Advanced Practice Registered Nurse - Ophthalmology, Neurology (BPEI- Miami, FL)

University of Miami•Miami, FL

1d•Onsite

About The Position

The University of Miami Uhealth Department of Ambulatory Nursing at Bascom Palmer in Miami has an exciting opportunity for an Advanced Practice Registered Nurse (APRN). The incumbent delivers medical care to a wide variety of patients. The APRN is also examines and treats patients independently and in autonomous collaboration with other health care professionals. Ensures proper illness and injury care and disease prevention, diagnosis, treatment, and recovery. May prescribe medications and order diagnostic tests. Advises patients about continuing care. CORE JOB FUNCTIONS Performs and documents complete physical examinations and comprehensive health histories. Functions independently to perform age-appropriate history and physical for patients. Orders and interprets diagnostic and therapeutic tests relative to patient’s age-specific needs. Prescribes appropriate pharmacologic and non-pharmacologic treatment modalities Implements interventions to support the patient to regain or maintain physiologic stability. Assists with the provision of care in accordance with facility, state, and federal regulations. Monitors the effectiveness of interventions. Facilitates the patient’s transition within and between health care settings, e.g. admitting, transferring, and discharging patients. Collaborates with multidisciplinary team members by making appropriate referrals. Facilitates staff, patient and family decision making by providing educational tools. Adheres to University and unit-level policies and procedures and safeguards University assets. This list of duties and responsibilities is not intended to be all-inclusive and may be expanded to include other duties or responsibilities as necessary. Department Specific Functions OVERVIEW: The BPEI Consult Service provides initial evaluation and high-standard eye care outside ABLEC to patients admitted at JMH, Holtz Pediatric Hospital, Ryder Trauma Center, and UHealth facilities: UHealth Tower, Sylvester Cancer Center, and others: UHM/Sylvester Consults Initiation of the consult: Consult APRN carries the page for UMH facilities, responds to page in less than 30 min and proceeds with the consult in a timely manner. Timing: Routine consults less than 12 h. UMH ER consult less than 3 h. STAT consults less than 1 h. Escalation of the consult as needed: Optometry resident/Consult APRN, Fellow OD, Director of Consult Service, Ophthalmology specialty Medical Director (Ex: Retina, Cornea, Pediatrics, Glaucoma, Neuro, etc.) Medical Director BPEI. Consult visit: Consult APRN notifies optometry resident about consultation request for preliminary evaluation. Optometry resident will be available from 8.00am to 5.00pm on weekdays. Optometry resident proceeds with preliminary evaluation using the case of instruments located at UHT pharmacy 4th floor. After preliminary evaluation optometry resident triage with Consult APRN and write a note in Epic, pending it for fellow evaluation and note signing. Consult APRN will exam patient: Adds addendum-documentation, signs attestation/encounter and update running list of UMH consult patients. The Consult APRN will escalate to appropriate service for additional evaluation if needed. Visit should be properly documented in EPIC and should include comments about discussion of the results with a patient or a next of kin, particularly in cases of poor visual prognosis. Assessment and Plan must be clearly documented, and HCP and nursing staff has to be informed about any critical decision. If discharged on the day of the consultation, have them open appointment slot at BP the same day. Inpatient psychiatry consults can be sent to BPEI ED and must have a sitter. UMH Instrument Case: Includes medications and instruments: Located at the 4th floor of UHT pharmacy. Optometric Resident and APRN will sign out case and return case to UHT Pharmacy. UHT Pharmacy will replace medication including expired medication. Non-functioning equipment will be reported by the Consult APRN for repair initiation/replacement. The case will be returned as orderly as it was received. Documentation of the visit: EPIC. Full note. Use smart phrases External photos should be included on the note Consent for any procedure to be performed including scrapping and testing. Instruction about follow up and calling back if any worsening Communication with HCP when radical procedures expected or needed Instruction upon discharge for FU. Signing Charts: Consult APRN will sign the chart in no more than 48h. APRN will assist in obtaining Informed Consent and necessary equipment for any bedside procedure including but not limited to testing, samples for microbiology or pathology, surgical procedures, transfer to BPEI for special treatment, among others. Running list of patients: Consult APRN is responsible to keep updated running list of patients in FU and recently discharged on EPIC. Active patients – patients requiring follow-up Completed patients - patients recently discharged Consult Service APRN will properly hand-off the active patients to evening/weekend Consult Fellow. Consult APRN will report monthly and as needed to the Consult Service Medical Director. JMH/Holtz/Ryder Consults Initiation of the consultation: Ophthalmology Resident carries the pager for Jackson facilities, responds to pager in less than 30 min and proceeds with the consultation in a timely manner. Timing: Routine consults less than 12 h., ER consultation less than 3 h., STAT consults less than 1 h. Escalation of the consultation as needed: Ophthalmology resident/Consult APRN, Fellow OD, Director of Consult Service, Ophthalmology specialty Medical Director (Ex: Retina, Cornea, Pediatrics, Glaucoma, Neuro, etc.) Medical Director BPEI. Consult visit: Ophthalmology resident proceeds with preliminary evaluation using the case of instruments. After preliminary evaluation Ophthalmology resident triage with Consult APRN and write a note in Cerner, pending it for fellow evaluation and note signing. Consult APRN will exam patient: Adds addendum-documentation, signs attestation/encounter and update running list of Jackson consult patients. The Consult APRN will escalate to appropriate service for additional evaluation if needed. Visit should be properly documented in Cerner and should include comments about discussion of the results with a patient or a next of kin, particularly in cases of poor visual prognosis. Assessment and Plan must be clearly documented, and HCP and nursing staff has to be informed about any critical decision. If discharged on the day of the consultation, have them open appointment slot at BP the same day. Inpatient psychiatry consults can be sent to BPEI ED and must have a sitter. Jackson Instrument Case: Includes medications and instruments: Located at BPEI Emergency Room. Non-functioning equipment will be reported by the Consult APRN for repair initiation/replacement. Documentation of the visit: EPIC. Full note. Use smart phrases External photos should be included on the note Consent for any procedure to be performed including scrapping and testing. Instruction about follow up and calling back if any worsening Communication with HCP when radical procedures are expected or needed Instruction upon discharge for FU. Signing Charts: Consult APRN will sign the chart in no more than 48h. APRN will assist in obtaining Informed Consent and necessary equipment for any bedside procedure including but not limited to testing, samples for microbiology or pathology, surgical procedures, transfer to BPEI for special treatment, among others. Running list of patients: Consult APRN is responsible to keep updated running list of patients in FU and recently discharged on EPIC. Active patients – patients requiring follow-up Completed patients - patients recently discharged Consult Service APRN will properly hand-off the active patients to evening/weekend Consult Fellow. Consult APRN will report monthly and as needed to the Consult Service Medical Director. Transfer for special procedures at BPEI: APRN will facilitate transfer for special procedures at BPEI following Patient Transfer policy. ABLEH/BPEI Internal Transfer scheduling process To request a consult appointment, please email Physician Logistics at [email protected] and provide the following information: Patient Name and MRN Required imaging/procedures Provider Name Preferred appointment location, date, and time Patient mobility: walking, wheelchair, stretcher, etc. Relevant patient medical needs: telemetry, negative pressure, etc. Use of Telehealth in Consults: As appropriate, there will be escalating levels of involvement. Ophthalmology consultant review of the medical record and EMR consult note written. Ophthalmology consultant to the patient attending telephone consult and EMR consult note written. The ophthalmology telemedicine consultation will be facilitated by attending using EMR, using a video call for evaluation. Ophthalmology consultant bedside exam and EMR consult note written.

