Nurse Practitioner-Integrative Pain Clinic na Tucson Medical Center

The TMC Integrative Pain Center provides highly specialized treatment for both acute and chronic pain.  Each patient receives individualized care with compassion and respect by highly skilled staff and providers.  We are looking for a team member who is experienced and has a passion for pain care.

Hours can vary, but 4-10's or 5-8's will work for this role. 

SUMMARY:

In collaboration with a physician, provides comprehensive assessment of patient’s health status, evaluates assessment data, and makes treatment decisions.

ESSENTIAL FUNCTIONS:

Initiates patient admissions and collects health, illness psychosocial, and family history from patients; provides initial care of emergencies.

Performs physical examinations, and orders appropriate diagnostic tests.

Records patient’s health information, performs periodic health evaluations, and establishes/records care plans; evaluates care plans, monitors and records progress, and makes modifications accordingly.             

Determines normal and abnormal findings on patient history, physical examination, diagnostic tests; initiates referral and consultation when appropriate.

Consults and collaborates with members of the health care team in the assessment and management of health care problems; functions as a liaison between physicians, nursing, technologists and area support staff.

Prescribes, regulates, and adjusts medications including over the counter medications and treatments.

Provides teaching and counseling aimed at prevention of illness and modification of risk factors to health, and maintenance of high-level wellness; instructs and supervises students and hospital personnel in methods and theories of diagnostic testing.

Assumes responsibility for the on-going therapeutic management of stable long-term health problems in the chronically ill.

Completes patient discharge summary.

Assists in the development, implementation, and revision of nursing protocols and standards of care.

Provides IT skills and familiarity, by using the basic functionality of the computer, Word, Excel, Outlook e-mail and attachment capabilities.

Maintains compliance with regulatory requirements.

Performs other evaluative and supportive duties, due to the advanced nature of training and the Licensed Independent Practitioner (LIP) status, as needed.

Researches and provides advice on patient care processes, nursing processes, and larger-scale quality improvement projects.

Adheres to and supports team members in exhibiting TMCH values of integrity, community, compassion, and dedication. 

Adheres to TMCH organizational and department-specific safety and confidentiality policies and standards.

Performs related duties as assigned.

Women’s Breast Oncology Program:

The Nurse Practitioner (NP) providing Women’s Health Services coordinates advanced nursing care across the continuum of health services to meet the specialized needs of Breast Oncology Program patients with complex acute, critical, and chronic health conditions.   Services include but are not limited to the following:  (1) serves as a liaison between the TMC for Women Breast Oncology Program and other organizations, agencies, specialty committees, and professionals in order to promote a safe and integrated work environment, (2) monitors, coordinates and facilitates High Risk Breast Clinic for patients, including definitive testing for disease identification and intervention, disease exclusion, and timely results communication to the patient, (3) actively participates in city-wide women’s health educational presentations and tumor boards, and (4) provides educational consultative services for patients and their family, nursing staff, and other health care professionals specific to breast oncology.

Diabetes:

Provides support to patients who have Diabetes including managing insulin therapies and infusions, monitoring patients glucose levels and provide education on diet and exercise. Follow appropriate policies, procedures and protocols for Diabetes patients. Develop diabetes education plan based on assessment of the patient’s medical, nutritional, lifestyle and educational needs. Collaborates as needed with the physician in developing an appropriate treatment plan including discharge instructions and follow-up.

Chest Pain:

Provides active daily support to patients who present with chest pain, myocardial infarction (MI), CHF, and A-Fib, utilizing approved pathways or order set implementation.  Provides auditing and data support for the purpose of process improvement in the clinical management of chest pain, MI, CHF, and A-Fib patients.  Responsible for cardiac program implementation including CHF/CAD Transition Clinic, Short Stay CP model, and Interventional Same Day Discharge Program.  Provide support to maintain CHF and Chest Pain Accreditations and A-fib Certification.  Performs exercise treadmill testing.  Educates staff on hospital initiatives related to cardiac.

Cardiothoracic Surgery and Structural Heart NP Coordinator:

1. Structural Heart: The Structural Heart coordinator works in direct collaboration with the cardiologists, cardiac surgeons, nurse practitioners and other team members; participates in the ongoing assessment of TAVR/Mitral Clip patients pre and post op; conferences frequently with the supervising cardiologist and CT surgeons and participates in clinical decisions regarding the management of in-patients and out-patients; provides and promotes patient education; promotes and encourages nursing staff education and involvement; and serves as a liaison between physicians, patients, families, nursing staff and referring facilities to promote quality and continuity of patient care.
   • Coordinates the referral, screening, additional patient testing requirements, consult appointments and hospital-based procedures.  Facilitates communication with cardiovascular surgeons and cardiologists, including referring physicians regarding patient eligibility and clinical status.
   •  Facilitates the progression of the valve procedure patient and assist with preparing the patient and family. Provides follow-up care per pre-determined clinic intervals, documents patient status and communicates ongoing patient condition to physicians during follow-up care.
   • Collaborates with an interdisciplinary cardiovascular health care team in planning, implementing and evaluation ongoing care programs and education for the patients, families, care givers and community.
   • Provide community physician outreach and education using nursing experience and networking in conjunction with physician leadership to build a referral program for Tucson Medical Center.

1. Cardiothoracic  NP Coordinator: The Cardiothoracic NP Coordinator serves as a consistent resource to support optimal care delivery for coronary artery bypass graft (CABG) patients and other projects as assigned, focusing on coordination of care during pre-procedure, hospitalization, discharge planning and facilitating post hospitalization follow up. The Coordinator is knowledgeable of multiple treatment decisions; evidence based practice guidelines and maintains care collaboratively across the continuum. The coordinator will work closely with the CT surgeons and other clinicians to identify and facilitate optimum cardiac care delivery with clinical expertise, strong interpersonal abilities and critical thinking skills.  

