Job Description Summary

Under the general guidance of the MD Chair of the Cath Lab and the Executive Director, APC program, the NP/PA will evaluate, diagnose and treat patients following written guidelines approved by the Department of Cardiology

Job Description


Reporting to the Chief of Cardiovascular Medicine for clinical issues and the Director of Cardiovascular Medicine for administrative issues, the Physician Assistant will work with the Cardiovascular physicians and particularly with the Interventional Team to facilitate the assessment, evaluation, preparation, procedures and follow up of interventional cardiology patients.

JOB REQUIREMENTS

Minimum Education - Preferred

Must have 4 years of college level education and bachelor's degree or equivalent. Must be a graduate of a Nurse Practitioner program approved by the AMA.

Minimum Work Experience

At least one year of clinical experience as a Nurse Practitioner preferably in Cardiology.

Required Licenses / Registrations

PA - Physician Assistant

Required additional Knowledge, and Abilities

Must possess current PA license and ACLS - Advanced Cardiac Life Support certification required.
License, certification and classes will be monitored through the Medical Staff Services Department.
Knowlege and competence of basic radiation safety during fluoroscopic procedures; required to attend at least one radiation safety training session per year.
Must have broad knowledge of medical environment, surgical practices and performance goals of the Cardiac Catheterization Laboratory and Interventional Services.
Must exercise the highest degree of professional judgement under the direction and guidance of a licensed physician.
Must be able to accept instruction and guidance and assume graded responsibility in complex teamwork.
Must be able to administer such care and treatment and exercise such 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 toward patients at all times and an excellent and collegial working relationship with other personnel involved in patient care.

1 - Facilitate the assessment and work up of cardiology patients in any environment including, but not limited to: ED, Noninvasive lab, CCL, Inpatient floors.

a - The Staff Physician Assistant will be responsible for obtaining and coordinating the following general items: history and physical, laboratory results, charting of clinical findings, admission orders, nursing instructions, pre-Cath orders, clinical documentation required by various registries and other required elements.

b - In collaboration with the Cardiovascular Access Coordinator and Hospitalist Service, will coordinate admissions and transfers to the hospital, and ensure that informed consent for procedures is obtained at the appropriate time.

c - Perform pre-procedure assessments in the Recovery room/holding area, Emergency Department, Inpatient Floors, or outpatient setting as needed.

2 - Interface between Cardiac Catheterization Laboratory and Recovery Area:

a - Maintains knowledge about the Cardiac Catheterization Laboratory scheduling, procedure room turnover and availability of resources including bed availability.

b - He/she will be called upon to manage patients after their procedures and while they await transfer to patient floor and will assure availability of equipment for special procedures.

c - Ensure blood bank preparation and formal or standing surgical backup, when required for patient care.

d - The Cardiovascular Physician Assistant will assist in communicating with the patients' families at all intervals of the care process and treatment.

3 - Medical Treatment and Post-procedure Care

a - The Staff Physician Assistant will be responsible for all aspects of care under the supervision of the attending physician, including but not limited to fluid and electrolyte management, nutrition, pain management, transfusion therapy, anticoagulation management and patient education.

b - Post procedure, the Physician Assistant will manage vascular access, monitor and manage arrhythmias, pacing, drug therapy, O2 therapy, and other non-cardiac medications, under the supervision of the attending physician.

c - Assist in the evaluation and management of clinical events such as fever, altered hemodynamics, CHF, pulmonary complications, abrupt vessel closure, arrhythmias, access site complications and others.

d - In collaboration with the Cardiovascular Access Coordinator and the Hospitalist Service, assist in transfers to and from the intensive care units.

4 - Procedure responsibilities:

a - Demonstrate knowledge and proper use of all required equipment and supplies used during diagnostic and interventional procedures performed in the Cardiac Catheterization Laboratory and other clinical areas.

b - Demonstrates sterile equipment and instrument set up according to standards including flushing and storage of guidewires, sheaths & coronary catheters; preparation of stent and balloon catheters; proper set up and use of medications and contrast on sterile field; Proper set up and continuous flushing of manifold to assure there is no air in system.

c - Provide support as 2nd operator to assist the attending physician during routine/elective diagnostic and interventional procedures performed in the Cardiac Catheterization Laboratory and other clinical areas.

d - Provide support as 2nd operator to assist the attending physician during emergency on call diagnostic and interventional procedures performed in the Cardiac Catheterization Laboratory and other clinical areas.

e - Maintains knowledge and competence regarding radiation safety and use of fluoroscopy during interventional procedures.

f - Demonstrates ability to gain and secure vascular access including ability to properly access femoral artery & vein, proper sheath placement.

g - Demonstrates ability to perform catheter, sheath and guidewire exchanges including short exchange; long exchange; sheath; catheter
guidewire (standard & angioplasty)

h - Demonstrates ability to insert angioseal/vasoseal device

i - Demonstrates ability to properly prepare and use ancillary equipment and supplies including: Intra-Aortic Balloon pump; Temporary Pacemaker and catheter; Thrombectomy devices.

5 - Post Procedure Care:

a - Performs vascular assessment and confirm assessment findings: Skin color and temperature, Capillary refill, Pulses, Edema, Sensation/strength
Movement

b - Properly and safely performs sheath removal

c - Demonstrates knowledge of actions and data required for patient transfer

d - Performs patient education regarding discharge including preventive care and risk factor reduction; assists in coordinating health related services (Cardiac Rehab/Home Care, etc.)

e - Writes discharge orders, prescriptions and dictate discharge summaries in collaboration with the attending physician.

6 - Education and Professional Development

a - Attends internal and external education meetings and read appropriate professional journals in order to maintain and enhance skills and clinical competence.

b - Completes 100 hours of continuing medical education necessary during each 2-year period of employment.

c - Attends all Cath Lab Staff Meetings and Interventional Physician meetings (scheduled and ad-hoc)

d - Analyzes causes of problems, identifies and evaluates alternative solutions, and selects appropriate solution, and communicates appropriately and effectively utilizing chain of command.

e - Provides teaching to students, house staff, nurses, technologists and cardiology fellows as instructed by the attending physician, particularly with regard to the evaluation, interventional treatment and longitudinal care of patients with cardiovascular disease.

f - Demonstrates conflict resolution among colleagues

g - Assumes an active role in keeping informed about changes in hospital policy, procedure, and equipment.