Advanced Practice Registered Nurse Medicine, Nephrology Full Time

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CORE JOB SUMMARY

The Advanced Practice Registered Nurse (APRN) d elivers patient-family centered care in a culturally competent and compassionate manner utilizing and promoting evidence-based standards of quality safety and service while ensuring population-specific patient care. The APRN provides and directs hands-on care to patients practicing within the Scope of Practice of the Florida Board of Nursing requirements standards of care and institutional policies and procedures. Within th is role the APRN performs all steps of the care process and monitors the quality of care provided . The APRN demonstrates expertise and mastery towards patient care p rovid ing care within the philosophy mission and objectives of the health system . The APRN delivers care that supports the UHealth mission to be a state - of - the - art academic medical center by participating in transforming patient care through innovative research.

CORE JOB FUNCTIONS

Caring Science

P rovides overall care with loving kindness. U ses creative problem-solving to meet the individual needs and requests of patients. Helps support the hope and faith of patients cared for. Is responsive to patient readiness to learn when they are taught something new. Is respectful of individual patient spiritual beliefs and practices. Creates an environment for the patient that helps them heal physically and spiritually. Establishes a helping-trusting relationship with the patients during their treatment period . Responds to each patient as a whole person helping to care for their needs and concerns. Encourages patients to speak honestly about their feelings no matter what their feelings are.

Leadership

Contributes concise constructive feedback in the provision of care to other staff and leadership . A ssumes responsibility and delegates to appropriate personnel and follows up to en sure completion. Serves as a clinical role model mentor and / or preceptor . T eaches others suggests process improvements provides e vidence -b ased p ractice suggestions coaches others to improve support changes and recognizes contribution of others.

P articipates and / or leads committees and task forces as they advance in expertise .

Establishes Therapeutic and Trusting Relationships

Creates and maintains a climate conducive to healing through being present to the patient and family . l eads and collaborates with the care team in identifying and managing discomforts; providing emotional support and information; guiding the patient and family through phases of illness and recovery / passage to death in accordance with the patients goals and culture. Mobilizes the patients strengths and abilities towards participation in recovery and control over plan of care.

Diagnostic and Monitoring Functions

Obtains accurate and relevant assessment data and interprets the data as normal vs. abnormal. Determines diagnosis. Modifies patient treatment plans as indicated by patients responses and conditions and collaborate s with physician s and other team members .

Plans and Implements Therapeutic Interventions

Collaborates with the patient family and members of health care team to develop an individualized plan of care including discharge planning. Implements medical interventions safely. Performs appropriate patient tests and safely administers medications within the scope of practice. Administers and maintains accurate records related to medications and treatments as per regulatory bodies policies and procedures . E valuates effectiveness of interventions and monitors patient for adverse responses and side effects.

Utilizes available technology platforms for telehealth encounter s . I nitiates and leads the development of policies procedures protocols standards of care; examines and questions treatment to determine if they are within best practice.

Teaching and Coaching : Patient and Staff Teaching

Assesses a patients and familys learning needs and readiness to learn. Teaches needed information for self-care and illness management and prevention. Adjusts i nformation and expectations based on responses from patient developmental levels physiological and psychological condition and cultural variations while addressing and meeting the needs of any language barriers that may be present.

Effective Management of Rapidly Changing Situations

R apidly grasp s problem situations and respond s quickly and appropriately. Identifies the need for and activates emergency protocols . S erves as a transformational leader in assisting others to adapt to changing work demands and environment. Anticipates possible problems and assists leadership in the de velopment of contingency plans.

Monitors and Ensures Quality Healthcare Practices

Monitors own practices and assists in monito ring and evaluating others for practices related to patient and employee safety and compliance to standards and policies. Looks for opportunities for continual improvement in patient care and the work environment. Adheres to University departmental and unit-level policies and procedures and safeguards Uni versity assets. Participates in activities such as leading an Evidence-based Practice / Performance Improvement project and / or a nursing theory-based methodologic approach to develop / submit a research proposal for Institutional Review Board (IRB).

