Advanced Practice Registered Nurses / Physician Assistants
GENERAL SUMMARY/ OVERVIEW STATEMENT:
An Advanced Practice Nurse is a registered nurse with master’s preparation in an expanded role, who provides direct care to individuals, families, and/or groups in a variety of patient care settings. In collaboration with the physician and other staff, (s)he is responsible for the diagnosing, prescribing treatment, and providing follow-up for patients during phases of wellness and illness. (S)he initiates referrals for implementing the patient’s total care plan involving other health disciplines within and outside the hospital. (S)he coordinates the care a patient may need in the community and oversees the case management of the patient and is accountable for keeping up to date with changes. Advanced Practice Nurses place a marked emphasis on patient teaching and education, and promote competent, compassionate nursing care for patients and families. The NP is expected to be HIPAA and Joint Commission compliant, follow the Unit’s code of conduct and be guided by the MGH Mission, Credo and Boundaries.
PRINCIPAL DUTIES AND RESPONSIBILITIES:
1.0 CLINICAL PRACTICE
Has appropriate knowledge of nursing, medical, and scientific principles, and appropriately applies those principles to practice of terminally ill clients and oncology patients.
Provides independent direct nursing care, performing physical examinations, ordering diagnostic studies, evaluates results and prescribes treatment as appropriate. Follows patients appropriately within Advanced Practice Role as delineated within the state of Massachusetts and MGH.
In collaboration with patients and families, designs a plan of care based on assessment of physical, emotional, and social needs. Initiates, facilitates, develops, and maintains collaborative relationships with peers, staff, administration, and interdisciplinary health team within the hospital and community to promote implementation and follow-up of care plan. Evaluates outcomes of treatment plans.
Identifies ethical issues in nursing practice and guides staff and other providers in application of ethical concepts to patient care issues. Particularly of importance is the patient’s privacy and dignity on the provision of care.
Identifies current trends in healthcare and their implications for nursing practice.
Identifies self to staff as a resource and describes role.
Provides information to staff about pertinent physical as well as psychosocial data which may affect patient and family care needs. Evaluates effectiveness of treatment plan.
Facilitates discussion around patient issues to ensure respect and agreement with treatment plan.
Coordinates implementation of patient and family decisions.
Throughout the patient’s care, provides counseling and ongoing support to nurses involved with care plan.
Responds to changes in clinical practice by planning, designing, implementing, and evaluating scientific based practice. Develops new techniques, guidelines, protocols, and standards in collaboration with other staff.
Applies problem solving approaches to teaching, guiding, and solving complex clinical problems.
Serves as change agent for clinical practice of terminally ill patients by sharing and participating in expanding knowledge of palliative care including teaching, role modeling and developing nursing practice guidelines.
Identifies self to families as a resource and describes role.
Provides information to family about disease process and terminal care.
Facilitates discussion to direct family to decision-making.
Coordinates implementation of patient and family decisions.
Throughout the patient’s care, provides counseling and ongoing support to patient and family.
Collaborates with insurance carriers and appropriate members of the health care teams such as primary nurse, case manager, and social worker on patient discharge planning that is appropriate, safes, and respects a patient’s dignity and wishes as much as possible.
Performs visits and gives nursing care when appropriate to patients and families in a variety of settings, including hospital, home, nursing home, or other facilities as appropriate. Documents findings, new information, and makes suggestions for the plan of care with appropriate agency or facility.
Fosters collaborative relationships with community agencies. Provides in-servicing and teaching as situation requires.
After discharge from hospital, maintains liaison with appropriate agency or facility to ensure continuity of care and quality of care.
Supports patient and family with ongoing care questions.
After patient death, provides bereavement follow-up and support.
Maintains 24-hour accountability for the assessment, planning, implementation, and evaluation of a multidisciplinary plan of care. Coordinates multidisciplinary plan of care for caseload.
Provides research-based patient care.
Collaborates with researchers in department.
Establishes and pursues own program of research as an investigator/co-investigator.
Conducts research as a principal investigator.
Seeks grant support from extra/intramural sources.
Presents findings at professional conferences.
Publishes scholarly work in peer-reviewed journals.
2.0 PROFESSIONAL DEVELOPMENT
Maintains and updates knowledge and skills based on current education, nursing, and health care practices.
Takes responsibility for participation on committees and task forces.
Participates in professional staff and student teaching, both formal and informal.
Fulfills professional role through involvement in professional organization activities, presentations, publications, and research.
Clear and direct in verbal and written communication.
Effective in facilitating group processes of decision-making for patient, family , and staff
Is empathic and respectful.
Is congruent with interpretation of plan of care to members of care team.
Accepts responsibility for conflict resolution between patient, family, and staff.
Advocates for patients choices.
4.0 PROGRAM DEVELOPMENT
Participates in developing policies, procedure, and standards of care.
Initiates and implements new programs relating to the Palliative Care Division.
Initiates quality improvement activities.
Monitors patient outcomes.
Recommends changes in practice as needed.
Integrates theoretical knowledge base and clinical expertise in decision making.
Advocates for patients, their significant others, coworkers, the community, and the nursing profession.
Consistently demonstrates accountability.
Champions collaborative practice with coworkers and other disciplines and departments.
Consistently demonstrates compassion to internal and external customers.
Dynamically represents the program and nursing profession in internal and external forums.
Exemplifies a professional behavior.
LICENSES, CERTIFICATIONS, and/or REGISTRATIONS
Current Registered Nurse licensure in Massachusetts as Nurse Practitioner.
Board certification as advanced hospice and palliative care nurse by a national recognized certifying agency.
Master’s degree from an accredited school of nursing as Nurse Practitioner.
Minimum of 2 years nursing experience as NP in the following: acute care, oncology, ambulatory care or palliative care.
Knowledge of end-of-life care, including advanced care planning, pain and symptom control of the terminally ill, and bereavement care issues.
FISCAL RESPONSIBILITY (if applicable):
Responsible billing per MGH Billing Compliance, Federal and State billing regulations.
40 hours, plus opportunity for up to 6 weekends on-call.
Patient care on MGH inpatient floors including, but not limited to: Bigelow, Blake, Ellison, Philips, and White.
Since 1811, Massachusetts General Hospital has been committed to delivering standard-setting medical care. Throughout the decades, the hospital has had a consistent commitment to advancing that care through pioneering research and educating future health care professionals. The third oldest general hospital in the United States and the oldest and largest hospital in New England, Mass General conti...nues its tradition of excellence today.Mass General has consistently placed among the top hospitals on the U.S. News & World Report Best Hospitals Honor Roll since the survey began in 1990. In 2015, Mass General was named #1 in the nation based on our quality of care, patient safety and reputation in 16 clinical specialties.In 2013, Mass General was also redesignated a Magnet hospital, the highest honor for nursing excellence awarded by the American Nurses Credentialing Center.