Advanced Practice Provider (NP/PA) - Psychiatric Emergency Svs

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Summary:
An APP functions as part of an interdisciplinary healthcare team in accordance with the privileges approved by the credentialing committee. To provide high quality, cost-effective care to patients within the APPs scope of practice in collaboration with a supervising physician. The APP reflects the mission, vision, and values of the organization and complies with all relevant policies, procedures, guidelines and other regulatory and accreditation standards.
Responsibilities:
1.Clinical: Obtains relevant psychiatric and medical history, performs thorough psychiatric and physical assessment, reviews and interprets pertinent diagnostic tests/results. Respond to all requests for evaluation and assessment via service pager and assist requesting staff in appropriate triaging of cases. Determines appropriate patient disposition including admission, transfer to appropriate facility, or discharge.
a. Assessment: The psychiatric emergency clinician will independently lead the assessment and care planning with support when needed from the supervising physician. Performs comprehensive risk assessment on UNC Emergency Department patients (Hillsborough Emergency Department via telepsychiatry) due to concern for dangerousness to self and/or community. Thorough documentation of safety assessment, recommendations for treatment, differential diagnosis, HPI, MSE and data collection (collateral contacts, chart review) to support clinical recommendations. Conducts preventative health screening based on age, history and patient needs. Administers formal clinical exams (suicide risk assessment, CSSRS, MMSE, MSE, MOCA, CAM-ICU) when appropriate to aid in assessment of safety and community functioning. Develops comprehensive differential diagnosis for patients that includes both psychiatric, characterological and medical comorbidities.
b. Intervention: Consistently derives correct diagnosis through synthesis of clinical data and proper selection and interpretation of diagnostic studies. Develops and implements treatment plans including prescribing/ordering appropriate evidence-based pharmacological agents, consistent with departmental guidelines and privileging, crisis counseling, family and individual therapy. Revises the plan of care to meet the changing needs of the patient. Respond and guide treatment team in the management of acutely dangerous patients.
c. Disposition: Determines the need for involuntary commitment and enters/ends proceedings as indicated and allowable by law. Clinician will also create and deliver discharge instructions for patient and family and write discharge orders as needed. Complete all needed legal and departmental paperwork to ensure safe transfer of patients to alternative facilities. Works with care managements to schedule appropriate follow-up for management of illness(s). Prioritizes workflow and assists staff to provide prompt and efficient client flow.
d. Collaboration: The clinician will guide and direct the psychiatric services provided by multidisciplinary team (CCM, RNs, NAs) and ensure they are focused on patient/community safety and individual needs of patient. Actively incorporates evidence-based hospital initiatives to improve patient care. Attend and lead complex care meetings and formulate solutions with representatives from the clinical care management department. Attend psychiatry flash rounds with Neurosciences nurse leadership to determine optimal use of hospital beds and patient placement. Provide guidance to UNC affiliates regarding psychiatric emergencies in their settings. Work closely with pharmacy and CCM to ensure discharge plan is appropriate and adequate resources are available. Consistently maintains high productivity according to identified standards. Leads, participates in projects to improve productivity. Appropriately performs medical procedures consistent with departmental guidelines, privileging, and clinical roles/responsibilities.
2.Education: Appropriately and professionally educates family and/or patient regarding medical and psychiatric conditions, treatment plans and follow-up. Collaborates with clinicians, staff and students to promote continuity and patient/family centered care. Develops educational materials based on the learning needs of clinicians, staff, and students. Provide peer supervision as needed. Provide formal supervision for provisionally licensed staff as needed/required. Provide education to physicians, housestaff nursing, ancillaries, and/or students. Actively recognizes and participates in identification and achievement of self-learning needs. Attends education programs based on identified learning needs. Continuously develops knowledge base to maintain expertise in psychiatric risk assessment.
3.Leadership: Identify cases of highest priority and allocate service resources (staff, students, provisionally licensed staff) to maximize patient care and patient throughput. Provides instruction to physicians, housestaff, nursing, ancillaries and/or students including but not limited to precepting, shadowing, lectures, training classes, rounds, morning report, and or staff meetings. Demonstrates both an understanding of the context and system in which healthcare is provided and the ability to apply this knowledge to improve and optimize health care delivery, leads/participates in systems improvements.
4.Professionalism:Interacts with patients and families in a respectful, courteous and timely fashion using appropriate communication for the patient and situation. Interacts collaboratively with coworkers, other team members and staff in a respectful, courteous and timely fashion appropriate to patient care needs and situations. Responds quickly to meet patient and family needs and resolve problems. Accepts responsibility for outcomes of ones work. Shares responsibility for overall workload with team members.
5.Quality/Research: Engages in daily continuous quality improvement by identifying and implements processes for improvement. Consults with management in assessment, problem solving, decision-making, and evaluating clinical/system issues and models of care. Leads interdisciplinary teams to provide integrated delivery of patient care services. Initiates and revises protocol or guidelines(s) to reflect evidence-based changes in care management. Works to influence police-making bodies to improve patient care. Develops new clinical programs or services within the department/unit/clinic to improve patient care.
Other Information
Other information:
Education Requirements:
•Completion of an accredited graduate-level Advanced Practice Provider (APRN or PA) program. •Completion of an accredited graduate-level advanced practice provider (PMHNP) degree PA program strongly preferred.
Licensure/Certification Requirements:
•Licensed as an Advanced Practice Provider (i.e., Nurse Practitioner, Physician Assistant, Clinical Pharmacist Practitioner, Certified Nurse Midwife, Certified Registered Nurse Anesthetist) in the state of North Carolina. Licensed as an APP (APP, PA) in the state of NC. Board certification strongly preferred by the department. Completion of Certified 1stLevel Commitment Examiner training and exam. It is expected that this certification be completed within 6 months of hire
•Board certification if required by the Department. DEA.
Professional Experience Requirements:
•No prior experience required. 1-2 years of working in a psychiatric emergency department preferred.
Knowledge/Skills/and Abilities Requirements:
•Demonstrated clinical competency.
•Effective leadership skills. Strong interpersonal skills.
•Ability to work independently and collaboratively.
•Demonstrated written and verbal communication and strong analytical skills.
•Effective interaction to ensure the successful care of patients in the clinical setting.
•Documentation in the medical record to substantiate accurate billing.
Job Details
Legal Employer: STATE
Entity: UNC Faculty Physicians
Organization Unit: Psychiatric Emergency Svs-EM
Work Type: Full Time
Standard Hours Per Week: 40.00
Work Assignment Type: Onsite
Work Schedule: Night Job
Location of Job: US:NC: Chapel Hill
Exempt From Overtime: Exempt: Yes
This is a State position employed by UNC Health Care System with UNC Health benefits. If, however, you are presently an employee of another North Carolina agency and currently participate in TSERS or the ORP, you will be eligible to continue participating in those plans at UNC Health.
Qualified applicants will be considered without regard to their race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
UNC Health makes reasonable accommodations for applicants' and employees' religious practices and beliefs, as well as applicants and employees with disabilities. All interested applicants are invited to apply for career opportunities. Please email if you need a reasonable accommodation to search and/or to apply for a career opportunity.