This fellowship in the Pediatric Heart Center offers advanced practice providers (NPs or PA-Cs) a rotation through various clinical settings, with a strong focus on the pediatric cardiac intensive care unit (PCICU), PICU, and pediatric cardiac stepdown. The fellow will work alongside APPs and MDs, providing direct patient care for congenital heart, surgical, and medically ill pediatric heart patients from birth to young adulthood.
Responsibilities
Round daily on patients to assess, diagnose, plan treatment, set priorities and realistic outcomes, and evaluate the effectiveness and cost efficiency of patient care, in collaboration with cardiology attendings, PCICU attendings, surgeon(s) and/or APPs
Provide and coordinate clinical care for service-specific patients through established protocols and under the hospitalist supervising physician or back-up physician who is either on site or available by pager
Collaborate with residents, fellows, attending other NP/PA colleagues, nurses, and patient resource managers to formulate treatment plans and monitor patient progress
Perform procedures specific to the work environment after demonstrated competency and within the guidelines of scope of practice and credentialing protocols
Assess patients for change in status and institute appropriate interventions
Initiate emergency interventions to stabilize the patient until physician support arrives
Perform postoperative stabilization and management
Develop patient care pathways, protocols and guidelines for the management of specific problems in conjunction with physicians and other members of the healthcare team
Analyze clinical practice patterns to provide the best medical care and to increase effectiveness and efficiency
Communicate verbally and in writing all pertinent patient information to supervising MD, nursing staff, patient resource manager, home health agency, and other relevant healthcare providers
Document in the patients’ medical record all relevant data including but not limited to results of diagnostic tests; laboratory results; patients’ condition and response to therapies/interventions; communications with supervising MD
Utilize prescriptive privileges only for identified patient population
Prescribe, order, and/or administer drugs, including schedule II, III, IV, and V drugs and necessary medical devices
Role model competence in all nurse practitioner/physician assistant advanced skills
Give daily handoff to appropriate APP, attending, resident and/or intern at the end of the shift
Assess educational needs of the patient-care staff and provide one-on-one as well as formal education as needed
Assess educational needs of the patients/families and provide culturally sensitive patient/family education interventions as indicated
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Use non-technical language when educating patients and families
Document all pre and post-op/procedure education in patients’ medical record
Implement and evaluate appropriate educational programs for DUHS patient care staff and other healthcare providers as appropriate
Role model and precept healthcare learners through contractual agreements
Utilize current research and evidence-based decision-making in all clinical practice
Incorporate clinical research findings in the development and implementation of standards of care
Support IRB approved clinical research/trials through a variety of activities including obtaining consent, ordering diagnostic tests, recording laboratory & diagnostic results, administering therapeutic interventions, and reporting patient outcomes including toxicities or adverse events
Participate in interdisciplinary quality improvement and/or research activities
Participate in measuring and documenting outcomes
Provide expertise and resource information to other healthcare providers, patients and families, and the community at large related to cardiothoracic diseases, procedures, interventions, and conditions
Implement and evaluate appropriate educational programs for referring MDs
Develop, implement and evaluate standards of care/practice guidelines/policies and procedures/care maps/protocols within area of specialization
Develop programs and projects in areas of expertise to facilitate the attainment of the goals and objectives of Duke University Hospital and Duke University Health System
Role model advanced practice professionalism through conduct, communication, dress, leadership, ethical decision-making, critical thinking and problem-solving skills
Participate in at least one professional organization
Demonstrate responsibility for professional practice through active participation in the Cardiology department, CAP Department, and professional organizations
Meet Continuing Education requirements as designated by the NC Medical Board and/or NC Nursing Board
Maintain professional certification
Enhance the body of knowledge in area of specialization through written publications, oral presentations, posters, continuing education, etc.
Maintain all professional requirements for licensure and certification
Attend educational conferences regularly, morbidity and mortality conferences, code reviews, NP monthly meetings and attend twice a year adult congenital sessions
When caring for adult patients with congenital heart disease, plan for situations beyond expertise, consult with and refer to other health care providers as appropriate
Requirements
Must graduate by December 31, 2025
PA: Graduate of ARC accredited Physician Assistant Program, Masters or DMSc degree preferred
NP: Graduate of accredited MSN or DNP Pediatric Acute Care Nurse Practitioner Program
PA: PA-C certification
NP: PNP-AC certification
PA: Current unrestricted medical license issued by the NCMB with authorization to practice as PA
NP: Current unrestricted RN license issued or recognized by the NCBON with authorization to practice as NP
Both: Federal and State DEA with unrestrictive full prescriptive authority
New PA or PNP-AC grads welcome to apply, no APP experience required
BLS (required)
PALS (required)
Nice to have:
ACLS (recommended)
Important Details
Schedule: Minimum of 12 to a maximum of 13, 12-hour shifts every 4 weeks, covering 7 days a week including days, nights, weekends and holidays; flexibility is required to meet clinical needs of the service
About the Company
Duke Health is driven by a commitment to compassionate care. Duke University Hospital is the largest of the four Duke Health hospitals with 1062 patient beds, featuring comprehensive diagnostic and therapeutic facilities. The Duke University Health System is designated as a Magnet organization and has over 6000 registered nurses.
