NURSE PRACTITIONER, M.S.- 40 HOURS-DAYS/ BWH Center for Weight Management / Wellness / Endocrine

• Exciting opportunity to join our established and growing Medical Weight Management program at Brigham and Women's Hospital with a focus on health equity and high-quality patient care.

The Nurse Practitioner is an expert registered nurse who has acquired specialized knowledge and skills through completion of a nurse practitioner program. The practitioner has the credentials to function in an expanded nursing role and is responsible for the daily management of selected patients. The practitioner has responsibility for assessment and management of patients including diagnostic and therapeutic interventions, and continuous implementation and evaluation of an appropriate plan of care. The Nurse Practitioner works under the supervision of the attending physician and is responsible to the Nurse Manager, or Director for the area.

About the role:

• The Center for Weight Management and Wellness (CWMW) Nurse Practitioner (NP) will be an integral member of an interdisciplinary team providing care to patients seeking medical and/or surgical treatment for a variety of weight-related metabolic conditions.
• Patient Care: Under direction of the supervising physician(s), the NP will be involved in all aspects of care including evaluation and medical management of new and return patients, primarily in the outpatient setting (individual and group visits). In collaboration with clinical staff, the NP will help to support patient needs between visits including medication refills, prior authorizations, responding to patient inquiries, referrals for diagnostic or therapeutic testing, and any additional follow-up required for the comprehensive care of CWMW patients.
• Locations: The NP may be engaged in seeing patients at the Brigham and Women's Hospital campus, Brigham and Women's Faulkner Hospital campus, and Brigham Health Care Center Foxborough campus with the possibility of additional Brigham Health locations as the service is in an active expansion phase.

NATURE AND SCOPE OF PRACTICE:

1. Performs and documents medical, physical, psychosocial and nutritional assessment on both new and established patients. Documentation requirements include electronic medical record documentation, dictations, medication reconciliation, and CWMW database entry for all patients.
2. Evaluates CWMW patients to establish candidacy for a broad range of weight management interventions including medical nutritional management, lifestyle interventions, obesity pharmacotherapy, endoluminal procedures, bariatric surgery, and investigational options under study in our institution.
3. Evaluates CWMW patients for undiagnosed obesity related co-morbidities that may impact their overall health and/or participation in weight management treatment options.
4. Educates patients regarding available weight management interventions that are currently being utilized in clinical practice.
5. In conjunction with supervisory staff, the NP will assist in gathering and interpreting data collected from patient visits and diagnostic studies in order to formulate and implement plans of care as well as to provide follow-up to assess patient outcomes.
6. Evaluates for and initiates specialist consults as deemed appropriate.
7. Triages patient inquiries related to their CWMW care.
8. In conjunction with the attending physician, the NP identifies and provides appropriate treatment for any complication related to weight management interventions.
9. Coordinates patient follow-up, reviews and communicates results from labs and other diagnostic studies, provides prescription refills, initiates prior authorizations, and places specialty referrals as needed.
10. Submits accurate billing for services provided.
11. As an active member of the CWMW team, the NP will work collaboratively in order to identify areas in need of improvement and implement appropriate and timely solutions.
12. Helps to analyze program data including patient demographics, clinic volume, no show rates, and clinical outcomes. Participates in the presentation of this data for administrative review, scientific/clinical conferences, and/or for publication.

GENERAL PRINCIPAL DUTIES AND RESPONSIBILITIES:

1. Patient Care Organization
   1. Provides direct care, counseling, and teaching to a select patient population.
   2. Performs physical examinations and provides preventive health measures appropriate to patient needs.
   3. Orders, interprets, and evaluates appropriate lab and diagnostic test to assess patient's clinical problems and health care needs.
   4. Arranges for appropriate plan of care and follow-up based on outcome of diagnostic, lab, and physical assessment findings.
   5. Performs laboratory tests appropriate for specific practice area.
   6. Orders medications and writes prescriptions according to organizational and regulatory policies and procedures.
   7. Records pertinent patient care findings in the medical records.
   8. Set priorities for appropriate and efficient management of patient care that reflects cost effective management of time, available human resources, supplies and equipment.
   9. Maintains interdisciplinary approach to planning and communicating patient care information by discussing patient data with appropriate physicians and other health care professionals.
   10. Incorporates the concepts of health maintenance, prevention, and promotion into daily practice through patient education and counseling.
   11. Demonstrates awareness of community resources and assists staff, patients, and families to effectively utilize them.

