Advanced Practitioner

Under general supervision, is responsible for the clinical management of patients in accordance with hospital, State and National regulatory agency standards.

This is a Surgical APP, 24 hour per week position, as follows:
Experience One (1) year acute care experience in a Surgical ICU, step down or Surgery Service strongly preferred.
Skills*Analytical skills to assess patients and implement appropriate intervention.
*Able to work under varying degrees of stress and the ability to adjust to changes in the work environment.
Licensures, Certifications*Licensed as a Physician Assistant or as an Adult Nurse Practitioner by the Board of Medical Examiners of Maryland / Maryland State Board of Examiners of Nurses.
*Certification as required.
*Completion of "Healthcare Provider" CPR course.
Physical Requirements: Work is of medium to heavy physical demand; walking and standing most of the time.
Working Conditions*Normal patient care environment with exposure to excessive noise, dust and temperature.
*Frequently exposed to moderately adverse working conditions due to performance of certain patient care activities.
*Exposure to communicable diseases.
Conditions of Employment*Maintain current licensure and certifications.
*Maintain CME requirements needed for licensure.
*Comply with conditions of contract
Standard PrecautionsStandard precaution policy and procedures are applicable to this job
Patient SafetyEmployee has knowledge and understanding of patient safety as it relates to the job duties.

Patient Population Demonstrates competency in the delivery of care and applies the knowledge to meet age-specific needs as license permits.

Reports toSurgery APP Lead and Senior Surgery APP
Supervises N/A

II. GBMC Values

GBMC ValuesValue DescriptionMethod of Verifying Performance

Respect*Treats others with fairness, kindness, and respect for personal dignity and privacy
*Listens and responds appropriately to others' needs, feelings, and capabilities.
*Actively pursues learning and self-development.
*Pays attention to detail; follows through.
Accountability*Sets a positive, professional example for others.
*Takes ownership of problems and does what is needed to solve them.
*Appropriately plans and utilizes required resources for various job duties.
*Reports to work regularly and on time
Teamwork*Works cooperatively and collaboratively with others for the success of the team.
*Addresses and resolves conflict in a positive way.
*Seeks out the ideas of others to reach the best solutions.
*Acknowledges and celebrates the contribution of others
Ethical Behavior*Demonstrates honesty, integrity and good judgment.
*Respects the cultural, psychosocial, and spiritual needs of patients/families/coworkers
Results*Embraces change and improvement in the work environment.
*Continuously seeks to improve the quality of products/services.
*Displays flexibility in dealing with new situations or obstacles.
*Achieves results on time by focusing on priorities and manages time efficiently.
III. Technical Assessment
Principal Duties and Responsibilities: Overview: This is both an inpatient and outpatient role for General Surgery at GBMC and is 24 hours per week.
The APP will divide duties with the Finney-Trimble Surgery group on designated weeks and on other designated weeks, work on the general surgical post-operative floor caring for general surgery, orthopedic, vascular surgery, plastics, private urology, CRS, surg oncology, breast, thoracic, some GYN and bariatric patients. Some weekend days will be required.
At no time will the APP be assigned both roles.
This role will also include some outpatient office evaluations.Method of Verifying Performance
*Assumes responsibility for the initial evaluation and treatment of admitted surgical patients, including for emergency admissions, in collaboration with the attending surgeon.
a. Performs admission history and physical as evidenced by appropriate documentation.
writes appropriate orders within approved delegation agreements.
b.Discusses with the attending physician and nursing staff, physical and/or emotional findings which impact patient care.

*Evaluates patient progress on a continuing basis and, in collaboration with the attending physician, alters treatment modalities.
a.Make daily rounds on assigned patients to evaluate medical, social, and educational needs.
b.Initiates referral to appropriate ancillary departments and community resources based on patient need and documents on the progress note.
c.Writes progress notes daily, documenting pertinent information regarding patient progress and treatment regime.
d.Documents pertinent findings on holidays/weekends.
e.Writes orders appropriate to the patient's care requirements in compliance with hospital policy.
f.Establishes medical diagnoses in compliance with standard accepted medical practice.
g.Refers to the attending physician or designee those problems, which require consultation and documents it on progress note.
h.Makes immediate referral of acute and/or life-threatening patient conditions to attending physician or designee.
*Performs technical functions as covered by the job description and delegation agreement submitted to BPQA and/or MBON, approved NP agreement and in accordance with hospital policy.
*Specific technical skills for this position (preceptorship also available for hired candidate):

Bedside punch biopsy
NGT and Dobhoff (Keofeed) catheter insertion
Assist clinic staff in answering patient/family calls/questions.
Outpatient office visits (mainly wound care, wound checks, staple/suture/drain removal).
Wound VAC placement/dressing changes
Enterocutaneous fistula wound care/management.
Communicate with GOR to post urgent/emergent cases.
Evaluate PACU patients for admissions/post-op issues/orders. Often called to assess patients in Phase 2 if there are concerns prior to discharge (most often to address bleeding at incision sites, urinary retention or increased pain, nausea)
Rounds include the surgical care and follow up of ICU patients.
a.Documents results of technical functions performed.
b.Reports to physician or designee any abnormal findings related to it.
c.Monitors patient response related to technical function performed and document it.
d.Acts as a clinical resource.
e.Actively supports and participates in nursing and/or hospital performance improvement initiatives.
*Performs activities to meet patient/family education needs.
a.Participates actively in health teaching of patient and family to include preventative health care, as well as current medical condition and treatment regime.
b.Plans and reviews home care instructions with patient and family if needed. Includes needs for service provided by community resources and hospital based ancillary services.
c.Maintains continual communication with health team members regarding patient education and discharge planning.

