NEONATAL NURSE PRACTITIONER
Duke University Hospital is consistently rated as one of the best in the United States and is known around the world for its outstanding care and groundbreaking research. Duke University Hospital has 957 inpatient beds and offers comprehensive diagnostic and therapeutic facilities, including a regional emergency/trauma center; a major surgery suite containing 51 operating rooms; an endo-surgery center; an Ambulatory Surgery Center with nine operating rooms and an extensive diagnostic and interventional radiology area. In fiscal year 2018, Duke University Hospital admitted 42,916 patients and had 1,085,740 outpatient visits in fiscal year 2017.
U.S News & World Report named Duke University Hospital #1 in North Carolina and #1 in the Raleigh-Durham area in 2018-19.
Duke University Hospital is ranked in the top 20 nationally for seven adult specialties, including cardiology and heart surgery, nephrology, ophthalmology, orthopedics, pulmonology, rheumatology, and urology.
In addition to its hospitals, Duke Health has an extensive, geographically dispersed network of outpatient facilities that include primary care offices, urgent care centers, multi-specialty clinics and outpatient surgery centers.
Duke Nursing Highlights:
- Duke University Health System is designated as a Magnet® organization
- Nurses from each hospital are consistently recognizedeach year as North Carolina’s Great 100 Nurses.
- Duke University Health System was awarded the American Board of Nursing Specialties Award for Nursing Certification Advocacy for being strong advocates of specialty nursing certification.
- Duke University Health System has 6000 + registered nurses
- Quality of Life: Living in the Triangle!
- Relocation Assistance!
The Neonatal Nurse Practitioner/ Critical Care Pediatric Nurse Practitioner (NNP) provides direct patient care services and performs medical acts as a Nurse Practitioner under the supervision of the supervisory physician to infant’s birth through 2 years of age in patient care units Duke Hospital ICN/Intermediate Care Nurseries and the Special Care Nurseries in the Duke University Health System. The NNP 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, and provides direct patient care services. The NNP contributes to excellence in patient care, research, teaching, and provides leadership in the organization.
Primary hours will be rotational covering 24 hours / 7 days per week including nights, weekends, and holidays. The NNP must also be flexible to provide on-call coverage, as needed.
The NNP will report directly to the Center for Advance Practice (CAP) Team Leader and Director. The NNP clinical practice is under the supervision of the Supervising Physicians for the NNP team, Dr. David Tanaka and Dr. Margarita Bidegain, and will also work under the supervision of all back-up attending physicians listed in the Collaborative Practice Agreement. In addition, s/he will be accountable to the Division of Neonatal-Perinatal Medicine/Department of Pediatrics for clinical outcomes and defined quality indicators and to the standards set forth by the Department of Center for Advance Practice.
Process of Evaluation
Evaluation will be ongoing and will encompass the six general areas of competency as defined by The Joint Commission (patient care, medical/clinical knowledge, practice-based learning & improvement, interpersonal & communication skills, professionalism and systems-based practice). Annual and midyear evaluations using the CAP PPR process will be conducted by the Department of Center for Advance Practice, in coordination with NP’s primary supervising physician. Ongoing Review of Care and Quality Improvement meetings with supervising physician will be conducted and documented monthly for the first six months, in accordance with Duke University’s and the designated Board’s standards, then at least once every six months.
Departmental Job Responsibilities and Standards
Collaborate with the neonatologist and healthcare team to assess, diagnose, plan, set priorities and realistic outcomes, and evaluate the effectiveness and cost efficiency of patient care.
