Duke Careers
Location
Durham, North Carolina
The Advanced Practice Provider provides direct clinical care for complex cardiothoracic surgery and heart failure patients in an intensive care setting. Responsibilities include performing diagnostic procedures, managing treatment plans, and collaborating with the surgical team to ensure high-quality patient outcomes.
Candidates must hold a graduate degree from an accredited Nurse Practitioner or Physician Assistant program and possess current, unrestricted licensure in North Carolina. At least one year of experience in a high-acuity adult ICU or CTICU setting is strongly preferred.
Provide /coordinate clinical care for cardiothoracic surgery patients at Duke Hospital being followed primarily in the Cardiothoracic Intensive Care setting through established protocols and under the supervision of the cardiothoracic surgeon or back-up supervising physician who is either on site or available by pager Patient rounding in collaboration with attending cardiothoracic surgeon(s),cardiac anesthesiologist(s), CTICU intensivists, and Medical Director of the CTICU, round daily on patients to assess, diagnose, plan treatment, set priorities and realistic outcomes, and evaluate the effectiveness and cost efficiency of cardiothoracic patient care; Perform procedures when indicated: (Partial listing…full list will be shared upon request or at time of interview)
Intubation / Extubation and/or airway management Flexible bronchoscopy for non-biopsy purposes in patients with an artificial airway Ventilator Management Tracheostomy tube changes Removal of diaphragm sutures Chest tube insertion / management / removal Paracentesis Thoracentisis Blood sampling via central venous lines (CVLs) including temporary central catheters, tunneled catheters, implantable vascular access devices Arterial and Venous sticks Arterial line placement and removal Intraortic balloon pump (IABP) removal Venous line placement/central line including PA catheter placement, temporary dialysis catheter, temporary transvenous pacemaker Venous line removal including temporary dialysis catheters Place gastric or post-pyloric feeding tubes Management of peripherally placed central and peripheral venous catheters (PICC/C) Peripheral intravenous catheter placement (PIV) Wound management including wound vac, application of dressings and bandages, simple debridements, suture removal/placement, local cauterization, staple removal/placement ECG Interpretation including atrial ECG Defibrillation/Cardioversion Temporary pacemaker wire removal and clipping as well as programing Transcutaneous pacing Assisting with ECMO cannulation/decannulation Manage acute cardio and/or respiratory decompensation, including rapid response and/or code Management of Mechanical Circulatory Support Device devices
will consider new grads with CTICU RN experience and/or CTICU rotation as NP student
PA 1-year experience as PA in an adult high acuity critical care/CTICU setting OR a one-year Critical Care Fellowship
Will consider new grad PA with CTICU rotation while in PA school
Able to clearly articulate scope of practice and practices within those guidelines as an NP/PA in the state of North Carolina and within the Duke University Health System (DUHS) Able to independently seek out resources and work collaboratively to solve complex problems Able to communicate clearly with patients, families, visitors, healthcare team, physicians, administrators, leadership, and others Able to use sensory and cognitive functions to process and prioritize information, perform health assessments, treatment, and follow-up Able to use fine motor skills Able to record activities, document assessments, and interventions; prepare reports and presentations. Able to use computer and learn new software programs Able to provide leadership in clinical area of expertise and in meeting organizational goals Able to navigate the Hospital and DUHS to provide clinical expertise to specific patient populations Able to withstand prolonged standing and walking with the ability to move or lift at least fifty pounds Able to remain focused and organized Able to work collaboratively with all levels of personnel
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