Organization and Work R ole Functions. Priorities Management and Delegation

Integrates multiple requests and work expectations by setting priorities delegating tasks appropriately and seeking assistance as needed. Contributes to team building through participation in unit programs and meetings.

Contributes to positive morale using constructive and effective conflict resolution skills. Learns and utilizes the available technology for communication documentation and locating information regarding unusual clinical situations diagnosis and treatments.

Contributes to the knowledge and skill of other members of Advanced practice through one or more activities such as formal or informal teaching participation i n Shared Governance groups professional publications and / or presentations.

Education

Attains and maintains knowledge and competence that reflects current advanced nursing practice for assigned patient population through professional development activities . D emonstrates an advanced level of competency in practice. Engages in activities such as membership or lead ership of a workshop or specialty continuing education course; serv ing as resource / super-user / specialist / support ; teaches specialty competency development and proctor skill validation

Communication

Communicates plan of care in a timely manner to patient and family as well as the appropriate team members ensuring compliance with all regulatory guidelines ( i.e. HIPAA). Uses best practices for transition of patient care.

Meets diverse communication needs of patients with Limited English Proficiency (LEP).

Professional Practice Evaluation

Evaluates Advanced practice in relation to professional practice standards and guidelines relevant statues rules and regulations. Provides focused constructive feedback and guidance with loving kindness to peers in a manner that provides growth and maintains self-esteem.

Participates in shared governance following the ANA Code of Ethics to elevate the professional integrating the professional practice model and relationship - based care delivery model into their practice. Integrates the Magnet Model components into practice.

Critical Thinking

Incorporates protocols and standards of care into daily practice. Uses sound judgement decision making criteria and available resources for drawing conclusions and taking required action. Applies evidence - based practices approaches and solves problems with a global perspective using creativity and flexibility.

This list of duties and responsibilities is not intended to be all-inclusive and may be expanded to include other duties or responsibilities as necessary.

CORE QUALIFICATIONS

Education :

Masters or Doctorate in Nursing (APRN) or Masters in Physician Assistant Studies from an accredited program.

Certification and Licensing :

Current board certification as an A cute C are nurse practi ti oner by an accredited APRN certifying body

Valid State of Florida r equired

BLS Basic Life Support certification

Must have a National Provider Identifier (NPI) or obtain an NPI prior to employment start date and meet current Medicare requirements for billing

Experience :

M inimum of 1 year of relevant experience.

Knowledge Skills and Attitudes :

Strong effective communication skills with patient s families and clinical team for innovative patient care and trust

Ability to c ollaborate with peers in the best interest of the patient to provide consistent quality of care

Ability to a dapt and exhibit flex ibility to handle new different or changing environments

Demonstrates strong time management skills to prioritize triage and act proactivity

Ability to u phold professional ethics and maintain patient confidentiality

Knowledgeable on all aspects of patient care including assessing planning coordinating monitoring and evaluating the patients progress through continuum of care

Department Specific Functions

The APRN is responsible for assessing physical and psychosocial status of patients in an outpatient clinic setting by means of interview health history physical examination and diagnostic studies. Assist physicians in performing and documenting medical procedures up to and including blood drawing vital signs nursing assessments and history and physicals . The incumbent will spend up to 8 half days per week in outpatient Nephrology clinics. APRN will manage ambulatory patients with chronic kidney disease create and carry out treatment plans educate about medication use diet restrictions and renal replacement choices and collaborate with consultants. APRN will be expected to cover outpatient dialysis service as needed. In addition the APRN will rotate as necessary in our UHealth Tower and Jackson Memorial Hospital inpatient dialysis units managing patients with end-stage kidney disease who are supported with hemodialysis report findings to and discuss management with the supervising physician until deemed independent and provide education to patients.

Seeking an Advanced Practice Provider (Nurse Practitioner or Physician Assistant) to join the Nephrology team providing care primarily in the outpatient hemodialysis setting with flexibility to assist with inpatient nephrology coverage at Jackson Memorial Hospital or UMH as needed. This role supports seamless continuity of care between the dialysis unit CKD clinic and hospital maintaining a balanced and collaborative workflow.

Manage outpatient dialysis patients (minimum 3 visits per patient per month) and collaborate with the multidisciplinary dialysis team.

