Remote Inpatient Hospice Rn Jobs in Carmel, IN (NOW HIRING)

Summary
Practices in the Surgical Service to the full extent of education, training, and certification.
PREFERRED EXPERIENCE: Demonstrated competency in first-line management of critically ill Cardiovascular / Surgical ICU patients-immediate postop cardiac surgery, acute coronary syndrome, heart failure, arrhythmias, hemodynamic instability; proficiency with invasive hemodynamic monitoring, mechanical ventilation, vasoactive/inotropic drips, and mechanical circulatory support devices (IABP, Impella).
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Duties
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Preferred Experience:

• Demonstrated competency in first-line management of critically ill cardiovascular and surgical ICU patients, including independent experience with immediate postoperative cardiac surgical patient management, acute coronary syndrome, heart failure, arrhythmias, and hemodynamic instability.
• Proficiency with invasive hemodynamic monitoring, mechanical ventilation, vasoactive/inotropic drips, and mechanical circulatory support devices such as IABP and Impella.
• Demonstrated competency in the management of critically ill cardiovascular patients, including post cardiac surgery, heart failure, acute coronary syndrome, arrhythmias, and hemodynamic instability.

Duties:
Provide medical and surgical care for both inpatients and outpatients in the sections of cardiothoracic surgery and surgical intensive care, serving as the primary coordinator for the physicians and PA/ARNP providers. Patients often have concomitant medical problems and are multi-symptomatic. The PA shall coordinate patient care programs based upon the admitting chief complaint and shall perform the following duties:

• Designing and conducting comprehensive examinations, diagnosis and implementation of treatment plans, admission orders, discharge summaries as well as ordering special labs, and radiographic studies.
• Provide medical education /counseling of patients and their families.
• Verify, establish and assure that identified pre-operative surgical requirements are met, assure appropriate arrangements have been established for admission, and coordinate inpatient activities on the floor.
• Primary responsibility for admissions and medical care of patients.
• Assist the surgeon in the operating room, including prepping and draping, and first or second assist in surgery.
• Perform bedside procedures including, placement of arterial lines, swan-ganz catheters and central lines, bronchoscopy, changing of tracheostomy tubes, wound care and debridement, thoracentesis, removal of chest tubes, temporary pacing wires, intra-aortic balloon pump, central lines, arterial lines, and drains.
• Demonstrate the ability to diagnose and treat cardiothoracic surgery patients seen in consultation with other health care providers.
• Integrates the activities of the cardiothoracic surgery service with other patient care programs at the facility.
• Manage a task force for Quality Assurance within the cardiothoracic section.
• Conduct problem solving to formulate a patient care plan to avoid these issues preoperatively while coordinating with social work.
• Establishes and maintains relationships with social work, rehabilitation, medical, and dietary services throughout the facility to result in improved efficient patient care.

Clinical Practice - Surgical Intensive Care

• Considers factors related to safety, effectiveness and cost in planning and delivering care.
• Obtains history, physical examination, and assessment of ongoing patient needs through effective use of the nursing process to make practice decisions in an ethical manner.
• Orders and interprets routine laboratory tests, diagnostic studies, and radiographic tests.
• Performs diagnostic and stabilization procedures as necessary based on ACLS.
• Collaborates with respiratory therapy and nursing for airway management and ventilator weaning.
• Writes orders for laboratory work, medications, and treatments in compliance with hospital policies.
• Communicates with Surgical Service physicians' patient problems and status updates.
• Participates in and prepares discharge planning needs for SICU patients through communication with team members, patients, families, and consultants.
• Documents relevant laboratory data, study results, patient care, pertinent procedures, and patient updates within notes.
• Demonstrates competence with placement and removal of enteral feeding tubes, central venous catheters, arterial lines, swan ganz catheters, sutures, drains/tubes.
• Assists with and performs invasive procedures including, central lines, arterial lines, bronchoscopy, PEG tube placement, and percutaneous tracheostomy.
• Collaborates with physicians, nurses, and other members of the health care team using effective communication and interpersonal skills to develop, promote, and maintain interdisciplinary teamwork.
• Participates in performance measures through documentation and data collection/reporting.
• Assists in investigation and documentation of patient issues and concerns.
• Identifies individual differences as related to the physiological, cultural, and psychological aspects of maturational development.
• Demonstrates ability to multi-task and prioritize patient care needs.

VA offers a comprehensive total rewards package.
Work Schedule: Monday - Friday, Night shift with rotating on-call and weekends.
Travel: Required. You may be expected to travel Up to 15% for this position.
Telework: Not Available
Virtual: This is not a virtual position.
Relocation/Recruitment Incentives: Not Authorized
Requirements
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Conditions of employment

• All qualified candidates encouraged to apply. Open to U.S. Citizens but non-citizens may be appointed when it is not possible to recruit qualified citizens.
• All applicants tentatively selected for VA employment in a testing designated position are subject to urinalysis to screen for illegal drug use prior to appointment. Applicants who refuse to be tested will be denied employment with VA.
• Selective Service Registration is required for males born after 12/31/1959.
• Must be proficient in written and spoken English.
• You may be required to serve a probationary period.
• Subject to background/security investigation.
• Selected applicants will be required to complete an online onboarding process. Acceptable form(s) of identification will be required to complete pre-employment requirements (https://www.uscis.gov/i-9-central/form-i-9-acceptable-documents). Effective May 7, 2025, driver's licenses or state-issued dentification cards that are not REAL ID compliant cannot be utilized as an acceptable form of identification for employment.
• Must pass pre-employment evaluation
• Participation in the seasonal influenza vaccination program is a requirement for all Department of Veterans Affairs Health Care Personnel (HCP).
• Complete all application requirements detailed in the "Required Documents" section of this announcement.

