PHYSICIAN ASSISTANT-NOCTURNIST-/DEPT of SURGERY - ENT/PRS/UROLOGY
Brigham & Women's Hospital(BWH)

Job Info

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GENERAL SUMMARY/ OVERVIEW STATEMENT:

Thephysician assistant (PA) is a licensed provider who has acquired a broad rangeof knowledge and skills through the successful completion of a physicianassistant program. The PA is responsiblefor the assessment and management of various populations of patients, medicaland/or surgical, including diagnostic and therapeutic interventions,development of appropriate plans of care and ongoing evaluation. The physician assistant works under thesupervision of an attending physician and reports directly to the departmentadministrator or chief physician assistant administratively.

The PAwill perform in accordance with all state and federal regulations andinstitutional policies including but not limited to the BWH PA Scope ofPractice, Prescriptive Guidelines, approved clinical privileges, and BWH PApolicy.

PRINCIPAL DUTIES AND RESPONSIBILITIES:

PrincipleClinical Duties and Responsibilities:

• Provides direct care, counseling, and teaching to a designated patient population in the ambulatory, inpatient, operative, and/or procedural setting
• Performs complete histories and physical examinations
• Orders, interprets, and evaluates appropriate laboratory and diagnostic tests
• Develops appropriate plans of care and follow-up based on the outcomes of diagnostic, laboratory, and physical examination findings
• Orders medications and writes prescriptions according to organizational and regulatory policies and procedures
• Consistently provides high quality and timely documentation including admission and progress notes, procedure notes, operative notes and discharge summaries
• Performs bedside procedures as are appropriate to the patient population
• In some settings, the PA may first assist in the operating room or procedural areas
• Practices cost effective medicine in an efficient manner, maximizing available resources
• Discusses patient data with other physicians and professionals as appropriate in a multidisciplinary setting
• Demonstrates expert clinical judgment skills to function in an independent role
• Additional duties and responsibilities as required by the department/division

Non-ClinicalDuties and Responsibilities:

• Demonstrates professional collaborative and consultative relationships with other providers
• Follows all designated prescriptive practices and monitoring requirements with the designated supervising physician and administrative report
• Participates in departmental and organizational committees and programs as appropriate and attends all required meetings, in-services, and professional trainings
• Maintains superior interpersonal and communication skills as a member of the healthcare team in order to collaborate effectively with patients, families, staff, and community health workers
• Remains actively involved in continuing education with a commitment to self and departmental growth
• Adheres to all established safety policies, procedures, and precautions; identifies potential or actual unsafe situations in the environment and takes measures to rectify the situation
• Demonstrates understanding of procedures, policies, and documentation required to ensure compliance with hospital standards of care
• Additional duties and responsibilities as required by the department/division

For all positions that include direct patient care, indicate with an "X" the age(s) of all patient populations served

No Direct Patient Care

All age groups

Adolescence (13 to 17 years)

Neonates (birth to 1 month)

Young Adult (18 to 25 years)

Infant (1 month to1year)

Adult (26 to 54 years)

Early Childhood (12 months to 5 years)

Senior Adult (55 to 64 years)

Late Childhood (6 to 12 years)

Geriatric (65 years and up)

Qualifications
QUALIFICATIONS:

• The appropriate candidate will have successfully completed a graduate level physician assistant program (Masters degree) accredited by the Accreditation and Review Committee for Physician Assistants (ARC-PA) or such other accrediting agency as may qualify a graduate to sit for the NCCPA certifying examination
• BS/MS joint programs and those candidates with a BS and PA certificate are eligible, but ONLY for those who graduated BEFORE 1995
• Certification by the National Commission on Certification of Physician Assistants (NCCPA) must be obtained prior to first day of employment
• Must hold a current valid license or be eligible for licensure as a physician assistant in the Commonwealth of Massachusetts
• Must have or eligible for, and maintain, a current DEA registration and Massachusetts Controlled Substance Registration
• Must complete 100 hours of CME according to national and state regulations during each two year period of employment
• Must complete the BWH Professionalism Program within three months of date of hire
• Must complete the BWH Procedural Sedation Training if deemed necessary

SKILLS/ ABILITIES/ COMPETENCIES REQUIRED:

• Must have the ability to work in a high stress, dynamic, busy clinical setting with changing organizational climate
• Must have the ability to be self-directive and to demonstrate initiative in addressing the responsibilities of the position
• Must have the ability to utilize appropriate problem-solving and conflict resolution skills
• Must be energetic and quality driven and have a proven ability to be a productive member of a team dedicated to providing optimal patient care
• Must be proficient with BWH computer systems as needed to independently perform daily tasks (EMR, Epic preferred)
• Must maintain the highest degree of professional judgment under the supervision and guidance of a licensed physician

WORKING CONDITIONS: .

