NURSE PRACTITIONER

Job DetailsJob Location: Ganado, AZ 86505Position Type: Full TimeEducation Level: Graduate DegreeJob Shift: AnyJob Category: Health CarePosition Summary: This position is located at the Sage Memorial Hospital (SMH) under the Medical Staff Department. The incumbent is a licensed Advanced Practice Nurse – Nurse Practitioner who provides care in the Outpatient, Emergency, and Inpatient Departments.  The incumbent provides direct, comprehensive primary, preventive, and therapeutic medical and nursing care in outpatient and rural health clinics within primary care to patients within the full extent of their licensure with approved Clinical Privileges. Incumbent leads and participates in patient care coordination using the Patient-Centered Medical Home (PCMH). Consults freely with Outpatient Department and Emergency Department physicians and has clinical notes and prescriptions counter-signed by a physician unless prescribing privileges have been granted. Comply with the Medical Staff Bylaws and Rules and Regulations.     Essential Duties and Responsibilities: Assesses, diagnoses, plans and provides comprehensive and therapeutic medical care to individual geriatric, adult, adolescent, pediatric patients and their families, specifically: Takes a complete health and developmental history from the patient and/or family member and performs a physical examination of the patient using palpation, percussion, auscultation, and observation using appropriate diagnostic instruments.  Orders and/or performs screening and diagnostic tests and procedures (lab studies, x-rays, electrocardiograms, audiograms, pulmonary function tests, etc.). Interprets test results and analyzes all collected data, discriminates between normal and abnormal findings to identify all stages of serious physical, emotional, or mental problems, and to prioritize health care needs, i.e., formulates a problem list. Makes diagnosis and decisions concerning medical and nursing care needs of patients, formulates and implements plan of care which may involve various treatment modalities, prescribing medications, consultation with other health care providers, and referrals. Identifies and manages both minor and serious acute and chronic illnesses (e.g., upper respiratory infections, venereal disease, hypertension, eye infections, tuberculosis, heart disease, nausea, angina, back pain, trauma, etc.) in accordance with established standards of medical care and approved clinical privileges. Provides surveillance of medical regimens for stabilized chronically ill persons, recognizing when to refer the patient to a physician or other health team members. Performs minor surgical and invasive procedures, such as suture of lacerations not involving nerves or tendons, incision and drainage of abscesses, insertion and/or removal of Norplant capsules, toenail removal, and skin biopsy. Patient Volume Expectations in Outpatient – It is expected that the practitioner is able to see two (2) patients per hour during their regular shift. This equates to sixteen (16) patients per 8-hour shift and twenty (20) patients per 10-hour shift. These projections reflect an anticipated average number of patient encounters and are not intended to represent a minimum or maximum threshold. Practitioner may not conclude their shift early or refuse patients at any time unless explicitly authorized by the OPD Clinical Director. Gives direct physical and psychological emergencies in the presence of illness or disability in order to maintain life, provide comfort, reduce stress, and enhance coping ability. Identifies components of the nursing regimen that may be delegated to nursing and measures as appropriate, i.e., cardiac shock, hemorrhage or overdose/poisonings, seizures, and emergency obstetric delivery. Provides health and preventive services to healthy individuals, including guidance in nutrition, illness prevention, accident prevention, and growth and development. Prescribes medications as delineated in the approved clinical privileges and in accordance with current DEA licensure for a variety of symptoms and illnesses. Monitors effectiveness of medications, adjusting dosages as appropriate to patient response to medications. Evaluates medical aspects of the plan of care periodically, recognizing the need for assessment by a physician or other health professional.  Recommends appropriate follow-up to patients and staff, making referrals when necessary. Assists in referral and medical management of patients requiring long-term care. Documents data, patient assessment, and care plan in acceptable form in medical records. Assesses, plans, and is involved in meeting the health needs of community and group health needs, taking into consideration socio-economic, epidemiological, and cultural influences. Develops and conducts health education classes and/or specialty clinics such as immunization, well-baby, nutrition, prenatal care, parenting, women's health, men's health, adolescent health or employee health. Adapts educational material/methods to meet the audience/patient level of understanding.  Educates and counsels patient and family on disease prevention and health maintenance techniques. Promotes responsible behavior and implements plans to further enhance patient/family understanding of medical problems. Serves as a consultant and provides technical assistance to other health care providers and staff.  