Duke Careers·Durham, North Carolina
The Advanced Practice Provider provides direct clinical care for complex cardiothoracic surgery and heart failure patients in collaboration with surgeons. Responsibilities include performing physical exams, ordering diagnostic studies, prescribing medications, and managing patient care pathways.
At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together.
Pursue your passion for caring with Duke University Hospital in Durham, North Carolina, which is consistently ranked among the best in the United States. The largest of the four Duke Healthhospitals with 1062 patient beds, it features comprehensive diagnostic and therapeutic facilities, including a regional emergency/trauma center, an endo-surgery center, and more.
The Duke University Hospital Cardiothoracic (CT) Surgery Step-Down Unit (SDU) Advanced Practice Provider (APP) provides direct patient care services for complex critically ill Cardiothoracic Surgery and Advanced Heart Failure patients in collaboration with and under the supervision of the cardiothoracic surgeon(s) and medical director of the CT SDU. The APP performs physical exams, collects and documents data, conducts diagnostic and therapeutic procedures, orders and schedules laboratory studies and professional consultations, prescribes appropriate interventions and medications, coordinates the care and discharge of patients, and provides direct patient care services.
Job Duties and Responsibilities
Provide /coordinate clinical care for cardiothoracic stepdown surgery patients at Duke Hospital being followed primarily in the Cardiothoracic Step-down setting but also throughout Duke Hospital and clinic 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 (including the OR, PACU, Step-down units, all inpatient units, ER and clinic setting).
In collaboration with attending cardiothoracic surgeon(s) 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;
Collaborate with residents, fellows and attendings to formulate treatment plans and monitor patient progress;
Assess patients for change in status and institute appropriate interventions. Initiates emergency interventions in an effort to stabilize the patient until physician support arrives.
Preoperative evaluation; including (but not limited to) establishing diagnosis, and baseline status
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 health care team.
Analyze clinical practice patterns so as 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 patient’s chart 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 populations.
Prescriptive authority for prescribing, ordering, and or administering drugs; including (but not limited to) schedule II, III, IV, and V drugs and necessary medical devices.
Role models competence in all nurse practitioner/physician assistant advanced skills.
PA: Graduate of an ARC-accredited Physician Assistant (PA) program. Master’s degree or Doctoral required.
NP: Graduate of an accredited MSN or DNP Acute Care Nurse Practitioner (NP) program for adult care.
Certification: PA: PA-C
Np: Acnp or agacnp
PA: Current unrestricted medical license issued by the NCMB with authorization to practice as a PA.
NP: Current unrestricted RN license issued by or recognized by NCBON with authorization to practice as a NP.
Both: Federal and State DEA with unrestricted prescriptive authority
PA: 1 year’s experience as a PA in a relevant clinical area preferred.
NP: 1-year NP experience or 2+ years RN experience in a cardiovascular or cardiothoracic surgery unit is preferred
*Will consider a new graduate with prior CTICU/CVICU or CTSD RN experience
Primary hours fourteen (12) hour shifts/month, rotating shifts, 7 days per week including holidays.
Duke is an Equal Opportunity Employer committed to providing employment opportunity without regard to an individual's age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex (including pregnancy and pregnancy related conditions), sexual orientation or military status.
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Certain jobs at Duke University and Duke University Health System may include essential job functions that require specific physical and/or mental abilities. Additional information and provision for requests for reasonable accommodation will be provided by each hiring department.
Market context
Advanced-practice roles in North Carolina often show steady demand in hospitals, clinics, and specialty practices, especially for candidates who can work autonomously and meet licensure and certification requirements. These positions can be competitive because employers often look for a graduate nursing degree, 2–4 years of relevant experience, and current NC licensure, DEA, and BLS credentials. Review the AI-summarized requirements and benefits on this page to save time, then confirm your certifications and tailor your application to the setting and scope of practice.