PRN Nurse Practitioner - VPEC

Discover Vanderbilt University Medical Center: Located in Nashville, Tennessee, and operating at a global crossroads of teaching, discovery, and patient care, VUMC is a community of diverse individuals who come to work each day with the simple aim of changing the world. It is a place where your expertise will be valued, your knowledge expanded, and your abilities challenged. Vanderbilt Health recognizes that diversity is essential for excellence and innovation. We are committed to an inclusive environment where everyone has the chance to thrive and where your diversity of culture, thinking, learning, and leading is sought and celebrated. It is a place where employees know they are part of something that is bigger than themselves, take exceptional pride in their work and never settle for what was good enough yesterday. Vanderbilt's mission is to advance health and wellness through preeminent programs in patient care, education, and research.

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Department Summary

VPEC has two locations: The Vanderbilt Clinic (TVC) and One Hundred Oaks (OHO), both are fully staffed clinics with 11 Nurse practitioners, 5 registered nurses and multiple MAs and PSRs. The staff at either location performs: vitals, images, sleep apnea screening and a complete review of systems and history and physical on patients undergoing elective surgeries. The nurse practitioners performs these visits in person, while the registered nurses use a virtual phone call model. We can also arrange for lab work and x-rays to be done at the time of the VPEC visit or through a local primary care doctor for our phone call patients. We gather any outside testing and can order electrocardiograms, cardiac consults, stress tests and echocardiograms if felt needed by the attending anesthesiologist.

Patients are usually referred to the clinic by one of our surgeons for medical optimization prior to the day of surgery. This process allows our team of Nurse Practitioners to ensure that preoperative patients are properly evaluated, educated and that all necessary testing and patient information are in hand before procedures. This is a free evaluation to assess the patients overall risk for surgery. This better ensures patient safety and helps prevent surgical delays and cancellations on the day of surgery. Once the patient evaluation is completed at VPEC, it becomes part of the patients electronic medical record and is accessible by any Vanderbilt medical provider.

VPEC has received several significant industry accolades, including the 2014 Top Performer Award and the coveted 5-Star Award for Overall Quality of Care. This means a score in the 90th 99th percentile based on results and as compared to similar centers nationwide. The award was given to both VPEC clinic sites. VPEC leadership is frequently consulted by other hospitals wanting to improve their preoperative processes.

KEY RESPONSIBILITIES
* Assessment of Health Status
* Performs and documents in the medical record a complete history and physical examination for acute and complex chronically ill patients.
* Orders and collects data using appropriate assessment techniques, relevant supporting diagnostic information and diagnostic procedures where indicated.
* The nurse practitioner may serve as the first responder for both nursing and house staff in the event of patient status changes, orders, and in situations requiring procedural and resuscitative interventions.
* Assesses for risks associated with the care of the acute and complex chronically ill patient including: medication side effects, immobility, impaired nutrition, fluid and electrolyte imbalance, immunocompetence, invasive interventions and diagnostic procedures.
* Coordinates daily rounds with the Attending physician teams, presents 24 hour patient report, collaborates in plan of care, and follows assigned patient population throughout the day.
* Diagnosis
* Collaborates with interdisciplinary health care team in making diagnoses of acute and complex chronic conditions.
* Manages diagnostic tests through ordering, interpretation, performance, and supervision.
* Formulates differential diagnoses by priority.
* Diagnoses complications and orders appropriate interventions
* Formulates Plan of Care
* Identifies expected outcomes from diagnosis, and formulates and documents a plan of care to address complex acute and chronic health care needs.
* Utilizes evidenced based practice guidelines or protocols in an individualized, dynamic plan of care that can be applied across the continuum.
* Implements and modifies plan of care
* Prescribes diagnostic strategies and therapeutic interventions both pharmacologic, non-pharmacologic and surgical, needed to achieve expected outcomes.
* Manages further diagnostic tests through ordering, interpretation, performance, and supervision.
* May perform advanced procedures consistent with privileges and competency validation including minor suturing, complex wound management, line and tube placements and removals.
* Communication and Collaboration
* Maintains ongoing communication and collaboration with interdisciplinary health care team .
* Facilitates and communicates with patient, family and staff to promote continuity of care across the inpatient and outpatient continuum of care.
* Documentation
* Documents/dictates key components of patient's progress via daily progress note, transfer, and discharge summary , and or clinic note where applicable. (h&p, daily progress notes, plan of care, problem lists, procedure notes, acute event note, discharge summaries, in medical record per specific patient unit or service, death summary)
* Documentation is timely, meets acute care compliance standards and captures patient acuity.
* Professional Practice
* Demonstrates Professional Practice behaviors including: preceptor/mentoring, education and instruction of students, nursing staff, nurses, graduate and novice nurse practitioners.
* Seeks opportunities for active engagement in research and the analysis of evidenced based practice.
* Actively participates in Grand Rounds, APN council meetings, faculty and unit meetings, M&M presentations.
* Maintains CEUs, and membership in a professional organization.

TECHNICAL CAPABILITIES

Our Nursing Philosophy:

We believe highly skilled and specialized nursing care is essential to Vanderbilt University Medical Center's mission of quality in patient care, education and research. We believe nursing is an applied art and science focused on helping people, families and communities reach excellent health and well-being.

As a Vanderbilt University Medical Center employee, you make a difference to our patients and their families by bringing compassion and care to those in need of hope and healing. Please see our current employee benefits offered:

• Affordable High Quality Health Plan Options
• Dental and /or vision plan
• 403 (b) retirement plan
• Paid Time off (flex PTO)
• Tuition Reimbursement and adoption assistance (maximums applied)
• Short-Long term disability
• Subsidized backup childcare
• And many more... Ask us about our current inpatient nursing supplemental Pay Program!

Achieve the Remarkable:

Learn more about VUMC Nursing:

• Nursing Careers: http://www.vumcnursingcareers.com/index.html
• Benefits: http://www.vumcnursingcareers.com/benefits.html
• Our Nursing Philosophy: http://www.vumcnursingcareers.com/philosophy.html
• Our Nursing Leadership: http://www.vumcnursingcareers.com/leadership.html
• Shared Governance: http://www.vumcnursingcareers.com/shared-governance.html
• Education& Professional Development: http://www.vumcnursingcareers.com/professional-development.html
• Life In Nashville: http://www.vumcnursingcareers.com/nashville.html
• VUMC Nursing: http://www.mc.vanderbilt.edu/root/vumc.php?site=vanderbilt-nursing

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Vanderbilt Health recognizes that diversity is essential for excellence and innovation. We are committed to an inclusive environment where everyone has the chance to thrive and to the principles of equal opportunity and affirmative action. EOE/AA/Women/Minority/Vets/Disabled