Advance Practice Provider, Orlando Health Children's Surgical Nocturnist

Position Summary

At Orlando Health Arnold Palmer Hospital Surgical Services, we offer comprehensive surgical services and award-winning healthcare for infants, children and teens.

Orlando Health Arnold Palmer Hospital for Children is the only pediatric Level One Trauma Center in Central Florida and is the children's hospital in Florida (and one of only 20 facilities nationwide) to achieve Level 1 Children’s Surgical Verification and Level 1 Trauma Verification by the American College of Surgeons.

We specialize in wide range of surgical conditions spanning across general surgery, trauma surgery, orthopedics, urology, craniomaxillofacial, otolaryngology, gynecology and many more.

The Surgical Nocturnist Advanced Practice Provider (APP) is an integral member of the multidisciplinary surgical care team, providing overnight surgical consultation and management across multiple surgical subspecialties. This role focuses on delivering high-quality, timely surgical care at Arnold Plamer Children’s Hospital including within the emergency department and other inpatient settings, supporting 24/7 surgical services to meet patient and institutional needs.

Position Summary

The Surgical Nocturnist APP team is designed to provide in-house overnight coverage from 7:00 PM to 7:00 AM, 365 days per year, as part of a rotating schedule.

The APP is primarily responsible for surgical consultations originating in the Emergency Center and collaborates closely with attending physicians across surgical specialties, as well as fellow and resident colleagues.

The role also includes inpatient surgical coverage, wound care rounding, operative support, and serving as the first point of clinical contact for postoperative patients during overnight hours for consultants, nursing calls etc.

Schedule and Work Hours

• Rotating schedule includes nights, weekends, and holidays.
• Twelve (12)-hour shifts.
• Coverage hours: 7:00 PM to 7:00 AM.
• Specific scheduling patterns and FTE expectations determined by operational needs.
• Paid Time Off (PTO)

Requests for PTO must be made at least 30 days in advance according to OH policy. However, operational needs may require additional notice. PTO requests are granted on a first come first serve basis

Holiday Coverage

• Holiday coverage is rotated among Surgical Nocturnist APPs, and contingent upon fellow and resident coverage
• Minor Holidays: Memorial Day, July 4th, Labor Day.
• Major Holidays: Thanksgiving Day, Christmas Day, New Years Day

Key Responsibilities

Receives sign-out on all active surgical patients at the start of each shift and performs nightly rounds as needed.

• Performs Emergency Department surgical consultations and evaluates patients requiring surgical admission.
• Completes admission histories and physicals (H&Ps) for surgical services.
• Develops and enters admission orders, pre-operative orders, and ensures patients are appropriately prepared for the operating room.
• Provides pre-operative medical clearance as indicated.
• Serve as First Assist in the operating room when necessary and credentialed.
• Acts as first call for nursing questions and clinical concerns related to post-operative surgical patients.

Collaborates with attending surgeons, fellows, residents, nursing staff, and ancillary teams to ensure safe and effective overnight surgical care.

Triages overnight clinical responsibilities and incoming calls based on patient acuity, urgency, and emergent circumstances to ensure timely and appropriate surgical intervention

Essential Functions

• Performs comprehensive and problem-focused progress notes and histories and physicals for:
• Peri-Surgical patients
• Emergency Department surgical consults and admission

Transfer Center Admissions

• Assists with surgical procedures, including first assist responsibilities, as needed and within scope of practice.
• Conducts hospital rounds on pre- and post-operative surgical patients.
• Orders and reviews appropriate pre-operative laboratory and radiology studies as directed by the surgeon and/or anesthesia.
• Evaluates and responds to changes in patient clinical condition and initiates appropriate interventions.
• Formulates and implements treatment and therapeutic plans for surgical patients in collaboration with the attending physician.
• Assists with discharge planning and completion of discharge summaries for surgical patients.

Assesses patient need for urgent or emergent surgical intervention and promptly notifies the appropriate surgeon.

Provides family and patient education regarding changes in clinical condition, diagnostic findings, and planned procedural or surgical interventions.

• Participates in education of pediatric residents, advanced practice providers, and registered nurses.
• Prioritizes and triages clinical responsibilities, consult requests, and nursing communications according to acuity and emergent needs while maintaining patient safety and workflow efficiency
• Discharge planning
• Patient Education
• Discharge Orders and Summaries
• Follow Up Appointments
• Outpatient prescription management

Program Impact

Delivers measurable value across quality, operations, workforce stability, and financial performance.

Provides dedicated overnight surgical coverage with acuity-based triage, improving early recognition and intervention while reducing failure-to-rescue events and surgical readmissions.

Improves emergency department and inpatient throughput, supporting timely surgical decision-making and patient flow.

Strengthens interdisciplinary collaboration and nursing empowerment through consistent overnight clinical support, contributing to improved engagement and GLINT survey outcomes.

Supports resident duty-hour compliance and trainee well-being by redistributing overnight clinical workload while preserving educational quality.

Enhances revenue integrity through timely documentation, consult management, admissions, procedures, and first-assist coverage, reducing missed revenue.

Positions the Surgical Nocturnist APP program as a scalable, value-based care model aligned with organizational strategy and quality incentive priorities.

Qualifications

Experience

Master’s degree or Doctorate degree in Nursing as an Advanced Practice Registered Nurse or completion of an accredited Physician Assistant Studies program.

Minimum of three (3) years of experience as a Registered Nurse or Advanced Practice Provider in Pediatric Emergency Medicine, Pediatric Intensive Care, or Pediatric Medical-Surgical units.

Ability to complete a Surgical First Assist Training Program.

Licensure and Certification

Certified as a Pediatric Acute Care Nurse Practitioner or dual-certified as a Pediatric Primary and Acute Care Nurse Practitioner or certified as a Physician Assistant.

Current, active licensure and certification in the State of Florida as an Advanced Practice Registered Nurse or Physician Assistant.

• Maintains current Basic Life Support (BLS) and Pediatric Advanced Life Support (PALS) certification.
• Ability to obtain Advanced Trauma Life Support (ATLS) certification.