Qualifications
Applicants pending the completion of educational or certification/licensure requirements may be referred and tentatively selected but may not be hired until all requirements are met.
Physician Assistant Basic Requirements

• English Language Proficiency. Candidates must be proficient in spoken and written English to be appointed as authorized by 38 U.S.C. § 7403(f).
• Education: Master's degree in any discipline or a bachelor's degree in any discipline with one year of experience as a Physician Assistant.
• Certification: Successfully passed the PA National Certifying Exam (PANCE) (or are you in the process to taking the exam) ~AND~
• Licensure: PAs must possess an active, current, full, and unrestricted license to practice in a State, Territory, or Commonwealth of the United States, or in the District of Columbia. PAs must maintain current registration in the State of licensure if this is a requirement for continuing active and current licensure in that State.
  
  • NOTE: Individuals who have or have had multiple licenses and had any such license revoked for professional misconduct, professional incompetence or substandard care, or who surrendered such license after receiving written notice of potential termination of such license by the State for professional misconduct, professional incompetence, or substandard care, are not eligible for appointment to the position unless such revoked or surrendered license is fully restored (38 U.S.C. § 7402(f)). This requirement does not apply to licensed PAs currently employed by VA as of November 30, 1999, provided they maintain continuous appointment and are not disqualified for employment by any subsequent revocations or voluntary surrenders of State license, registration or certification.

GRANDFATHERING PROVISION. All persons employed in VHA in this occupational series that are also performing the duties as described in the qualification standard on the effective date of this qualification standard are considered to have met all qualification requirements for the grade held including positive education and licensure/certification.
Grade Determinations:
Physician Assistant-I (PA-I)

• Experience and Education. None beyond the basic requirements. This is the entry level for PAs.
• Demonstrated Knowledge, Skills, and Abilities. The following list of knowledge, skills, and abilities (KSA) present the minimum skill set expected of an Entry Level PA. This practice may include, but is not limited to:
  
  • Ability to utilize the principles of PA practice in the care of assigned patients to provide appropriate care.
  • Ability to perform patient history and physical.
  • Ability to formulate a plan and provide treatment to the patient.
  • Ability to provide patient care that is abreast of changing concepts and advancements in the profession.

Physician Assistant-II (PA-II)

• Experience and Education. The PA at this grade is at the intermediate grade level and has had progressively increasing responsibility and experiences as indicated in the KSAs listed below. Individuals will have demonstrated the ability to analyze and solve more complex medical problems than at the entry level grade and can utilize their training in the successful practice of patient care and participate in team problem solving. Individuals demonstrate the KSAs of PA-II intermediate level by:
  
  • Two years of successful practice as a PA. OR
  • Successful completion of a PA post-graduate residency program sponsored by VHA Office of Academic Affiliations or other postgraduate residency programs accredited by VA, ARC-PA, U.S. Armed Forces, or another accrediting agency. OR
  • A doctoral degree in a health-related field from an accredited college or university recognized by the U.S. Department of Education.
• Demonstrated Knowledge, Skills, and Abilities (KSAs). PAs at this level are not required to meet each individual KSA listed below to qualify, but should be able to demonstrate, develop, or acquire those not met upon appointment for PA-II:
  
  • Skills to analyze and solve complex medical problems.
  • Ability to function autonomously and make independent medical decisions.
  • Skill to incorporate training and experience into the successful practice of patient care including telehealth medical care.
  • Ability to work effectively in an interdisciplinary environment for improvement of services for patient care.
  • Ability to practice with colleagues and peers collaboratively.

Physician Assistant-III (PA-III)

• Experience and Education. PAs at the PA-III grade are at the full performance level and lead and organize patient care independently, practice within multi-disciplinary teams, and coordinate all aspects of patient care across the health care system. They utilize advanced clinical knowledge and judgment in decision-making and evaluating outcomes. They function as experts in clinical practice and/or in areas related to the assigned roles and responsibilities, may serve as mentors for transitioning PAs, and may provide training for health care students. Individuals can demonstrate the KSAs for the full performance level by:
  
  • Three years of successful practice as a PA. OR
  • Successful completion of a PA post-graduate residency program sponsored by VHA Office of Academic Affiliations or other postgraduate residency programs accredited by VA, ARC-PA, U.S. Armed Forces, or another accrediting agency and one year of professional practice as a PA. OR
  • A doctoral degree in a health-related field from an accredited college or university recognized by the U.S. Department of Education and one year of professional practice as a PA.
• Demonstrated Knowledge, Skills, and Abilities. PAs at this level are not required to meet each individual KSA listed below to qualify, but should be able to demonstrate, develop, or acquire those not met upon appointment for PA-III:
  
  • Ability to clinically evaluate facility patient care delivery systems and validate or identify barriers to safe and effective patient care.
  • Skill to consistently demonstrate an elevated level of expertise and autonomy in diagnosing and treating seriously ill, multi-symptomatic patients through facility Focused Professional Practice Evaluation (FPPE) and Ongoing Professional Practice Evaluation (OPPE).
  • Ability to present clinical findings and recommendations to appropriate management officials.
  • Ability to clinically facilitate the delivery of patient care in collaboration with health