·       Works in collaboration with the providers and referring physicians to assure a smooth transition of patients during preadmission, hospitalization, preparation for discharge and outpatient services.

·       Works in collaboration with others to implement and improve care plans to improve outcomes.

·       Navigate and coordinate major aspects of care delivery.

·       Emphasize empowerment of patients through education and support and promote patient advocacy.

Behavioral Health Services

The Nurse Practitioner (NP) providing Behavioral Health Services coordinates advanced nursing care across the continuum of health services to meet the specialized needs of behavioral health patients with complex behavioral health and physical health conditions.   Services include but are not limited to the following:

·       Provide psychiatric evaluation and medication management services on Geropsychiatric unit and for pediatric and/or adult patients on inpatient medical units or emergency department;

·       Evaluate patients by interviewing patient, family, care givers, and other persons; review medical history and related documents; administer and interpret psychological tests; order laboratory tests and evaluate results;

·       Treat patients using psychotherapeutic methods and medications, discuss progress toward treatment goals with patients, and monitor effects of medications;

·       Develop treatment plans based on nature and extent of cognitive, emotional, and behavioral disorders and on patient treatment goals;

·       Participate in interdisciplinary treatment team huddle;

·       Participate in family meetings;

·       Improve staff competence by providing training regarding the interrelationship between psychosocial and physiological problems

Interventional Pain Clinic:

The Nurse Practitioner will provide support to patients who may experience chronic paint for various illnesses. The goal is to provide a multimodal approach to patient care to include medication management, interventional procedures, referrals to physical therapy, and cognitive behavioral therapy. Physicians in this practice perform a wide range of interventional procedures such as epidural injections, radiofrequency ablations and joint injections. The well-established team consists of several physicians as well as nurse practitioners whose main goal is to manage the patients’ concerns to the best of their abilities.

Neurosurgery:

Must be an Acute Care Nurse Practitioner (ACNP) or Adult-Gerontology Acute Care Nurse Practitioner (AGACNP).

Within the outpatient (office) setting, the neurosurgical NP responsibilities include:

• Evaluating and treating new and existing patients
• Obtaining and documenting comprehensive history, performing physical examinations, and conducting other assessment and screening tools, as appropriate
• Diagnosing, treating, and managing patients with acute and chronic neurosurgical conditions
• Performing minor office procedures, including routine wound care, dressing changes, drain removal aspiration of subcutaneous fluid collections for culture or therapeutic purposes, suture/staple removal, shunt evaluation and programming
• Prescribing medications, durable medical equipment, and therapeutic interventions

Within the inpatient/hospital setting, the neurosurgical NP responsibilities include:

·       Rounding/follow-up care and management of postoperative patients.

·       Complete perioperative orders for surgical patients (including preoperative and postoperative management)

• Diagnosing, treating, and managing patients with acute and chronic neurosurgical conditions. This includes new hospital consults and existing inpatients as appropriate.
• Obtaining and documenting comprehensive history, performing physical examinations, and conducting other assessment and screening tools, as appropriate
• Performing minor bedside procedures or assisting physician with procedures, including routine wound care, drain removal, dressing changes, aspiration of subcutaneous fluid collections for culture or therapeutic purposes, suture/staple removal, shunt reservoir aspiration, shunt programming.

Neonatal:

The Nurse Practitioner provides support to our Level IIIB NICU Practice.  Attendance at High-Risk Deliveries is shared between the Neonatologists and the NNPs; transports not required, NNPs place PICC lines as part of an NNP/RN/MD team that places lines. Dedicated team of Neonatologists and Advanced Practice Providers are focused on delivering state-of-the-art, innovative neonatal care where quality improvement and evidence-based practice are at the forefront.  Collaborative culture where Neonatologists as partners with the NNPs and consider them a valuable part of the team. 

MINIMUM QUALIFICATIONS

EDUCATION: Master’s degree in Nursing or related area, or an equivalent combination of relevant education and experience. 

EXPERIENCE:  Five (5) years of related experience, preferably in an acute care setting.

LICENSURE OR CERTIFICATION:  National certification as a Nurse Practitioner or must be National Certification as a Nurse Practitioner eligible, must become credentialed at TMC through the Professional Staffing Office prior to appointment.  Must have and maintain a current Arizona state license as a Registered Nurse and Nurse Practitioner including prescriptive authority.  Must obtain and maintain a current Federal Drug Enforcement Agency License for prescribing controlled substances.  Additional certifications may be required based on delineation of privileges as outlined by Medical Staff.

KNOWLEDGE, SKILLS AND ABILITIES: 

·       Knowledge of nursing care and assessment best practices.

·       Knowledge of regulations and policies as it relates to patient evaluation, care and information.

·       Skill in evaluating comprehensive health assessments and evaluating results to ensure the most appropriate treatment option.

·       Skill in providing the best practice patient care.

·       Ability to read, analyze, and interpret professional journals, technical procedures, or governmental regulations.

·       Ability to write reports, correspondence, and procedure protocols.

·       Ability to effectively present information and respond to inquiries or complaints from patients and/or their representatives, and the general public.

·       Ability to work with concepts such as fractions, percentages, ratios, and proportions, and to apply mathematical operations to solve or analyze job-related situations.

·       Ability to identify positive or negative variances from expected outcomes.

·       Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists.

·       Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.