nicotine addiction. 
•    Ability to counsel and teach healthy and ill individuals, families, and groups on health care maintenance. 
•    Ability to provide preventive health cate to healthy individuals, including guidance in nutrition, common illnesses, and growth and development through the entire life span.
•    Ability to recognize the need for and to provide emergency medical treatment for conditions such as cardiac arrest, shock) hemorrhage, overdose, and respiratory failure. Knowledge of emergency procedures and drug therapy to be initiated in the absence of a physician.
•    Ability to consult and/or provide technical direction to nursing staff, ancillary staff, and other health care personnel.
•    Knowledge of the process and procedures for establishing, revising, monitoring, and evaluating clinical standards.
•    Ability to recognize limitations and when to refer to a physician.
•    Ability to relate effectively and compassionately to patients.

Physical Demands:
The work involves walking, sitting, standing, reaching, and bending in the assessment and treatment of patients.  Lifting may involve moving patient’s equipment that may weigh over 50 pounds (up to 250 pounds with assistance of another person). The employee frequently is required to walk. 

Work Environment:
The work is performed in a hospital, urgent care or clinical setting, and on the Mobile Health Unit, where exposure to infections and communicable disease is common. Requires the wearing of specialized personal protective equipment to prevent exposure to blood and body fluids. Exposure to outside climate is necessary because of travel in all kinds of weather to clinic assignments in remote sites up to 30 miles from the base assignment site. Work may be performed throughout the 24-hour day, due to presenting health care programs in the evening and weekend hours due to providing emergency room/urgent care services on evening, night and weekend tours of duty.