Nurse Practitioner / Physician Assistant, Liver Transplant

Stanford Medicine Children's Health•Palo Alto, CA

1d•$94 - $115•Onsite

About The Position

This position is responsible for the management of inpatient liver and intestinal transplant patients. The role involves direct patient care, evaluation, and medical management of patients on acute care and intensive care units. It ensures ongoing continuity of care for transplant patients and assists with the transition from inpatient to outpatient care. Key responsibilities include daily pre-rounding, rounding, lab review, immunosuppression management, order completion, consultations, and documentation for all inpatient liver and intestinal transplant patients. The role also involves leading multidisciplinary team rounds, handling inpatient consultations for other service lines, and serving as the primary point of contact for patients, families, and nursing staff. Admissions, transfers, and discharges for the inpatient service are also managed. The position requires holding the pager for the transplant service during daytime hours when on service, responding to communications promptly, and escalating acute care concerns. Participation in patient care conferences, pathology conferences, radiology conferences, and departmental education is expected. Collaboration with other Advanced Practice Providers (APPs) on the liver and intestinal transplant service is crucial for patient care coverage and communication with attending staff, support staff, and resident/fellow staff. Education regarding liver and intestinal transplantation will be provided to nursing staff, students, and residents. The role also includes seeing patients in outpatient transplant clinics, both independently and in shared visits with Hepatology and Surgery attendings, and managing documentation and care for these patients. This position offers the flexibility to work in both inpatient and outpatient settings and requires weekend and holiday coverage. The APPs are integral to a collaborative team, respected by attending physicians, and actively participate in the education of fellows and residents. Responsibilities include receiving sign-out from the overnight team, pre-rounding on assigned patients, developing daily plans of care, presenting patients on rounds, writing daily notes, implementing agreed-upon plans, and addressing nursing concerns throughout the day. The APP is credentialed to perform procedures such as intubation, central line placement, arterial line placement, chest tube insertion, PD drain placement, chest tube removal, and pacing wire removal.

Requirements

Physician Assistant (PA): Bachelor’s degree or above from an accredited college or university.
Physician Assistant (PA): Graduate of a PA program accredited by the Accreditation Review Commission on Education for the Physician Assistant, Inc.
Nurse Practitioner (NP): Master’s or doctoral degree in nursing from an accredited college or university.
Nurse Practitioner (NP): Graduate of an NP program accredited by the National League of Nursing Accrediting Commission (NLNAC) or the Commission on Collegiate Nursing Education (CCNE).
Physician Assistant (PA): Licensure as a Physician Assistant (PA) in the State of California.
Physician Assistant (PA): Certification as a Physician Assistant (PA) by the National Commission on Certification of Physician Assistants (NCCPA)
Physician Assistant (PA): Certification in Basic Life Support (BLS) from the American Heart Association (AHA)
Physician Assistant (PA): 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
Nurse Practitioner (NP): Licensure as a Registered Nurse (RN) in the State of California
Nurse Practitioner (NP): Certification as a Nurse Practitioner (NP) in the State of California
Nurse Practitioner (NP): National Board Certification as a Nurse Practitioner (NP) from an agency accredited by the American Board of Nursing Specialties (ABNS).
New graduate NPs will be allotted six (6) months from their graduation date to obtain national board certification.
Nurse Practitioner (NP): Certification in Basic Life Support (BLS) from the American Heart Association (AHA).
Nurse Practitioner (NP): Furnishing license issued by the Board of Registered Nursing (BRN), required only if furnishing medications
Nurse Practitioner (NP): 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.
Must perform all duties and responsibilities in accordance with the hospital's policies and procedures, including its Service Standards and its Code of Conduct.
An NP/PA may provide only those medical services which he/she is competent to perform, which are consistent with the NP/PA's education, training and experience, and which are performed in collaboration with a physician.
An NP/PA shall consult with a physician regarding any task, procedure or diagnostic problem which the NP/PA determines exceeds his/her level of competence or shall refer such cases to a collaborating physician.

Nice To Haves

Additional board certification(s) may be required by certain services/departments (for PA).
Additional board certification(s) may be required by certain specialties/departments (for NP).

Responsibilities

Management of inpatient liver and intestinal transplant patients.
Provides direct patient care, evaluation, and medical management of patients on acute care and intensive care units.
Ensures ongoing continuity of care for transplant patients and assists with transition of care from inpatient to outpatient provider teams.
Responsible for daily pre rounding, rounding, lab review, immunosuppression management, completing orders, consultations, and documentation for all inpatient liver and intestinal transplant patients.
Leads the multidisciplinary team on rounds.
Responsible for inpatient consultations for transplant on other service lines.
Primary point of contact for patients and families admitted to the hospital under the transplant service.
Primary point of contact for nursing staff.
Responsible for admissions, transfers, and discharging patients from the inpatient liver and intestinal transplant service.
Responsible for holding the pager for the transplant service during daytime hours when on service.
Responsible for responding to communications in a respectful and timely manner and escalating acute care concerns for patients.
Participates in patient care conferences, pathology conferences, radiology conferences, and departmental education.
Works collaboratively with other APPs on the liver and intestinal transplant service to provide patient care coverage.
Actively communicates with other APPs on the liver and intestinal transplant service, attending staff, support staff and resident/fellow staff.
Provides education regarding liver and intestinal transplantation to nursing staff, students, residents.
Able to see patients in outpatient transplant clinics in independent and shared visits with Hepatology and Surgery attendings.
Responsible for documentation and care management for outpatient transplant patients.
Receiving sign-out from overnight team.
Pre-rounding on assigned patients, developing a plan of care for the day for that patient, present patients on rounds, write a daily note.
Implementing the plan agreed upon on during rounds and responding to any issues raised by the nurses during the course of the day.
Performing procedures: intubation, central line placement, arterial line placement, chest tube insertion, PD drain placement, chest tube removal, pacing wire removal.
Evaluates and treats patients with acute, chronic complaints and health maintenance concerns related to specialty, according to written standardized procedures.
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 as indicated upon evaluation of the patient.
Administers, orders, furnishes and 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, according to written standardized procedures where applicable.
Obtains informed consent, as indicated.
Initiates arrangements for hospital admissions and discharges and completes appropriate paperwork.
As directed by the supervising physician, enrolls patients in investigational studies approved by the Investigational Review Board (IRB), and orders the necessary tests and medications.
After appropriate training, assists the supervising physician in the operating room.
Recognizes and considers age-specific needs of patients.
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 as needed.
Facilitates collaboration between providers and coordination of community resources.
Ensures compliance with legal, regulatory and clinical policies and procedures.
Participates in quality improvement initiatives.
Provides and coordinates patient teaching and counseling.