APP: PA/NP/CNS- Inpatient Neurosurgery

Stanford Health Care – Palo Alto, CA

The Advanced Practice Provider (APP) position is part of a collaborative team model of care consisting of Attending physicians, Fellows, Residents and a team of NP/PAs who provide care for Neurosurgery patients in the inpatient setting. Common diagnoses include: Subarachnoid hemorrhage, subdural hematoma, brain tumors, spinal stenosis, and surgery for epilepsy and Parkinson s Disease.

  • The primary location will be Palo Alto Main Campus at Stanford Health Care
  • The position is part-time benefited, 0.9 FTE. Schedule includes 6, 12-hour days, biweekly
  • There are multiple learning opportunities including department specific MD Grand Rounds, Fellows/Residents lectures, Nursing Grand Rounds, journal club, as well as regularly scheduled APP grand rounds.

  • General:
    Nurse Practitioner (NP): The Nurse Practitioner functions under the general Nurse Practitioner Standardized Process Protocol approved by the Interdisciplinary Practice Committee (IDPC). The Nurse Practitioner provides routine care and management of the patient with acute and chronic complaints, in collaboration with the supervising physician and through implementation of standardized procedures. Specific functions pertaining to the Service, Clinic or Department are established by the Nurse Practitioner and the supervising physician(s), and approved by the appropriate medical and nursing administrators, the IDPC, and the Stanford Hospital and Clinics (SHC) Medical Executive Board and Board of Directors.
    Physician Assistant (PA): The Physician Assistant functions under the general Physician Assistant Role Description approved by the Interdisciplinary Practice Committee (IDPC). Specific functions pertaining to the Service, Clinic or Department are established by the Physician Assistant and his or her supervising physician(s), and approved by the appropriate medical and nursing administrators, the IDPC, and the Stanford Hospital and Clinics (SHC) Medical Board and Board of Directors.
    Clinical Nurse Specialist (CNS): The Clinical Nurse Specialist (CNS) is a direct care clinician who also collaborates with members of the health care team to enhance patient care by developing and supporting nursing staff and providing care to patients and families within an identified specialty.This model describes the CNS s practice competencies within three spheres of influence: the patient/client, nursing and nursing practice and the organization/system sphere with the patient being the most important sphere. The CNS s clinical expertise arises from competencies inherent within a specialty of nursing practice and are used to address nursing issues within the patient/client, nursing and nursing practice, and the organization/system spheres. The essential roles of the CNS: expert clinician, interdisciplinary consultant, educator, researcher, and leader help to
    1) Provide direct patient and family care;
    2) Direct specialty knowledge and skill acquisition,
    3) Shape core competencies of clinical practice,
    4) Promote evidence-based outcome-guided nursing care,
    5) Integrate quality patient care across SHC practice sites,
    6) Promote promoting an environment of mentoring and system change that empower the nurse to experience professional growth and development.

    ESSENTIAL FUNCTIONS

    Evaluates and treats patients with acute, chronic complaints and health maintenance concerns

    Obtains complete histories and performs pertinent physical exams with assessment of normal and abnormal findings on new and return patients

    Performs or requests and evaluates diagnostic studies

    Administers, orders, furnishes and/or prescribes medications

    Orders and collects specimens for routine laboratory tests, screening procedures and therapeutic procedures, including blood and blood products

    Orders physical therapy, occupational therapy, respiratory therapy, radiology examinations and nursing services

    Performs designated procedures after demonstrated competency

    Obtains informed consent

    Initiates arrangements for hospital admissions and discharges

    Effectively communicates and interacts with patients, families, staff and members of the community from diverse backgrounds

    Recognizes situations which require the immediate attention of a physician, and initiates life-saving procedures when necessary

    Facilitates the coordination of inpatient and outpatient care and services

    Facilitates collaboration between providers and coordination of community resources

    Provides and coordinates patient teaching and counseling.

