Description
GENERAL SUMMARY/ OVERVIEW STATEMENT: Summarize the nature and level of work performed.
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 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: Indicate key areas of responsibility, major job duties, special projects and key objectives for this position. These items should be evaluated throughout the year and included in the written annual evaluation.
Principle Clinical Duties and Responsibilities:
- Provides direct care, counseling, and teaching to a designated patient population in the 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 appropriate to the patient's clinical needs
- 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
Non-Clinical Duties and Responsibilities:
- 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
For all positions that include direct patient care, indicate with an "X" the age(s) of all patient populations served
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No Direct Patient Care
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All age groups
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Adolescence (13 to 17 years)
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X
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Neonates (birth to 1 month)
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Young Adult (18 to 25 years)
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X
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Infant (1 month to1year)
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Adult (26 to 54 years)
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X
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Early Childhood (12 months to 5 years)
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Senior Adult (55 to 64 years)
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X
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Late Childhood (6 to 12 years)
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Geriatric (65 years and up)
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X
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QualificationsQUALIFICATIONS: (MUST be realistic, neither overstated nor understated, and related to the essential functions of the job.)
- The appropriate candidate will have successfully completed a graduate level physician assistant program (Master's 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 the first day of employment
- Must hold a current valid license as a physician assistant in the Commonwealth of Massachusetts
- Must have 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 be realistic, neither overstated nor understated, and related to the essential functions of the job.)
- 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 Epic computer systems as needed to independently perform daily tasks
- Must maintain the highest degree of professional judgment under the supervision and guidance of a licensed physician
WORKING CONDITIONS: Describe the conditions in which the work is performed.
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.
SUPERVISORY RESPONSIBILITY: List the number of FTEs supervised.
The Physician Assistant I does not have any supervisory responsibility.
FISCAL RESPONSIBILITY: Indicate financial "scope" information, i.e.: size of budget, volume, revenue, etc.
The Physician Assistant I does not have any fiscal responsibility.
ADDENDUM: Document any additional skills, abilities, criteria, requirements, and/or details pertinent to this role.
The BWH cardiac surgery service is a 24/7 PA run service, therefore working weekends and holidays are required. The BWH rotating cardiac surgery PA I is scheduled to work a relatively predictable rotating 50/50 day/night schedule of 12-hour days with the frequency of 3, 3, 4 days per week, averaging 40 hours per week over a three-week cycle. Scheduling variations may occur to cover the needs of the cardiac surgery services. The cardiac surgery PA I may be asked to pick up additional shifts and/or provide back-up coverage as needed.
The nighttime rotating cardiac surgery PA I is the responding clinician for cardiac surgery ICU patients in addition to the cardiac surgery and mechanical circulatory support (VAD) step-down unit patients. During the daytime the cardiac surgery PA I is responsible for cardiac surgery ICU patients or step-down unit patients while working in conjunction with ICU attendings, cardiac surgery residents/fellows, critical care fellows and cardiac surgery PA staff.
Required clinical duties:
- The BWH CSS PA I will independently perform the following:
a) insertion of urinary catheters
b) dress and debride surgical incisions
c) removal of intra-aortic balloon pump catheter under supervision.
d) removal of epicardial pacing wires
e) removal of chest tubes
f) assist with procedures in the ICU and step-down units
g) insertion of central venous and arterial lines
h) insertion of nasogastric and Dobhoff feeding tubes
- Provide clinical oversight and care for all cardiac surgery patients in the cardiac surgery ICU,
including CABG, valve, aortic surgery and cardiac transplant patients along with patients on assist devices (ECMO and VADs) in conjunction with the CSS, ECMO and MCS ICU teams
- Provide clinical oversight and care for all cardiac surgery patients on the step-down units, expedite discharges and perform complete history and physical examinations on admissions and transfers in conjunction with the cardiac surgery attending and resident team.
- Performs cardiac resuscitation and defibrillation as indicated.
- Educate patients and their families about their cardiac surgical procedure.
- 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.
- Other duties as assigned.
Required physical and mental abilities:
- Must be quality driven and have proven ability to be a productive member of a cohesive team of peers, dedicated to providing optimum patient care.
- Must exercise the highest degree of professional judgment under the direct supervision and guidance of a licensed physician.
- Must maintain a professional attitude toward patients and exercise mature independent problem solving to meet the needs of the patients.
- Must demonstrate understanding of procedures, policies and documentation required to ensure compliance with hospital standards of care.
EEO StatementBrigham and Women's Hospital is an Affirmative Action Employer. By embracing diverse skills, perspectives and ideas, we choose to lead. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment.
