Nurse Practitioner, Critical Care

Position Summary Department: WPH Critical Care Status: Full-Time Shift: Nights Title: Nurse Practitioner, ARNP, APP, Advanced Practice Provider ORLANDO HEALTH WINNIE PALMER HOSPITAL FOR WOMEN & BABIES Located on the downtown Orlando Health campus, Orlando Health Winnie Palmer Hospital for Women and Babies provides specialized care that covers all facets of women's health, from comprehensive gynecological services and minimally invasive surgeries to general obstetrics and high-risk pregnancies and births. Orlando Health Winnie Palmer welcomes nearly 14,000 babies each year. Our 350-bed hospital includes 142 beds in neonatal intensive care units (NICUs), making Orlando Health Winnie Palmer one of the largest NICUs in the nation. We are proudly the first - and only - hospital in Florida to offer in utero surgery to repair spina bifida. Named a Top Teaching Hospital by The Leapfrog Group, our hospital also is proudly recognized as a "Best Children's Hospitals in Neonatology" by U.S. News & World Report and has held Magnet Recognition from the American Nurses Credentialing Center since 2013. Orlando Health Winnie Palmer is part of the Orlando Health system of care, which includes award-winning hospitals and ERs, specialty institutes, urgent care centers, primary care practices and outpatient facilities that span Florida's east to west coasts and beyond. Collectively, our 27,000+ team members honor our over 100-year legacy by providing professional and compassionate care to the patients, families and communities we serve. Orlando Health is committed to providing you with benefits that go beyond the expected, with career-growing FREE education programs and well-being services to support you and your family through every stage of life. We begin your benefits on day one and offer flexibility wherever possible, so that you can be present for your passions. "Orlando Health Is Your Best Place to Work" is not just something we say, it's our promise to you. Under the supervision of the physician, according to established practice guidelines and utilizing evidence-based clinical practice standards, provides inpatient management, consultations, and co-management of critically ill patients. Responsibilities Essential Functions Possess specialized skill and knowledge unique to the ICU setting in which they practice (Medical, Surgical, Neurosurgical, Cardiovascular, etc) Provides direct clinical services for critically ill patients according to established protocols and utilizes evidence-based clinical practice standards. Obtains comprehensive and focused history and physician exam on critically ill patients Responsible for evaluating critically ill complex (multi-organ failure) patients in the ICU and step down units by synthesizing data, physical exam and pertinent medical history to assess clinical scenario and prescribe appropriate interventions and medications. Uses clinical judgment and evidence based medicine to order and schedule appropriate laboratory and radiographic studies. Works with supervising physician to determine and place appropriate specialty consultations. Evaluates critically ill patients in the ICU and step down units by synthesizing data, physical exam and pertinent medical history to assess clinical scenario and prescribe appropriate interventions and medications. Works in collaboration with supervising and consulting physicians to formulate and implement plan for management of critical ill patients. Performs complex procedures in the diagnosis and treatment of medical and surgical problems (including but not limited to: Central venous catheter placement, arterial catheter placement, chest tube placement, lumbar puncture, thoracentesis, paracentesis, endotracheal intubation, therapeutic bronchoscopy -i.e removal of secretions and BAL.) Performs advanced cardiac life support. In a medical emergency, the nurse practitioner will act on behalf of the supervising medical staff member to maintain life support until a licensed physician arrives to manage the patient. Removes catheters, drains, sutures and staples. Interprets arterial blood gas report and appropriate management of invasive and noninvasive modes of mechanical ventilation. Assesses need for vasoactive medication and places appropriate order sets and titration parameters. Interpretation of invasive and noninvasive hemodynamic monitoring, waveforms and EKG and institutes appropriate interventions. Interprets radiographic tests, including but not limited to CT scan, MRI and X-rays. Operates with the highest degree of independence in provision of patient care services with minimal physician supervision and generally in a highly specialized area Performs emergent lifesaving procedures in cases such cardiac arrest, respiratory arrest, massive hemorrhage, or similar catastrophe. Performs preliminary daily rounds independently and daily multidisciplinary rounds (i.e., attending physicians, fellows, pharmacist, dietician, respiratory therapist) Assesses patient for changes in status and capable of instituting appropriate interventions in sub-acute, acute and emergent situations. Notifies attending physician about unusual or unexpected events or problems requiring direct physician consultation. Initiates necessary emergent interventions to stabilize acutely deteriorating patients. Prescribes medication using evidence based medicine, clinical judgment and plan of care as discussed in rounds as agent for supervision physician. Writes and/or dictates concise thorough patient progress notes, consult notes, history and physical notes and clinical resumes. Documents the preparation, procedure, outcome and complications of therapeutic and diagnostic procedures performed. Explains the necessity, preparation, nature and anticipated effects of procedures or tests to patients, patient's family and staff. Provides family-centered care by communicating with family regarding the changing health care status of their family member. Provides family education as needed and works to answer or address family's questions or concerns. Assesses family adaptation, coping skills and need for crisis or other intervention. Utilizes current research and evidence based medicine approach in all clinical practice. Supports IRB approved clinical research/trials through a variety of activities including but not limited to: ordering diagnostic tests, prescreening patients, recording laboratory and diagnostic results, administering therapeutic interventions per trial protocols and documenting outcomes per hospital and trial protocols. Remains in compliance with national accreditation and state licensure Participates and supports accreditation, compliance, policies, procedures and regulatory activities. Embodies professionalism through conduct, appearance, communication, mutual respect, ethical decision making and leadership skills. Demonstrates responsibility for professional practice through active participation in professional organizations and continuing education. Contributes to excellence in patient