• Palliative Care Nurse Practitioner / Physician Assistant

    Location US-MA-Boston
    Job Posted Date 3 weeks ago(3/29/2018 7:32 AM)
    Job ID
    2018-10282
    Category
    NP/PA
    Type
    full time
    Grade
    65
  • Overview

    Our Palliative Care Clinic is integrated in the Dana-Farber Cancer Institute.  Patients are referred from DFCI oncology providers or inpatient Palliative Care providers for assistance in managing pain and non-pain symptoms, psychosocial stresses, and help in navigating medical-decision making related to a cancer diagnosis.  The Palliative Cancer Care NP provides outpatient consultation and follow-up including opioid management for a patient caseload.  Other team members include palliative care physicians, palliative care pharmacist and Palliative Care Program Nurse. 

    The Palliative Care Nurse Practitioner (NP) is an advanced practice nurse who demonstrates clinical expertise and leadership skills and has specialty training or experience in palliative or hospice care. The NP uses advanced skills in the evaluation, diagnosis and treatment of patients with diseases and adverse health conditions. The NP manages therapeutic regimens for acute and chronic problems associated with such diseases and conditions. The NP provides anticipatory guidance, patient and family education, and psychosocial and emotional support. The NP has prescriptive authority which includes Schedule II through V controlled substances in the Commonwealth of Massachusetts.

    The NP meets all requirements of the registered nurse's responsibilities which include assessment, planning, implementation and evaluation of nursing care for a complex patient population. Patients have a wide range of ages, acuity, and hematological and/or oncological diagnoses.

    The NP is a member of a multidisciplinary care team that requires effective communication and collaboration with co-workers and staff at the Institute and other collaborating institutions and agencies. The role requires critical thinking, an understanding of research principles and practices, and an expanded scope of clinical practice and leadership that improves the quality of care and advances the practice of nursing throughout the work setting and community. The Mission, Vision and Core Values of the Dana-Farber Cancer Institute are incorporated into all areas of practice.

    Located in Boston and the surrounding communities, Dana-Farber Cancer Institute brings together world renowned clinicians, innovative researchers and dedicated professionals, allies in the common mission of conquering cancer, HIV/AIDS and related diseases. Combining extremely talented people with the best technologies in a genuinely positive environment, we provide compassionate and comprehensive care to patients of all ages; we conduct research that advances treatment; we educate tomorrow's physician/researchers; we reach out to underserved members of our community; and we work with amazing partners, including other Harvard Medical School-affiliated

     

