Nurse Practitioner

Nature of Duties :

With the collaboration and guidance of the physicians, the certified registered nurse practitioner (CRNP) assists in assessing, planning, diagnosing, implementing, coordinating, and evaluating care provided to patients within the legal realm as established by the Louisiana State Board of Nursing.

The practice of the certified registered nurse practitioner is collectively guided by : (1) the Nurse Practice Act (R. S.

27 : 911-913) of the Louisiana State Board of Nursing (LSBN), (2) a collaborative practice agreement, (3) (ANA), and (4) (ANA).

Qualifications :

1. Graduate of accredited schools of nursing, AND

2. Current licensure by the Louisiana State Board of Nursing as a Registered Nurse, AND

3. Satisfactory completion of a formal education program preparing graduates to practice advanced practice nursing, AND

4. A minimum of a Masters Degree with concentration in the respective nursing specialty area, AND

5. Current licensure by the Louisiana State Board of Nursing as an Advanced Practice Nurse, AND

6. Current certification by a nationally recognized certifying agency for Advanced Practice Registered Nurses, AND

7. Basic Life Support (BLS) certification and Advanced Cardiovascular Life Support (ACLS) certification are both required.

8. Successful completion of assigned EKG Courses within 12 months

9. Effective communications skills.

Suggested :

1. Advanced credentials and / or certification in any field of medicine or nursing.

Specific Duties :

The certified registered nurse practitioner provides healthcare to patients in accordance with his / her knowledge base, experience, competence, and within the scope of practice defined by the Louisiana State Board of Nursing.

Direct Patient Care Items :

1. Provides patient care within the framework of the standards of practice and standards of care guidelines outlined in the collaborative practice agreement and practice protocols.

2. Perform comprehensive health histories & physicals, discharge summaries, documents daily progress notes, transfer summaries, procedural notes, physical, mental, developmental, and functional status determination.

3. Order and / or performs, and interprets pertinent diagnostic studies.

4. Analyses patient data to determine health status and formulates diagnosis.

5. Order appropriate pharmacological and non-pharmacological therapeutics within scope of practice.

6. Evaluates effectiveness of care continually and modifies plans of care based on evaluation and patient responses.

7. Identify teaching needs of patients and provide them with information or appropriate resources.

8. Make rounds daily on assigned patients independently :

• a) Before the attending physician - to compile objective date;
• b) With the physician - to actively convey suggestions and participate in the health care team;

c) After the physician - to assess newly derived data or changes in the patient's clinical condition.

9. Assist team members in giving care to patients or administer direct care when necessary.

10. Assist physicians with special tests and procedures as needed.

11. Initiate orders for medications as per collaborative practice agreement, protocols, and legal limits of prescriptive authority.

12. Review and interpret chest x-rays when necessary.

13. Act independently within the legal realm of the advanced nurse practitioner to assure safe, quality, and therapeutic care.

14. Assist with or institute emergency measures for sudden adverse developments in patient's condition.

15. Evaluate patients and make appropriate changes in medical regiment on a daily basis in the Infusion Center on patients assigned with the diagnosis of advanced heart failure.

16. Perform invasive and non-invasive procedures as allowed by the Louisiana State Board of Nursing, Scope of Practice of the Advanced Practice Registered Nurse, and agency staff privileges.

17. Accept call status, when required, with a collaborative physician both in the outpatient and inpatient settings.

18. Evaluate and implement care in the emergency department with appropriate collaboration with physician(s).

19. Manage selected patients in the outpatient clinic setting when required (i.e. coumadin clinic, heart failure clinic, pacer clinic, lipid clinic, etc.).

Documentation / Records / Billing :

1. Document subjective, objective, assessed clinical findings, as well as planned therapies in the medical progress notes so that all members of the health care team may treat holistically.

Document pertinent information for the physician concerning the projected plan of care for the patient in the medical record using the subjective, objective, assessment, plan format (S.O.A.P.).

2. Complete all necessary and required documentation for each patient encounter.

3. Complete medical records generated in a timely and accurate manner.

4. Provide / Submit pertinent information to clerical personnel concerning billing for services rendered by the physician and nurse practitioner.

Communication & Coordination of Patient Care :

1. Monitor results of therapeutic tests and procedures in accordance with patient's clinical diagnosis, report findings to physicians, and institute appropriate nursing instructions.

2. Communicate with other physicians as needed to either obtain or offer information to improve interdisciplinary communication and make appropriate referrals and consultations with sub-specialists as needed.

3. Collaborates with health care professionals in a multidisciplinary approach to meet client health care needs.

4. Respect the patient by conveying his wishes concerning medical therapies, advance directives, and the use of extraordinary care by completing orders / forms necessary for life sustaining / limiting procedures.