Requirements

Master’s degree in relevant field
Valid State of Florida APRN License
Ability to exercise sound judgment in making critical decisions.
Skill in completing assignments accurately and with attention to detail.
Ability to analyze, organize and prioritize work under pressure while meeting deadlines.
Ability to work independently and/or in a collaborative environment.
Ability to communicate effectively in both oral and written form.

Nice To Haves

Minimum 2 years of relevant advanced practice nursing experience preferred

Responsibilities

Performs and documents complete physical examinations and comprehensive health histories.
Functions independently to perform age-appropriate history and physical for patients.
Orders and interprets diagnostic and therapeutic tests relative to patient’s age-specific needs.
Prescribes appropriate pharmacologic and non-pharmacologic treatment modalities
Implements interventions to support the patient to regain or maintain physiologic stability.
Assists with the provision of care in accordance with facility, state, and federal regulations.
Monitors the effectiveness of interventions.
Facilitates the patient’s transition within and between health care settings, e.g. admitting, transferring, and discharging patients.
Collaborates with multidisciplinary team members by making appropriate referrals.
Facilitates staff, patient and family decision making by providing educational tools.
Adheres to University and unit-level policies and procedures and safeguards University assets.
Consult APRN carries the page for UMH facilities, responds to page in less than 30 min and proceeds with the consult in a timely manner.
Consult APRN notifies optometry resident about consultation request for preliminary evaluation.
Consult APRN will exam patient: Adds addendum-documentation, signs attestation/encounter and update running list of UMH consult patients.
The Consult APRN will escalate to appropriate service for additional evaluation if needed.
Consult APRN will sign the chart in no more than 48h.
APRN will assist in obtaining Informed Consent and necessary equipment for any bedside procedure including but not limited to testing, samples for microbiology or pathology, surgical procedures, transfer to BPEI for special treatment, among others.
Consult APRN is responsible to keep updated running list of patients in FU and recently discharged on EPIC.
Consult Service APRN will properly hand-off the active patients to evening/weekend Consult Fellow.
Consult APRN will report monthly and as needed to the Consult Service Medical Director.
APRN will facilitate transfer for special procedures at BPEI following Patient Transfer policy.