Physician Assistant/Family Nurse Practitioner - Urgent Care
WestCare Health System - Sylva, NC

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Education and Training : Graduation from an accredited Physician Assistant program or Family Nurse Practitioner program. Certificate License: Certification from National Commission on Physician Assistants. Family Nurse Practitioner should maintain current Board of Nursing license. Knowledge of professional medical practice and care to give and evaluate patient care. Knowledge of organization policies, regulations, and procedures to administer patient care. Knowledge of medical equipment and instruments to administer patient care. Skill in maintaining effective working relationships with patients, medical staff, and the public, and the ability to interpret, adapt, and apply guidelines and procedures.

Experience : Minimum of 6 months experience in emergency room or urgent care preferred. Family Practice experience good. Occupational Health experience a plus. The Physician Assistant/Family Nurse Practitioner must be credentialed or eligible for credentialing on the Medical Staff. If eligible, must be completed in six months probationary period. The primary duties of the Physician Assistant/Family Nurse Practitioner will be providing primary health care in the UCC and performing selective medical services under the direction of the UCC physician. The PA/FNP will complete health assessments of patients, perform physical exams, and interpret and integrate data to determine appropriate diagnostic and therapeutic services as needed. Will provide acute care services for injuries and/or illnesses and will administer injections and oral medications. Will suture minor wounds and prepare written prescription orders for drugs and controlled substances under the direction of the physician. Will maintain and review patient record chart and other pertinent information. Will review post test and examination results. Will interview and advise patients regarding health and illness prevention. Will recommend community resources to meet patient and family needs. Will triage patient telephone calls and provide consultation. Will attend required meetings and participate on committees as requested. Will participate in professional development activities and maintain professional affiliations. Will maintain confidentiality and perform related work as required. The Physician Assistant/ Family Nurse Practitioner may need to assist staff with admitting and discharging patients, obtaining triage information, administering medications, cleaning rooms, and other duties. The PA/FNP may be asked to evaluate and treat OHD patients as needed. The PA/FNP will report directly to the physician for medical services and to the OHD/UCC Director for all other duties assigned.

Environmental and Special Demands : Typical physical demands will require full range of body motion, including handling and lifting patients, manual and finger dexterity, and eye-to-hand coordination. Standing and walking for prolonged period of time. Occasionally lifts and carries items weighing up to 25 lbs or greater. Also, requires normal visual acuity and hearing. My be exposed to communicable diseases and bodily fluids. This position may require working in stress and emergency situations during our regular hours.

Typical Working Conditions : Frequent exposure to communicable disease, toxic substances, blood and body fluids, and medical preparation and other conditions, to a clinical hospital environment. Scope of Practice for Physician Assistant/Family Nurse Practitioner: Scope of practice is specific to the duties and responsibilities of the PA/FNP by the UCC. His/her direct supervisor will be the UCC physician for clinical duties and the UCC/OHD Director for administrative duties. The UCC physician is the agent in rendering of patient care and the PA/FNP will exercise no independent authority. In the absence of the UCC physician from the clinic, the OHD physician will provide back-up to the PA/FNP. Writing of Orders: The PA/FNP is authorized to write medical orders on patients that are seen through the UCC. All orders written by PA/FNP will be within the parameters of the scope of practice and will be reviewed by the physician and countersigned within a reasonable period of time which will not exceed one week from initiation. All progress notes, consultation reports, report of histories, physical exam, and drug testing written by the PA/FNP will clearly identify him/her as the PA/FNP. The PA/FNP will not write prescriptions which imitate therapy outside of his/her scope of practice. All approved formulary medications will be considered to be within the approved scope of practice of the PA/FNP. Routine Duties: The PA/FNP is authorized to perform the following tasks on a regular and ongoing basis. These duties may be performed without specific prior discussion with the managing physician and/or medical director.

Job Specific Standards : 1. Performs initial and interim histories and physical exam on employees and patients assigned to UCC. The initial history and physical will be reviewed by the physician of the UCC and countersigned. Random review of care rendered to patients will also be accomplished. 2. May order routine lab, radiology, and diagnostic tests on patients treated in the UCC and provide initial interpretation of results. Radiology films will be read by PA/FNP with over read by physician and by Radiologist. 3. May perform venipuncture to obtain test specimens when personnel who customarily perform these procedures are not available. 4. May initiate and/or expedite request for consultations, special tests, or studies on assigned patients and will keep the physician apprised of results, progress, and need for further evaluation. 5. May write interim progress notes, document findings as history and physical exam, and may dictate other medical information as deemed necessary by physician. 6. May order electrical cardiograms and provide initial interpretation of EKG. 7. May provide necessary patient education and apply currently accepted preventive health care measures to employees and patients. 8. As appropriate will maintain certifications as required. 9. May mix and start I.V. solutions, administer I.V. medications after conferring with the physician. 10. May order and/or insert Foley catheters as necessary. 11. May order and/or give oxygen as necessary. 12. May administer TB tests, required immunizations. 13. May initiate treatment for minor injuries, abrasions, contusions, and burns. 14. May initiate treatment for minor illnesses. Other Duties Requested: The PA/FNP is authorized to Perform the following duties after consultation with the physician. During the performance of these duties, a staff physician must be immediately available for consult by telephone and if summoned must be visibly present at the site of the procedure. Procedure: Administer of local or digital anesthesia Application of casts/splints Incision and drainage Needle aspiration of joints, tendons, or bursa Perform minor/diagnostic surgical procedures Remove ingrown toenail/callous Suturing or Stapling of simple lacerations Wound debridement and care Emergency Duties: The PA/FNP is authorized to perform the following duties with patients with life threatening situations where a physician is not immediately available. He/she will initiate these procedures, but will make every effort to summon a physician as soon as possible. Advanced cardiac life support in accordance with current ACLS protocols to include defibrillation and cardioversion. Treatment of acute respiratory therapy, treatment of life threatening traumatic injuries, and treatment of severe allergic reactions/anaphylaxis. The PA/FNP is authorized to participate in the following miscellaneous duties not otherwise specified in the scope of practice: Clinical research, administrative duties such as quality assurance, peer review, and serving on various committees as may be directed by the OHD/UCC Director of medical director. Other nonclinical tasks as deemed necessary. Instruction of allied health care students assigned to our service.

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