POSITION OVERVIEW: Neonatal Nurse Practitioner or Physician Assistant provides leadership during resuscitation at birth of both term and preterm infants. Develops a plan of care for neonates admitted into the NICU in collaboration with the multidisciplinary team. Particiaptes in ongoing quality improvement, educational, and clinical leadership activities in collaboration with the NICU Medical Director and NICU Leadership.

Work schedule: The Bend NICU operates with 24/7 APP coverage. The NNP/PA will be responsible for both day and night coverage, as directed by the schedule with oversight from the NICU Medical Director. Shift length is 12 hrs, with handoff occurring at 7:00am and 7:00pm.

Call expectation: There are no formal call expectations for this position, though a collaborative and supportive team culture will remain a top priority to best support the NICU provider team in times of high census and/or cross coverage.

Work location: St. Charles Bend

** This position has flexibility in FTE selection.

FUNCTIONS AND DUTIES:

Clinical Duties:

• Assists in monitoring the effectiveness and quality of patient care with primary focus on neonatal intensive care management, newborn delivery and resuscitation, and neonatal transport.
• Provides effective, efficient, appropriate care, with a central focus on infant evaluation, management of acute and ongoing care, and development of treatment plans.
• Performs health assessment of at risk infants at the time of delivery.
• Performs health assessment of infants admitted to the NICU, completes admission H and P.
• Determines normal vs abnormal findings via exam and/or diagnostic tests.
• Admits infants to NICU as appropriate.
• Acts appropriately and timely in addressing urgent care needs of infants both at the time of delivery and on-going in the NICU – including initiating full resuscitations when appropriate.
• Develops plan of care for infants in the NICU consistent with approved protocols – makes adjustments to plan based on changes in infants condition.
• Prescribes treatments, medications, respiratory care and miscellaneous care instructions as necessary.
• May discharge or transfer infants from NICU – consults with discharge Pediatrician as necessary.
• Performs pre-delivery consults as requested by OB services.
• Manages newborn transition support as needed.
• Management of patients in the NICU may include daily physical exams, evaluation of progress, documentation via progress and procedure notes, rounds with attending physician and other team members, and writing orders.
• Recognizes when the infant’s needs are not within scope of practice and collaborates with other medical and nursing specialists.
• Communicates with infants family regarding infant’s status and plan of care, provides family centered care at all times, and acts as a liaison between parents and caregiver team.
• Participates in telemedicine support (Telebaby) to our referral hospitals as requested
• Manages patients on transport. 
• Supports/mentors NICU transport nurses as clinical situation warrants. 
• Accompanies team when deemed necessary for patient acuity and/or orientation of staff. 
• May be required to attend transport as the NNP if no transport nurse available. 
• Attend at least 50% of NICU TR team meetings.
• Attend all required safety briefings and safety days as outline by Airlink.
• Participate in skills labs related to transport.
• Seek out opportunities to maintain knowledge of aircrafts and all emergency procedures related to each.
• Adheres to SCMC service standards, including interaction agreements.
• Participation in departmental opportunities i.e., NICU/Peds committee, UPC committee, RN/RT committee.
• Collaborates with NICU caregiver team to develop teaching/learning priorities for families and caregiver staff.
• Demonstrates compliance with National Certification, State of Oregon, and SCMC requirements for minimal continuing NNP/PA education.
• Acts as primary preceptor/mentor for newly hired NNP/PAs and transport team.
• Consults with physicians as appropriate to plan care.
• Provides Family Centered Care including advocating for newborns and responding to special family needs.
• Participates in appropriate and timely documentation that meets relevant coding and billing guidelines. 
• Skills:

• Intubation
• Manage full resuscitation e.g. bag-mask ventilation, CPAP, intubation, chest compressions, resuscitation medications, pneumothorax management
• Thoracentesis and Chest tube insertion
• Umbilical venous and arterial line placement
• Peripherial arterial line placement
• PIV placement
• PICC placement and management
• Ventilator and CPAP management
• Lumbar punctures
• Suprapubic taps
• Urinary catheterization

