Under the supervision and direction of the Orthopaedic Department Executive Director, Physician Chief of the Children's Service, APP Clinical Director, and service Practice Manager, the Nurse Practitioner (NP) is responsible for the care of the Orthopaedic Pediatric patient population in the outpatient setting.
The NP will function at the highest level of licensure, optimizing advanced practice by conducting independent clinics, a minimum of 3 per week, which include new (increase patient access), established, surgical optimization, postop and urgent patient visits. The NP will support the surgeons of the Children's service by providing ongoing care coordination and symptom management for their patients.
The NP will collaborate with all providers in the Children's service to identify obstacles/challenges to daily practice and/or clinic flow and develop interventions for quality improvement.
The NP will practice in accordance with the rules, regulations and standards of nursing practice issued by the state and federal governing boards, including the American Association of Nurse Practitioners (AANP) and the American Nurses Credentialing Center (ANCC).
PRINCIPAL DUTIES AND RESPONSIBILITIES:
Provides direct care, counseling, and teaching to the Pediatric patient population.
Functions independently in own clinic.
Assists all surgeons in the Children's service with the management of their pediatric patients and organization/workflow of clinics.
Performs complete histories and physical examinations on new, established, preop, postop patients.
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.
Consults with supervising physician/other surgeons regarding abnormal findings outside of scope of practice.
Prescribes medications and narcotics as necessary according to organizational and state/federal regulatory policies and procedures.
Initiates consultations and referrals for patients.
Obtains preoperative surgical consents; Confirms laterality and abides by all hospital consent guidelines.
Performs preoperative preparation/education for patient and family, reinforcing the surgical plan presented by the attending physician.
Orders necessary preoperative diagnostic tests (MRSA/MSSA, COVID test), imaging, consultations, and procedures as indicated or requested by the attending physician to prevent delay with surgical procedure, which also includes obtaining medical clearance and instruction regarding medications/anticoagulation prior to surgery.
May function as first assist in the OR, when necessary, IF has completed certification as an RNFA, and has hospital first assist privileges.
See patients in clinic for urgent issues (signs of infection, wound problems, worsening pain, impending pathologic fracture).
Provides symptom management for orthopedic oncology patients.
Manage is high volume of patient calls, emails and completes all outpatient clinical forms (FMLA, insurance disability, hardship needs).
Obtains prior authorizations for surgery, scans, medications, DME and other procedures as necessary
Consistently provides high quality and timely documentation of clinic visits, admission and progress notes, procedure notes, and e-mail/phone conversations.
Contributes to patient presentation at morning rounds, weekly indications conference, and multi-disciplinary meeting slash conferences as necessary.
Identifies patients appropriate for division research studies and obtains consents.
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.
Maintains communication with all inpatient staff (APPs, case management, OT/PT, consults) and all involved in the transition of patient care (skilled facility, VNA, PCP, referring physicians).
Provides an environment for effective patient-family centric care.
Demonstrates expert clinical judgment skills to function in an independent role.
Additional duties and responsibilities as required by the department/division.
Demonstrates professional collaborative and consultative relationships with inpatient Orthopaedic APP colleagues and other multidisciplinary providers.
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 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.
SKILLS/ ABILITIES/ COMPETENCIES REQUIRED:
Must be flexible and be able to work in a high stress, dynamic, acute clinical setting within an ever-changing organizational climate.
Must be self-directive and to demonstrate initiative in addressing the responsibilities of the position.
Must demonstrate problem-solving and conflict resolution skills.
Must excel in effective and positive communications with patients, families, staff nurses, case managers, surgeons, trainees, support staff, and many interdisciplinary providers.
Must be energetic and quality driven to partner in the progress of the trauma service and be a productive member of a team dedicated optimal safe patient care.
Must be proficient with MGH computer systems as needed to independently perform daily tasks (Epic preferred).
Holds self and colleagues accountable to learn, develop and achieve the best and highest quality results.
Treats leadership and colleagues with respect.
Must maintain the highest degree of professional judgment under the collaborating supervising physician and Director of Orthopaedic APPs.
Fast paced, high volume Children's service working in collaboration with 6 surgeons, 5 APPs and Medical Assistants at various MGH/MGB sites. The work requires some heavy lifting and/or transfer of patients from wheelchairs to exam tables, as well as exposure to potentially infective material. Work requires contact with needles and other sharp instruments, monitoring devices, complex wound care, and other state-of-the-art equipment. Prolonged standing can be expected. Walking to and from the patient care units can be expected.
The appropriate candidate will be a graduate of an accredited NP school with ANCC or AANP Board Certification.
Current Commonwealth of Massachusetts RN license with authorization to practice in the expanded role (NP).
Must have or be eligible for and maintain a current DEA registration, Massachusetts Controlled Substance Registration (MCSR).
Qualified in basic life support standards as established by the American Heart Association.
Massachusetts General 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.