The Advanced Practice Provider (APP) is a faculty member credentialed and privileged to serve as a Nurse Practitioner (NP) in a respective Specialty area; i.e., Certified Nurse Anesthetist (CRNA), Certified Nurse Midwife (CNM), Clinical Nurse Specialist (CNS), or a Physician Assistant (PA). The APP is a member of the OHSU Professional Staff practicing in accordance with the respective bylaws. The APP delivers preventive, primary and acute healthcare services to individuals of all ages; provide advanced education to students, peers and others; and, contribute to new knowledge and/or technology by conducting or participating in research. 

 

Departments have flexibility to hire either a Nurse Practitioner or Physician Assistant.  The determination of whether to engage a Nurse Practitioner or Physician Assistant is dependent on a variety of factors, including but not limited to the Department’s need, availability of qualified candidates, and the medical or surgical specialty requirements for the job.  Position specialty information follows in Section 3 below.

 

In addition to key job responsibilities, qualifications and other job requirements listed below, the APP is expected to comply with scope of practice, other laws, regulations, OHSU policy, and other applicable professional standards of practice.  

 

The APP job search may be managed as a multi-level recruitment, e.g. recruit generically for an APP with their attendant professional credentials.  This approach allows the hiring manager to consider Nurse Practitioner and Physician Assistant candidates, assuming the position can be managed by either qualified professional.  In addition to basics set forth herein, specific position requirements may vary by department and those should also be included in the job posting.

 

The Pre Operative Medicine Nurse Practitioner (NP) position reports to the Nurse Manager and the Medical Director of the Pre Op Medicine Clinic (PMC). The PMC NP functions under and is held accountable to the Professional Practice Standards for Nurse practitioners. 

Job Key Responsibilities and Performance Expectations

• Patient Care: Assure the safe, efficient, high quality and customer oriented management of patient care to identified patient populations, including but not limited to completing a comprehensive assessment of the patient’s status; developing, monitoring and revising, as appropriate, an evidence-based treatment plan that addresses diagnoses, patterns of disease, risk factors, and treatment alternatives; treat many common acute and chronic health problems; interpret diagnostic tests  prescribe and manage medications and other therapies, provide health teaching with an emphasis on prevention of  illness and health maintenance; and, refer patients to other healthcare professionals as necessary.
• The PMC NP performs preoperative risk assessment on pre surgical patients by obtaining an H and P and ordering appropriate diagnostic studies and laboratory tests. He/she will collaborate with other members of the team regarding pre-op instructions, medication management, and patient education. The NP is expected to function independently but also work in close collaboration with providers from other departments (cardiology, anesthesiology, internal medicine, etc.)  to coordinate medical optimization of the patient prior to surgery. This includes but is not limited to following up on lab tests, cardiac testing, referrals to other specialties and documenting plan of care in EMR. NPs also communicates with the surgical team (surgeons, surgery schedulers) when necessary to share concerns about   patient readiness for scheduled surgeries. Timely, focused documentation with the referring surgeon, PCP and anesthesiologist when appropriate to ensure quality patient care.  The NP will review the patient’s history, via patient’s verbal report and the review of previous medical records from internal and external sources, and perform a complete physical exam on each patient- including but not limited to auscultation of the heart and lungs. Consistent patient education about good preparation for surgery. Documentation in the EMR of the clinical assessment will be executed according to documentation standards for licensed providers at OHSU. Chart documentation will be accurate and timely. The NPs will perform peer reviews on a yearly basis. This is a requirement of the academic staff . The NP staff will perform peer chart audits according to the chart audit program in PMC. The PMC medical director will review peer chart audits and provide the NPs with feedback about documentation completeness.  Charts will be forwarded to coding professionals for billing. All encounters will be closed by the end of the work day and submitted for billing within 24 hours of patient encounter.  These nurse practitioners are billing for services rendered.
  PMC NPs are responsible for reviewing and signing off on the documentation and medication/allergy review of all medical assistant staff. The NP as assigned will be asked to cover for the Nurse Manager during vacations and/or extended illness.
• Education:  Support OHSU’s academic missions by participating in the design, development and assessment of program curricula for professional specialty area;  including course objectives, instructional methods, learning outcomes, projects and assessment measures.   Teach program courses as needed according to specified learning outcomes; academic advising and career related counseling for students; monitoring student retention and identifying and assisting at-risk students.  May serve as the faculty of record and principle contact for extern placements and student’s performance at the assigned site.
• Clinical Supervision:  Deliver individual instruction to support fellows’, residents’ and interns’ (these are all residents with their personal program of learning in the applicable specialty area.  Provide instruction and review of the practices, policies and procedures in a variety of functions; including but not limited to development of treatment plans, interpretation of clinical diagnostic data; developing orders; patient and family communication and education; management of medical equipment, electronic medical records;  performing procedures, and transitioning patients to the next level of care. Assures adherence to the specialty specific protocols, best practices, quality, and organizational indicators.  Provides input to the performance of the resident as a provider in the clinical setting.
• The PMC NP provides clinical instruction and supervision for CRNA students and residents related to the preoperative assessment and risk stratification. 
• Performance Improvement:  Keep abreast of changes in field and applies knowledge to identify and recommend enhancements to clinical quality, patient experience/satisfaction, length of stay and to achieve improvement that demonstrates a higher standard of care.  Assesses and recommends initiatives to improve performance indicators related to patient experience, quality, and costs.
• The NP will attend monthly NP PMC QI meetings. The NP will be required to select a clinical topic and present his/her topic, via a power point presentation, at these monthly meetings.  The PMC NP may be asked to participate in special projects as assigned by the medical director and or clinic manager. The focus on these projects may include but will not be limited to improving quality of patient care, clinic work flow and/ or customer service.  OHSU Clinic support is provided (conference days/financial support-see PMC NP Continuing Education policy) to enhance professional development of the NP staff. NPs are encouraged to participate in continuing education opportunities such as classes and conferences at least once a year. 
• Research:  Fosters advances in healthcare by participating in research activities in specialty area; including but not limited to identifying protocols to improve care delivery; contributing to development of new drugs to effectively treat disease; performing clinical trials using human or animal subjects to determine the effectiveness and effects of pharmaceuticals.  Demonstrate success or productivity in the field as evidenced by securing research funding, publication in journals and/or other forms of peer presentations.