C onduct a ½-day CKD clinic weekly for chronic kidney disease management.

Assess and manage volume status vascular access anemia bone-mineral balance and medication

adjustments.

Provide inpatient nephrology week and weekend coverage at JMH / UMH as needed

Recognizes deviations from normal in the physical assessment. Works in collaboration with a physician in formulating treatment plans for health problems and follow-up.

Writes prescriptions for medication blood products based upon laboratory results routine diagnostic and follow-up studies therapeutic measures diet and post-discharge care in accordance with written practice protocols.

Participates in and facilitates clinical research protocols and coordinates patient care with research staff.

Obtains complete medical history and physical examinations without supervision by the physician.

See patients in follow up in between dialysis treatments and post procedure as necessary

Initiate and Maintain orders as per protocol

Orders appropriate laboratory tests according to practice guidelines.

Develops implements and evaluates a plan of care that is appropriate for the patient and family.

Actively participates in quality assurance programs and peer review activities.

Responsible for providing assistance to physicians in the care and treatment of patients.

Provides medical support to staff triaging and implementing care in a knowledgeable and skillful manner as evidenced by team feedback and documentation in medical records.

Assess severity of patients condition determining and directing patients to appropriate medical providers.

Requests prior authorizations and provides peer-to-peer reviews with insurance carriers in support of patients medications

Consents patients for procedures and places orders for procedures

Maintain EMR inbox and close encounters in a timely fashion according to UMMG guidelines.

APRN inpatient job description

The APRN will see alone all ESRD consults with the exception of PD patients

Fellow and APRN should sign out guarded status patients every day at 5pm to the night float fellow via text or phone call.

APRN to cover fellow when at clinic if needed.

The APRN will carry an APRN ESRD phone from 8 a m to 5pm.

Inpatient job description is based on service needs; APRNs are exempt staff not hourly.

For inpatient daily responsibilities APRN is to arrive no later than 8am and leave at 5pm or unless service dictates otherwise.

Fellows on the consult service will forward their phones from 11 : 45a m to 1 pm on Monday Thursday and Fridays to the APRN of the hospitals they are assigned to . Either Jackson Memorial or UHT /

Daily huddle at 11 : 30am between APRN and fellow to bring up to date about calls / new consults / follow upquestions via text or phone call.

Whoever is holding phone should text the other teams if they get a new consult .

It is the responsibility of the ARNP to find coverage when going on vacation or absent leaves by another APRN for both inpatient and outpatient activities ex. answer calls from patients followed in outpatient clinics covering inpatient services and covering outpatient dialysis services APRN should declare vacations 2 or 3 months ahead of time and assigned coverage and cancel their PM clinic.

APRN inpatient coverage during sick days the APRN should email the APRN lead ( MD supervisor and Elias Fernandez APRN and Sr. Clinical Practice Manager) and the faculty on service to have the teams find coverage.

It is expected that APRNs will have at least 75% participation in our noon teaching conferences.

APRNs will be evaluated by their clinic patients using the Ganey consumer experience survey; group and individual data will be shared monthly.

APRNs are expected to see consults until 5 PM even during clinic days.

Provide inpatient nephrology week and weekend coverage at JMH / UMH as neede d

The University of Miami offers competitive salaries and a comprehensive benefits package including medical dental tuition remission and more.

UHealth-University of Miami Health System South Floridas only university-based health system provides leading-edge patient care powered by the ground breaking research and medical education at the Miller School of Medicine. As an academic medical center we are proud to serve South Florida Latin America and the Caribbean. Our physicians represent more than 100 specialties and sub-specialties and have more than one million patient encounters each year. Our tradition of excellence has earned worldwide recognition for outstanding teaching research and patient care. Were the challenge youve been looking for.

The University of Miami is an Equal Opportunity Employer - Females / Minorities / Protected Veterans / Individuals with Disabilities are encouraged to apply. Applicants and employees are protected from discrimination based on certain categories protected by Federal law. Click here for additional information.

Job Status : Full time

Employee Type : Staff

Pay Grade : H15

Key Skills

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Employment Type : Full-Time

Experience : years

Vacancy : 1