Physician Assistant 30 Hours Days - Bwh Obstetrics Gynecology

The Physician Assistant (PA) is a member of the inpatient Obstetricsand Gynecology team. As part of a team PA is responsible for assisting attendingphysicians fellows and resident in the medical management of patients. In addition outpatient duties that willassist the patient care teams in their daily responsibilities are included

PRINCIPAL DUTIES AND RESPONSIBILITIES: I

The PA works closely with the physicians fellows and residentstaff to develop and coordinate a plan of care designed to meet the physicalpsychological and social needs of patients and their families. Stronginterpersonal organizational and communication skills are required. Knowledgeof current literature and a commitment to continued learning are also required.The mission vision and core values of the Brigham and Womens

Hospital(BWH) are incorporated into all areas of practice. The PA will Act as theprimary resource to the inpatient staff in dealing with routine and acutepatient management issues duringprotected didactic time and operating room time for the residentscontacting the resident staff or attending in emergent situations (or as neededfor patient safety).

Inpatient Clinical Duties

Competencies and task in routine care ofhospitalized gynecologic or postpartum patients:

perform admission history and physical exam andaccurately record in the patient record

Change surgical dressings including wound packing andwound vacs

Remove sutures and staples

Write daily progress notes

Write orders

Dictate discharge summaries complete discharge paperwork

Assist in making appropriate post hospitalizationappointments and referrals

Communicate with referring health care providers andinstitutions

Write prescriptions

Carry the primary postpartum/inpatient gynecologic/EDbeeper during resident didactics protected resident OR time or as requestedduring times of personnel shortages contacting the resident staff or attendingin emergent situations or as needed for patient safety.

Responsive to postpartum and gynecologicinpatient floor pages to evaluate situations that may represent variance innormal hospital course.

Act as liaison between postpartum and gynecologicinpatient floors/patient care teams and out patient area or in the case oftransfer within the hospital other care unites.

Round with individual residents/teams as requestedreport back to team leaders

Implement attending physician instructions for patientmanagement in close cooperation with nursing staff

Perform procedures within the PA scope ofpractice and as directed by the attending including:

Order andinterpret appropriate laboratory testing and other special examinations asrequested

Serve as a resource to the health care team for patient care issues

Collaborate with care coordinator for all patient care referrals

Prepare succinct and accurate signout to facilitate the smooth transition ofpatient care from one PA to another PA or physician

Assist in the planning and implementation of discharging patients

Additional Competencies and Tasks in Routinecare of Postpartum patients: Evaluate stability and progress of routinepostpartum patient

PhysicalExam: appropriately evaluate uterinesize tenderness; perineal discomfortand healing; quality of Lochia; breast exam; cesarean section incision.

Vital signs/chart/history: Appropriately interpret vital signs in normalpostpartum patient and in patient with complications including hypertensionbleeding infection; appropriatelyinterpret postpartum symptoms/issues including bleeding lactation extremityedema and tenderness

Counsel and educate patients and family aboutpostpartum events activities lactation and contraception

Additional Competencies and Tasks in Careof Outpatient Gynecological Patients

Conduct initial evaluation of gynecologicalpatients seen in the Emergency Room including:

Conduct andappropriately interpret Physical Exam

Orderingappropriate laboratory and noninvasive testing and collating results

Accuratelyinform responsible physician 1500 beeper or Chief Resident) of acutesituations

Accuratelyreport results of initial assessment and subsequent information to responsiblephysician (per above)

Interactwith all ER personnel in collegial manner

In absence of an onsite physician respond tothe ambulatory gynecology clinic for initial assessment of nonscheduled(walkin) patients in manner described above.

Assist the resident physician team withevaluation of outpatients on the ectopic list

Collate laboratory data and present to responsiblephysician as requested

Communicate with patient on a regular basis asrequested by the team

Assist in arrangements for sequential testing andambulatory appointments

General Duties

Work collaboratively and function as an efficient member of the health careteam
Assist in the coordination of consultation of other subspecialists involved inthe care of patients
Provide education to patients and families
Document in the medical record as appropriate and communicateobservations/findings with attending physicians
Monitor environment of care and comply with regulatory agency standards
Ensure that his or her clinical practice is consistent with physician assistantpolicies procedures and standards
Participate in QA/QI projects as appropriate

OR rounds on Tuesdays

Brigham and Womens Hospital is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race sex color religion national origin sexual orientation protected veteran status or on the basis of disability.

Must have successfully completed a Graduate Level accreditedPhysician Assistant Program approved by AMA Board of Approval and Certificationof PA programs.
Must have 4 years of college leveleducation and bachelors degree or equivalent. (BS/MS joint programs are alsoacceptable; BS with PA certificates are acceptable for graduates before 1995.
Board Certification by the NationalCommission on Certification of PAs is required.
Each PA shall meet the following minimum requirements for work experience:
a. One year of relevant full time experience as a PA in this specialtypreferred.
b. Other previous Hands on patient care experience may be considered at thediscretion of the Medical Director.
Specificlicense/certification/registration required to perform the job
a. NCCPA certified
b. License as a Physician Assistant in Massachusetts
c. Maintain current DEA and Massachusetts Controlled Substance Licenses
d. Complete 100 hours of CME according to national and state regulations duringeach 2 year period of employment.
e. Maintain current BLS/ACLS certification
f. Complete BWH Professionalism Program within 3 months of date of hire.
g. Complete BWH Procedural Sedation Training if determined necessary.

Medical Knowledge

Train and educate Interns around procedures
Medical knowledge includes an understanding of pathophysiology patientpresentation differential diagnosis patient management surgical principleshealth promotion and disease prevention.

Demonstrate core knowledge about established and evolvingbiomedical and clinical sciences and the application of this knowledge topatient care in their area of practice. Demonstrate an investigatory andanalytic thinking approach to clinical situations.

Able to place nasogastric (NG) tube & performparacentesis

Identify signs and symptoms of medical conditions includingbut not limited to; urine output shortness of breath (SOB) chest pain activebloating.
Select and interpret appropriate diagnostic or lab studies
Manage general medical and surgical conditions to include understanding theindications agents and other relevant treatment modalities
Identify the appropriate site of care for presenting conditions includingidentifying emergent cases and those requiring referral or admission
Identify appropriate interventions for prevention of conditions
Identify the appropriate methods to detect conditions in an asymptomaticindividual Differentiate between thenormal and the abnormal in anatomic physiological laboratory findings andother diagnostic data
Appropriately use history and physical findings and diagnostic studies to formulatea differential diagnosis
Provide appropriate care to patients with chronic conditions.
Demonstrate proficiency with BWH computer systems as needed to independentlyperform daily tasks such as order entry EMAR lab tests and results incidentreporting BICS etc.
Consistently provide high quality and timely documentation including admissionnotes progress notes discharge summaries and dictations.
Must have knowledge of billing practices.

This PA position can be quite challenging requiring bothteamwork and individual initiative. A high level of patient care is requiredwhile working quickly and often multitasking. The schedule may require longworkdays while maintaining a goal of 4045 hours/week on average. PAs arerequired to cover weekends holidays and sick call on a rotational basis

FISCAL RESPONSIBILITY:

Proper complete and timely documentation
Awareness of billing and compliance issues helpful.