    Responsibilities

    • Delivers expert, scientifically based care to patients using advanced skills in the evaluation, diagnosis and treatment of patients with hematological-oncological diseases and adverse health conditions.
      1. Assesses patient and family needs from a holistic viewpoint.
      2. Performs comprehensive physical assessment. Differentiates between normal and abnormal physical findings, and interprets to determine the severity of illness. Recognizes and differentiates oncological emergencies associated with specific diseases and conditions.
      3. Assesses pain and symptom management associated with cancer treatment and complications.
      4. Formulates a multidisciplinary plan of care based on identified diagnoses. Continually reassesses plan based on patient's current condition.
      5. Incorporates age-specific interventions related to safety, nutrition, physical limitations, polypharmacy, skin integrity, psychosocial needs and other areas as appropriate in the care provided.
      6. Documents care reflective of advanced practice, and complies with all Institute, collaborating institution and regulatory agency requirements.
      7. Provides patient and family education, instruction and reinforcement to meet identified learning needs.
      8. Identifies appropriate community resources to provide continuity of care, palliative or hospice care and makes appropriate referrals.
      9. Adheres to the Code of Ethics for Nurses with Interpretive Statements (ANA, 2001) in all aspects of professional practice.
      10. Recognizes and responds to emergency situations appropriately. Maintains BLS certification.
      11. Pursues active membership of local and national professional organizations including Hospice and Palliative Nurses Association.
      12. Contributes to department-wide initiatives including education of palliative care interprofessional fellows and learners from diverse backgrounds.
    • Manages therapeutic regimes and appropriate follow-up care for acute and chronic problems associated with hematological-oncological diseases and conditions.
      1. Prescribes medications to manage pain and non-pain symptoms in accordance with Medical Staff Bylaws, Institute, state and federal regulations, and collaborating institution policies.
      2. Understands the risks and benefits of opioid use and participate in monitoring for safe prescribing and screening for opioid use disorder.
      3. Evaluates the patient's response to therapy and appropriately modifies interventions as needed.
      4. Orders consultations, diagnostic and laboratory tests and scans in accordance with current practice standards. Completes all requisitions in accordance with DFCI policies and procedures.
      5. Performs diagnostic and therapeutic procedures in accordance with practice guidelines, research protocols, Medical staff Bylaws, Institute and collaborating institution policies.
      6. Coordinates elective and emergency admissions to collaborating institutions in accordance with the patient's medical condition, research protocols, Medical Staff Bylaws, Institute and collaborating institutions' policies and procedures.
      7. Obtains required consents for treatment and procedures.
    • Practices according to written guidelines in compliance with the Massachusetts Board of Registration in Nursing. Maintains prescriptive privileges as defined by the Massachusetts Department of Public Health. Utilizes prescriptive authority responsibly for Schedule II through V controlled substances in the Commonwealth of Massachusetts.
      1. Develops and maintains current practice guidelines that specifically describe the nature and scope of the nurse's practice; the circumstances in which physician consultation or referral is required; the use of established procedures for the treatment of common medical conditions which the nurse may encounter; and provisions for managing emergencies. Guidelines must also include a mechanism to monitor prescribing practices including documentation of review with a supervising physician at least every three months; protocols for the initiation of intravenous therapies and Schedule II drugs; specify the frequency of review of initial prescription of controlled substances. The initial prescription of Schedule II drugs must be reviewed within 96 hours. 
      2. Monitors prescriptive practice in collaboration with the supervising physician and submits quarterly reports to direct supervisor.
      3. Maintains current Collaborative Practice Agreement signed by NP and supervising physician.
    • Establishes rapport with patients and families from a variety of cultural, ethnic and religious backgrounds.
      1. Interacts with patients and families in a caring and compassionate manner.
      2. Provides patient and family education related to the disease process, treatment plan, alternatives, symptom management, care and follow up.
      3. Provides care based on the age-specific needs of the patient.
      4. Fosters an environment that is sensitive to the needs of diverse populations, including but not limited to culture, ethnicity, gender, and age.
      5. Navigates serious illness communication about patient’s goals of care, illness understanding, and end of life issues using advanced communication techniques.
    • Manages the environment for patient care providing leadership in the identification and integration of resources to achieve desired outcomes.
      1. Monitors the environment of care with attention to patient safety, and assures compliance with regulatory agency standards.
      2. Complies with Institute, nursing, and collaborating institutions' unit policies, procedures, work rules and standards of conduct.
      3. Develops collaborative relationships with colleagues which facilitate mutual involvement in planning care. Acknowledges and uses expertise of others through formal and informal consultation in planning and evaluating patient care. 
      4. Provides leadership in the development and implementation of an integrated plan of care.
    • Provides leadership in the formulation and achievement of Palliative Care Clinic goals within the Department of Psychosocial Oncology and Palliative Care, Nursing and Patient Care Services, the Institute and the community.
      1. Assists in defining goals and developing systems and work processes for the Palliative Care Clinic, Nursing and Patient Care Services, the Institute and collaborating institutions.
      2. Participates in and provides leadership to committees, councils, and initiatives.
      3. Works collaboratively and functions as an effective member of the health care team.
      4. Demonstrates flexibility and the ability to set and change priorities.
      5. Participates in QA/QI projects in the Department and the Division of Nursing and Patient Care Services. 
      6. Fosters and promotes an environment that facilitates professional communication and collaboration with colleagues.
      7. Supports research activities within the Department, the Division of Nursing and Patient Care Services, the Institute, and collaborating institutions.

    Qualifications

      • Authorization to practice in an expanded role as a Nurse Practitioner in the Commonwealth of Massachusetts
      • Current certification from a nationally recognized accrediting body approved by the Massachusetts Board of Registration in Nursing for Nurse Practitioners
      • Minimum of 24 contact hours beyond generic education in pharmacotherapeutics
      • Masters or Doctoral degree in Nursing
      • Minimum of 3 years' Nurse Practitioner experience preferred
      • Oncology or Palliative Nurse Practitioner experience preferred
      • In possession of Massachusetts Department of Public Health and Federal DEA numbers
      • Certification in Oncology Nursing preferred - OCN, AOCN, CPON
      • Certification in Palliative Nursing preferred- CHPN or ACHPN
      • Demonstrated ability to work as an effective member of an interdisciplinary team.
      • Demonstrated critical thinking, problem solving skills and ability to make independent decisions.

    Dana-Farber Cancer Institute is an equal opportunity employer and affirms the right of every qualified applicant to receive consideration for employment without regard to race, color, religion, sex, gender identity or expression, national origin, sexual orientation, genetic information, disability, age, ancestry, military service, protected veteran status, or other groups as protected by law.

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