Physician Assistant / Nurse Practitioner

 Under clinical supervision of a physician and direct supervision of the Manager/Director, the Physician Assistant provides general medical care, treatment and health care services to patients within the scope of their licensure and expertise level of the supervising physician.

Essential Job Functions

• Supports and models behaviors consistent with the mission and philosophy of Billings Clinic and department/service.

• Examines patients and performs comprehensive physical examination, compiles patient medical data including health history and results of physical examination.

• Administers or orders diagnostic tests, such as x-ray, laboratory, and other ancillary services as appropriate and differentiates between normal and abnormal information contained in the test results. (Patient Care, Testing Diagnostic Tests)

• Performs therapeutic procedures, such as injections, immunizations, suturing, wound care and managing infections within the scope of their licensure and the expertise level of the supervising physician. (Patient Care, Procedures, Midlevel Scope of Practice)

• Formulates diagnosis of medical problem, develops, implements and monitors patient care plans, records progress notes and assists in the provision of continuity of care; conferring with the supervising physician as necessary and/or appropriate. (Patient Care, Treatment plan, Patient Care Plan)

• Instructs and counsels patients and families regarding compliance with prescribed therapeutic regimens. (Education, Patient, Educates Patient)

• Refers patients to other health care providers and appropriate sources of care as necessary.

• Participates in on-call rotations and off hour rounding as it pertains to the specific department. (working condition)

• Identifies needs and sets goals for own growth and development; meets all mandatory organizational and departmental requirements; acquires knowledge and skills essential to incorporating into practice proven new evaluation/treatment modalities.

• Utilizes performance improvement principles to assess and improve quality; participates in the continued program development and marketing of service line.

• Maintains competency in all organizational, departmental and outside agency environmental, employee or patient safety standards relevant to job performance.

• Performs other duties as assigned or needed to meet the needs of the department/organization.                      

Additional Duties for PA/NP - ED Locums and Rural CAH/RHC

• Provides relief coverage in the emergency department and assists the physicians in all aspects of care in the emergency department. (Patient Care, ED, Coverage)

• Maintains appropriate theoretical and clinical skills with application and patient relevance of commonly utilized equipment specific to the emergency department needs and other areas as appropriate; pharmacological application; application of laboratory values and radiologic findings with disease process or physiological status. (patient Care, ED, ED Equipment)

• Performs wound exposure, suturing, hemostasis and tissue handling procedures as training and skill level allows under the direct supervision of the physician. (Patient Care, Surgical Services, Wound Care)

Knowledge, Skills, and Abilities

• Personal computers, hardware and software

• Microsoft Office Programs (i.e., Windows, Outlook, Word, Excel, etc.)

•  PAA and confidentiality requirements

• Patient’s/resident’s rights

• Patient safety standards, safety procedures and guidelines

• Health care trends and development relating to specialty area

• Physician Assistant practices and scope of licensure

• Healthcare reimbursement methodologies

• Ancillary services

• Regulatory requirements and guidelines (i.e., Joint Commission, CMS, OSHA, etc.)

• Infection control practices

• Pharmacology

• Scope of Practice, rules and regulations of the Montana Board of Nursing

• Nursing practice, planning and assessment within scope of practice

• Nursing Research

• Cerner utilization, and compliance with organization expectations around EMR

• Health reimbursement methodologies

• Ancillary services

• Infection control practices

• Pharmacology

• Nursing practices, planning and assessment within scope of practice

• American Nurse’s Association (ANA) Code of Ethics

• ANCC (American Nurse Credentialing Center) principles and standards

• Additional Knowledge for Physician Assistants / Nurse Practitioner -Surgical

• Surgical procedures and post-operative care standards/protocols

• Additional Knowledge for Physician Assistants / Nurse Practitioner -Express Care

• DOT examinations

• Professional communication skills, both verbal and written

• Analyzing data to formulate diagnosis and treatment care plans

• Exercising initiative and judgment

• Develop and formulate effective, cost efficient treatment care plans

• Problem identification and resolution relating to health care issues

• Conflict resolution

• Instructing and educating patients and families in the prescribed therapeutic regimens

• Demonstrating empathy and sensitivity necessary to elicit patient’s/family’s cooperation and allay apprehensions

• Working in a manner which is conducive to productivity, efficiency and cost effectiveness

• Additional skills for Neonatal Nurse Practitioner

• Proficient with insertion of UAC/UVC, PICC lines, intubation, thoracentesis, peripheral arterial blood sampling, and peripheral IV insertion.

• Proficient with ventilator management, nitric oxide administration and x-ray interpretation.

• Proficient with stabilization and transport of critical infant.

• Proficient with neonatal pharmacology and nutritional management.

• Experience with head or body cooling and encephalopathy management.

• Incorporate cultural diversity and age appropriate care into all aspects of communication and patient care; scope of services provided will encompass age groups from infant through geriatric

• Communicate clearly and effectively, both verbal and written

• Establish and maintain collaborative relationships

• Work effectively in a team environment

• Work independently with minimal supervision

• Respond calmly and effectively in emergent or difficult situations

• Maintain flexibility to adapt to a variety of work-load assignments

• Work with frequent interruptions and competing priorities

• Perform physical assessments

• Perform record keeping and documentation responsibilities

• Perform in a manner which is fiscally responsible

• Performs duties under the direct supervision of the practice physician

• Know and accept that the role of the Physician Assistant is limited, display sensitivity to the partial overlapping and possible sharing of responsibilities with other health care professionals

• Major roles include providing clients with health-related information, preventative measures and timely consultations with their practice physician, and to help them achieve and maintain good health

• Position requires the highest degree of integrity and confidentiality due to the sensitive nature of information handled