Nurse Practitioner

Summary:

The Nurse Practitioner is an advanced practice nurse who, by education, training and experience, is prepared to provide advanced practice nursing care in collaboration with the physician and assure outcomes that ensure comprehensive oversight for medical/nursing problems. The Hospital does not authorize prescriptive authority to nurse practitioners.

Job Duties & Responsibilities:

1. Attend Patients at the Site: The AHP will be expected to care for patients and assist with patient coverage at the locations assigned by Employer (the "Site(s)"). In addition, AHP may be expected to cover additional locations or "Sites", as assigned by Employer if Site does not have enough patient availability for AHP to achieve RVU targets or daily patient visit goals as set forth in Section 2.16, or there are provider shortages at a particular location and Employer needs AHP to provide additional coverage. Upon patient discharge the AHP will refer the patient to the referring provider for outpatient care, unless the patient expresses another preference, or the AHP determines that this is not in the best medical interests of the patient.

Notwithstanding the forgoing, Employer does not guarantee any minimum or maximum number of patients at any one time.

The AHP may be required by Employer to participate in call coverage based on the pre-determined schedule established by the Employer, which will include an equitable division of dates across providers.

The AHP will:
a. Attend assigned patients depending on AHP's specific educational qualifications in Rogers programs to which AHP is assigned. These programs may include the following levels of care:
i) inpatient
ii) residential
iii) or other levels as requested by Employer
b. 1:1 medication management sessions with patients.
c. Weekly (or more often) staffing of patients.
d. Review and sign a treatment plan for each patient.
e. Family education, as clinically indicated.
f. Attend unit meetings, status report as appropriate.

2. Medical Activities: The AHP shall perform all medical functions necessary to insure the delivery of high quality treatment for medical issues caused by illness or injury for patients at the Sites, including, but not limited
to:
a. Take emergency call for medical care of units' patients as referred to the AHP.
b. Round on units' patients assigned within twenty-four (24) hours of admission and as needed thereafter.
c. Comply with Joint Commission and bylaw requirements to conduct histories and physicals within twenty-four (24) hours of admission.
d. Provide coverage for medical care to assigned patients twenty-four (24) hours per day, three hundred sixty-five (365) days per year.
e. Serve on the Medical Services committee of the hospital.
f. Provide medical services to inpatient and residential services as referred by attending AHP.
g. Read EKGs for assigned patients as needed.
h. Assist in the coordination of care for patients that are referred from Hospital to a local medical-surgical hospital.
i. Participate in quality assurance activities.
j. Provide in-services and teaching opportunities to Hospital staff as deemed appropriate.
k. Medical Evaluations in Consultation following admission (H&P) completed and signed in timely fashion per regulations for inpatient and residential patients.
l. Follow up visits with progress note completed as needed by medical necessity, patient request after RN triage, and/or attending request. Goal is for a 3:1 ration of subsequent: initial visits as we are primary care service and not an H&P service.
m. Monitoring all labs and diagnostic tests for each patient on unit throughout hospitalization. Monitoring includes acknowledging/signing labs in Cerner and completed lab progress note for abnormal labs and following standard work for abnormal labs/tests of discharged patient.
n. Follow up visits with patient with chronic disease 10-14 days even if everything is stable and more often as needed.
o. Communicating with covering PCP all necessary significant medical information prior to going off call.
p. In person visits daily with any patient in isolation. Timely document in Cerner reasons for isolation and reasons for removal from isolation.
q. Communication with ER or Medical Hospitals for all transfers if requested by attending.
r. Communication with families of patients if requested by attending.
s. Ongoing medical awareness of each patient with higher lengths of stay even if medically stable and not needing to be seen for extra medical visits.
t. Expectation 24hr coverage/working day.

3. Payor Relations: The AHP will assist the Site in its contracting with payors for mental health services. The AHP will also assist in developing and maintaining positive working relationships with all contracted payors.
The AHP will assist in the review of all denials of service from all payors that are deemed for medical reasons.
a. Interface with referring parties, the psychiatrist, family practice and/or pediatrician, to coordinate care, aftercare. Market Employer as appropriate, to include off-site meetings and marketing activities.
b. Review potential admissions, pending cases, and declined admissions, as needed, to assure Employer policy execution and compliance with EMTALA.

4. Advocate: In addition to the above duties and responsibilities, the AHP needs to be an advocate for the Sites.
Advocacy is both an informal activity and a formal activity. It is expected that the AHP will provide support, information, education and services when appropriate opportunities present themselves. The AHP must be committed to assisting the Site in becoming highly visible and respected for the contributions it does and can make to quality patient care.
a. Participate in and support Employer's quality assurance and performance improvement activities and meetings.
b. Take an active role in identifying new program development opportunities for patient care services and Employer.
c. Participate in community education of behavioral health issues, as requested by Employer.

Additional Job Description:

Physical/Mental Demands:

• Work takes place the majority of time inside the building. Walking, pulling, pushing, bending, twisting, sitting and grasping are routine activities. Required to lift work equipment, patient care equipment, supplies and patients, within reason. Personal judgment dictates weight-lifting limits, but must be able to life a minimum of 50 pounds.
• Verbal and hearing ability is required to interact with patients and employees. Numerical ability is required to maintain records and operate a computer.
• Able to plan, control and direct all aspects of employee relations. Tact is required to deal effectively with employees and professional staff. Logical thinking and discretion are required to make decisions in initiating and implementing policies, procedures and standards.
• Must be able to read and communicate through written, verbal and auditory skills and abilities.
• Physically/Mentally able to perform job duties as verified by a physical exam by a licensed physician, per post-employment physical.

Education/Training Requirements:

• Registered nurse licensed by Wisconsin State Board of Nursing. License must be in good standing with that Board.
• Nurse practitioner certification in behavioral health or related area of specialty is required; certification must be in good standing with the Board.
• Previous experience as a nurse practitioner within a behavioral health setting is preferred.