5. Utilize the nursing process to assess the patient's physical, psychological, emotional, rehabilitative and social needs and convey those needs to appropriate health team members.

6. Act as a liaison between the patient, family physician, nursing staff, ancillary personnel, social services, administrative and clerical personnel to assure optimum patient care.

7. Participate as a member of a holistic health care team to achieve a goal of maximum wellness.

8. Interpret, implement, and assist others in implementing physicians or nurse practitioners orders accurately. Clarify and consult with the physician regularly and as needed.

9. Explain procedures and treatments to patients and families to obtain legal informed consent.

10. Demonstrate effective leadership skills by attending appointed committees or interdisciplinary teams, tasks forces, or special projects meetings.

11. Triage telephone calls received via the internet for information.

12. Function in a general leadership position in the clinic setting over all office ancillary staff.

13 Perform patient and family teaching in all settings when required.

Professional Duties :

1. Maintain knowledge base and competence in clinical practice through participation in continuing education.

2. Utilizes the research process, participates in all levels of research, evaluates relevant research for merit, and incorporates findings into clinical practice.

3. Participate in institutional review board approved research and clinical trials as necessary including appropriate documentation and record keeping.

4. Participates in quality assurance and performance improvement activities.

5. Participate in professional development and ongoing continuing education of students and colleagues.

6. Participate in orientation of new team members and foster a learning environment when mentoring and precepting.

7. Maintain current proficiency in cardiopulmonary resuscitation and advanced cardiac life support.

8. Perform community and lay public presentations representing CIS for the purposes of primary prevention and community education.

General Guidelines :

1. Provides care based upon current standards of practice and clinical guidelines / protocols.0

2. Utilizes principles of ethical decision-making, patient advocacy, and risk / benefit factors assessments in determining the best plan of care.

3. Act as a patient advocate.

4. Prescribe, distribute, administer, and evaluate medications and treatments with proper technique and with professional knowledge.

5. Accept responsibility for actions performed.

6. Provides patient care within the framework of the standards of practice and standards of care found in the collaborative practice agreement and protocol for practice.

7. Consult with the collaborating physician whenever a patient's diagnosis, treatment, or response to treatment so indicates and for each of the following :

a) a new diagnosis is made,

b) new medication is initiated and required by regulations of limited prescriptive authority for advanced registered nurse practitioners,

c) a significant change in the patients condition,

d) upon request of the patient or family,

e) the appropriate or indicated intervention exceeds the scope of practice of the advanced nurse practitioner,

f) patient's condition fails to respond as expected to initial treatment modalities, OR

g) A state-reportable or other incident occurs.

8. Suggest, coordinate, and implement new programs for patient care.

Other Duties & Responsibilities :

1. Complete and revise call schedules in a timely manner and when necessary.

2. Participate in the Wellness Council planning and implementing of activities.

3. Attend committee meetings when required.

4. Supervise employees as assigned.

5. Performs other related duties as assigned and serves in whatever other capacity deemed necessary for successful completion of the mission and goals of CIS and in concordance with its patient philosophy.

Standards of Performance :

1. Keeps work area neat and organized. Reports safety issues to team leader immediately.

2. Works efficiently and manages time wisely. Assist other employees when all duties are complete.

3. Communicates any problems, difficulties or concerns regarding job duties to the team leader.

4. Performs all duties without significant error occurring with any regularity.

5. Meets all deadlines and timeframes for completion of assignments.

6. Represents CIS in a professional manner at all times. Demonstrates acceptable ability to interact with physicians, staff ("internal customers") and "external customers" (patients, family members, insurance companies, home health etc.

on a professional level at all times. Exhibits good communication skills with physicians, patients, team leaders, and co-workers at all times.

7. Exhibits whenever possible a harmonious relationship with other CIS employees in order to accomplish the duties and responsibilities of the position.

While perfect harmonious relationships with all employees is sometimes not achievable, not more than an occasional complaint should be received by the team leader about the incumbent of this position.

8. The employee shall work and relate cooperatively with all other employees (internal customers) of CIS to assure optimum care for the patients of CIS and to achieve standards of care set forth by the CIS medical staff.

9. Adheres to the CIS Compliance Plan as it pertains to the above specific job duties. Uses best efforts to maintain compliance by following the CIS Corporate Compliance Plan, attending CIS compliance education, following medical documentation guidelines, and communicating concerns regarding compliance issues.

10. Performs accurate and complete documentation in the patient's medical record, when applicable. This includes documentation in both the paper record and the electronic medical record (EMR).

11. Work with the electronic medical record (EMR) staff to maintain quality and work towards future EMR development.

12. Maintains patient confidentiality according to the HIPAA standards of privacy and security.