Physician Assistant

Job Type

Full-time

Description

Lexington Regional Health Center
Title: PHYSICIAN ASSISTANT
Supervisor: Clinic Administrator

Department: Family Medicine Specialists
FLSA Status: Exempt

Principle duties and responsibilities

1. Collects pertinent medical and psychosocial history including: patient profile, chief complaint, history of present illness, past medical history, social history and review of body systems.

2. Performs a physical examination as pertinent, modifying the examination for the nature of the complaint or problem, age/sex of patient and physical condition of patient, and determines patient's mental status (e.g. level of consciousness, orientation, mood, etc.). Differentiates between normal and abnormal (including variations of normal) information obtained from history, physical and screening examination of the following:

- Adult patients

- Pediatric patients

- Obstetrical patients

- Newborn patients/infants

- Geriatric patients

3. Orders laboratory, xray and diagnostic studies appropriate for complaint, age, race, sex and physical condition of patient. Completes preliminary interpretation of diagnostic tests with consultation as necessary (such as routine x-rays of chest and extremities, lab studies, EKG, etc). Develops initial impression as to severity, etiology and immediacy of patient's problem based on analysis of data obtained from history, physical, laboratory and x-ray studies.

4. Records and transmits findings from data base into medical record:

- Summarizes pertinent aspects of history.

- Summarizes pertinent aspects of physical exam.

- Prepares patient visit summaries/progress notes.

5. Establishes diagnosis of common problems with physician consultation and guidance as appropriate. Develops a management plan considering patient's problem, age, sex, race and condition, conferring with the patient, supervising physician, patient's family and other health professionals as appropriate. Applies established therapeutic practices to patient's problem:

- Prescribes medications.

- Performs other therapies and minor surgical procedures.

6. Provides patient education services in areas such as:

- Explains patient's condition/disease its etiology, course and prognosis.

- Explains treatment rationale, side effects, risks and special instructions.

- Provides, where appropriate, information necessary for informed consent.

- Instructs patient, family and community about health related topics, preventive health care and self-care.

7. Patient Counseling:

- Identifies mental health problems through accepted techniques such as: interviewing, observation for behavioral/mood changes, identification of outside factors influencing psychological state and relation of physical condition/problems to mental health disorders.

- Counsels patient concerning nonreferral type mental health problems such as: anxiety reactions, nonpsychotic depression, adjustments to aging, developmental problems of children and adolescents, adjustment to chronic disease/terminal illness and psychological influences on physical condition.

- Supports and counsels family in dealing with patient's condition

8. Refers patients as necessary: Refers patients having medical/psychological problems beyond the PA's professional competence to appropriate sources of care, such as supervising physician, medical specialists, mental health agencies and community resource agencies.

9. Makes hospital/nursing home rounds and reports any complicated cases and what, if any, action was taken or is deemed necessary.

- Performs and records histories and physical exams.

- Records daily progress notes.

10. Participates in patient care activities that could include blood exposure and risk to bloodborne pathogens (eg: lacerations, handling of blood-contaminated specimens, etc.)