Work settings may include ambulatory clinics and treatment rooms, inpatient areas, intensive care units, operating rooms, and/or procedural areas. There may be loud noises, noxious odors, and temperature extremes. A large portion of the workday may be spent either standing or walking and the position may require heavy lifting of equipment and patients.

The PA may be exposed to radiation, potentially infectious bodily fluids, and sharp instruments such as needles and scalpels. Knowledge of Universal Precautions and proper use of surgical sharp instruments may be required. The consequences of contamination from bodily fluids or from being stuck with a sharp instrument include the possibility of physical harm to the employee or others. BWH is a fast paced, dynamic environment with a very large and complex patient volume; exposure to stress in the workplace is expected.

SUPERVISORY RESPONSIBILITY:

The Physician Assistant I does not have any supervisory responsibility.

FISCAL RESPONSIBILITY:

The Physician Assistant I does not have any fiscal responsibility.

ADDENDUM:

While the PA can expect a relatively predictable work schedule planned in advance whenever possible, scheduling variations may occur in order to cover clinical needs as they become apparent to the department/division/clinic. The PA may be asked to take call, pick up additional shifts, work variable hours, and/or provide backup coverage as needed.

The PA nocturnist and weekend specialist will be required to work nights (shifts 6 pm to 6 am), Monday through Sunday, on a rotating schedule covering inpatients on the Otolaryngology, Plastic Surgery and Urology services. This position will also require coverage on Saturdays and Sundays 6 am to 6 pm on a rotating basis. This is a full-time position with variation of hours on site per week.

General Responsibilities:

This work will include receive patient sign outs from residents/PAs in a timely fashion and caring for inpatients during assigned shifts. It will also include creating work list for each service for the following day and providing sign out of overnight events to the resident/PA.

The PA will also be required to evaluate patients on service who have an acute change in clinical status. The PA will be required to have basic surgical knowledge and skills in the management of post-operative patients including removal of surgical drains, removal of central lines, removal and placement of urinary catheters, placement and removal of nasogastric tubes and basic suturing. The PA will also be required to help with patient throughput, including inpatients but also patients admitted to the Extended Recovery and Post Anesthesia Care Units who will be discharged the following morning or admitted to the floor.

Finally, the PA may be required to assist in the operating room on cases that extend into the late evening or for emergency surgical procedures. However, it is anticipated that the majority of will be spent managing non-OR, floor issues.

Otolaryngology (ORL) Service Requirements:

The PA will be required to have or develop knowledge of basic ORL procedures not limited to but including, total thyroidectomy, radical neck dissection, retropharyngeal abscess drainage and complex head and neck cancer resections and flaps. The PA will be required to be trained in epistatxis management with nasal packing and removal, tracheostomy tube changes, drainage of superficial abscesses and NG tube and small bore feeding tube placement in complex post-op patients.

Plastic Surgery Service Requirements:

The PA will be required to have or develop knowledge of basic Plastic Surgery procedures not limited to be including, breast reconstruction (allograft, implants, tissue expanders), complex wound management, skin grafts and complex flap reconstruction. The PA will be required to be trained in the following procedure skills and maintain competency in: incision and drainage of superficial abscesses, suturing, removal of drains.

Urology Service Requirements:

The PA will be required to have or develop knowledge of basic Urology procedures not limited to but including, lithotripsy, transurethral resection of the prostate, penile implants, artificial urinary sphincter insertion, prostatectomy and cystectomy. The PA will be required to be trained in the following procedure skills and maintain competency in: placement of difficult urinary catheters, management of 3-way urinary catheters with and without irrigation, replacement/change of superpubic tubes and bladder irrigation.

EEO Statement
Brigham and Women's Hospital is an Equal Opportunity Employer. Allqualified applicants will receive consideration for employment without regardto race, color, religion, creed, sex, sexual orientation, gender identity,national origin, ancestry, age, veteran status, disability unrelated to jobrequirements, genetic information, military service, or other protected status.

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