Nurse Practitioner 1

Come join our dynamic, highly skilled Cardiothoracic (CT) Surgery inpatient APP team. The Cardiothoracic Surgery Advanced Health Practitioner position has clinical, procedural, administrative, and educational responsibilities in the care of adult patients requiring cardiac and thoracic surgery. The CT surgery service provides advanced surgical treatments, including coronary artery bypass grafting, aortic and mitral valve replacement, extracorporeal membrane oxygenation, and heart transplantation. We value individuals who are professional, with strong interpersonal and communication skills, and able to prioritize and adapt to changing situations. Our CT surgery APPs manage patients collaboratively with CT Surgery Fellows and Physicians, perform bedside procedures, and assist in the operating room. The CT Surgery APP assists in the development of practice protocols, evaluation of quality of care, and education of patients, families, and other health care practitioners.

90% Inpatient - Direct Patient Care (may include some or all of the responsibilities listed)

1.1. Independently (independent APP encounter) or collaboratively (shared physician and APP encounter) evaluates and manages patients.

1. Includes taking histories, performing physical examinations, responding to changes in patient status, performing consults, ordering or furnishing medications/diagnostic tests/treatments/therapies/consultations/referrals/durable medical equipment (DME)/home health services.
2. Care provided must be documented in the electronic medical record in accordance with the UCSF Rules and Regulations.
3. Provider services must be billed to reflect the performing provider and comply with the APP Billing Policy 3.08.01.
4. APPs must respond to clinical documentation integrity inquiries from the Department of Quality and Patient Safety within 3 days.

1.2. Performs procedures granted to them via privileges/standardized procedures.

1.3. Identifies patients with acute decompensation or failure and responds to the hospital plan of care and reviews with physician.

1.4. Initiates consultations as indicated.

1.5. Documents independent assessment findings and recommends appropriate treatments.

1.6. Participates in service rounds and patient evaluation and treatment planning. 

1.7. Reviews lab tests, x-rays, and other diagnostic tests, and initiates appropriate team plans.

1.8. Evaluates complex cases, establishes individualized plans of care for disposition to a lower level of care.

1.9. Interprets and acts upon completed tests, procedures, and radiographic studies.

1.10. Completes clinically relevant paperwork/electronic health record (EHR) documentation, including but not limited to ordering medications, completing episodic care notes and discharge summaries in accordance with the UCSF Rules and Regulations.

1.11. Effectively communicates findings, treatment options, and care plans with patients and their families 

1.12. May first assist in the operating room if privileged to do so through OMAG after completing the required certification and proctoring.

1.13. Monitors and evaluates patients for discharge. Sets parameters and guidelines for continuum of care with multi-disciplinary team. This includes evaluating and defining discharge regimen.

1.14. Discharges patients including prescribing/furnishing medications, ordering DME, and recommending or referring for ongoing follow up care, providing discharge teaching, and completing discharge summaries.

10% Inpatient – Care Coordination (may include some or all of the responsibilities listed)

1.1. Coordinates care throughout the continuum including hospital admission, care coordination with staff and consulting services, and hospital discharge planning.

1.2. Coordinates episodic care and determines timing of routine clinic follow up.

1.3. Participates in huddles with clinic/hospital staff and anticipates patients who require close management or intervention.

1.4. Consults with nursing staff on plan and implementation of individualized nursing care plans. 

1.5. Independently provides case summaries for disability, insurance agencies, workers compensation, work releases, and medical supply agencies.

1.6. Formulates and implements protocols to improve quality and efficiency and control waste in the clinical specialty.

Requirements:

Graduation from a California Board of Registered Nursing recognized Nurse Practitioner Program with a master’s or doctoral degree aligned with the patient population and clinical role.

Nurse Practitioner 1:

•  Five (5) years of experience in cardiovascular critical care as an RN.

Nurse Practitioner 2:

• One (1) year of cardiothoracic surgery, vascular surgery, cardiology, or critical care ICU NP experience.

Preferred Qualifications:

• Recent experience managing complex cardiac patients with heart failure, heart transplant, and ECMO
• Specialty certification: RNFA
   

License/Certifications:

1. California Registered Nurse (RN) License without restriction
2. California Certified Nurse Practitioner (NP) without restriction
3. California Nurse Practitioner Furnishing Number including Schedule II furnishing privileges
4. NP national board certification from an accepted certifying agency aligned with the patient population and clinical role. Adult Inpatient (ACNP-BC, AGACNP-BC, ACNPC-AG, ACNPC). 
5. California Driver License (if required for position)
6. Drug Enforcement Administration (DEA) Registration with Schedules 2, 2N, 3, 3N, 4, and 5 registered to a California address
7. American Heart Association (AHA) Basic Life Support (BLS) certification
8. Additional required AHA certifications: Both ACLS and PALS
9. Additional required certifications (such as ENLS): None

Minimum Knowledge, Skills, and Abilities (KSA):

1. Excellent verbal and written communication skills 
2. Judgement skills to effectively meet the needs of patients
3. Self-direction and organizational skills to function in an independent role
4. Ability to cope with personal stress experienced by health care providers and team members
5. Ability to meet minimum standards for hospital credentialing and billing standards as a billable provider
6. Submit health plan (Medicare, Medicaid, and commercial for all APPs; also, CCS for pediatric providers) enrollment by first clinical day 
7. At all times, must adhere to the UCSF Medical Staff Bylaws, Rules and Regulations, Code of Conduct, PRIDE values, and applicable medical center/campus/departmental policies and procedures
8. At all times, must adhere to all UCSF policies regarding HIPPA, privacy, communication, documentation, encounter closure, and billing
9. Mandatory attendance at the Office of Advanced Practice Providers Orientation Sessions
10. Mandatory attendance at the APP Onboarding Committee APP Onboarding Series
11. This position requires flexibility for the APP to work at all UCSF Health facilities/locations
12. Performs other duties as assigned

Preferred Knowledge, Skills, and Abilities (KSA):

1. Able to perform endoscopic vein harvesting
2. Able to perform thoracostomy tube placement
3. Experience with EPIC