11. Responsible for safe bagging and disposal of biohazardous waste.

12. Responsible for following safe-injection practices.

13. Responsible for ensuring the patient care environment meets appropriate governing body standards.

14. Responsible for proper collection, storage and labeling of biological specimens.

15. Ensure patients and visitors follow current infection control guidelines.

16. Maintains patient and staff safety through the use of patient safety tools (Teamstepps, Just Culture, etc.).

17. Regular attendance at the assigned work location is required.

18. Performs all other duties as assigned.

Minimum knowledge, skills, and abilities

1. Medical knowledge about established and evolving biomedical, clinical and cognate sciences and the application of this knowledge to patient care; knowledge and understanding of patient care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health as is typically acquired through the completion of a Physician Assistant Education Program accredited by the Council on Allied Health Education of the American Medical Association.
2. Must hold a current active Physician Assistant license from the State of Nebraska and all duties performed shall be approved by the supervising physicians and the Medical Staff of Lexington Regional Health Center.
3. Current Basic Life Support certification required.
4. Attention to detail for up to 90% of work time when assessing, diagnosing and treating patients, synthesizing information related to patient care and accurately documenting care.
5. Ability to maintain strict confidentiality with regard to protected and sensitive information.
6. Ability to complete reports and correspondence at a professional level.
7. Ability to immediately respond to common inquiries and complaints from patients, employees and regulatory agencies.
8. Ability to effectively communicate with individuals from diverse backgrounds. Communication skills necessary to discuss complex healthcare issues with patients, families and other healthcare professionals, collaborate with healthcare team to develop patients' plan of care, etc.
9. Successful completion of required knowledge and training of standard precaution and transmission protocols and when to apply during principle duties and responsibilities.

Working conditions

1. Works in a normal office work environment with little exposure to excessive noise, dust, temperature, etc.
2. Spends up to 40% of day completing various desk/computer work, and the rest of shift moving around facility completing patient care activities. Patient transferring may be required, lifting up to 35 pounds to assist a stand pivot transfer. Completes various upper extremity gross motor functions for completing various patient care related activities, such as taking vitals, bracing, performing examinations, etc. Required to help assist in the event of emergency situations, including performing CPR which may require getting onto floor to assist.
3. Exposure to chemicals and other hazards related to patient care. Appropriate safety precautions, such as safety glasses, gloves, etc. must be used to minimize risk of injury.
4. Direct exposure to body substances during patient care activities and on contaminated surfaces such as patient equipment.

Management responsibilities

1. None

Lexington Regional Health Center
Title: NURSE PRACTITIONER
Supervisor: Clinic Administrator

Department: Family Medicine Specialists
FLSA Status: Exempt

Principle duties and responsibilities

1. Participates in the development, execution and review of the written policies governing the services the clinic furnishes.

2. Participates with a physician in a periodic review of the patient's health records per the State of Nebraska regulations.

3. Performs the following functions to the extent they are not being performed by a physician:

- provides services in accordance with the clinic's policies;

- arranges for, or refers patients to, needed services that cannot be provided at the clinic;

- assures that adequate patient health records are maintained and transferred as required when patients are referred.

4. Process of Care: Utilizes the nursing process as the framework for managing client care.

- Assessment of Health Status:

- obtains a relevant health and medical history;

- performs a physical examination based on age and history;

- conducts preventive screening procedures based on age and history;

- identifies medical and health risks and needs;

- updates and records changes in health status.

- Diagnosis:

- formulates the appropriate differential diagnosis based on the history, physical examination and clinical findings;

- identifies needs of the individual family or community as a result of the evaluation of the collected data.

- Development of a Treatment Plan: priorities are established and a mutually acceptable plan of care is devised to maximize the health potential of the individual, family or community; this includes:

- orders appropriate diagnostic tests;

- identifies appropriate pharmacologic agents;

- identifies non-pharmacologic interventions;

- develops a client education plan.

- Implementation of the Plan: interventions are based upon established priorities. Actions by the nurse practitioner are consistent with the appropriate plan of care; based on scientific principles, theoretical knowledge, and clinical expertise; individual to the specific situation and consistent with teaching and learning opportunities. Actions include:

- venipuncture for diagnostic testing;

- accurately conducts and interprets diagnostic tests;

- prescribes pharmacologic agents;

- prescribes non-pharmacologic therapies;

- provides relevant patient education;

- makes appropriate referrals to other health professionals and community agencies.

- Follow-up and Evaluation of the Client Status. Maintains a process for systematic follow-up by:

- determining the effectiveness of the plan of care through documentation of client care outcomes;

- reassessing and modifying the plan as necessary to achieve medical and health goals.

- Patient Education: provides educational opportunities for the individual and/or family related to health status, utilizing additional resources when indicated.

