Nurse Practitioner / Physician Assistant, Cardiothoracic Surgery
About The Position
The Advanced Practice Provider (APP) works as part of a collaborative cardiothoracic surgery team of attending physicians, fellows, nurse practitioners, and physician assistants. The team provides care for complex cardiac patients, including patients undergoing congenital cardiac surgery, heart transplantation, and ventricular assist device treatment. The role includes pre-operative evaluation, intra-operative assistance, and post-operative rounding and management, including care for adult congenital heart disease (ACHD) patients. The APP receives handoff from the overnight team, pre-rounds on assigned patients, develops and presents each patient’s daily care plan during rounds, documents a daily note, implements the agreed-upon plan, and responds to concerns raised by nurses during the day. Credentialed procedures include intubation, central line and arterial line placement, chest tube insertion and removal, peritoneal dialysis drain placement, and pacing wire removal. Within their education, training, experience, and scope of practice, the NP or PA evaluates and treats patients with acute and chronic complaints and health-maintenance needs related to the specialty, in collaboration with physicians. The role also includes obtaining histories and performing examinations, ordering and evaluating diagnostic studies, managing medications, coordinating care, educating patients and families, and supporting quality, safety, and regulatory requirements. The position may assist in the operating room after appropriate training and may participate in approved investigational studies as directed by the supervising physician. NPs practice under the applicable standardized process and procedures; PAs practice under the approved PA role description. Clinical supervision is provided by a supervising or sponsoring physician. The position is not remote and is scheduled for 40 hours per week on a rotating 10-hour shift. Compensation is listed as an hourly range of $93.75 to $114.84, with placement dependent on role requirements and factors including education, experience, skills, location, and internal equity.
Requirements
- For the PA pathway: bachelor’s degree or higher from an accredited college or university and graduation from a PA program accredited by the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA).
- For the NP pathway: master’s or doctoral degree in nursing from an accredited college or university and graduation from an NP program accredited by NLNAC or CCNE.
- For the PA pathway: California Physician Assistant licensure and NCCPA certification.
- For the NP pathway: California Registered Nurse licensure, California Nurse Practitioner certification, and national NP board certification from an ABNS-accredited agency. New graduate NPs have six months from graduation to obtain national board certification.
- Current Basic Life Support (BLS) certification from the American Heart Association for either pathway.
- For the NP pathway, a furnishing license from the California Board of Registered Nursing is required if furnishing medications.
- An individual DEA license for Schedule II–V controlled substances is required only if prescribing controlled substances to outpatients.
- Additional board certification may be required by certain services, specialties, or departments.
- Provide only medical services within the APP’s competence, education, training, and experience, in collaboration with a physician.
- Communicate and interact effectively with patients, families, staff, and community members from diverse backgrounds.
- No specific number of years of experience is stated.
Responsibilities
- Receive sign-out from the overnight team and pre-round on assigned patients.
- Develop a daily plan of care for assigned patients and present patients during rounds.
- Write daily patient notes, implement the plan agreed upon during rounds, and respond to concerns raised by nurses.
- Provide pre-operative evaluation, intra-operative first and second assistance, and post-operative surgical rounding and management.
- Evaluate and treat patients with acute or chronic complaints and health-maintenance needs related to the specialty.
- Obtain patient histories and perform pertinent physical examinations, assessing normal and abnormal findings.
- Perform or request and evaluate diagnostic studies as indicated.
- Administer, order, furnish, and prescribe medications within applicable scope and authorization.
- Order and collect specimens for routine laboratory tests, screening, and therapeutic procedures, including blood and blood products.
- Order physical, occupational, and respiratory therapy, radiology examinations, and nursing services.
- Perform designated procedures after demonstrating competency and in accordance with applicable standardized procedures.
- Obtain informed consent when indicated.
- Arrange hospital admissions and discharges and complete appropriate paperwork.
- Assist the supervising physician in the operating room after appropriate training.
- Enroll patients in IRB-approved investigational studies and order necessary tests and medications as directed by the supervising physician.
- Recognize age-specific patient needs and situations requiring immediate physician attention; initiate life-saving procedures when necessary.
- Coordinate inpatient and outpatient care, collaborate with providers, and coordinate community resources.
- Provide and coordinate patient teaching and counseling.
- Participate in quality improvement initiatives and comply with legal, regulatory, clinical, safety, and hospital policies and procedures.
- Consult with or refer to a physician when a task, procedure, or diagnostic problem exceeds the APP’s competence.
- Participate in ongoing performance evaluation and applicable supervision processes.
Benefits
- Eligible positions may receive up to $9,600 through the Student Loan Assistance Program, applied directly to the employee’s student loan account.
- Benefits eligible; specific benefit plans are not listed.
