Physician Assistant - Er 0.75Fte (Dh4867)

In accordance with Navajo Nation and federal law, TCRHCC has implemented an Affirmative Action Plan pursuant to the Navajo Preference in Employment Act. Pursuant to this Plan and corresponding TCRHCC Policy, applicants who meet the necessary qualifications for this position and (1) are enrolled members of the Navajo Nation, Hopi Tribe, or San Juan Southern Paiute Tribe will be given preference in hiring and employment for this position, (2) are legally married to enrolled members of the Navajo Nation, Hopi Tribe, or San Juan Southern Paiute Tribe and meet residency requirements will be given secondary preference, and (3) are enrolled members of other federally-recognized American Indian Tribes will be given tertiary preference.

Position Summary

This position serves as a Physician Assistant (PA) or Nurse Practitioner (NP), which involves performance of medical care services for patients of all ages in the Emergency Department. Interviews, assesses, and evaluates patients to determine their physical condition and type of medical services needed, and orders initial diagnostic studies appropriate for the patient’s medical condition.

Necessary Qualifications

Education

Bachelor’s Degree in Nursing or Physician Assistant studies

Experience

At least 2 years’ experience working in emergency department or urgent care setting. Comfort with the treatment and management urgent and emergency conditions from suturing to fracture reduction to sick patient with abdominal pain; sees 4 patients per hour continuously for 12-hour shift in Fast Track setting; and has a good command of ACEP Standards and clinical policies.

Licensure/Certification

• Must possess a valid, current, full and unrestricted license to practice as a nurse practitioner in any state within the United States, District of Columbia, or the Commonwealth of Puerto Rico
• Must possess a certificate from the NCCPA (National Commission for Certified Physician Assistants) or the American Association of Nurse Practitioners.

Credentialing

Must be credentialed and privileged to serve on the Medical Staff

Other Skills and Abilities

A record of satisfactory performance in all prior and current employment as evidenced by positive employment references from previous and current employers. All employment references must address and indicate success in each one of the following areas

• Responds effectively to sensitive inquiries or complaints
• Successful completion of fingerprint clearance requirements, physical examinations, and other screenings indicating that the applicant is qualified to be employed by TCRHCC and demonstrating to the satisfaction of TCRHCC that the applicant can perform the essential functions of the job
• Submission of all required employment-related documents, applications, resumes, references, and other required information free of false, misleading or incomplete information, as determined by TCRHCC
• Possession of high ethical standards and no history of complaints
• Positive working relationships with others; has the ability to work effectively in a culturally diverse environment
• Must possess excellent communication and interpersonal skills to optimize the care of patients
• Successful completion of and positive results from all background and reference checks, including positive employment references from authorized representatives of past and current employers demonstrating to the satisfaction of TCRHCC a record of satisfactory performance and that the applicant can perform the essential functions of the job
• Is seen as a staff member who is trustworthy and willing to share information
• Reliable and dependable; reports to work as scheduled without excessive absences
• Excellent clinical skills and judgment
• Is a mentor to colleagues and other organizational staff
• Completion of and above-satisfactory scores on all job interviews, demonstrating to the satisfaction of the interviewees and TCRHCC that the applicant can perform the essential functions of the job

MENTAL AND PHYSICAL EFFORT

The physical and mental demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

Physical

Must have ability of prolonged walking and maintaining balance, ability to frequently stand, bend, kneel, crouch, maintain balance, reach, and occasionally sit, drive, and climb. Frequent ability to lift, push, and pull up to 34lbs is required, must also be able to occasionally lift, push, and pull over 100lbs as needed. Sensory requirements for position include prolonged ability of far, near, color vision, depth perception, seeing fine details, hearing normal speech, hearing overhead pages, and telephone use. Must have both hand manipulation of continuous simple and firm grasping, fine manipulation and frequent use of keyboards.

Mental

Must be able to perform evenings, nights, and weekends on a regular basis and handle the stresses of rural medicine with critically ill patients; must have high degree of judgment and leadership in coordinating emergency services. Must have ability to cope with high level of stress, make decisions under high pressure, concentrate, handle a high degree of flexibility handle multiple priorities in stressful situation, work alone, demonstrate high degree of patience, adapt to shift work, work in areas that are close and crowded, and frequently cope with anger/fear/hostility of others in a calm way, as well as occasionally managing altercations. Must accept a flexible schedule to meet unit needs.

Environmental

May be exposed to infectious diseases for a prolonged amount of time, frequent exposure to loud noises, and occasional exposure to chemical agents, and hazardous or moving equipment.

Essential Functions

• Secures a health and developmental history from the patient or parent, records findings and contributes in making critical evaluations. Performs or requests special screening and developmental tests and laboratory tests and reviews and interprets obvious results.
• Ensure proper PPE is always worn while on duty including but not limited to, face mask, gloves, gown, isolation gown, NIOSH-approved N95 filtering facepiece respirator or higher, if available), and eye or face shield.
• Provides health care and preventive services to healthy individuals including immunizations, guidance in nutrition, common illnesses, accidents, child growth and development, substance abuse, exercise, and depression screening.
• Provides comprehensive diagnostic, preventative, and therapeutic health care services to patients. Documents visits in the medical records of patients including updating problem lists.
• Handwriting must be legible and must be willing to use an Electronic Health Record.
• Responsible for electronic health records data entry pertinent to patient service role.
• Complete task training for all routine cleaning and decontamination processes for all surfaces contaminated by a communicable disease to ensure a high level of patient, visitor, employee, and external customer satisfaction.
• Gives direct physical and psychological care in emergencies and in the presence of illness or disability in order to maintain life, provide comfort, reduce distress and enhance coping ability. Identifies and manages a full range of complex to general illnesses.
• Performs other duties as assigned.
• Provides emergency services or crisis intervention in the absence of the physician. Review and evaluates the nursing and medical aspects of care, plans periodically, recognizing when there is a need for reassessment by the physician or other health professionals.
• Keeps abreast of the latest medical knowledge via CME as required by respective licensing agency.
• Complete all donning and doffing tasks in a safe acceptable method and discard of used PPE accordingly. (see CDC website for most current updates)
• Consults and collaborates with other health care professionals to establish health care plans and to review patient progress and response to therapy, including the use of written referrals to Community Health Nurses, specialty clinics, schools, etc.
• Participates in performance improvement initiatives which may involve chart reviews, studies relevant to health care and nursing needs of patients.
• Performs a basic physical assessment using techniques of observation, inspection, auscultation, percussion, palpation and diagnostic instruments. Discriminates between normal and abnormal findings to recognize early stages of serious physical, emotional, and mental problems.
• Carries out treatments and procedures, administers medications; observes and documents changes in patient’s condition, reactions to medications and treatments. Responsible for prescribing medications including computation of doses.
• Comfortable handling of basic trauma, suturing, fracture reduction, chest pain & abdominal pain work up.
• Participates in planning, instituting, evaluating, and revision program plan, assist in determining conditions, resources, and policies essential to delivery of health care services. Participates in a teaching capacity in the development of other health care workers.
• Adheres to medical regimens to stabilize chronically ill persons and adjusts regimens within established protocols. Makes decisions concerning medical care needs of patients consulting with physicians as appropriate. Works collaboratively with the physician in management of selected complex medical problems. Makes referrals for home visits when indicted to implement a care plan based on family needs.
• Teaches patients and family member(s) ways to maintain or improve their health status.