Psychiatric Advanced Practice Clinician

Sheridan Memorial Hospital•Sheridan, WY

About The Position

The Psychiatric Advanced Practice Clinician (APC), either a Nurse Practitioner (NP) or Physician Assistant (PA), provides psychiatric and medical care to patients experiencing behavioral health crises at The Path Behavioral Health Center. The role spans the Crisis Stabilization Unit (CSU), time-limited outpatient discharge follow-up, and adult inpatient psychiatric care. The APC assesses and manages acute psychiatric conditions, substance intoxication and withdrawal, and common co-occurring medical conditions, collaborating with psychiatrists, therapists, nursing staff, and other healthcare professionals. The primary role is as the CSU’s on-unit provider. The CSU is a 24-hour observation unit for adults and adolescents aged 13 and older that uses the Emergency Psychiatric Assessment, Treatment and Healing (EmPATH) model. The APC leads daily clinical work with the care team, including assessment, medication support, brief supportive interventions, safety planning, and disposition planning. The aim is to stabilize patients in the least restrictive safe setting and support return to home and community when appropriate. For appropriate discharge plans, the APC provides time-limited follow-up in the outpatient Behavioral Health clinic until ongoing outpatient care is established. When the adult inpatient psychiatric unit opens, the APC supports psychiatrists with rounds, medical management, documentation, and discharge planning. Psychiatrists lead admission, discharge, and initial diagnostic assessments; the APC does not independently admit or discharge patients. The APC practices within organizational and professional standards, supports patient safety and quality improvement, maintains complete documentation, and contributes to multidisciplinary care and the professional culture of The Path. The position requires effective communication, sound decision-making in a fast-paced crisis setting, and a constructive, collaborative team approach.

Requirements

Completion of an accredited Nurse Practitioner or Physician Assistant program.
Current Wyoming APRN or PA licensure, or eligibility for Wyoming licensure upon hire.
For NPs: master’s or doctoral degree and national certification.
For PAs: current NCCPA certification.
Current DEA registration, Wyoming controlled substance registration, and BLS certification.
At least one year of psychiatric advanced practice experience or three years of advanced practice clinical experience.
Eligibility for medical staff privileges and Medicare/Medicaid enrollment.
Ability to communicate effectively in English, verbally and in writing.
Basic computer knowledge and organizational skills.
Working knowledge of psychopharmacology, suicide and violence risk assessment, management of substance intoxication and withdrawal, and Wyoming Title 25 emergency detention and involuntary hospitalization processes, or willingness to learn.
Ability to apply trauma-informed, recovery-oriented, and least-restrictive principles; make sound, timely decisions in a fast-paced crisis setting; and lead a multidisciplinary team.
Ability to be flexible, organized, and function effectively under stressful conditions.
Pre-employment drug and alcohol screening is required.

Nice To Haves

PMHNP certification; NPs without it must obtain it within four years of hire.
Psychiatric, emergency, crisis, or behavioral health experience.
Psychiatric or behavioral health training or experience for PAs.
ACLS certification.
Additional language skills.

Responsibilities

Serve as the primary on-unit provider for the Crisis Stabilization Unit and lead daily clinical work with the psychiatrist, therapists, and nursing staff using the EmPATH care delivery model.
Complete timely psychiatric evaluations and medical assessments, including suicide and violence risk assessments, substance use and withdrawal screening, and assessment of medical stability for CSU care.
Perform medical screening examinations as a qualified medical person designated under the hospital’s Medical Staff Bylaws.
Initiate and adjust medications to relieve acute symptoms, favoring collaborative, voluntary, and oral treatment; respond to agitation with de-escalation and the least restrictive safe intervention.
Provide brief trauma-informed supportive interventions, crisis counseling, motivational interviewing, and patient and family education; partner with therapists in therapeutic care.
Complete a collaborative written safety or relapse prevention plan before discharge, including counseling on access to lethal means and involving supports as the patient permits.
Reassess patients during their stay and determine the safest, least restrictive disposition within the observation period, including discharge with follow-up, voluntary admission, or transfer.
When necessary, initiate emergency detention or involuntary hospitalization under Wyoming Title 25 and serve as an examiner by completing examinations, documenting facts, and reporting findings as required.
Provide developmentally appropriate care to adolescent patients, involving parents or legal guardians as required by law and hospital policy.
Consult the psychiatrist on high-risk, diagnostically complex, or medically complicated patients and make appropriate referrals.
Coordinate handoffs with the Emergency Department, inpatient units, receiving facilities, outpatient providers, and primary care; participate in CSU huddles, monitor patient flow, and escalate barriers to safe disposition.
Provide time-limited, in-person outpatient follow-up after CSU discharge; review safety plans, symptoms, medication adherence, and side effects, and adjust bridging medications as indicated.
Coordinate linkage to ongoing behavioral health, primary care, and community resources and communicate the care plan to receiving providers.
When the inpatient unit opens, support psychiatrists with adult inpatient rounds, admission history and physical examinations, daily medical management, progress documentation, discharge planning, and interdisciplinary treatment team meetings, as directed.
Perform detailed assessments and order routine laboratory, radiological, and other diagnostic tests; diagnose and treat health problems, assess pain, and formulate and revise individualized plans of care.
Screen for suicide risk using a validated tool, document risk and mitigation plans, and reassess risk at transitions of care.
Ensure restraint and seclusion are used only as a last resort and are ordered, applied, and monitored safely according to policy and applicable standards.
Review the Wyoming Prescription Drug Monitoring Program as required by law and prescribe controlled substances electronically.
Maintain documentation consistent with applicable standards, policies, regulatory and accreditation requirements, and billing needs.
Report near misses, adverse events, complaints, and other situations affecting safe patient-centered care in a timely manner.
Communicate with healthcare team members, consult other departments, participate in multidisciplinary rounds, and contribute to performance measures, performance improvement, and continuous quality improvement activities.
Provide administrative support for The Path as needed and assist with programs that improve coding and reimbursement for office-specific procedures.
Treat patients and families with respect and dignity; identify and address psychosocial, cultural, ethnic, and religious or spiritual needs; and serve as a liaison among patients, families, providers, and administration.
Adhere to organizational policies, professional practice standards, service standards, and required focused and ongoing professional practice evaluations.
Participate in continuing education and departmental meetings, maintain current knowledge of clinical and evidence-based practice guidelines, and keep up to date with organizational policies.