Pediatric Nurse Practitioner or Physician Assistant - Pediatric Heart Center Fellowship

At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together.   About Duke University Hospital Pursue your passion for caring with Duke University Hospital in Durham, North Carolina, which is consistently ranked among the best in the United States. The largest of the four Duke Healthhospitals with 1062 patient beds, it features comprehensive diagnostic and therapeutic facilities, including a regional emergency/trauma center, an endo-surgery center, and more. Duke Nursing Highlights:   Duke University Health System is designated as a Magnet organizationNurses from each hospital are consistently recognized each year as North Carolina's Great 100 Nurses. Duke University Health System was awarded the American Board of Nursing Specialties Award for Nursing Certification Advocacy for being strong advocates of specialty nursing certification. Duke University Health System has 6000 + registered nurses Quality of Life: Living in the Triangle! Relocation Assistance (based on eligibility)  Job Location – Duke University Hospital

Job Summary

The Duke Pediatric Heart Center Advanced Practice Provider (NP or PA-C) Fellowship rotates through clinical settings in the pediatric heart center which includes inpatient and outpatient locations.  There will be heavy emphasis in the pediatric cardiac intensive care unit (PCICU), PICU, and pediatric cardiac stepdown.  The APP Heart Center fellow will work alongside APPs and MDs to provide direct patient care services for newborn congenital heart, surgical, and medically ill pediatric heart center patients from birth to young adults at Duke University Hospital or in the clinics in collaboration with APPs, cardiologists, and surgical physicians.  The APP Fellow performs physical exams, collects and documents data, conducts diagnostic and therapeutic procedures, orders and schedules laboratory studies and professional consultations, prescribes appropriate interventions and medications, coordinates the care and discharge of patients, and provides direct patient care services.  The APP Fellow contributes to excellence in patient care, research, teaching, and learns to provide leadership in the organization.

Goals of Pediatric Heart Center fellowship

Acquire a deep and broad knowledge base of the common congenital heart anomalies and disease

processes for which patients are hospitalized, understanding the pathophysiology, various presenting

clinical presentations and disease prognosis

Develop a diverse differential diagnosis and respective diagnostic and treatment plan based upon the

patient's presenting symptoms along with evidence-based and cost-effective medical care

Manage patients effectively throughout the whole hospital stay, including admission, daily rounds and

continuing evaluation, and dismissal, while remaining cognizant of the patient's or families emotional,

physical and spiritual needs

Learn practice management, including strategies in training APPs and APP students

Develop keen verbal skills to effectively communicate with colleagues, physicians, patients and

ancillary staff to ultimately become a key part of the inpatient health care delivery team

Job Duties and Responsibilities

Clinical Expert

In collaboration with cardiology attendings, PCICU attendings, surgeon(s) and/or APPs, round daily on patients to assess, diagnose, plan treatment, set priorities and realistic outcomes, and evaluate the effectiveness and cost efficiency of patient care.

Provide and coordinate clinical care for service specific patients through established protocols and under the hospitalist supervising physician or back up physician who is either on site or available by pager.

Collaborate with the residents, fellows, attending other NP/PA colleague’s nurses, and patient resource managers to formulate treatment plans and monitor patient progress.

Perform procedures specific to the work environment after demonstrated competency and within the guidelines of scope of practice and credentialing protocols.

Assess patients for change in status and institute appropriate interventions.  Initiate emergency interventions to stabilize the patient until physician support arrives.

Postoperative stabilization and management.

Develop patient care pathways, protocols and guidelines for the management of specific problems in conjunction with physicians and other members of the health care team.

Analyze clinical practice patterns so as to provide the best medical care and to increase effectiveness and efficiency.

Communicate verbally and in writing all pertinent patient information to supervising MD, nursing staff, patient resource manager, home health agency, and other relevant healthcare providers.

Document in the patients’ medical record all relevant data including but not limited to results of diagnostic tests; laboratory results; patients’ condition and response to therapies/interventions; communications with supervising MD.

