Under the supervision and direction of the Division Chief and Sr. Administrative Manager, in collaboration with the Advanced Practitioner (APP) will support the Division of Plastic and Reconstructive Surgery at the Massachusetts General Hospital in Waltham. The incumbent will provide patient care within the operating rooms as first assist, outpatient office setting of the surgical practices.
In addition, the incumbent will coordinate and perform patient assessments, treatment, patient education, and assist in the follow-up. The APP will obtain patient histories, perform comprehensive physical examinations to evaluate plastic surgery patients, arrange diagnostic procedures, coordinate consultations, implement treatment plans, communicate with referring physicians, and provide patient and family education.
The APP will promote a collaborative relationship and effort between the patient and surgical teams, including other clinicians, medical assistants, and support staff. The incumbent is responsible to maintaining state licensure in good standing.
PRINCIPAL DUTIES AND RESPONSIBILITIES:
For patients within the Plastic Surgery practices, provides sound nursing practice using advanced knowledge of clinical patient care. Provides and coordinates care of plastic surgery patients at the surgical practices in Boston, Newton, Danvers, and Waltham. Effectively communicates with patients, families, providers, and staff. Participates in projects, programs, and other activities to support clinical practice and practice operations. Maintains necessary licensure and completes continuing education to ensure performance of all responsibilities. Working independently under the broad direction of the supervising surgeon, the Lead Nurse Practitioner and the Senior Administrative Manager and in collaboration with other clinicians as needed, the work of the NP will include:
CLINICAL PRACTICE:
• Evaluates follow-up patients, and pre- and post-operative patients.
• Obtains health and medical history, performs physical examination, and constructs problem list.
• Collects, records, and interprets patient data.
• Reviews and interprets diagnostic data.
• May order necessary diagnostic tests, consultations and procedures as requested by the attending surgeon.
• Conducts examination, preoperative teaching, post-operative evaluation and management, and follow-up.
• Consults with Lead NP, surgeon and others on complex clinical matters.
• Performs simple skin biopsies, cyst aspirations, incisions, and drains.
• Removes drains.
• Removes sutures/staples.
• Completes disability paperwork for patients.
• Fills out visiting nursing paperwork for patients.
• Triages urgent referrals.
• Prescribes medications / medication refills while adhering to hospital policies for medication administration as necessary.
• Completes and submits billing for services in a timely and accurate manner.
• Provides timely, complete, and coordinated communication, including:
• Returns patient phone calls.
• Communicates care plan to all referring providers, MD of record, and patients/patient families.
• Implements effective communication and coordination with residents, fellows, nurses, and other physicians involved with the care of hospitalized patients.
• Serves as an information resource for patients.
• Coordinates interface between inpatient and outpatient care.
PLASTIC SURGERY FIRST ASSISTANT DUTIES:
• Serves (directly or once trained) as first assistant to surgeons during plastic surgery operations/procedures performed in the operating rooms at the afore mentioned hospitals and surgical centers.
• Preoperative patient management in collaboration with the surgeon, including:
o Performing focused preoperative nursing assessments,
o Participating in the patient plan of care,
o Intraoperative performance of surgical first assistant techniques such as:
• using instruments and medical devices,
• providing surgical site exposure,
• handling and/or cutting tissue,
• providing hemostasis,
• suturing, and
• wound management
• Postoperative patient management in collaboration with other health care providers in the immediate postoperative period and beyond, such as participating in postoperative rounds and assisting with patient discharge planning and identifying appropriate community resources as needed.
PRACTICE SUPPORT:
• Participates as requested in MGH and MGB quality initiatives.
• Meets routinely with supervisors to review statistics, progress, and provide feedback for use in the overall performance of advanced practice service of the practice.
• Works with Lead NP for clinical information, practice standards, feedback, training needs and other support.
• Provides timely and accurate documentation in Epic; monitors and responds to in-basket messages. Uses Patient Gateway in a proper and effective manner.