Non-Clinical Duties:

Non-clinical activities vary from provider to provider and may include a combination of the following:

QA/QI unit based projects, as well as Vermont Oxford and related collaboratives. Leads or participates in a variety of educational programs such as: STABLE, NRP, Neonatal Simulations and Mock Codes to meet unit needs.  May participate in ongoing outreach education, simulations and presentations to hospitals in and out of system and EMS units on request. Opportunities exist to engage in EPIC specific optimization related to NICU and other I/T trouble shooting as needed. May participation in NICU/Peds committees and high-risk developmental clinic, and general on-going NICU education- i.e. chart reviews, journal club, article reviews, lectures, case reviews as requested by the Medical Director or NICU Leadership team.

Essential Functions:

• Acts as a leader and supports departmental goals and the vision, mission and values of the St. Charles Health System in all respects.
• Provides customer service in a manner that promotes goodwill, is timely, efficient and accurate.
• Creates a healing environment that supports all aspects of care, respects the wholeness of the individual, and demonstrates therapeutic presence through attitudes and behaviors that enhance the safety and care experience for patients, caregivers and guests.
• Supports Value Improvement Practice (VIP- Lean) principles of continuous improvement with energy and enthusiasm, functioning as a champion of change; Contribute as necessary to assist in policy formation for the organization.
• Participates in creating intentional relationships, and put a high level of focus on attitudes and behaviors that enhance the care experience.

• Is familiar with the organization structure, communications systems and billing process, completing billing and coding documentation within time assigned.
• Conducts all activities with the highest standards of professionalism and confidentiality.  Complies with all applicable laws, regulations, policies and procedures, supporting the health system’s corporate integrity efforts by acting in an ethical and appropriate manner, reporting known or suspected violations of applicable rules, and cooperating fully with all health system’s investigations and proceedings.
• Keep all licenses and appropriate certifications current and unrestricted to maintain privileges at a St. Charles Health System hospital sufficient to permit performance of job duties.
• Increases understanding and collaboration throughout the medical community.

Maintain compliance of hospital’s Medical Staff Bylaws, Rules and Regulations, as required by SCHS Board of Directors.

EDUCATION

Required: 

• Successful completion of an approved Physician Assistant and/or Nurse Practitioner course of study and certification as appropriate to the incumbent’s license.
• Complete annual fire/safety, etc. education in-services as required.
• Attend mandatory educational offerings as described in SCHS policies/procedures and/or as required by other regulatory bodies.
• Complete annual CME as required to maintain license and appropriate Board certification.
• Complete in a timely manner assigned Computer Based Learning modules. 

LICENSURE/CERTIFICATION/REGISTRATION

Required:

• Unrestricted Nurse Practitioner/Physician Assistant licensure.
• Nurse Practitioner requires AANC, NCC or AANP, AMCB certification
• Physician Assistant requires NCCPA certification and Practice Agreement with Supervising physician
• Unrestricted Federal DEA number registered in Oregon                        
• Unrestricted ability to participate in Medicare / Medicaid, or other federal or state governmental health care programs.
• Valid driver’s license and the ability to meet SCHS driving requirements.

• Current BLS certification required.
• If provider will practice sedation, moderate or deep, ACLS certification is also required.
• Additional certifications may be required based on privileges granted to provider by Medical Staff Services at SCHS Inpatient locations.

Preferred:        

• Nurse Practitioner/Physician Assistant licensure in the state of Oregon.
• Federal DEA number registered in Oregon.

EXPERIENCE

Required:        

• Minimum two years experience as a Neonatal Nurse Practitioner/Neonatal Physician Assistant in a level III nursery.
• Experience using EMR (Electronic Medical Records) software
• Advanced written and verbal communication skills to effectively interact with a diverse population and professionally represent St. Charles Health System
• Experience working in a team environment and proven ability to collaborate, manage facilitation and consensus building among health care professionals and agencies to achieve expected results

Preferred:

• Experience in evaluation and management of patients requiring inpatient and outpatient services.
• Experience in Neonatal Transport.
• Epic EMR software experience.