Utilize prescriptive privileges only for identified patient population.

Prescriptive authority for prescribing, ordering, and or administering drugs; including (but not limited to) schedule II, III, IV, and V drugs and necessary medical devices.

Role model competence in all nurse practitioner / physician assistant advanced skills.

Give daily handoff to appropriate APP, attending, resident and/or intern at the end of the shift

Educator:

Assess educational needs of the patient-care staff and provide one-on-one as well as formal education as needed.

Assess educational needs of the patients / families and provide culturally sensitive patient/family education interventions as indicated.  Use non-technical language when educating patients and families.  Document all pre and post-op/procedure education in patients’ medical record.

Implement and evaluate appropriate educational programs for DUHS patient care staff and other healthcare providers as appropriate.

Role model and precept healthcare learners through contractual agreements.

Research Utilization and Investigation:

Utilize current research and evidence-based decision-making in all clinical practice.

Incorporate clinical research findings in the development and implementation of standards of care.

Support IRB approved clinical research/trials though a variety of activities including but not limited to obtaining consent, ordering diagnostic tests, recording laboratory & diagnostic results, administering therapeutic interventions, and reporting patient outcomes including toxicities or adverse events.

Participate in interdisciplinary quality improvement and/or research activities.

Participate in measuring and documenting outcomes.

Consultant:

Provide expertise and resource information to other healthcare providers, patients and families, and the community at large related to cardiothoracic diseases, procedures, interventions, and conditions.

Implement and evaluate appropriate educational programs for referring MDs

Develop, implement and evaluate standards of care/practice guidelines/policies and procedures/care maps/protocols within area of specialization.

Develop programs and projects in areas of expertise to facilitate the attainment of the goals and objectives of the Duke University Hospital and Duke University Health System.

Professional Leadership and Development:

Role model advanced practice professionalism through conduct, communication, dress, leadership, ethical decision-making, critical thinking and problem-solving skills.

Participate in at least one professional organization.

Demonstrate responsibility for professional practice through active participation in the Cardiology department, CAP Department, and professional organizations.  Meet Continuing Education requirements as designated by the NC Medical Board and/or NC Nursing Board.  Maintain professional certification.

Enhance the body of knowledge in area of specialization through written publications, oral presentations, posters, continuing education, etc.

Maintain all professional requirements for licensure and certification

Attend educational conferences regularly, morbidity and mortality conferences, code reviews, NP monthly meetings and attend twice a year adult congenital sessions.

When caring for adult patients with congenital heart disease, plan for situations beyond expertise, consult with and refer to other health care providers as appropriate.

• Job Eligibility Requirements
• Education (MUST GRADUATE BY DECEMBER 31, 2025)
• PA:         Graduate of ARC accredited Physician Assistant Program, Masters or DMSc degree preferred
• NP:         Graduate of accredited MSN or DNP Pediatric Acute Care Nurse Practitioner Program

Certification

PA:         PA-C

NP:         PNP-AC

• License
• PA:         Current unrestricted medical license issued by the NCMB with authorization to practice as PA

NP:         Current unrestricted RN license issued or recognized by the NCBON with authorization to practice as NP

Both:     Federal and State DEA with unrestrictive full prescriptive authority

Experience

New PA or PNP-AC grads welcome to apply, no APP experience required

Life support

• BLS (required)
• PALS (required)
• ACLS (recommended)

Physical and mental requirements

Able to clearly articulate scope of practice, and practices within those guidelines as a Nurse Practitioner / Physician Assistant

Able to independently seek out resources and work collaboratively to solve complex problems

Able to communicate clearly with patients, families, visitors, healthcare team, physicians, administrators, leadership, and others.

Able to use sensory and cognitive functions to process and prioritize information, perform health assessments, treatment, and follow-up.

Able to use fine motor skills

Able to record activities, document assessments & interventions; p