care, research, teaching and consulting. Provides appropriate patient and family education. Maintains reasonably regular, punctual attendance consistent with Orlando Health policies, the ADA, FMLA and other federal, state and local standards. Maintains compliance with all Orlando Health policies and procedures. Other Related Functions Participates in basic science and clinical research projects. Other duties as assigned. Qualifications Education/Training Graduate of accredited nurse practitioner program with a Master's Degree and completion of a board certification if graduated after July 2006. New hires and Team Members placed in this job after May 1, 2021 must obtain acute care certification. Licensure/Certification ARNP license in the state of Florida. Maintains current ACLS and BLS. Fundamental Critical Care Support (FCCS) Certificate, or obtain the FCCS certification within 6 months of hire if preapproved by the Physician Director of Critical Care Services Experience If graduated before July 2006, and without certification, must have 2 years experience as a nurse practitioner in a critical care APP roleEducation/Training Graduate of accredited nurse practitioner program with a Master's Degree and completion of a board certification if graduated after July 2006. New hires and Team Members placed in this job after May 1, 2021 must obtain acute care certification. Licensure/Certification ARNP license in the state of Florida. Maintains current ACLS and BLS. Fundamental Critical Care Support (FCCS) Certificate, or obtain the FCCS certification within 6 months of hire if preapproved by the Physician Director of Critical Care Services Experience If graduated before July 2006, and without certification, must have 2 years experience as a nurse practitioner in a critical care APP roleEssential Functions Possess specialized skill and knowledge unique to the ICU setting in which they practice (Medical, Surgical, Neurosurgical, Cardiovascular, etc) Provides direct clinical services for critically ill patients according to established protocols and utilizes evidence-based clinical practice standards. Obtains comprehensive and focused history and physician exam on critically ill patients Responsible for evaluating critically ill complex (multi-organ failure) patients in the ICU and step down units by synthesizing data, physical exam and pertinent medical history to assess clinical scenario and prescribe appropriate interventions and medications. Uses clinical judgment and evidence based medicine to order and schedule appropriate laboratory and radiographic studies. Works with supervising physician to determine and place appropriate specialty consultations. Evaluates critically ill patients in the ICU and step down units by synthesizing data, physical exam and pertinent medical history to assess clinical scenario and prescribe appropriate interventions and medications. Works in collaboration with supervising and consulting physicians to formulate and implement plan for management of critical ill patients. Performs complex procedures in the diagnosis and treatment of medical and surgical problems (including but not limited to: Central venous catheter placement, arterial catheter placement, chest tube placement, lumbar puncture, thoracentesis, paracentesis, endotracheal intubation, therapeutic bronchoscopy -i.e removal of secretions and BAL.) Performs advanced cardiac life support. In a medical emergency, the nurse practitioner will act on behalf of the supervising medical staff member to maintain life support until a licensed physician arrives to manage the patient. Removes catheters, drains, sutures and staples. Interprets arterial blood gas report and appropriate management of invasive and noninvasive modes of mechanical ventilation. Assesses need for vasoactive medication and places appropriate order sets and titration parameters. Interpretation of invasive and noninvasive hemodynamic monitoring, waveforms and EKG and institutes appropriate interventions. Interprets radiographic tests, including but not limited to CT scan, MRI and X-rays. Operates with the highest degree of independence in provision of patient care services with minimal physician supervision and generally in a highly specialized area Performs emergent lifesaving procedures in cases such cardiac arrest, respiratory arrest, massive hemorrhage, or similar catastrophe. Performs preliminary daily rounds independently and daily multidisciplinary rounds (i.e., attending physicians, fellows, pharmacist, dietician, respiratory therapist) Assesses patient for changes in status and capable of instituting appropriate interventions in sub-acute, acute and emergent situations. Notifies attending physician about unusual or unexpected events or problems requiring direct physician consultation. Initiates necessary emergent interventions to stabilize acutely deteriorating patients. Prescribes medication using evidence based medicine, clinical judgment and plan of care as discussed in rounds as agent for supervision physician. Writes and/or dictates concise thorough patient progress notes, consult notes, history and physical notes and clinical resumes. Documents the preparation, procedure, outcome and complications of therapeutic and diagnostic procedures performed. Explains the necessity, preparation, nature and anticipated effects of procedures or tests to patients, patient's family and staff. Provides family-centered care by communicating with family regarding the changing health care status of their family member. Provides family education as needed and works to answer or address family's questions or concerns. Assesses family adaptation, coping skills and need for crisis or other intervention. Utilizes current research and evidence based medicine approach in all clinical practice. Supports IRB approved clinical research/trials through a variety of activities including but not limited to: ordering diagnostic tests, prescreening patients, recording laboratory and diagnostic results, administering therapeutic interventions per trial protocols and documenting outcomes per hospital and trial protocols. Remains in compliance with national accreditation and state licensure Participates and supports accreditation, compliance, policies, procedures and regulatory activities. Embodies professionalism through conduct, appearance, communication, mutual respect, ethical decision making and leadership skills. Demonstrates responsibility for professional practice through active participation in professional organizations and continuing education. Contributes to excellence in patient care, research, teaching and consulting. Provides appropriate patient and family education. Maintains reasonably regular, punctual attendance consistent with Orlando Health policies, the ADA, FMLA and other federal, state and local standards. Maintains compliance with all Orlando Health policies and procedures. Other Related Functions Participates in basic science and clinical research projects. Other duties as assigned.

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