Develops and conducts formal education programs for hospital/clinical staff (i.e., in-service) and other health care providers within the community such as CHR, EMT, school nurse, etc.  Collaborates with other health care professionals to develop treatment protocols, standards of practice, and policies.  Participates in ongoing quality improvement activities, including audits, chart reviews, development of review criteria, development of plans, and evaluation of effectiveness of actions in improving performance.   Consults with other professionals regarding health care issues and complex medical problems.  Serves as a preceptor for nurse practitioner students with clinical rotations in the clinic and community setting. Collaborates with community leaders to foster and promote a good relationship between the health care facility and the community. Participates in problem identification, literature review, data collection, and interpretation of results for studies and research, which will influence the improvement and/or change in patient care. Reviews and critiques current research, giving recommendations to medical staff for adapting current research results to medical practice. Maintains and improves professional knowledge and skills by participating in seminars, accredited home study, in-service education and/or individualized preceptorship. Maintains current clinical competence through self-study, review of professional journals and tapes, etc. Meet and comply with standards of Navajo Health Foundation Personnel Manual.  Maintain confidentiality at all times.  Attend regular meetings of the Medical Staff Department, including morning report, etc. Perform other duties as assigned. QualificationsMinimum Qualifications: Master of Science in Nursing (MSN) Degree. Unrestricted state or compact state Board of Nursing license as a Certified Nurse Practitioner with a specialty in Family. Board Certification through American Nurses Credentialing Center (ANCC) or American Academy of Nurse Practitioners (AANP) as a Family Nurse Practitioner. Current DEA License.  Current BLS, ACLS, and PALS Certification. Current, valid, and unrestricted Driver’s License. Must be able to successfully pass the Employee Health Program and background investigation. Knowledge, Abilities, Skills, and Certifications: Knowledge of the wide range of professional nursing and nurse practitioner principles, concepts, practices and procedures applied in order to provide comprehensive and therapeutic health care to individuals and community groups.  Knowledge of physical and psychosocial assessment and history taking skills (i.e., palpation, percussion, auscultation, listening and observation) in order to perform and complete physical examinations.  Ability to interpret diagnostic tests and procedures and to analyze data in order to discriminate between normal and abnormal, communicate results, and to identify early stages of serious physical, emotional, or psychological problems, make a diagnosis, and to implement or modify treatment. Ability to assess and treat both minor and serious illnesses and health states such as respiratory infections, lacerations fractures, pregnancy, urinary tract infections, trauma, etc. Knowledge of prevention and health maintenance measures, disease control activities, and early identification of disease in order to provide health maintenance education to individuals and community groups. Knowledge of and ability to treat chronic health problems as hypertension, diabetes, obesity, cardiovascular disease, substance abuse and nicotine addiction.  Ability to counsel and teach healthy and ill individuals, families and groups on health care maintenance. Ability to provide preventive health cate to healthy individuals, including guidance in nutrition, common illnesses, and growth and development through the entire life span. Ability to recognize the need for and to provide emergency medical treatment for conditions such as cardiac arrest, shock) hemorrhage, overdose, and respiratory failure.  Knowledge of emergency procedures and drug therapy to be initiated in the absence of a physician. Ability to consult and/or provide technical direction to nursing staff, ancillary staff, and other health care personnel. Knowledge of the process and procedures for establishing, revising, monitoring and evaluating clinical standards. Ability to recognize limitations and when to refer to a physician. Ability to relate effectively and compassionately to patients. Physical Demands: The work involves walking, sitting, standing, reaching, and bending during patient assessment and treatment.  Lifting may involve moving patient’s equipment that may weigh over 50 pounds (up to 250 pounds with assistance of another person). The employee frequently is required to walk.  Work Environment: The work is performed in a hospital, urgent care, or clinical setting where exposure to infections and communicable diseases is common. Specialized personal protective equipment must be worn to prevent exposure to blood and body fluids. Exposure to all seasonal weather conditions, including high-desert and inclement weather, when reporting for clinical assignments at remote sites up to 30 miles from the main hospital. Based on clinical healthcare program needs, work may be performed throughout the 24-hour day and may require irregular working hours and shifts, such as evenings, weekends, and holidays, due to providing emergency room/urgent care services on evening, night, and weekend tours of duty.