Nurse Practitioner

Overview:
 

The Nurse Practitioner (NP) is a Registered Nurse (RN) with advanced education and clinical practice. The NP manages LIFE Program participants, providing primary health care and case management, focusing on disease prevention, wellness and management of chronic and acute illness in collaboration with the LIFE Program Primary Care Providers (PCPs) and Medical Director. The NP provides holistic care, within the established goals of care of the participant. NP works in close collaborations with the entire LIFE Program inter-disciplinary team to establish realistic goals and a thorough participant Plan of Care (POC).

Responsibilities:
 

• Provides comprehensive, coordinated care to LIFE Program participants in day health center, nursing home or participant home, as appropriate.
• Works closely with the LIFE Program Medical Director, PCP and nursing staff to meet medical needs of participants.
• Acts as Nurse Practitioner per license and the LIFE Program Standard Care Agreement; following consultation with PCP, makes appropriate referral to consultant; acts as spokesperson for the medical team to ensure IDT team is fully apprised of medical conditions of participants, hospitalizations and other medical updates.
• Upon receipt of appropriate waiver, performs initial assessments, semi-annual reassessments, and collaborates with the IDT in developing an appropriate, realistic POC. The NP is an additional member of the IDT.
• Works with the clinic staff to coordinate efficient clinic activities; assists in the development of policies and procedures working closely with management.
• Provides relevant participant education. Educates and train family and caregivers in appropriate care and interventions; and provides staff in-service on a variety of relevant topics.
• Rotates on call duties with other clinicians to troubleshoot, advise, teach and coordinate participant care including emergency services.
• Works closely with PCPs and consultant pharmacists to provide and monitor necessary medications.
• Acts within the Pennsylvania Advanced Practice Nurse Scope of Practice and in compliance with all LIFE policies and
• Procedures. Complies with all elements of the Collaborative Practice Agreement.
• Participates in Quality Assurance activities, systematically reviews records, treatment plans and other sources of data as requested.
• Works closely with the Medical Director on specified QA activities.
• Uses Evidence based medicine, when available, for appropriate up to date medical practice.
• Become familiar with the National PACE Association’s three goals of care trajectories: Longevity, Functional, and Palliative, and with the NPA Model Practices for management of common chronic diseases in the context of the participant’s goal of care trajectory.
• Collaborates easily with other professional health care providers.
• Is available to colleagues who are seeking to consult with the NP.
• Participates in interdisciplinary team meetings and Morning Report Meetings. Participates in small group meetings and informal family meetings.
• NP is proficient in computer order entry of pharmaceuticals, maintain a willingness to work with suggestions of the consulting pharmacists, and a working knowledge and meaning of the medication risk management (MRM) vectors, and using the information from the MRM in appropriate prescribing.
• Comprehend and distinguish a participants present directives, advance directives, goals of care and a physician orders for life sustaining treatment (POLST) form and obtain this sensitive information from the participant and/or his/her family or caregivers.
• Evaluates a participant’s level of health and function.
• Observes changes in mental status or functional ability and assesses what factors – physiologic, pharmaceutical, psychological, social, etc. – are in play that could be causing increased dysfunction then intervenes with appropriate measures.
• Assesses the results of the intervention for improvement or deteriorate and takes appropriate actions based on that assessment.
• Recognizes when collaboration with the PCP or other members of the health care team is warranted and initiates timely consultation with the appropriate health care professional.
• Requests utilization of services whether it is a pharmaceutical, professional consultation with specialists, requests for laboratory testing, diagnostic imaging, or with requests for durable medical equipment (DME).
• References the NPA model practices to assess that the testing and procedures being requested are consistent with the Model Practices and the participant’s goals of care.
• Assist’s the PCP to oversee the overall functioning of the medical clinic, making sure that the participants have appropriate access to medical care, and that the clinic is functioning in an efficient fashion.
• NP is required to follow the Physician – NP communication policy and procedure for physician access for emergency and non-emergency medical advise and consultation on a twenty-four (24) hours, seven (7) day per week basis.
• TRAINING: On an annual basis employee will have completed training including:
  • the need of the participants in the center’s targeted population,
  • body mechanics/transfer techniques,
  • voluntary reporting requirements involving abuse, neglect and exploitation,
  • positive approach methods to manage behavior,
  • and two (2) sessions, (totaling a minimum of eight (8) hours), targeted at enhancing the quality of care given and the employees job performance.
• OPERATING PRINCIPLES.... Employees of Lutheran SeniorLife are expected to demonstrate the following through everyday performance of their job responsibilities: i.e. Operating Principles...
  • Acknowledge the value of the contribution of each individual,
  • Demonstrate fairness and equity in all interactions,
  • Live with integrity, and be honest at all times,
  • Demonstrate excellence in service.
• Performs other duties and responsibilities as assigned.

Qualifications:
 

• Graduate of accredited school of nursing, licensed as RN in the state of Pennsylvania with Advance Practice Certification for nurse practitioner by a national certifying organization recognized by the PA CRNP Scope of Practice and state of Pennsylvania Board of Nursing.
• Certificate of Authority and Standard Care Agreement with collaborating physician.
• One year experience with elderly as RN or NP.
• Thorough working knowledge of current community health practice for the frail elderly from direct service experience.
• Working knowledge of the interdisciplinary model of care management.
• Experience working with cognitively impaired seniors.
• Must be able to relate well with seniors and their families to deal with sensitive issues and facilitate problem solving.
• Must have one year experience with the frail and elderly population.
• Must be flexible.
• Working knowledge of computers, Microsoft Word and Excel required