NURSE PRACTITIONER

Sage Memorial Hospital seeks a licensed Nurse Practitioner to provide comprehensive primary, preventive, and therapeutic medical and nursing care in outpatient, emergency, and inpatient departments. This role serves geriatric, adult, adolescent, and pediatric patients across primary care and rural health clinics within the full extent of your licensure and approved clinical privileges. You will lead and participate in patient care coordination using the Patient-Centered Medical Home (PCMH) model, consulting with physicians and other healthcare providers as needed.

Clinical Setting

You will work in a hospital, urgent care, and clinical setting where exposure to infections and communicable diseases is common. Work may be performed at remote sites up to 30 miles from the main hospital, requiring travel through high-desert and inclement weather conditions. Based on clinical healthcare program needs, you may work throughout the 24-hour day with irregular hours, including evenings, weekends, and holidays for emergency room and urgent care services.

Responsibilities

• Assess, diagnose, and provide comprehensive medical care to patients of all ages and their families
• Take complete health and developmental histories and perform physical examinations using appropriate diagnostic instruments
• Order, perform, and interpret screening and diagnostic tests and procedures including lab studies, x-rays, electrocardiograms, audiograms, and pulmonary function tests
• Make diagnoses and clinical decisions regarding medical and nursing care needs
• Formulate and implement plans of care involving various treatment modalities, medication prescribing, consultation with other healthcare providers, and referrals
• Identify and manage both minor and serious acute and chronic illnesses including upper respiratory infections, hypertension, eye infections, tuberculosis, heart disease, back pain, and trauma
• Provide surveillance of medical regimens for stabilized chronically ill patients and recognize when to refer to a physician or other health team members
• Perform minor surgical and invasive procedures such as suture of lacerations, incision and drainage of abscesses, insertion and removal of Norplant capsules, toenail removal, and skin biopsy
• Provide direct physical and psychological emergency care to maintain life, provide comfort, reduce stress, and enhance coping ability
• Prescribe medications as delineated in approved clinical privileges and in accordance with current DEA licensure
• Monitor medication effectiveness and adjust dosages based on patient response
• Evaluate medical aspects of the plan of care periodically and recognize the need for assessment by a physician or other health professional
• Recommend appropriate follow-up and make referrals when necessary
• Assist in referral and medical management of patients requiring long-term care
• Document data, patient assessment, and care plans in medical records
• Assess and address community and group health needs considering socio-economic, epidemiological, and cultural influences
• Develop and conduct health education classes and specialty clinics such as immunization, well-baby, nutrition, prenatal care, parenting, women's health, men's health, adolescent health, and employee health
• Educate and counsel patients and families on disease prevention and health maintenance
• Serve as a consultant and provide technical assistance to other healthcare providers and staff
• Develop and conduct formal education programs for hospital and clinical staff and community healthcare providers
• Collaborate with other healthcare professionals to develop treatment protocols, standards of practice, and policies
• Participate in ongoing quality improvement activities including audits, chart reviews, and evaluation of effectiveness
• Serve as a preceptor for nurse practitioner students with clinical rotations
• Collaborate with community leaders to foster good relationships between the healthcare facility and community
• Participate in problem identification, literature review, data collection, and interpretation for studies and research
• Review and critique current research and provide recommendations to medical staff
• Maintain and improve professional knowledge and skills through seminars, accredited home study, in-service education, and preceptorship
• Maintain current clinical competence through self-study and review of professional journals
• Attend regular meetings of the Medical Staff Department including morning report
• Maintain confidentiality at all times
• Comply with Medical Staff Bylaws and Rules and Regulations and Navajo Health Foundation Personnel Manual standards

Patient Volume Expectations

In the outpatient setting, you are expected to see two patients per hour during regular shifts, equating to 16 patients per 8-hour shift and 20 patients per 10-hour shift. These projections reflect an anticipated average number of patient encounters and are not intended to represent a minimum or maximum threshold. You may not conclude your shift early or refuse patients at any time unless explicitly authorized by the Outpatient Department Clinical Director.

Required Qualifications

• Master of Science in Nursing (MSN) degree
• Unrestricted state or compact state Board of Nursing license as a Certified Nurse Practitioner with specialty in Family
• Board certification through American Nurses Credentialing Center (ANCC) or American Academy of Nurse Practitioners (AANP) as a Family Nurse Practitioner
• Current DEA license
• Current BLS, ACLS, and PALS certification
• Current, valid, and unrestricted driver's license
• Ability to successfully pass the Employee Health Program and background investigation

Knowledge, Abilities, and Skills

• Knowledge of professional nursing and nurse practitioner principles, concepts, practices, and procedures applied to provide comprehensive and therapeutic healthcare
• Physical and psychosocial assessment and history taking skills including palpation, percussion, auscultation, listening, and observation
• Ability to interpret diagnostic tests and procedures and analyze data to discriminate between normal and abnormal findings
• Ability to assess and treat both minor and serious illnesses and health states
• Knowledge of prevention and health maintenance measures, disease control activities, and early disease identification
• Knowledge of and ability to treat chronic health problems including hypertension, diabetes, obesity, cardiovascular disease, substance abuse, and nicotine addiction
• Ability to counsel and teach healthy and ill individuals, families, and groups on health maintenance
• Ability to provide preventive healthcare including guidance in nutrition, common illnesses, and growth and development across the lifespan
• Ability to recognize the need for and provide emergency medical treatment for cardiac arrest, shock, hemorrhage, overdose, and respiratory failure
• Knowledge of emergency procedures and drug therapy to be initiated in the absence of a physician
• Ability to consult and provide technical direction to nursing staff, ancillary staff, and other healthcare personnel
• Knowledge of processes and procedures for establishing, revising, monitoring, and evaluating clinical standards
• Ability to recognize limitations and when to refer to a physician
• Ability to relate effectively and compassionately to patients

Physical Demands

The work involves walking, sitting, standing, reaching, and bending during patient assessment and treatment. Lifting may involve moving patient equipment weighing over 50 pounds (up to 250 pounds with assistance). You will frequently be required to walk.

Work Environment

Exposure to infections and communicable diseases is common. Specialized personal protective equipment must be worn to prevent exposure to blood and body fluids. You may be exposed to all seasonal weather conditions, including high-desert and inclement weather, when reporting for clinical assignments at remote sites up to 30 miles from the main hospital.