• Master’s degree or Doctorate from an accredited graduate school of nursing. Current unencumbered Oregon Nurse Practitioner license with Prescriptive Privileges  and DEA license
• Ability to fulfill responsibilities for the specific role of an Advanced Practice Provider.
• Recent graduates of a NP program will be considered IF the following requirements are met: a minimum of 5 years RN experience in one of the following areas: ER, ICU, Peri OP (Pre Op and/or  PACU) or internal medicine (inpatient or ambulatory) 
• Demonstrated ability to satisfy standards of performance delineated by law and associated professional practice standards, the latter set forth as an addendum to the position description.
• Ability to manage heavy workload with multiple priorities and inflexible deadlines.
• Ability to communicate effectively verbally and in writing.
• Proficient in the use of computing hardware and software, including personal computing equipment, electronic medical record, word processing and spreadsheet software.
• Regular and consistent attendance at work
• Strong cardiology knowledge base
• Ability to be an accountable, communicative  member of a team made up of a MDs, other NPS,  RNs and MAs
• Demonstrated strong service excellence skills

• 3 – 5 years clinical experience as an Advanced Practice Provider.
• Previous experience with Epic and/or Centricity
• Computer/word processing skills.

• Hours vary.
• Frequent interruptions in an evironment of frequent change and fluctuations.
• May be exposed to excessive auditory and visual stimulation.
• May be required to attend out of town conferences according to hospital travel and reimbursement policicies.
• May be exposed to body fluids, tissue, possible radiation exposure, and infectious processes.
• Subject to computer work for several hours, as needed.
• Able to use all appropriate patient care equipment and office equipment within work area.

Oregon Health & Science University values a diverse and culturally competent workforce. We are proud of our commitment to being an equal opportunity, affirmative action organization that does not discriminate against applicants on the basis of any protected class status, including disability status and protected veteran status. Individuals with diverse backgrounds and those who promote diversity and a culture of inclusion are encouraged to apply. To request reasonable accommodation contact the Affirmative Action and Equal Opportunity Department at 503-494-5148 or aaeo@ohsu.edu.