Physician Assistant Cardiothoracic

The physician assistant will function within the setting of the cardiothoracic section of the department of surgery at the RLR VA Medical Center. Provide medical and surgical care for both inpatients and outpatients in the sections of cardiothoracic surgery and surgical intensive care, serving as the primary coordinator for the physicians and PA/ARNP providers. Cardiothoracic patients often have concomitant medical problems and are multi-symptomatic.

EDUCATION: Note: Only education or degrees recognized by the U.S. Department of Education from accredited colleges, universities, schools, or institutions may be used to qualify for Federal employment. You can verify your education here: http://ope.ed.gov/accreditation/ . If you are using foreign education to meet qualification requirements, you must send a Certificate of Foreign Equivalency with your transcript in order to receive credit for that education. For further information, visit: https://sites.ed.gov/international/recognition-of-foreign-qualifications/ . RESPONSIBILITIES: Cardiothoracic Surgery Duties:

Provide medical and surgical care for both inpatients and outpatients in the sections of cardiothoracic surgery and surgical intensive care, serving as the primary coordinator for the physicians and PA/ARNP providers. Cardiothoracic patients often have concomitant medical problems and are multi-symptomatic. The PA shall coordinate patient care programs based upon the admitting chief complaint and shall perform the following duties:

Designing and conducting comprehensive examinations, diagnosis and implementation of treatment plans, admission orders, discharge summaries as well as ordering special labs, and radiographic studies.

Provide medical education /counseling of patients and their families.

Verify, establish and assure that identified pre-operative surgical requirements are met, assure appropriate arrangements have been established for admission, and coordinate inpatient activities on the floor.

Primary responsibility for admissions and medical care of patients.

Assist the surgeon in the operating room, including prepping and draping, and first or second assist in surgery.

Perform bedside procedures including, placement of arterial lines, swan-ganz catheters and central lines, bronchoscopy, changing of tracheostomy tubes, wound care and debridement, thoracentesis, removal of chest tubes, temporary pacing wires, intra-aortic balloon pump, central lines, arterial lines, and drains.

Demonstrate the ability to diagnose and treat cardiothoracic surgery patients seen in consultation with other health care providers.

Promote patient care programs for the cardiothoracic surgery patient and periodically update them based upon current and new concepts, research, as well as findings of the attending physician.

Integrates the activities of the cardiothoracic surgery service with other patient care programs at the facility.

Manage a task force for Quality Assurance within the cardiothoracic section.

Role of coordinating holistic care in the inpatient and outpatient realms requiring significant skills involving independent identification of problems, issues, conflicts or barriers to uneventful patient care.

Conduct problem solving to formulate a patient care plan to avoid these issues preoperatively while coordinating with social work.

Establishes and maintains relationships with social work, rehabilitation, medical, and dietary services throughout the facility to result in improved efficient patient care.

Clinical Practice - Surgical Intensive Care

Considers factors related to safety, effectiveness and cost in planning and delivering care.

Obtains history, physical examination, and assessment of ongoing patient needs through effective use of the nursing process to make practice decisions in an ethical manner.

Orders and interprets routine laboratory tests, diagnostic studies, and radiographic tests.

Performs diagnostic and stabilization procedures as necessary based on ACLS.

Collaborates with respiratory therapy and nursing for airway management and ventilator weaning.

Writes orders for laboratory work, medications, and treatments in compliance with hospital policies.

Communicates with Surgical Service physicians' patient problems and status updates.

Participates in and prepares discharge planning needs for SICU patients through communication with team members, patients, families, and consultants.

Documents relevant laboratory data, study results, patient care, pertinent procedures, and patient updates within notes.

Demonstrates competence with placement and removal of enteral feeding tubes, central venous catheters, arterial lines, swan ganz catheters, sutures, drains/tubes.

Assists with and performs invasive procedures including, central lines, arterial lines, bronchoscopy, PEG tube placement, and percutaneous tracheostomy.

Collaborates with physicians, nurses, and other members of the health care team using effective communication and interpersonal skills to develop, promote, and maintain interdisciplinary teamwork.

Identifies 'at risk' individuals in need of referrals.

Maintains accurate, timely medical records.

Participates in performance measures through documentation and data collection/reporting.

Assists in investigation and documentation of patient issues and concerns.

Identifies individual differences as related to the physiological, cultural, and psychological aspects of maturational development.

Bases ones practice on research and participates in clinical research projects.

Demonstrates ability to multi-task and prioritize patient care needs.

VA offers a comprehensive total rewards package .

Work Schedule: Monday - Friday 8:00AM - 4:30PM with some on call and weekends

Travel: Required. You may be expected to travel Up to 15% for this position.

Telework : Not Available

Virtual : This is not a virtual position.

Relocation/Recruitment Incentives : Authorized QUALIFICATIONS: Applicants pending the completion of educational or certification/licensure requirements may be referred and tentatively selected but may not be hired until all requirements are met.

Physician Assistant Basic Requirements

English Language Proficiency. Candidates must be proficient in spoken and written English to be appointed as authorized by 38 U.S.C. § 7403(f).

Education : Master's degree in any discipline or a bachelor's degree in any discipline with one year of experience as a Physician Assistant.

Certification: Successfully passed the PA National Certifying Exam (PANCE) (or are you in the process to taking the exam) ~AND~

Licensure: PAs must possess an active, current, full, and unrestricted license to practice in a State, Territory, or Commonwealth of the United States, or in the District of Columbia. PAs must maintain current registration in the State of licensure if this is a requirement for continuing active and current licensure in that State.