• Participates in patient outreach as well as research initiatives as needed.
• Serves as subject matter expert, providing information, in-service education and other assistance to staff.
• Works safely and properly uses equipment across all clinical settings.
EDUCATIONAL:
• Participates in educational meetings.
• Pursues independent learning opportunities.
• Completes continuing education in relevant fields to maintain professional licensure.
• Completes the 100 hours of continuing medical education necessary during each 2-year period of employment. Attends internal and external education meetings and reads appropriate professional journals to maintain and enhance skills and clinical competence.
• Advances medical and technical skills as appropriate to deliver optimum patient care.QUALIFICATIONS:.
• Current Physician Assistant or Nurse Practitioner licensure in Massachusetts
• 3-5 years experience in the Advanced Practice role, particularly in either breast oncology, plastic and reconstructive surgery or general surgery arena
• CRNFA certified (Certified Registered Nurse First Assist) or
• Current Massachusetts Controlled Substance Certificate and DEA license
• Qualified in all basic and advanced cardiac life support standards as established by the American Heart Association
SKILLS/ ABILITIES/ COMPETENCIES REQUIRED: MUST be realistic, measurable, objective, and related to the essential functions of the job.
• Broad clinical understanding of nursing care especially as provided in an outpatient setting.
• Demonstrated skills in delivering direct patient care at the advanced practice level, performing both collaboratively and independently.
• Able to diagnose and treat health problems; obtain patient histories, perform comprehensive physical examinations, perform simple diagnostic tests / procedures, and prescribe medications.
• Able to identify and solve routine and complex clinical care matters.
• Maturity, self-confidence, and ability to support the management of patients across more than one discipline, specifically plastic surgery, and surgical oncology.
• Exceptional organizational skills and ability to prioritize effectively and complete tasks; flexibility to handle multiple tasks and deadline pressures.
• Highly motivated, independent, and capable of performing in a complex environment; strong sense of initiative and perseverance to carry through to completion of tasks; demonstrates forthrightness and integrity. Ability to identify issues/projects and initiate plans to address asking for direction when appropriate. Ability to take ownership and responsibility for activities.
• Must work in a collaborative manner with physicians and other clinicians.
• Excellent interpersonal, written, and oral communication skills with good command of English language, including medical and scientific terminology. Able to effectively communicate clinical information to patients and family members.
• Exceptional computer skills in systems pertinent to the position.
• Skills to work efficiently and effectively and strive to do so in all aspects of position.
• Ability to appropriately evaluate all aspects of a situation and to independently make appropriate and timely decisions.
• Ability to handle sensitive and confidential matters discreetly.
• Knowledge in aspects of safety applicable to position.
• Knowledge and compliance with all hospital, State and Federal regulatory requirements, including hospital Policy and procedures (where applicable to the performance of the job), JCAHO and HIPAA.
• Must meet and maintain credentialing requirements for both Massachusetts General Hospital, Newton Wellesley Hospital, Mass General Waltham, and Surgical Associates and Day Surgery at Mass General/North Shore Center. Must complete orientations and precepting at both institutions. Follow policies of all institutions and ensure compliance with all clinical requirements.
WORKING CONDITIONS: Describe the conditions in which the work is performed.
Standard outpatient clinic setting with procedure and treatment rooms, as well as standard operating rooms and inpatient units in a hospital setting. The work may require the lifting of heavy objects and patients as well as exposure to potentially infective material. Work requires contact with needles and other sharp instruments, electric-cautery devices, monitoring devices, and other state-of-the-art equipment. Prolonged standing can be expected. Walking to and from the patient care units can be expected. Ability to use electronic medical record and e-prescribing systems. Hazards present from exposure to combustible anesthetic or disinfecting agents are minimized when safety precautions are strictly adhered.
Work includes regular travel between office and hospital locations requiring a valid Massachusetts driver’s license.
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