Education:

• Successful completion of Physician Assistant Program OR Nurse Practitioner Program

Licensures/Certifications:

• Licensed as a Physician Assistant or as an Adult Nurse Practitioner by the Board of Medical Examiners of Maryland / Maryland State Board of Examiners of Nurses.
• Certification as required.
• Completion of "Healthcare Provider" CPR course.
• Completion of "Healthcare Provider" ACLS course

Experience:

• One (1) year acute care experience preferred.

Skills:

• Analytical skills in order to assess patients and implement appropriate intervention.
• Able to work under varying degrees of stress and the ability to adjust to changes in the work environment.

Patient & Workplace Safety:

• Employee has knowledge and understanding of patient and workforce safety as it relates to job duties.

Patient Population:

• Demonstrates competency in the delivery of care and applies the knowledge to meet age-specific needs if applicable.

Principal Duties and Responsibilities:

• Trains staff to receive and screen visitors and telephone calls.

• Assumes responsibility for the initial evaluation and treatment of admitted surgical patients, except for emergency admissions.
• Performs admission history and physical as evidenced by appropriate documentation.
• Writes appropriate orders within approved delegation agreements.
• Discusses with the attending physician and nursing staff, physical and/or emotional findings which impact patient care.
• Evaluates patient progress on a continuing basis and, in collaboration with the attending physician, alters treatment modalities.
• Make daily rounds on assigned patients to evaluate medical, social and educational needs.
• Initiates referral to appropriate ancillary departments and community resources based on patient need and documents on the progress note.
• Writes progress notes daily, documenting pertinent information regarding patient progress and treatment regime.
• Writes orders appropriate to the patient's care requirements in compliance with hospital policy.
• Establishes medical diagnoses in compliance with standard accepted medical practice.
• Refers to the attending physician or designee those problems, which require consultation and documents it on progress note.
• Makes immediate referral of acute and/or life threatening patient conditions to attending physician or designee. Documents physical findings and treatment plan pertaining to same.
• Performs technical functions as covered by the job description and delegation agreement submitted to BPQA and/or MBON, approved NP agreement and in accordance with hospital policy.
• Documents results of technical functions performed.
• Reports to physician or designee any abnormal findings related to it.
• Monitors patient response related to technical function performed and document it.
• Acts as a clinical resource.
• Actively supports and participates in nursing and/or hospital performance improvement initiatives.
• Performs activities to meet patient/family education needs.
• Participates actively in health teaching of patient and family to include preventative health care, as well as current medical condition and treatment regime.
• Plans and reviews home care instructions with patient and family if needed. Includes needs for service provided by community resources and hospital based ancillary services.
• Maintains continual communication with health team members regarding patient education and discharge planning.
• Assumes responsibility for utilizing opportunities for educational advancement by pursuing activities to meet identified educational needs and those required for continued certification as well as attending mandatory inservice as required.

All roles must demonstrate GBMC Values:

Respect

I will treat everyone with courtesy. I will foster a healing environment.

• Treats others with fairness, kindness, and respect for personal dignity and privacy

• Listens and responds appropriately to others' needs, feelings, and capabilities

Excellence

I will strive for superior performance in every aspect of my work. I will recognize and celebrate the accomplishments of others.

• Meets and/or exceeds customer expectations
• Actively pursues learning and self-development
• Pays attention to detail; follows through

Accountability

I will be professional in the way I act, look and speak. I will take ownership to solve problems.

• Sets a positive, professional example for others
• Takes ownership of problems and does what is needed to solve them
• Appropriately plans and utilizes required resources for various job duties
• Reports to work regularly and on time

Teamwork

I will be engaged and collaborative. I will keep people informed.

• Works cooperatively and collaboratively with others for the success of the team
• Addresses and resolves conflict in a positive way
• Seeks out the ideas of others to reach the best solutions
• Acknowledges and celebrates the contribution of others

Ethical Behavior

I will always act with honesty and integrity. I will protect the patient.

• Demonstrates honesty, integrity and good judgment
• Respects the cultural, psychosocial, and spiritual needs of patients/families/coworkers

Results

I will set goals and measure outcomes that support organizational goals. I will give and accept help to achieve goals.

• Embraces change and improvement in the work environment
• Continuously seeks to improve the quality of products/services
• Displays flexibility in dealing with new situations or obstacles
• Achieves results on time by focusing on priorities and manages time efficiently

COVID-19 Vaccination

All applicants must be fully vaccinated against Covid-19 or obtain a GBMC approved medical or religious exemption prior to starting employment at GBMC Healthcare, to include Gilchrist and GBMC Health Partners.

Equal Employment Opportunity

GBMC HealthCare and its affiliates are Equal Opportunity employers. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity and expression, age, national origin, mental or physical disability, genetic information, veteran status, or any other status protected by federal, state, or local law.