APP - Neurocritical Care (Full Time, Day shift) (Healthcare)

Job Summary

Primary responsibility in association with the Attending Physician/Surgeons(s), for the inpatient management of critically ill neurosurgical or neurologic pediatric patients in the intensive care setting. Participates in critically ill pediatric patients clinical care demonstrating high levels of critical thinking skills as a member of an interdisciplinary team. Participates in the development of guidelines for Advanced Practice Providers and serves as a resource for staff members, patients, and family. Responsibilities include completing history and physical examinations; ordering and interpreting radiological and laboratory test results; prescribing medications; documenting patient care services within EMR and departmental records; and performing procedures within scope of practice and demonstrated through competency. 

Job Specific Duties

• Conducts medical rounds (history, verification of medication, etc.), oversees and documents the plan of care in collaboration with PICU/CICU, and ensures best practices are in place. Performs focused neurological or comprehensive assessments and provide accurate documentation.  Ensures plan of care for the neurocritical care patient is of sufficient breadth and depth to guide the interdisciplinary team in achieving the desired health outcomes.
• Ensures proper communication between physicians and families. Serves as a patient advocate and educator and provides family with support and community resources.  Promotes teamwork and serves a role model, consultant, delegator, educator, and resource for all members of the health care team by providing education and emotional support.
• Provides patient information and effectively completes the hand off process to physicians using SBAR at shift change and patient reassignments 100% of the time. Models professional verbal and written communication with the interdisciplinary team members involved in the ongoing management of patients to maintain continuity and optimize patient outcomes. 
• Maintains a high level of critical thinking and time management skills to balance coverage of two different services simultaneously for both Neurology services and Neurosurgery services. 
• Completes clinical documentation accurately and in a timely manner of 24 hours. Documents patient follow up per guidelines. Generates, collects, and integrates data from a wide variety of sources in order to make clinical judgments and critical decisions about the initiation of orders, procedures, referrals, and treatments. 
• Writes orders, monitors & alters drug therapies, and orders, interprets, and evaluates diagnostic tests with education and experience within established protocol in collaborative relationship with a Physician(s).
• Reviews all patient records prior to admission (labs, consents, advance directives, custody documentation, etc.) in a timely and accurate manner. 
• Provides mentoring in precepting APPs, Medical Students, and Residents; actively provides feedback and detailed description of areas. Contributes to the development of peers, colleagues, and others to improve patient outcomes and to promote growth of the nursing profession by facilitating collaboration and communication. 
• Ensures zero-based medication errors by efficiently and accurately ordering medication following “Five Patient Rights of Medication Administration” and Medication Administration Policies. 
• Accountable to follow all Infection Control standards and ensures proper use of Personal Protective Equipment per policy and procedures to ensure safe patient care. 
• Provides education to patient and families on the continuing plan of care to include medications and side effects; updates patient and families daily on Plan of Care (POC). Evaluates and applies knowledge of cultural, socioeconomic, and age-appropriate factors in assessments, treatment, and patients/family education.
• Accountable for measuring key metrics in program. Influences quality of patient care through research. Evaluates data, updates database, and patient outcomes from research initiatives. Performs and maintains competency in designated diagnostic and clinical neurosurgical procedures as defined in and agreed upon in APP protocol. 
• Participates in gathering data for research and development, education, and implementation of system changes. Identifies opportunities for improvement in patient gathering and evaluating quality data to implement QI projects and protocols. Collaborates with ICU Nursing Leadership team to conduct an in-service for RNs on particular area of expertise and promotes awareness of best practices. 
• Monitors and evaluates the appropriateness of care in the critically ill neurosurgical and neurological patients through collaboration within the multi-disciplinary team by participating in daily ICU rounds. Communicates effectively within a multidisciplinary team to modify a neurological plan of care to attain expected outcomes. 

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Minimum Job Requirements

• Master's degree in nursing or Doctor of Nursing Practice (DNP)
• APRN State of Florida Licensure - maintain active and in good standing throughout employment
• Pediatric Acute Care Nurse Practitioner Certification by the Pediatric Nursing Certification Board (PNCB)-maintain active an in good standing throughout employment
• American Heart Association BLS - maintain active and in good standing throughout employment
• American Heart Association PALS - maintain active and in good standing throughout employment
• Level II Background Check - maintain active and in good standing throughout employment
• Successful completion of Credentialing by NCH Medical Administration required

Knowledge, Skills, and Abilities

• Available to work weekends and holidays with varying schedules.
• Able to interpret, adapt, and react calmly under stressful conditions.
• Able to recognize subtle changes in the patient's condition and to adapt care based on those changes.
• Strong interpersonal, communication, collaboration, and conflict resolution skills.
• Able to work independently and collaboratively with other disciplines using discretion and independent judgment.
• Able to relate cooperatively and constructively with patients, families, and co-workers.
• Able to maintain confidentiality of sensitive information.
• Ability to problem solve, to formulate a plan of care, and evaluate the patient's response to care.
• Able to communicate within a multidisciplinary team approach to modify a neurological plan of care to attain expected outcomes.