Provide /coordinate clinical practice for neonatal patients at:
- Duke Hospital being followed on the clinical care units of Intensive/Intermediate Care Nurseries Setting
- Duke Regional Hospital being followed on the clinical care unit of Special Care Nursery Setting through established protocols and under the supervision of a Duke Neonatologist who is either on site or available by pager
- In collaboration with the neonatal attending, the NNP will round daily on patients to assess, diagnose, plan treatment, set priorities and realistic outcomes, and evaluate the effectiveness and cost efficiency of neonatal patient care;
- Provide evidence-based clinical care by actively engaging in review of literature
- May order and/or perform the following procedures:
b. Laboratory, radiology, and/or diagnostic procedures/tests
c. Interpretation of laboratory, radiographic and diagnostic tests
d. Intubation / Extubation and airway management
e. Mechanical ventilation
f. Flexible bronchoscopy for non-biopsy purposes in patients that are already intubated or has a tracheostomy
g. Conscious / Moderate Sedation per protocol
h. Chest tube insertion / removal
k. Evaluation of pleurovacs (chest tube drainage systems)
l. Lumbar puncture
m. Exchange Transfusion
n. Line placement for venous or arterial access:
- Umbilical venous and arterial linesPercutaneous arterial line placementPercutaneous central line placement
q. Application of dressings, bandages, wound vacs
r. Simple debridement
s. Manage NG tubes, D tubes, G tubes, J tubes
t. Manage support devices, including (but not limited to), JP drains, arterial lines, wound vac
u. Bladder catheterization
v. Extra digits / skin tag removal
w. Drainage of superficial abscesses
x. Venipuncture for blood sampling
y. Capillary blood sampling
z. Blood sampling via central venous lines, including:
- Temporary central cathetersTunneled cathetersImplantable vascular access devicesUmbilical venous and/or arterial lineAdministration of infusion therapy, including:
- Inhalation therapy or medications to alleviate the distress of dyspnea or shortness of breath.
- Communicate verbally and in writing all pertinent patient information to supervising MD, referring MD, nursing staff, home health, hospice agency and other relevant healthcare providers.
- Document in patients’ charts 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.
- Provide leadership and coordination of care and services for the neonatology service.
- Provide / coordinate clinical care for neonatal patients requiring Transport to Duke Hospital in collaboration with the Life Flight Team, in accordance with Neonatal and Life Flight guidelines Utilize prescriptive privileges for identified patient populations and in accordance with DUH and NC Board of Nursing/NC Medical Board regulations.
- Role model competence in advance nursing skills and provides evidence-based practice.
- Assess educational needs of the nursing staff and healthcare team members and provide one-on-one as well as formal education as needed
- Implement and evaluate appropriate educational programs for nursing staff, MDs, and other healthcare providers as appropriate.
- Role model and precept healthcare learners through contractual agreements.
- Assess educational needs of patients/families and provide culturally-sensitive patient/family interventions as indicated. Use non-technical language when educating patients/families. Document educational interventions in the patients’ medical record.
Research Utilization and Investigation:
- Utilize current research and evidence-based decision-making in all clinical practice.
- Incorporate clinical research findings in the development and implementation of standards of care.
- Support IRB approved clinical research/trials though a variety of activities including but not limited to: obtaining consent, ordering diagnostic tests, recording laboratory and diagnostic results, administering therapeutic interventions, and reporting patient outcomes including toxicities or adverse events.
- Participate in interdisciplinary quality improvement and/or research activities.
- Participate in measuring and documenting outcomes.
- Provide expertise and resource information to other healthcare providers, patients and families, and the community at large related to neonatal diseases, procedures, interventions, and conditions.
- Implement and evaluate appropriate educational programs for referring physicians and nurses
- Develop, implement and evaluate standards of care/practice guidelines/policies and procedures/care maps/protocols within area of specialization.
- Develop programs and projects in areas of expertise to facilitate the attainment of the goals and objectives of the Duke University Hospital and Duke University Health System.
Professional Leadership and Development:
- Role model Advanced Practice Nursing through conduct, communication, dress, leadership, ethical decision-making, critical thinking and problem solving skills.
- Participate in at least one professional organization. Demonstrate responsibility for professional practice through active participation in Department of Pediatrics/Division of Neonatal-Perinatal Medicine, ACP Department, and professional organizations.
- Share clinical expertise, program accomplishments, and research findings with other professionals through written publications, oral presentations, posters, continuing education, etc.
- Maintain all professional requirements for licensure and certification.
Completion of an accredited Neonatal Nurse Practitioner Program
Minimum 3 years as Registered Nurse in neonatology strongly preferred.
Degrees, Licensures, Certifications
- Current licensure as a Registered nurse in North Carolina and National Certification as a Neonatal Nurse Practitioner required
- Demonstrate and maintain credentialing and licensing requirements for Duke University Hospital, North Carolina State Board of Nursing and North Carolina Board of Medical Examiners
- Current BLS, NRP, PALS certification mandatory
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Essential Physical Job Functions: 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.