Nurse Practitioner

Hospital Details: (UMC)

• Hospital Bed Size: 446
• Trauma Level: Level I

Reason For Coverage: short staffed need 1/2 time provider

Dates & Required Availability:  
in terms of dates as we are flexible
12hr nights only
12-14 days / month can accommodate
No Call

• Setting: Inpatient Adult ICU (>18yo) with primary neurologic diagnosis
• Patient Volume: 12 bed ICU Neurocritical care patients/night 
• Support Staff: Nursing, RT, NCC attending, +/- additional APPs
• Skills Required: Facilitate patient admission, treatment and discharge. Compose medical records to be cosigned by medical staff (H&P, consult notes, progress notes, discharge summary). Conduct rounds on patients. Direct care as specified by approval protocols; initiate appropriate referrals and consults. Provide patient education, perform debridement and care for superficial wounds. Perform minor superficial surgical procedures. Perform incision and drainage of superficial abscesses. Perform dressing changes. Take wound cultures. Remove packing. Remove drains at direction of surgeons. Remove sutures at direction of surgeon. Insert and remove nasogastric tubes. Perform urinary bladder catheterization. Perform venous punctures. Perform routine immunization. Provide critical care to patients, including mechanical ventilator management, noninvasive ventilation management, calibration and operation of hemodynamic monitoring systems, management of critical care analgesia and sedation. Perform critical care procedures on patients to include bag mask ventilation, laryngeal mask insertion.

• Skills Preferred: CVC insertion, arterial line insertion, lumbar puncture;

  Implement SAH, ICH, and AIS pathways 

  Document core stroke measures, namely last known well for all, Hunt and Hess for SAH, ICH Score for ICH, NIHSS for AIS 

  Manage high-morbidity Neurosurgery post-operatively, including craniotomy, craniectomy, cranioplasty, transphenoidal resection, spine decompression/stabilization, carotid/intracranial stenting, and aneurysm clipping/coiling 

  Detect neurocritical emergencies on CT head 

  Interpret CXR and ECG accurately 

  Complete timely, updated, and accurate notes including Medication Reconciliation, Family History, and Social History
  
   

• Assess, examine, and present patients
• Place orders
• Update handoffs
• Follow up studies, labs
• Obtain and provide signouts
• Interpret CXR and ECG accurately
• Complete timely, updated, and accurate notes including Medication Reconciliation, Family History, and Social History
• Hold phone with supervision by day APP/attending supervision
• Address provider, nursing, pharmacy, radiology calls and messages
• Evaluate patient complaints, exam changes, and hemodynamic deteriorations
• Contact attending appropriately with patient developments
• Respond to Code Blue in critical care for NCC patients
• Implement SAH, ICH, and AIS pathways
• Document core stroke measures, namely last known well for all, Hunt and Hess for SAH, ICH Score for ICH, NIHSS for AIS
• Manage high-morbidity Neurosurgery post-operatively, including craniotomy, craniectomy, cranioplasty, transphenoidal resection, spine decompression/stabilization, carotid/intracranial stenting, and aneurysm clipping/coiling
• Detect neurocritical emergencies on CT head
• +ventilator management
  
  We don't offer a lot of training on these topics for our locums. More along the lines of can you login? Here's the patients. Here's the fridge. Here's the numbers you need. 1-2 shadow shifts before we expect competent,  independent practice.

   

• Special Equipment: Ultrasound, EVD, EEG, ICP bolt, Phillips hemodynamic monitoring, ceribell, pupillometer
• EMR: Epic (experience preferred)
• Travel Accommodations: Mileage reimbursement/Lodging (if additional travel is needed, let’s discuss)
  
  Additional Details:

• Hourly Bill Rate: Target $190/hr

• Name Clear/Sub Process: Submit to Charlotte. Not required unless if worked with LCMC or subbed prior with other agency.
• Credentialing Client Requirements: None