NOTE: Individuals who have or have had multiple licenses and had any such license revoked for professional misconduct, professional incompetence or substandard care, or who surrendered such license after receiving written notice of potential termination of such license by the State for professional misconduct, professional incompetence, or substandard care, are not eligible for appointment to the position unless such revoked or surrendered license is fully restored (38 U.S.C. § 7402(f)). This requirement does not apply to licensed PAs currently employed by VA as of November 30, 1999, provided they maintain continuous appointment and are not disqualified for employment by any subsequent revocations or voluntary surrenders of State license, registration or certification.

GRANDFATHERING PROVISION. All persons employed in VHA in this occupational series that are also performing the duties as described in the qualification standard on the effective date of this qualification standard are considered to have met all qualification requirements for the grade held including positive education and licensure/certification.

Grade Determinations : Physician Assistant-I (PA-I)

Experience and Education. None beyond the basic requirements. This is the entry level for PAs.

Demonstrated Knowledge, Skills, and Abilities. The following list of knowledge, skills, and abilities (KSA) present the minimum skill set expected of an Entry Level PA. This practice may include, but is not limited to:

Ability to utilize the principles of PA practice in the care of assigned patients to provide appropriate care.

Ability to perform patient history and physical.

Ability to formulate a plan and provide treatment to the patient.

Ability to provide patient care that is abreast of changing concepts and advancements in the profession.

Physician Assistant-II (PA-II)

Experience and Education. The PA at this grade is at the intermediate grade level and has had progressively increasing responsibility and experiences as indicated in the KSAs listed below. Individuals will have demonstrated the ability to analyze and solve more complex medical problems than at the entry level grade and can utilize their training in the successful practice of patient care and participate in team problem solving. Individuals demonstrate the KSAs of PA-II intermediate level by:

Two years of successful practice as a PA. OR

Successful completion of a PA post-graduate residency program sponsored by VHA Office of Academic Affiliations or other postgraduate residency programs accredited by VA, ARC-PA, U.S. Armed Forces, or another accrediting agency. OR

A doctoral degree in a health-related field from an accredited college or university recognized by the U.S. Department of Education.

Demonstrated Knowledge, Skills, and Abilities (KSAs). PAs at this level are not required to meet each individual KSA listed below to qualify, but should be able to demonstrate, develop, or acquire those not met upon appointment for PA-II:

Skills to analyze and solve complex medical problems.

Ability to function autonomously and make independent medical decisions.

Skill to incorporate training and experience into the successful practice of patient care including telehealth medical care.

Ability to work effectively in an interdisciplinary environment for improvement of services for patient care.

Ability to practice with colleagues and peers collaboratively.

Physician Assistant-III (PA-III)

Experience and Education. PAs at the PA-III grade are at the full performance level and lead and organize patient care independently, practice within multi-disciplinary teams, and coordinate all aspects of patient care across the health care system. They utilize advanced clinical knowledge and judgment in decision-making and evaluating outcomes. They function as experts in clinical practice and/or in areas related to the assigned roles and responsibilities, may serve as mentors for transitioning PAs, and may provide training for health care students. Individuals can demonstrate the KSAs for the full performance level by:

Three years of successful practice as a PA. OR

Successful completion of a PA post-graduate residency program sponsored by VHA Office of Academic Affiliations or other postgraduate residency programs accredited by VA, ARC-PA, U.S. Armed Forces, or another accrediting agency and one year of professional practice as a PA. OR

A doctoral degree in a health-related field from an accredited college or university recognized by the U.S. Department of Education and one year of professional practice as a PA.

Demonstrated Knowledge, Skills, and Abilities . PAs at this level are not required to meet each individual KSA listed below to qualify, but should be able to demonstrate, develop, or acquire those not met upon appointment for PA-III:

Ability to clinically evaluate facility patient care delivery systems and validate or identify barriers to safe and effective patient care.

Skill to consistently demonstrate an elevated level of expertise and autonomy in diagnosing and treating seriously ill, multi-symptomatic patients through facility Focused Professional Practice Evaluation (FPPE) and Ongoing Professional Practice Evaluation (OPPE).

Ability to present clinical findings and recommendations to appropriate management officials.

Ability to clinically facilitate the delivery of patient care in collaboration with health professionals, health managers, and other health care personnel.

Ability to implement and initiate clinical changes to established treatment protocols based upon new medical literature research findings to enhance patient delivery care for improved patient outcomes.

Ability to participate clinically in the development of the PA patient care audit processes involving in-depth review and analysis of medical records.

Reference: For more information on this qualification standard, please visit https://www.va.gov/ohrm/QualificationStandards/ .

Physical Requirements: This clinical position includes a level of physicality normally associated with direct patient care duties performed by nurses for potentially long periods of time. This may include walking, standing, stooping, bending, sitting, reaching, pushing, and pulling. It may include moderate lifting/carrying, not greater than 35 pounds following Safe Patient Handling and Mobility (SPHM) guidelines. Employees are expected to employ proper body mechanics during lifting and seek assistance or use mechanical lifts for weights greater than 35 pounds following Safe Patient Handling Guidelines. Requires adequate vision to accurately perform the assigned duties, distinguish basic colors and assess patients and the environment safely. The position requires the ability to hear at a level to perform the assigned duties, and the use of hearing aids is permitted. SALARY: QuantitativeValue EMPLOYMENT TYPE: Other