Nurse Practitioner

Job Description Salary - OverviewFull Time Employees of Confluence Health receive a wide range of benefits in addition to compensation.here SummaryProvides appropriate specialized health care services to hospital and clinic patients. Performs examinations and provides treatment to routine clinical problems; performs or orders diagnostic testing; establishes diagnosis; prescribes medication; instructs patients and family members about continuing care.Position Reports To: Practice Manager Essential FunctionsOutpatient Practice DutiesStaff outpatient office clinic in WenatcheeStaff outpatient office clinic in satellite locations (either Moses Lake or Omak)1-4 days per monthProvide comprehensive history and physical examinations on new cardiology patientsProvide comprehensive history and physical examinations for pre-operative clearance of non-cardiac surgeryProvide comprehensive history and physical examinations prior to cardiac procedures, in conjunction with cardiologist performing procedureProvide post-operative evaluation after cardiac operations/procedures)Order and/or perform pertinent diagnostic tests—ECG, echocardiogram, nuclear stress test, exercise stress test, chest x-ray, etcEvaluate cardiac patient’s medical history, physical exam findings and diagnostic/laboratory dataFormulate cardiac care plan using established guidelines from ACC/AHA/NHLBI/HFS, and under the direction of a cardiologistInitiate hospital admission orders after consulting with on-call cardiologist, including admission history and physical, on cardiac patients that require admissionProvide education and counseling to cardiac patients, patients families, and community groups on prevention and treatment of cardiovascular diseaseProvide care in Areas of special interest may be assigned (ie HF, Lipid management, EP clinic)Act as preceptor for physician assistant/nurse practitioner studentsActively recruit patients for cardiology-oriented research studiesEducate and communicate with patients and families regarding cardiac procedures, including cardiac catheterization, PCI, CABG, Pacemaker/ICD implantation, cardioversion, stress testing, echocardiography, etcEducate Cardiac Rehab participants on cardiovascular disease and preventionParticipate in Community Wellness events, as schedule allows, with focus on cardiovascular disease Place referrals to other healthcare professional/specialties as neededParticipate in telemedicine clinic to outreach/satellite locations as needed and when travel is not possibleInpatient Practice DutiesStaff hospital services as assigned, 4–-hour shift rotation, including weekendsComplete comprehensive health history and physical examination of patients with acute or chronic cardiac conditionsOrder and/or perform pertinent diagnostic studies, including ECG, echocardiograms, treadmill stress tests, nuclear stress tests (pharmacologic and exercise), stress echocardiograms (pharmacologic and exercise), chest x-rays, etcPerform cardiac patient’s medical history, physical exam findings, and evaluate diagnostic/ laboratory dataAssist the on-call cardiologist with daily rounds, new consults, NSTEMI/STEMI triage in the EDGenerate daily progress notes to be used as shared-visits with on-call cardiologistNotify on-call cardiologist of any change in patient conditionEvaluate and formulate treatment plan for new consults, in conjunction with on-call cardiologistGenerate discharge summaries, discharge orders, plus complete patient education and follow-up plans for NSTEMI/STEMI patientsAdmit and perform History and Physical on Antiarrhythmic therapy patientsMonitor QTc interval on Antiarrhythmic patients, as directed by supervising physicianPerform medication reconciliation between hospital discharge and home medications, writing new prescriptions as appropriateComplete daily patient education on cardiac conditions, treatment options, medications, and prognosisAssist on-call cardiologist with triage of patients consults and needsCommunicate effectively with on-call cardiologist, hospital service, nursing staff, and other support staffOrder cardiovascular procedures (cardiac catheterizations, pacemaker implantations, etc.) as directed by attending cardiologistTake weekend calls from nursing staff and from outpatient clinic cardiology line from Friday 0 through Monday 0Assist in ACLS/BLS codes, as directed by supervising physician(s)Perform device interrogations, reprogramming and deactivation of ICDs in the setting of end-of-life care, per physician recommendationsPerform Pacemaker interrogations and interpretation of rhythm data, as directed by supervising physician(s)Assist in suturing pacemaker pockets and implanting loop recorders, as directed by supervising physician(s)Stress Testing Practice DutiesPossess knowledge/competency of appropriate indications/contraindications for exercise and pharmacologic stress testing, plus review stress test orders, to assess for appropriate use criteria by non-cardiology providersPossess knowledge/competency to promptly recognize and treat complications of exercise and pharmacologic stress testingPossess knowledge/competency of appropriate contraindications, risk assessment of testingPossess knowledge/competency of BLS/ACLS on an annual basisPossess knowledge/competency of Cardiovascular and Exercise PhysiologyPossess knowledge/competency of Exercise and Pharmacologic Stress testing ProtocolsPossess knowledge/competency of Cardiac Arrhythmias, at rest and during exerciseOther duties as assignedDemonstrate Standards of Behavior and adhere to the Code of Conduct in all aspects of job performance at all times. QualificationsRequired:Active Registered Nurse and ARNP licensure with prescriptive authority in the state of Washington, required by start date.CPR/ACLS Certification.Desired:Related experience.Cardiology Specialty Certification. Physical/Sensory DemandsO = Occasional, represents 1 to % or up to minutes in a 2 hour workday.F = Frequent, represents to % or up to 1 hour of a 2 hour workday.C = Continuous, represents % to % or up to 2 hours of a 2 hour workday.Physical/Sensory Demands For This Position:Walking - FSitting/Standing - FReaching: Shoulder Height - FReaching: Above shoulder height - OReaching: Below shoulder height - OClimbing - OPulling/Pushing: pounds or less - OPulling/Pushing: pounds to pounds - OPulling/Pushing: Over pounds - OLifting: pounds or less - FLifting: pounds to pounds - OLifting: Over pounds - OCarrying: pounds or less - OCarrying: pounds to pounds - OCarrying: Over pounds - OCrawling/Kneeling - OBending/Stooping/Crouching - OTwisting/Turning - ORepetitive Movement - OWorking Conditions:Work is performed at in patient exam and treatment rooms, where space may be limited and confined. Requires a combination of working independently and also working closely with others.Job Classification:FLSA: ExemptHourly/Salary: SalaryPhysical Exposures For This Position:Unprotected Heights - NoHeat - NoCold - NoMechanical Hazards - NoHazardous Substances - YesBlood Borne Pathogens Exposure Potential - YesLighting - NoNoise - NoIonizing/Non-Ionizing Radiation – NoInfectious Diseases - Yes