Advanced Practice Provider Jobs (NOW HIRING)

POSITION: Advanced Practice Provider

REPORTS TO: Physician Leader

Approved/Revised: June 2008/August 2023

SUMMARY: The advance practice provider (APP) is an advanced practice nurse (APRN) or Physician Assistant (PA) who demonstrates clinical expertise and leadership skills. The advance practice provider uses advanced skills in the evaluation, diagnosis and treatment of patients with disease and adverse health conditions. The advance practice provider manages therapeutic regimens for acute and chronic problems associated with such disease and conditions, as directed by the attending physician. The advance practice provider provides anticipatory guidance, patient and family education, and psychosocial and emotional support. The advance practice provider has prescriptive authority which includes Schedule II thru V controlled substances in the State of New Hampshire and the Commonwealth of Massachusetts (if licensed, depending on clinic assignment).

The advance practice provider is a member of a multidisciplinary team that requires effective communication and collaboration with co-workers and staff within NHOH and other collaborating institutions and agencies. The role requires critical thinking, an understanding of research principles and practices, and an expanded scope of clinical practice and leadership that improves the quality of care and advances the practice of clinical care throughout the work setting and community. The Mission and Values of NHOH and collaborating intuitions are incorporated into all areas of practice.

ESSENTIAL DUTIES & RESPONSIBILITIES:

A. Delivers expert, scientifically based care to patients both using advanced skills in the evaluation, diagnosis, and treatment of patients with hematological-oncological disease and adverse health conditions, as directed by the attending physician. This care is provided to outpatients in the clinic setting and inpatients where we are called to consult/round:

· Assesses patient and family needs from a holistic viewpoint

· Performs comprehensive physical assessment. Differentiates between normal and abnormal physical findings and interprets to determine the severity of illness.

· Recognizes and differentiates oncological emergencies associated with the specific disease and conditions.

· Assesses pain and symptom management that includes side effects of chemotherapy and radiation therapy.

· Formulates a multidisciplinary plan of care based on identified diagnoses and continually reassesses plan based on patient’s current condition, as directed by the attending physician.

· Incorporates age-specific interventions related to safety, nutrition, physical limitations, polypharmacy, skin integrity, psychosocial needs and other areas as appropriate in the care provided.

· Performs procedures as determined by patient care needs, as directed by the attending physician.

· Documents care reflective of advanced practice and complies with all NHOH, collaborating institution and regulatory agency requirements.

· Provides patient and family education, instruction and reinforcement to meet identified learning needs, including chemotherapy/immunotherapy teaching sessions.

· Meets chart documentation requirements, including note completion turn-around-times, charge entry, prescription processing timelines.

· Identifies appropriate community resources to provide continuity of care and makes appropriate referrals to homecare and hospice agencies.

· Delegates responsibilities for performance of selected patient care activities to assistive personnel within regulations and policies. Provides appropriate and intermittent supervision.

· Responds and assists with emergency situations that arise in the clinic setting, related to infusion reactions or otherwise.

· Provides guidance for patient symptom management calls through dedicated triage staff. Processes prescription refills as needed.

· Completes forms and/or supportive letters for patients surrounding FMLA, disability, work restrictions, etc….

· Sees patients in the outpatient and inpatient setting (as needed). Participates in the weekend and holiday patient call rotation.

· Adheres to code of ethics in all aspects of professional practice.

· Recognizes and responds to emergency situations appropriately. Maintains BLS certification through a nationally accredited agency/facility.

B. Manages therapeutic regimens and appropriate follow-up for acute and chronic problems associated with hematological-oncological disease and conditions, as directed by the attending physician.

· Prescribes medications, which may include chemotherapy, IV fluids, and blood component therapy in accordance with research protocols, Medical staff Bylaws, NHOH, state and federal regulations, and collaborating institution policies, under the direction of the attending physician.

· Evaluates the patient’s response to therapy and appropriately modifies interventions as needed, under the direction of the attending physician.

· Orders consultations, diagnostic and laboratory tests and scans in accordance with research protocols and current practice standards. Completes all orders/requisitions in accordance with NHOH policies and procedures and collaborating institutions.

