Advanced Practice Provider, APP (Nights) - Critical Care - ORMC - Orlando Health

Department: OHMG ORMC CCM

Status: Full-Time

Shift: Nights

Title: Nurse Practitioner, ARNP, Physician Assistant, PAC, APP, Advanced Practice Provider

ORLANDO HEALTH ORLANDO REGIONAL MEDICAL CENTER

Located in downtown Orlando, Orlando Health Orlando Regional Medical Center (ORMC) has served the Central Florida community for more than 100 years. With 898 acute-care and rehabilitative beds, it is among the largest acute-care facilities in the region and the only Level I Trauma Centers in Central Florida. The hospital has earned recognition from U.S. News & World Report as a “Best Hospital” in Central Florida and rated high performing in 12 adult procedures and conditions. Orlando Health ORMC holds the most Beacon Awards for Excellence in the state, awarded by the American Association of Critical-Care Nurses to units that employ evidence-based practices to improve patient and family outcomes, and is the only adult-care hospital in Orlando to achieve Magnet® Recognition, the gold standard for nursing’s contribution to quality patient care, safety, research and service excellence.

Orlando Health ORMC is the flagship hospital of the Orlando Health system of care, which includes award-winning hospitals and ERs, specialty institutes, urgent care centers, primary care practices and outpatient facilities that span Florida’s east to west coasts and beyond. Collectively, our 27,000+ team members honor our over 100-year legacy by providing professional and compassionate care to the patients, families and communities we serve.

Orlando Health is committed to providing you with benefits that go beyond the expected, with career-growing FREE education programs and well-being services to support you and your family through every stage of life. We begin your benefits on day one and offer flexibility wherever possible so that you can be present for your passions. “Orlando Health Is Your Best Place to Work” is not just something we say, it’s our promise to you.

Under the supervision of the physician, according to established practice guidelines and utilizing evidence-based clinical practice standards, provides inpatient management, consultations, and co-management of critically ill patients.

• Possess specialized skill and knowledge unique to the ICU setting in which they practice (Medical, Surgical, Neurosurgical, Cardiovascular, etc)
• Provides direct clinical services for critically ill patients according to established protocols and utilizes evidence-based clinical practice standards.
• Obtains comprehensive and focused history and physician exam on critically ill patients
• Responsible for evaluating critically ill complex (multi-organ failure) patients in the ICU and step down units by synthesizing data, physical exam and pertinent medical history to assess clinical scenario and prescribe appropriate interventions and medications.
• Uses clinical judgment and evidence based medicine to order and schedule appropriate laboratory and radiographic studies.
• Works with supervising physician to determine and place appropriate specialty consultations.
• Evaluates critically ill patients in the ICU and step down units by synthesizing data, physical exam and pertinent medical history to assess clinical scenario and prescribe appropriate interventions and medications.
• Works in collaboration with supervising and consulting physicians to formulate and implement plan for management of critical ill patients.
• Performs complex procedures in the diagnosis and treatment of medical and surgical problems (including but not limited to: Central venous catheter placement, arterial catheter placement, chest tube placement, lumbar puncture, thoracentesis, paracentesis, endotracheal intubation, therapeutic bronchoscopy –i.e removal of secretions and BAL.)
• Performs advanced cardiac life support. In a medical emergency, the nurse practitioner will act on behalf of the supervising medical staff member to maintain life support until a licensed physician arrives to manage the patient.
• Removes catheters, drains, sutures and staples.
• Interprets arterial blood gas report and appropriate management of invasive and noninvasive modes of mechanical ventilation.
• Assesses need for vasoactive medication and places appropriate order sets and titration parameters.
• Interpretation of invasive and noninvasive hemodynamic monitoring, waveforms and EKG and institutes appropriate
  interventions.
• Interprets radiographic tests, including but not limited to CT scan, MRI and X-rays.
• Operates with the highest degree of independence in provision of patient care services with minimal physician supervision and generally in a highly specialized area
• Performs emergent lifesaving procedures in cases such cardiac arrest, respiratory arrest, massive hemorrhage, or similar catastrophe.
• Performs preliminary daily rounds independently and daily multidisciplinary rounds (i.e., attending physicians, fellows, pharmacist, dietician, respiratory therapist)
• Assesses patient for changes in status and capable of instituting appropriate interventions in sub-acute, acute and emergent situations.
• Notifies attending physician about unusual or unexpected events or problems requiring direct physician consultation.
• Initiates necessary emergent interventions to stabilize acutely deteriorating patients.
• Prescribes medication using evidence based medicine, clinical judgment and plan of care as discussed in rounds as agent for supervision physician.
• Writes and/or dictates concise thorough patient progress notes, consult notes, history and physical notes and clinical resumes.
• Documents the preparation, procedure, outcome and complications of therapeutic and diagnostic procedures performed.
• Explains the necessity, preparation, nature and anticipated effects of procedures or tests to patients, patient’s family and staff.
• Provides family-centered care by communicating with family regarding the changing health care status of their family member.
• Provides family education as needed and works to answer or address family’s questions or concerns.
• Assesses family adaptation, coping skills and need for crisis or other intervention.
• Utilizes current research and evidence based medicine approach in all clinical practice.

Education/Training

Nurse Practitioner

• Graduate of accredited nurse practitioner program with a Master’s Degree and completion of a board certification if graduated after July 2006. New hires and Team Members placed in this job after May 1, 2021 must obtain acute care certification.

Physician Assistant

• Graduate of accredited physician assistant program.
• New hires and Team Members placed in this job after May 1, 2021 must obtain acute care or critical care fellowship program.

Licensure/Certification

Nurse Practitioner

• ARNP license in the state of Florida.
• Maintains current ACLS and BLS.
• Fundamental Critical Care Support (FCCS) Certificate, or obtain the FCCS certification within 6 months of hire if preapproved by the Physician Director of Critical Care Services

Physician Assistant

• Current licensure in State of Florida renewed every two years.
• Maintains current ACLS and BLS.
• Fundamental Critical Care Support (FCCS) Certificate, or obtain the FCCS certification within 6 months of hire if preapproved by the Physician Director of Critical Care Services

Experience

Nurse Practitioner

• If graduated before July 2006, and without certification, must have 2 years experience as a nurse practitioner in a critical care APP role

Physician Assistant

• Two (2) years of critical care experience in an APP role, a fellowship may substitute for the required experience.