Emergency Medicine Observation NP/PA Fellowship.

Seeking Nurse Practitioner and Physician Assistant candidates for a unique Emergency Medicine Observation Fellowship. Candidates must demonstrate knowledge and competency of core skills related to observation medicine that will serve as a basis for continued growth and progression of skills and pace. The Advanced Practice Provider Fellow (APPF) must pass monthly core competency assessments, participate in lecture and interdepartmental rounds, be proficient in simulation lab exercises and demonstrate patient care skills commensurate with working in a Level 1 Trauma Center. The APPF role is applicable for a 12-month period.

The APPF serves as a member of a dynamic healthcare team made up of physicians, physician assistants, nurse practitioners, nursing staff, technicians and various support personnel. Under general physician supervision, the APPF provides quality service in a caring and professional manner, actively supporting team efforts to ensure cost effectiveness and service excellence for an adult population with predicted short hospital stays. The APPF role includes responsibility for identifying the patient's health and medical status through taking of health histories; performing physical examinations; initiating screening and diagnostic procedures; management of minor trauma and acute health problems; identifying/initiating necessary interventions; coordinating care with various specialty services; health maintenance and clinical management of stable chronically ill patients; choosing appropriate patient disposition.

• Participates in a 12-month intense training program in emergency and observation medicine consisting of patient care in a Level 1 Trauma Center, simulation lab training, off-service rotations and rotations to community hospital emergency departments and observation units.
• Attends interdepartmental rounds and lectures, develops beginner and advanced skills in the management of patients in the Emergency Department Observation Unit.
• Becomes proficient in basic ultrasound diagnostic abilities and EKG interpretation.
• Conducts necessary steps to obtain comprehensive health history. Performs basic physical, psychological and developmental assessments using the techniques of observation, inspection, auscultation, percussion and palpation.
• Discriminates between normal and abnormal physical, psychological and developmental findings and appropriately determines when to consult and/or refer the patient to other members of the health care team.
• Assesses, diagnoses, and manages selected acute and chronic illnesses and conditions. Performs or requests laboratory/radiology procedures and/or other screening tests based on age, health history and health assessment. Analyzes and interprets these and other health data. Initiates and implements appropriate treatment plan using established protocols or physician consultation. Administers treatments as needed.
• Utilizes automated computer systems, including electronic medical records. Accurately records assessment findings, documenting in a clear and concise manner all actions taken in response to these findings. Documents patient information including, but not limited to treatment procedures, medication refills, test results, patient concerns, etc. in the medical records in a timely manner.
• Coordinates necessary appointments and referrals, including the use of community resources, as the patient's health status dictates.
• Consults with supervising physicians, as appropriate, keeping physician informed of needs and problems related to patient care. Recognizes limits in role as APPF provider.

Education: Graduate of an accredited Physician Assistant Program or Nurse Practitioner Program required.

Experience: Clinical experience appropriate to specific practice/ department preferred.

Licensure, certification, and/or registration: Current Physician Assistants or Nurse Practitioner license (PA) required. DEA licensure required. AHA BLS, ACLS certification required. PALS required within 6 months of Fellowship training.

Other Minimum Qualifications: Meets credentialing requirements. Qualifies for malpractice insurance and is accepted by Carilion Clinic's malpractice insurance carrier. Ability to work collaboratively with physicians and other health care providers. Maintains open and supportive communications between all department members and other employees, patients and their family members. Commitment to continued professional development.

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