    Equal Opportunity Employer Stanford Health Care (SHC) strongly values diversity and is committed to equal opportunity and non-discrimination in all of its policies and practices, including the area of employment. Accordingly, SHC does not discriminate against any person on the basis of race, color, sex, sexual orientation or gender identity and/or expression, religion, age, national or ethnic origin, political beliefs, marital status, medical condition, genetic information, veteran status, or disability, or the perception of any of the above. People of all genders, members of all racial and ethnic groups, people with disabilities, and veterans are encouraged to apply. Qualified applicants with criminal convictions will be considered after an individualized assessment of the conviction and the job requirements.
    Physician Assistant:
    A. Education
    1. Bachelor s degree or above from an accredited college or university.
    a. Note: PAs hired prior to July 1, 2012 are not subject to this educational requirement.
    2. Graduate of a PA program accredited by the Accreditation Review Commission on Education for the Physician Assistant, Inc.

    B. Licensure/Certification
    1. Licensure as a Physician Assistant (PA) in the State of California.
    2. Certification as a Physician Assistant (PA) by the National Commission on Certification of Physician Assistants (NCCPA)
    3. Certification in Basic Life Support (BLS) from the American Heart Association (AHA).
    4. An individual Drug Enforcement Agency (DEA) license issued by the United States DEA for Schedule II-V controlled substances, required only if prescribing controlled substances to outpatients.
    a. PAs who will need to prescribe medications to outpatients shall obtain a current DEA license within six (6) months of hire.
    b. Note: Controlled substances ordered for inpatients will be covered under SHC s DEA license.
    5. Additional board certification(s) may be required by certain services/departments.

    Nurse Practitioner:
    A. Education
    1. Master s or doctoral degree in nursing from an accredited college or university.
    a. Note: NPs hired prior to March 1, 2012 are not subject to this educational requirement.
    2. Graduate of an NP program accredited by the National League of Nursing Accrediting Commission (NLNAC) or the Commission on Collegiate Nursing Education (CCNE).

    B. Licensure/Certification
    1. Licensure as a Registered Nurse (RN) in the State of California.
    2. Certification as a Nurse Practitioner (NP) in the State of California.
    3. National Board Certification as a Nurse Practitioner (NP) from an agency accredited by the American Board of Nursing Specialties (ABNS).
    a. Note: All NPs hired after November 1, 2013 must be nationally certified upon hire.
    4. Certification in Basic Life Support (BLS) from the American Heart Association (AHA).
    5. Furnishing license issued by the Board of Registered Nursing (BRN).
    a. NPs with six (6) months or more experience shall obtain a current furnishing license within six (6) months of hire.
    6. An individual Drug Enforcement Agency (DEA) license issued by the United States DEA for Schedule II-V controlled substances.
    a. NPs with six (6) months or more experience shall obtain a current DEA license within six (6) months of hire.
    b. New graduate NPs, who will need to prescribe controlled substances to outpatients, must first obtain a furnishing license and then obtain an individual DEA license.
    c. Note: Controlled substances ordered for immediate patient use in inpatient/outpatient settings will be covered under SHC s DEA license.
    7. Additional board certification(s) may be required by certain specialties/departments.

    Clinical Nurse Specialist:
    A. Education
    1. Master s or doctoral degree in nursing from an accredited college or university.
    2. Graduate of a CNS program accredited by the National League of Nursing Accrediting Commission (NLNAC) or the Commission on Collegiate Nursing Education (CCNE).

    B. Licensure/Certification
    1. Licensure as a Registered Nurse (RN) in the State of California.
    2. Certification as a Clinical Nurse Specialist (CNS) in the State of California.
    3. Certification in Basic Life Support (BLS) from the American Heart Association (AHA).
    4. Additional board certification(s) may be required by certain specialties/departments.
    5. If credentialed through the Medical Staff Office and billing for services, national certification through a certification corporation recognized by the American Board of Nursing Specialties is required.

    Work experience as an Advanced Practice Provider in Inpatient Neurosurgery is preferred.

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