Nurse Practitioner Diabetes

This a 40-hour position. 4 (10 hour days.) There may be some weekend and holiday requirements

The Diabetes Advance Practice Provider (APP) is an advanced practice registered nurse or physician assistant that has acquired specialized knowledge and skills in diabetes through completion of a nurse practitioner program, completion of a diabetes certificate program and/or work experience in the care of patients with diabetes. The APP has the credentials to function in an advance practice role and is responsible for the daily management of diabetes patients. The APP has the responsibility for assessment and management of patients including diagnostic and therapeutic interventions, and continuous implementation and evaluation of appropriate plan of care. The APP works within a team model in collaboration with attending physician colleagues, interdisciplinary team members and is responsible to the Division Chief of Endocrinology and BWFH Chief Advance Practice Provider.

PRINCIPAL DUTIES AND RESPONSIBILITIES:

1. In clinical care, performs in the role of Licensed Independent Practitioner and is responsible to work independently and in collaboration with other providers to maintain a panel of patients.
2. Provides direct care, counseling, and teaching to a select inpatient population
3. Works collaboratively with the Endocrinology Attending on service to provide direct care, counseling and teaching to patients with diabetes admitted to BWFH inpatient service. Requires candidate to be on site for all inpatient management.
4. Provides comprehensive diabetes education in both one-on-one as well as in group settings.
5. Provides patient instruction in the use of and administration of injectable medications, Continuous Glucose Monitoring systems (CGMs) and Insulin pump therapy.
6. Key participant in quality improvement for diabetes management and active member of Diabetes Committee
7. Performs physical examinations and provides preventative health measures appropriate to patient needs.
8. Works collaboratively with physicians and other to triage diabetes-specific clinical calls from patients and direct care appropriately.
9. Orders, interprets and evaluates appropriate lab and diagnostic tests to assess patients' clinical problems and health care needs.
10. Arranges for appropriate plan of care and follow-up based on outcome of diagnostic, lab, and physical assessment findings.
11. Performs laboratory tests appropriate for specific patient population.
12. Orders medications and writes prescriptions according to organizational and regulatory policies and procedures.
13. Records pertinent patient care findings in the medical record.
14. Sets priorities for appropriate and efficient management of patient care that reflects cost effective management of time, available human resources, supplies and equipment.
15. Maintains interdisciplinary approach to planning and communicating patient care information by discussing patient data with appropriate physicians and other health care professionals.
16. Utilizes available resources and methodologies to advance practice within the division and beyond, with the aim of improving the care of all patients, particularly those most at risk for adverse outcomes.
17. Incorporates the concepts of health maintenance, prevention and promotion into daily practice through patient education and counseling.
18. Demonstrates awareness of community resources and assists staff, patients, and families to effectively utilize them.
19. Performs other related duties and responsibilities with the support of the diabetes program team as required.

SKILLS/COMPETENCIES REQUIRED:

* Staff adheres to all C.A.R.E. Standards

Overview of Skills

The APP works closely with the physician and nursing staff to develop and coordinate a plan of care designed to meet the physical, psychological and social needs of patients and their families. Strong interpersonal, organizational and communication skills are required. Knowledge of current literature and a commitment to continued learning are also required. The mission, vision and core values of Faulkner Hospital are incorporated into all areas of practice

Medical Knowledge Medical knowledge includes an understanding of pathophysiology, patient presentation, differential diagnosis, patient management, surgical principles, health promotion and disease prevention. The APP must demonstrate core knowledge about established and evolving biomedical and clinical sciences and the application of this knowledge to patient care in their area of practice. In addition, the APP is expected to demonstrate an investigatory and analytic thinking approach to clinical situations.

The APP is expected to:

• Understand etiologies, risk factors, underlying pathologic process, and epidemiology for medical conditions
• Identify signs and symptoms of medical conditions
• Select and interpret appropriate diagnostic or lab studies
• Manage general medical conditions to include understanding the indications, agents and other relevant treatment modalities
• Identify the appropriate site of care for presenting conditions, including identifying emergent cases and those requiring referral or admission
• Identify appropriate interventions for prevention of conditions
• Identify the appropriate methods to detect conditions in an asymptomatic individual
• Differentiate between the normal and the abnormal in anatomic, physiological, laboratory findings and other diagnostic data
• Appropriately use history and physical findings and diagnostic studies to formulate a differential diagnosis
• Provide appropriate care to patients with chronic conditions.
• Demonstrate proficiency with BWFH computer systems as needed to independently perform daily tasks such as order entry, EMAR, lab tests and results, incident reporting etc.
• Consistently provide high quality and timely documentation including admission notes, progress notes, discharge summaries and dictations.
• Must have knowledge of billing practices.

Physical and mental abilities required

• Ability to provide support, direction and development to staff.
• Ability to work effectively with all levels of the organization.

• Must be energetic, quality driven and have proven ability to develop a cohesive team of peers, dedicated to providing optimum patient care.
• Must exercise the highest degree of professional judgment under the direct supervision and guidance of a licensed physician.
• Must maintain a professional attitude towards patients and exercise such mature independent originality in solving problems not covered by existing guidelines, within legal limits, to meet the needs of the patients.
• Must maintain a professional attitude towards patients at all times and an excellent and collegial working relationship with other personnel involved in patient care.
• Must demonstrate understanding of procedures, policies and documentation required to ensure compliance with hospital standards of care.

EDUCATION:

* Must have successfully completed a Graduate Level, accredited Physician Assistant Program approved by AMA Board of Approval and Certification of PA programs.

* Must have 4 years of college level education and baccalaureate degree or equivalent. (BS/MS joint programs are also acceptable; BS with PA certificates are acceptable for graduates before 1995).

OR

* Must have completed a graduate degree in an accredited program with a Masters in Nursing in a Nurse Practitioner Program.

LICENSES, CERTIFICATIONS, and/or REGISTRATIONS

* Licensed as a Physician Assistant in Massachusetts or a Massachusetts Nurse Practitioner License

* If a PA, Board Certification by the National Commission on Certification of Pas (NCCPA) is required

• Certified Diabetes Care and Education Specialist (CDCES) or Board Certification in Advanced Diabetes Management (BCADM) preferred.

* Maintain current DEA and Massachusetts Controlled Substance Licenses

* Complete 100 hours of CME according to national and state regulations during each 2 year period of employment or other continuing education as required to maintain professional license.

* Maintain current BLS/ACLS certification

EXPERIENCE:

* Five (5) or more years of clinical Diabetes Management experience preferred.

* One year experience as an Advanced Practice Professional required.

* Current inpatient diabetes experience required.

* Bi-lingual strongly preferred, Spanish or Haitian Creole preferred second languages

* Experience in Motivational Interviewing preferred.

* Demonstrated knowledge of hospital-based and community-based care-strongly prefer both.

* Experience working in large complex health care organizations.

* Experience working with a diverse patient population.

* Ability to work with a variety of information systems and databases: MS Word, PowerPoint, Access, and Electronic Health Record.

* Knowledge of and commitment to the principles of team-based care and aware of local, regional and national trends in chronic disease care redesign and transformation.

WORKING CONDITIONS:

The APP position on the team can be quite challenging, requiring both teamwork and individual initiative. APP work schedule may subject to change based on patient care needs.

Brigham and Women's Faulkner Hospital is an Affirmative Action Employer. By embracing diverse skills, perspectives and ideas, we choose to lead. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment.