Job Location     

Duke Hospital, 2301 Erwin Road, Durham, NC

Job Summary

We are seeking a Critical Care Advanced Practice Provider in Durham, NC for Duke Emergency Medicine's Observation Unit, which serves as a tertiary care center and Level 1 Trauma Center to patients in North Carolina and surrounding states.  The Emergency Department at Duke University Hospital is comprised a 14 bed Pediatric ED, four adult care areas, two fully equipped x-ray rooms and two state of the art dedicated CT scanners, a 7,000 square foot ambulance bay, 8 bed psychiatric emergency unit, and a clinical evaluation / observation unit.   Our team is active in delivering exemplary care for each patient to ensure an excellent patient experience, every time.

Job Duties & Responsibilities

• In collaboration with the attending physician(s), provide direct clinical services for critically ill patients according to the established protocols and utilizing evidence-based clinical practice in the Clinical Evaluation Unit.
• Perform detailed histories and physical exams on patients placed in observation.
• Develop, initiate, and manage individualized treatment plans for a broad range of acute and subacute conditions.
• Order, interpret, and act on diagnostic studies including labs, imaging, and EKGs.
• Initiate appropriate therapeutic interventions including medications, IV fluids, respiratory therapies, wound care, and other procedures within scope of practice. 
• Monitor and reassess patient status throughout their observation stay to ensure clinical stability and progress toward discharge goals.
• Make timely decisions regarding patient disposition, coordinate specialty consultations, and facilitate transitions of care.
• Communicate effectively with patients and families regarding diagnosis, treatment plans, expectations, and follow-up.
• Document all clinical encounters and updates in the electronic medical record.
• Complete required admission, progress, and discharge notes in accordance with departmental protocols.
• Support the operational goals of the ED and hospital by managing observation patients efficiently. 
• Assist in identifying barriers to timely discharge and proactively work to resolve them.
• Help ensure appropriate use of observation status in compliance with regulatory guidelines.
• Adhere to evidence-based clinical pathways, protocols, and institutional guidelines.
• Participate in ongoing quality improvement initiatives, case reviews, and morbidity & mortality discussions.
• Promote a culture of safety, respect, and accountability within the unit.
• Stay current with developments in emergency and observation medicine through CME, journal review, and departmental education sessions.
• Support orientation and mentoring of new APPs, residents, and students rotating through the observation unit.
• Seek opportunities to contribute to operational improvements, academic projects, or protocol development.

Job Eligibility Requirements

Education           

• Nurse Practitioners:  Work requires completion of an accredited Nurse Practitioner program, with a Master's degree in Nursing. Critical Care / Acute Care NP Master's or completion of ACNP/CCNP post-Master's program required.
• Physician Assistants:  Completion of an accredited Physician Assistant program. A Bachelor's degree required; Master's degree strongly preferred.

Certification 

• BLS required.

• ACLS required within 3 months of hire

License                

• Nurse Practitioners:  Must have current or compact RN licensure in the state of North Carolina. BLS required. National certification as a NP required prior to employment. Certification as an Acute Care or Critical Care Nurse Practitioner required.
• Physician Assistants:  Must be licensed in the state of NC, and be certified as a Physician Assistant by the National Commission on Certification of Physician Assistants.

Minimum Experience Requirements          

• 1 year of advanced practice emergency medicine, observation, or critical care experience preferred. Completion of a residency/fellowship in emergency medicine, observation, or critical care preferred. 
• Nurse Practitioners: 1 year of experience as a nurse practitioner in an emergency medicine, observation, or critical care setting preferred.
• Physician Assistants: 1 year of experience as a physician assistant in emergency medicine, observation, or critical care setting preferred. 

Job Hours

12-hour day or night shifts or rotating day/night shifts available - flexible options available