- Facilitation of Client Participation in Self Care. Facilitates client participation in medical and health care by providing information needed to make decisions and choices about the:

- promotion, maintenance and restoration of health;

- seeking and utilization appropriate health care personnel;

- appropriate utilization of health care resources.

- Promotes optimal health of all patients through preventive care and education to patient.

- Facilitates entry into health care system: Upon entry into the health care system, facilitates appropriate utilization of the system and encourages appropriate follow-up care.

5. Interdisciplinary/Collaborative Responsibilities: Participates as a team member in the provision of medical and health care, interacts with professional colleagues to provide comprehensive care.

- Care should be discussed with the healthcare team to ensure appropriate care and services are provided.

6. Responsibility as client advocate: Interprets the role of the nurse practitioner to individuals, families, and other professionals. As an advocate, participates in health policy activities at the local, state, national, and international levels.

7. Quality Assurance: participates in self-directed continued learning including:

- participation in quality assurance review on a periodic basis, including systematic review of records and treatment plans;

- maintenance of current knowledge by attending educational programs;

- maintenance of certification on compliance with current state law.

8. Participates in patient care activities that could include blood exposure and risk to bloodborne pathogens (eg: lacerations, handling of blood-contaminated specimens, etc.)

9. Responsible for safe bagging and disposal of biohazardous waste.

10. Responsible for following safe-injection practices.

11. Responsible for ensuring the patient care environment meets appropriate governing body standards.

12. Responsible for proper collection, storage and labeling of biological specimens.

13. Ensure patients and visitors follow current infection control guidelines.

14. Maintains patient and staff safety through the use of patient safety tools (Teamstepps, Just Culture, etc.).

15. Regular attendance at the assigned work location is required.

16. Performs all other duties as assigned.

Minimum knowledge, skills, and abilities

1. Medical knowledge about established and evolving biomedical, clinical and cognate sciences and the application of this knowledge to patient care; knowledge and understanding of patient care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health as is typically acquired through the completion of a Nurse Practitioner license by the State Board of Nursing and advanced education and clinical competency necessary for the delivery of health and medical care. The State Board of Nursing authorizes the Nurse Practitioner to practice in Nebraska. Authorization by the State Board of Nursing entitles the Nurse Practitioner to use the credential CRNP (Certified Registered Nurse Practitioner).
2. Must hold a current active Nurse Practitioner license from the State of Nebraska and all duties performed shall be approved by the supervising physicians and the Medical Staff of Lexington Regional Health Center. Physician will review charts of sample patients seen by Nurse Practitioner.
3. Current Basic Life Support certification required.
4. Attention to detail for up to 90% of work time when assessing, diagnosing and treating patients, synthesizing information related to patient care and accurately documenting care.
5. Ability to maintain strict confidentiality with regard to protected and sensitive information.
6. Ability to complete reports and correspondence at a professional level.
7. Ability to immediately respond to common inquiries and complaints from patients, employees and regulatory agencies.
8. Ability to effectively communicate with individuals from diverse backgrounds.
9. Successful completion of required knowledge and training of standard precaution and transmission protocols and when to apply during principle duties and responsibilities.

Working conditions

1. Works in a normal office work environment with little exposure to excessive noise, dust, temperature, etc.
2. Spends up to 40% of day completing various desk/computer work, and the rest of shift moving around facility completing patient care activities. Patient transferring may be required, lifting up to 35 pounds to assist a stand pivot transfer. Completes various upper extremity gross motor functions for completing various patient care related activities, such as taking vitals, bracing, performing examinations, etc. Required to help assist in the event of emergency situations, including performing CPR which may require getting onto floor to assist.
3. Exposure to chemicals and other hazards related to patient care. Appropriate safety precautions, such as safety glasses, gloves, etc. must be used to minimize risk of injury.
4. Direct exposure to body substances during patient care activities and on contaminated surfaces such as patient equipment.

Management responsibilities

1. None

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