2. Quality of Care

1. 1. Assist in the development, implementation and revision of nurse practitioner guidelines.
   2. Evaluates outcomes of own patients' care and makes necessary revisions in care plans.
   3. Seeks and provides consultative services as required.
   4. Participates in departmental and organization quality improvement.
   5. Utilizes quality improvement data and research findings to enhance patient care.

3. Coordination

1. 1. Demonstrates appropriate collaborative and consultative relationships with other provides within the institution and community.
   2. Serves on Nursing and Hospital Committees and assumes responsibility for disseminating and communicating information to staff.

4. Budget

1. 1. Participates in cost effective management of personnel, time, supplies, and equipment in his/her area
   2. Collaborates with the Nurse Manager/Practice Manager/Director in the recommendation of appropriate staffing patters for their clinical areas.

5. Personnel Management

1. 1. Participates in selection process of new employees in group or team practice as requested
   2. Provides input into evaluation of other staff as appropriate.

6. Education

1. 1. Acts as a preceptor for nursing students and staff as requested.
   2. Assists in determining, evaluating, and/or implementing clinical area goals and objectives.
   3. Maintains interdisciplinary approach for planning and communicating information for patient care and operation of practice.
   4. Maintains current knowledge of legislation that may affect the health care delivery system.

7. Planning

1. 1. Develops annual objectives and reviews with Nurse Manager and/or Director at time of performance review and at appropriate intervals.
   2. Assists in determining, evaluating, and/or implementing clinical area goals and objectives.
   3. Maintains interdisciplinary approach for planning and communicating information for patient care and operation of practice.
   4. Maintains current knowledge of legislation that may affect the health care delivery system.

8. Research

1. 1. Participates in nursing research at a level consistent with educational background and experience
   2. Maintains understanding of current research of others in related clinical area through review of relevant publications.
   3. Participates in grant writing as appropriate.

Qualifications

Education/Licensure:

• Completion of Master's, DNP or PhD Degree in Nursing required. Completion of a Master's or post Masters' degree in adult or family NP program accredited by the Commission on Collegiate Nursing Education (CCNE) or the National League for Nursing Accrediting Commission (NLNAC) required.
• Current Adult/Geriatric or Family Nurse Practitioner Certification by an accredited APRN certifying body required.
• Valid prescriptive authority from both MA DPH and Federal DEA required.
• Current APRN license to practice in Massachusetts required.

Experience:

1. Minimum 1 year recent clinical Nurse Practitioner experience with an Endocrine and Weight management focused patient population required.
2. Minimum 5 years clinical Nurse Practitioner experience strongly preferred.
3. Clinical experience in nutritional counseling strongly preferred.

Other:

• ANA or other appropriate nursing certification in the area of practice and authorization by the Massachusetts Board of Registration in Nursing to practice in an expanded role. DEA for prescription writing.

SKILL/ABILITIES/COMPETENCIES REQUIRED:

1. Expert Clinical judgement skills to function in the independent role.
2. Excellent interpersonal relationship and communication skills in order to collaborate with patients' families, staff and community health workers.
3. Ability to work with frequent stress resulting from busy clinical settings and changing organizational climate.
4. Ability to self-directive and demonstrate initiative in addressing responsibilities of position.
5. Ability to utilize appropriate problem solving and conflict resolution skills.

CLINICAL STANDARDS THAT SERVE AS GUIDELINES FOR THIS PRACTICE

Nurse practitioner practice conforms to generally accepted standards of care as promulgated by the American Nurses Association and other relevant professional organizations. Patient care management is based on current evidence and sound clinical judgment. Clinical references may include but are limited to:

Harrison's Principles of Internal Medicine; Physician's Desk Reference; Barker, Principles of Ambulatory Medicine

EEO Statement

Brigham and Women's 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.