ICU Nurse Practitioner (NP) or Physician Assistant (PA)MGH

We welcome both newly-graduated and experienced NPs and PAs interested in a full-time position. Our only absolute minimum requirements for consideration are:

• 2 or more years of full-time critical care RN experience PLUS graduation from an Acute Care NP program; OR,

• 1 or more years of full-time ICU APP experience

Our usual patient populations are adult complex surgical patients including burns along with acutely ill medical patients (i.e. both SICU and MICU-type patients). While Ellison 14 is the official 'Burn ICU' at MGH and has a storied history of caring for critically ill burn patients, currently, thermal burns constitute a minority of our patients (<10%).

Ellison 14 ICU has a 'closed ICU' model. All patients on the unit are cared for by the same team. Our APPs are the primary ICU care providers, supported by admitting surgical teams and consultants. Our multispecialty care team model, in-line with other ICUs at MGB, is based on responding clinicians (APPs and residents) supervised by 24/7 in-house attending ICU staff physicians and supported by critical care fellows.

The job requires a regular, equitably distributed quota of day, nights, and weekend shifts. Currently, a full-time assignment is three 13-hour shifts plus one hour of education every week. Shifts are 6am-7pm and 6pm-7am with one hour overlap for sign out and to sort out pending patient care issues.

The APP administrative structure at MGB is evolving. You will be administratively working with the Department of Surgery APP Clinical Practice Director, the Ellison 14 Nursing Director, and the Ellison 14 Medical Director(s).

In addition to offering a video or in-person interview, we encourage prospective candidates to come shadow our team in-person for a half or full day to get a feel of the ICU. Our group is collegial and supportive and you will have ample opportunity to ask questions and get a candid, up-close view of our work.

All new hires go through a detailed on-boarding experience and several weeks-long orientation at MGH ICUs tailored to their background and prior experience.

Every institution and ICU has unique workflows. Our team members have been able to quickly learn the processes and workflows. The following paragraphs are a more generic description of the job at MGB ICUs. Please reach out to our recruitment associate with specific questions.

The job includes, but is not limited to critical care interventions, intensive care monitoring, diagnosing and prescribing treatments, therapeutics, and medications, coordinating referrals and discharging patients from the ICU. We emphasize and expect responsible, collaborative decision-making from our APPs, within their full scope of supervised practice. We encourage procedural excellence.

In collaboration with a multidisciplinary care team, they would be responsible for establishing, implementing, and evaluating the ICU course of treatment and the coordination and communication of the treatment plan. The APP will have a key role in patient and family teaching, while promoting competent, compassionate nursing care for patients and relatives. They will serve as a role model for professional nursing practice.

In this role, the APP

• Develops, implements, and evaluates a program of specialized health care for a select patient population.

• Promotes a collaborative relationship and effort between the medical staff and professional nurses toward continuity of patient care and efficient use of resources.

• Serves as a role model for professional nursing practice.

• Provides direct care to a select patient population in collaboration with the physician. - Performs and records the patient history and physical exam and discusses findings with the physician.

• Utilizes advanced nursing knowledge to identify, prevent or solve complex and/or recurring patient care problems.

• Follows and manages patients (in collaboration with MD) enhancing continuity of care. - Performs (oversees/assures completion of) specialized procedures particular to the select population mutually agreed upon with collaborating physician.

• Performs medically delegated aspects of patient care as agreed upon by nursing and medical administrators according to practice guidelines.

• Collaborates with unit staff and physicians to facilitate a comprehensive plan of care and coordinate resources. - Writes orders which are in accord with current guidelines.

• Maintains and practices in accord with practitioner guidelines per state and hospital regulation Provides consultation to both nurses and physicians.

• Serves as a go-to person for staff in area(s) of expertise.

• Serves on appropriate intra and interdepartmental committees. Participates in the development of formal and informal educational programs for the unit-based nursing staff.

• Develops educational programs within area of expertise.

• Collaborates with unit staff, Clinical Educators, Clinical Nurse Specialists, Staff Specialists, and other health care professionals to meet staff and patient educational needs. Monitors patient outcomes in accordance with defined standards of patient care.

• Collaborates with nurse managers, clinical nurses, and medical staff to plan, implement and evaluate pertinent change in practice and health care delivery.

• Identifies system-wide factors causing undesirable outcomes, such as complications, increased length of stay and over utilization of services.

• Facilitates patient movement through the system and efficient use of resources through interdepartmental collaboration. Supports research efforts to advance knowledge and to promote research-based practice

• Evaluates own practice and program effectiveness.

• Identifies pertinent nursing and health delivery problems for investigation.

• Evaluates current research findings for clinical specialty and determines applicability to unit practice.

• Assists nursing and medical colleagues in research efforts.

• Conducts own research. Responsible for own professional growth and maintenance of required credentials.

• Maintains the standards and educational requirements specific to the position and licensure.

• Identifies own learning needs and goals. Takes responsibilities for leadership and participation on committees and task forces of the DON and the hospital. Maintains and updates clinical knowledge and skills based on current health care practice/research