· Demonstrates awareness of protocols available in the disease center. Complies with clinical protocol requirements regarding appropriate collection and recording of data and information required. This may include clinical trial/research regimens which require the APP complete required trainings before trial patients can be seen.

· Performs diagnostic procedures in accordance with practice guidelines, research protocols, Medical staff Bylaws, NHOH and collaborating institutions’ policies and procedures, primarily bone marrow biopsies in the clinic or inpatient setting.

· Coordinates elective and emergency admissions to collaborating institutions in accordance with the patient’s medical condition, research protocols, Medical staff Bylaws, NHOH and collaborating institutions’ policies and procedures.

· Obtains required consents for treatment and procedures.

C. Practices according to written guidelines in compliance with respective governing license board. Maintains prescriptive privileges as defined by the state of New Hampshire and the Commonwealth of Massachusetts (as needed based on assignment). Utilizes prescriptive responsibly for Schedule II through V controlled substances in the state of New Hampshire and the Commonwealth of Massachusetts (as needed based on assignment).

· Maintains DEA certification and state licensure. Completes necessary paperwork to enroll in e-prescribing and narcotic processing.

· Completes all required competency and continuing education requirements for role and license.

· Pursues active membership of local and national professional organizations.

· Completes required medical staff applications for hospital affiliations as needed for clinic assignment/coverage.

D. Establishes rapport with patients and families from a variety of cultural, ethnic, and religious backgrounds.

· Interacts with patients and families in a caring and compassionate manner

· Provides patient and family education related to the disease process, treatment plan, alternatives, symptom management, care, and follow up.

· Provides care based on the age specific needs of the patient

· Fosters an environment that is sensitive to the needs of diverse populations, including but not limited to culture, ethnicity, gender, and age.

E. Manages the environment for patient care providing leadership in the identification and integration of resources to achieve desired outcomes.

· Monitors the environment of care with attention to patient safety, and assures compliance with regulatory agency standards

· Complies with NHOH and collaborating institutions’ policies, procedures, work rules and standards of conduct

· Develops collaborative relationships with colleagues which facilitate mutual involvement in planning care. Acknowledges and uses expertise of others through formal and informal consultation in planning and evaluating patient care.

· Provides leadership in the development and implementation of an integrated plan of care

F. Provides leadership in the formulation and achievement of goals within NHOH and the community.

· Assists in defining goals and developing systems and work processes for NHOH and collaborating institutions.

· Participates in and provides leadership to committees, councils, and initiatives.

· Works collaboratively and functions as an effective member of the healthcare team.

· Demonstrates flexibility and the ability to set and change priorities.

· Participates in QA/QI projects as requested.

· Fosters and promotes an environment that facilitates professional communication and collaboration with colleagues.

· Supports research activities within NHOH and collaborating institutions and meets all regulatory training and maintenance activities.

KNOWLEDGE & SKILLS:

• Demonstrated ability to work as an effective member of an interdisciplinary team.
• Demonstrated critical thinking, problem solving skills and ability to make independent decisions.

EXPERIENCE/EDUCATION

• Authorization to practice in an expanded role as advance practice provide in the state of New Hampshire (and the Commonwealth of Massachusetts as needed for clinic assignment).
• Current certification from a nationally accrediting body approved by the NH Board of Registered Nursing for Nurse Practitioners or a nationally accrediting body approved by the NH Board of Medicine for Physician Assistants.
• Minimum of 1 year oncology nursing experience or advanced practice experience preferred, but not required.

WORKING CONDITIONS:

Works in clinic and office settings with possible exposure to infectious diseases through airborne transmission or contact with blood or body fluids. Work is performed in a clean and neat medical office/treatment environment. Workstations, appropriate equipment and supplies are provided for ease in performing tasks. Employees are responsible for maintaining their work area in a clean, neat, safe and orderly condition. The employee is introduced to the Hazard Communication Program, Bloodborne Pathogen Program and Emergency Procedures during the introductory period of training and annually as required by statute. Employees are responsible for wearing any Personal Protective Equipment that may be required in performing tasks that involve exposure to chemicals, blood or bodily fluids. The employee must be able to perform the duties and responsibilities of the position without posing a direct threat to his or her health and safety, or the health and safety of other individuals in the workplace.