Advanced Practice Provider PD Emergency Medicine

General Responsibilities:

Under the general direction of the APP (Advanced Practice Provider) Medical Director or Associate Medical Director, this Advanced Practice Provider (APP) position is responsible for practicing emergency medicine in the Emergency Department. The Emergency Department Advanced Practice Provider will obtain medical histories, perform physical examinations, and order and interpret diagnostic tests to establish diagnoses and develop and implement treatment plans for emergency department patients. Additionally, the APP will perform diagnostic and therapeutic emergency medicine procedures.

All practice is performed under the supervision of the Attending Physician and in accordance with written policies and protocols developed and approved by the Emergency Department, the Medical Executive Committee, and the Board of Rhode Island Hospital/Miriam Hospital/Newport Hospital.

Minimum Qualifications:

• Physician Assistants: Master's Degree in Physician Assistant Studies

• Nurse Practitioners: graduate degree (Master of Science in Nursing or Doctor of Nursing Practice) from an accredited Nurse Practitioner Program

• Minimum of 1 year of experience as an Advanced Practice Provider, preferably in an emergency department setting.

• National Certifying Commission of Physician Assistants (NCCPA) certification, or equivalent Nurse Practitioner national board certification

• Current Physician Assistant or Nurse Practitioner Rhode Island State Licensure

• Current DEA and Rhode Island Controlled Substance Registration (CSR) or ability to obtain prior to start date.

• Must be able to meet credentialing requirements as a Medical Staff member of Brown University Health Medical Staff, including submission of a background release form demonstrating proof of no disqualifying information.

Skills Required

• Ability to handle confidential information in a discrete and professional manner consistent with HIPAA privacy rules

• Ability to prioritize and perform multiple tasks in an efficient, timely manner within a fast-paced clinical environment

• Ability to work both independently and collaboratively within a multidisciplinary team

• Excellent oral and written communication skills.

• Exemplary professionalism and interpersonal skills

• Proficiency with EMR platforms for efficient clinical documentation and workflow

Primary Contacts:

The Advanced Practice Provider is supervised by the APP Medical Director and Chief APP, with collaborative relationships across Brown EM, Hospital Administration, and Clinical Teams.

Physical Effort / Environment:

This position required moderate physical effort to perform clinical duties. Prolonged standing on your feet and a considerable amount of walking in the emergency department per shift is required.

Work Schedule Demands:

Full-time Advanced Practice Providers typically work 36-40 clinical hours per week, with variable scheduling that includes days, evenings, weekends, and holidays.

Communication Skills:

Very good communication, writing, and analytical skills are required, as APP often interacts with physicians, other APP members, community resources, providers, other employees, and the public.

Confidentiality of Information:

This position requires full access, review, preparation, and use of confidential information of medical, personal, social, and psychological nature, based on data and histories obtained from emergency room patients. HIPAA Compliance is essential both in and out of the work setting. Incumbent must maintain confidentiality of all patient information in accordance with HIPAA regulations.

Significant Job Functions:

Clinical Duties

• Assess all patients presenting for care at the Andrew F. Anderson Emergency Center (AEC), The Miriam Emergency Department, Newport Hospital Emergency Department, or Hasbro Emergency Department for an emergency medical condition under the criteria embodied in EMTALA.

• Use published triage guidelines to establish patient acuity and determine the appropriate care area patient should be triaged to.

• Evaluate patients in accordance with Attending Physician supervision requirements, as follows:

  • Patients deemed to have a lower acuity complaint by nursing triage (i.e. ESI 4 or 5) can be evaluated, treated and dispositioned from the Emergency Department by an Advanced Practice Provider without requiring an evaluation by the Attending Physician.

  • Higher acuity patients designated ESI 3 or ESI 2 by triage nursing, require that an Attending Physician also evaluate the patient in the emergency department before discharge.

  • Critical Care patients require direct bedside supervision by the attending physician.

• Conduct a history and physical examination on all patients in the emergency department seen by the APP and appropriately document in the patients' record.

• Order and interpret laboratory testing and radiology studies.

• Request respiratory therapy, psychiatric, medical, and surgical consultations as well as interventional radiology procedures, and social work, case management, and PT/OT evaluations.

• Order emergency department therapeutics including medications and IV fluids

• Prescribe outpatient medications

• Perform the following procedures:

  • Blood draws excluding femoral sticks

  • Arterial Blood Gas

  • Establish IV access including US Guided peripheral IV and External Jugular IV access

  • Insertion of Foley catheters, nasogastric tubes, and reinsertion of gastric feeding tubes or suprapubic catheters

  • Epistaxis management including chemical cautery and packing insertion

  • Foreign Body Removal

  • Paracentesis, Arthrocentesis, Lumbar Puncture

  • Orthopedic injury management including splinting and reduction of certain fractures and dislocations

  • Wound management, including suturing and suture/staple removal

  • Incision and Drainage

  • Eye evaluation including fluorescein and slit lamp examination and removal or corneal foreign bodies

  • Certain nerve blocks (e.g. infraorbital, supraorbital, digital, and dental nerve blocks)

  • Advanced procedures (e.g., intubation, central line placement) may be performed under direct attending supervision, based on training and privileging

General

• Attends internal/external meetings/conferences/training opportunities related to areas of responsibility, when necessary.

• Meets with APP Medical Director or Associate Medical Director as needed.

• Maintains professional standards in clinical and administrative settings.

• The Advanced Practice Provider must maintain professional behavior when interacting with hospital employees, patients, staff members, and other community agency representatives.

• Keeps current with all professional email correspondence and practice requirements

Other

• To make Brown EM operate more efficiently, at the discretion of the APP Medical Director or Associate Medical Director, the Physician Assistant or Nurse Practitioner Advanced Practice Provider will be expected to do other non-routine tasks or projects as needed.

Pay Range:

EEO Statement:

Brown University Health is committed to providing equal employment opportunities and maintaining a work environment free from all forms of unlawful discrimination and harassment.

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