GENERAL SUMMARY/ OVERVIEW STATEMENT:
The physician assistant (PA) is a licensed provider who has acquired a broad range of knowledge and skills through the successful completion of a physician assistant program. The PA is responsible for the assessment and management of various populations of patients, medical and/or surgical, including diagnostic and therapeutic interventions, development of appropriate plans of care and ongoing evaluation. The physician assistant works under the supervision of an attending physician and reports directly to the department administrator or chief physician assistant administratively.
The PA will perform in accordance with all state and federal regulations and institutional policies including but not limited to the BWH PA Scope of Practice, Prescriptive Guidelines, approved clinical privileges, and BWH PA policy.
PRINCIPAL DUTIES AND RESPONSIBILITIES:
Provides direct care, counseling, and teaching to a designated patient population in the ambulatory, inpatient, operative, and/or procedural setting
Performs complete histories and physical examinations
Orders, interprets, and evaluates appropriate laboratory and diagnostic tests
Develops appropriate plans of care and follow-up based on the outcomes of diagnostic, laboratory, and physical examination findings
Orders medications and writes prescriptions according to organizational and regulatory policies and procedures
Consistently provides high quality and timely documentation including admission and progress notes, procedure notes, operative notes and discharge summaries
Performs bedside procedures as are appropriate to the patient population
In some settings, the PA may first assist in the operating room or procedural areas
Practices cost effective medicine in an efficient manner, maximizing available resources
Discusses patient data with other physicians and professionals as appropriate in a multidisciplinary setting
Demonstrates expert clinical judgment skills to function in an independent role
Additional duties and responsibilities as required by the department/division
Demonstrates professional collaborative and consultative relationships with other providers
Follows all designated prescriptive practices and monitoring requirements with the designated supervising physician and administrative report
Participates in departmental and organizational committees and programs as appropriate and attends all required meetings, in-services, and professional trainings
Maintains superior interpersonal and communication skills as a member of the healthcare team in order to collaborate effectively with patients, families, staff, and community health workers
Remains actively involved in continuing education with a commitment to self and departmental growth
Adheres to all established safety policies, procedures, and precautions; identifies potential or actual unsafe situations in the environment and takes measures to rectify the situation
Demonstrates understanding of procedures, policies, and documentation required to ensure compliance with hospital standards of care
Additional duties and responsibilities as required by the department/division
The appropriate candidate will have successfully completed a graduate level physician assistant program (Masters degree) accredited by the Accreditation and Review Committee for Physician Assistants (ARC-PA) or such other accrediting agency as may qualify a graduate to sit for the NCCPA certifying examination
BS/MS joint programs and those candidates with a BS and PA certificate are eligible, but ONLY for those who graduated BEFORE 1995
Certification by the National Commission on Certification of Physician Assistants (NCCPA) must be obtained prior to first day of employment
Must hold a current valid license or be eligible for licensure as a physician assistant in the Commonwealth of Massachusetts
Must have or eligible for, and maintain, a current DEA registration and Massachusetts Controlled Substance Registration
Must complete 100 hours of CME according to national and state regulations during each two year period of employment
Must complete the BWH Professionalism Program within three months of date of hire
Must complete the BWH Procedural Sedation Training if deemed necessary
SKILLS/ ABILITIES/ COMPETENCIES REQUIRED:
Must have the ability to work in a high stress, dynamic, busy clinical setting with changing organizational climate
Must have the ability to be self-directive and to demonstrate initiative in addressing the responsibilities of the position
Must have the ability to utilize appropriate problem-solving and conflict resolution skills
Must be energetic and quality driven and have a proven ability to be a productive member of a team dedicated to providing optimal patient care
Must be proficient with BWH computer systems as needed to independently perform daily tasks (EMR, Epic preferred)
Must maintain the highest degree of professional judgment under the supervision and guidance of a licensed physician
Work settings may include ambulatory clinics and treatment rooms, inpatient areas, intensive care units, operating rooms, and/or procedural areas. There may be loud noises, noxious odors, and temperature extremes. A large portion of the workday may be spent either standing or walking and the position may require heavy lifting of equipment and patients.
The PA may be exposed to radiation, potentially infectious bodily fluids, and sharp instruments such as needles and scalpels. Knowledge of Universal Precautions and proper use of surgical sharp instruments may be required. The consequences of contamination from bodily fluids or from being stuck with a sharp instrument include the possibility of physical harm to the employee or others. BWH is a fast paced, dynamic environment with a very large and complex patient volume; exposure to stress in the workplace is expected.
The Physician Assistant I does not have any supervisory responsibility.
The Physician Assistant I does not have any fiscal responsibility.
1.Assists the surgeon in the OR, acting as first or second assistant during the following phases:
a) prepare and drape patient, make skin incisions, harvesting long saphenous vein, b) prepare and expose the femoral vessels for cannulation and assist in insertion of femoral cannula placement c)harvest or assist in harvesting the radial artery, d) close fascia, subcutaneous tissue and skin, dress surgical incisions, e) caring for patients on step down units and ICU as warranted by operation and patients condition, f) insertion and removal of intra-aortic balloon pump catheter under supervision.
2.Administers intravenous therapy and inserts central venous and arterial lines by means of Surgical cutdowns and venipunctures where indicated.
3.Inserts nasogastric tubes and maintains suction decompression of the stomach as well as irrigation of the same tubes.
4.Catheterizes and maintains indwelling urinary drainage tubes.
6.Inserts and removes chest tubes.
7.Manages ventilators in conjunction with the respiratory therapists.
8.Cleans, debrides and sutures minor lacerations. Cares for wounds, including debridgement, I&D's dressings, removal of drains and tubes and suture removal.
9.Performs EKG's when technician is unavailable and reviews tracing for arrhythmias and ischemia.
10. Performs cardiac resuscitation and defibrillation as indicated.
11. Performs and records complete history and physical examination.
12. Makes daily rounds by him or herself or with surgical team on patients with a variety of surgical conditions and reports findings to the Attending Surgeon. Manages patient care (both ICU and step-down units), evaluates change in patient status, writes orders, obtains consultations, and interprets lab values and x-rays with assistance of physicians as necessary. Gives special instructions to patients prior to discharge.
13. Writes daily progress notes and dictates discharge summaries.
14. Collects data from charts or interviews with patients for clinical studies being performed under the direction of the Attending Surgeon.
15. Assists the surgeon in highly specialized procedures in approved protocol of clinical investigation in patients and experimental surgery in animals.
16. Must be able to demonstrate the knowledge and skills necessary to provide care appropriate to the age of the patients served on his/her assigned unit.
17. Other duties as assigned.
While the CSS PA can expect a relatively predictable work schedule planned in advance whenever possible, scheduling variations may occur in order to cover the needs of the cardiac surgery service. The CSS PA will be expected to take weekday and weekend call for the operating room, work scheduled weekends and holidays in the cardiac surgery ICU and step-down units, pick up additional shifts as needed and overall work as a member of the CSS PA team.
The PA I shall provide leadership and participation in teaching new residents and PA students.
The PA I shall be capable of independently orienting, on-boarding and training new hire CSS PAs within the division of cardiac surgery.
The PA I shall be actively involved in ongoing quality improvement and patient safety initiatives.
The PA I shall be open to actively participating in projects and contributing to assignments that may arise as delegated by the chief CSS PA.
Brigham And Women's Hospital