Physician Assistant-Ob/Gyn

Full-time 40 hours per week, Monday-Friday. Gynecologic/oncology is a very busy inpatient practice with a high-volume patient load.Primary responsibility is to provide inpatient care for those women with gynecologic diseases and gynecologic cancers; to work closely with the faculty gynecologic oncology physicians, gynecologic oncology fellows, obstetrics and gynecology residents and nursing staff to coordinate a plan of care designed to meet the physical, psychosocial and social needs of patients and their families. Strong interpersonal, organizational and communication skills are required. Knowledge of current literature and a commitment to continued learning are also required. A collaborative relationship and effort among the physician assistant, the physicians, residents, fellows, NPs, staff nurses and support staff is expected to provide quality patient care and use resources efficiently.The inpatient gynecologic oncology service resides on Ellison 21. The inpatient census ranges from six to twenty patients. Occasionally, patients are boarded on other floors. Some of the gynecologic oncology patients spend part of their inpatient stay in the intensive care unit. The gynecologic oncology service is primarily managed by the second or third year gynecologic oncology fellow. The fellow coordinates the time of morning rounds, and evening sign-out. All clinical decisions must be passed through the fellow. A first and third year resident in obstetrics and gynecology rotate through the inpatient unit each month. The intern's primary responsibility is running the day to day activities of the inpatient service under the supervision of the fellow. The Physician Assistant will work closely with the intern and the fellow. The third-year resident writes the daily notes during morning rounds and then is primarily in the operating room. Both the intern and the third-year resident have a half day per week of continuity clinic during which time they are off the inpatient unit. The fellow, intern, and physician assistant participate in the evening sign-out to the night resident who is a second-year resident in obstetrics and gynecology. One of the faculty gynecologic oncologists is on call for the inpatient service from Monday through Sunday each week (DOW; Doctor of the week). The DOW is responsible for supervising the residents, fellows, and physician assistant during their time as DOW.PRINCIPAL DUTIES AND RESPONSIBILITIES:* Collaborate with gynecology oncology team in admission of patients to the Gynecologic Oncology service * Participate and assist attending physicians, fellows and residents on daily patient rounds to monitor patient care and formulate treatment plan in coordination with the nursing and physician teams, including the workup of but not limited to:*

Chest pain * Reduced I&O* Shortness of breath * Active bleeding postop * Wound care * Evaluation of deep vein thrombosis and / or pulmonary embolus * Change in mental status * Nausea, vomiting, changes in bowel function * Mental status changes * Pain management * Provides direct patient care for women with gynecologic cancers. * Understands chemotherapy and radiation therapy for treatment of gynecologic cancers. * Understands the scope of palliative care and indications for palliative care consultations. * Performs and records the patient history and physical exam and discusses findings with the intern and fellow. Utilizes medical knowledge to identify, prevent or solve complex and/or recurring patient care problems. Follows and manages patients (in collaboration with the gynecologic oncology inpatient team) enhancing continuity of care. * Writes daily progress notes, consult notes, updates, and documents any change in the status of the patient. * Implements attending physician instructions for patient management working closely in cooperation with nursing staff. * Performs procedures within scope of practice and as directed by the fellow or DOW including:*

Passing nasogastric tube * Paracentesis * Wound debridement * Vacuum dressing placement * Foley catheter placement * Orders/ interprets appropriate laboratory testing and other special examinations as requested. * Prepares succinct and accurate sign out to facilitate a smooth transition to outpatient care. * Documents the medical record as appropriate and communicates the observations/findings with attending physician, residents, fellows and nursing staff. * Performs medically delegated aspects of patient care as agreed upon by nursing and medical administrators per practice guidelines. * Collaborates with unit staff and physicians to facilitate a comprehensive plan of care and coordinate resources. Writes orders, which are in accord with current guidelines. Maintains and practices in accord with practitioner guidelines per state and hospital regulations. * Monitors patient outcomes in accordance with defined standards of patient care. Collaborates with physicians and nursing team, implements and evaluates pertinent changes in practice and health care delivery. * Identifies system-wide factors contributing to undesirable outcomes, such as complications, breaches of infection control standards (such as hand washing, precaution measures, sterile techniques). * Participates in administration of Phase 1, 2 and 3 clinical trials. * Provides consultation to both nurses and physicians. Serves as a resource to staff in area(s) of expertise. * Participates in family meetings and goals of care discussions. * Serves on appropriate intra and interdepartmental committees. * Facilitates patient movement through the system and efficient use of resources through interdepartmental collaboration. * Is Responsible for own professional growth and maintenance of required credentials. Maintains the standards and educational requirements specific to the position and licensure. Identifies own learning needs and goals. * Maintains and updates clinical knowledge and skills based on current health care practice/researchSkills abilities/competencies required: * Medical knowledge includes an understanding of pathophysiology, patient presentation, differential diagnosis, patient management, health promotion and disease prevention. * Understand appropriate diagnostic lab studies to order for the specific clinical situation. * Manages general medical and surgical conditions to include understanding the indications, agents and other relevant treatment modalities. * Differentiates between the normal and abnormal in anatomic, physiologic, laboratory findings and other diagnostic data. * Demonstrates proficiency with MGH computer system as needed to independently perform daily tasks such as order entry, ROE, POE, and incident reports. * Consistently provide high quality and timely documentation including admission notes, progress notes, discharge summaries and dictations. * Current licensure in the Commonwealth of Massachusetts as a Physician Assistant. * Experience with the care of Gynecologic patients and / or with inpatient surgical patients preferred.* 3-5 years of related experience preferred.