Nursing Advance Practice
Unscheduled Relief, 0.001 FTE, 8 Hour Day Shifts
Lucile Packard Children's Hospital Stanford is the heart and soul of Stanford Children’s Health. Nationally ranked and internationally recognized, our 311-bed hospital is devoted entirely to pediatrics and obstetrics. Our six centers of excellence provide comprehensive services and deep expertise in key obstetric and pediatric areas: brain & behavior, cancer, heart, pregnancy & newborn, pulmonary and transplant. We also provide an additional, wide range of services for babies, kids and pregnant moms.
The Nurse Practitioner (NP) functions under this Nurse Practitioner Job Description approved by the Interdisciplinary Practice Committee (IDPC). The NP provides medical evaluation and management of the patient with acute and chronic complaints/conditions, in collaboration with the supervising physician, and through implementation of standardized procedures. Specific functions pertaining to the Service, Clinic or Department are established by the NP and his/her supervising physician(s), and approved by the appropriate medical and nursing administrators, the IDPC, the Credentials & Privileges Committee, the Lucile Packard Children’s Hospital and Clinics. Medical Executive Committee and the LPCH Board Credentials, Policies and Procedures Committee.
An NP may provide only those medical services which he/she is competent to perform, which are consistent with the NP's education, training and experience, and which are performed in collaboration with a physician. An NP shall consult with a physician regarding any task, procedure or diagnostic problem which the NP determines exceeds his/her level of competence or shall refer such cases to a collaborating physician.
Scope of Practice of the NP
Evaluates and treats patients with acute, chronic complaints and health maintenance concerns related to specialty, according to written standardized procedures.
Obtains complete histories and performs pertinent physical exams with assessment of normal and abnormal findings on new and return patients.
Performs or requests and evaluates diagnostic studies as indicated upon evaluation of the patient.
Administers, orders, furnishes and prescribes medications.
Orders and collects specimens for routine laboratory tests, screening procedures and therapeutic procedures, including blood and blood products.
Orders physical therapy, occupational therapy, respiratory therapy, radiology examinations and nursing services.
Performs designated procedures after demonstrated competency, according to written standardized procedures where applicable.
Obtains informed consent, as indicated.
Initiates arrangements for hospital admissions and discharges and completes appropriate paperwork.
As directed by the supervising physician, enrolls patients in investigational studies approved by the Investigational Review Board (IRB), and orders the necessary tests and medications.
After appropriate training, assists the supervising physician in the operating room. The RN First Assistant directly assists the surgeon and practices under the supervision of the surgeon during the intraoperative phase. The RN First Assistant must adhere to standardized procedures and not concurrently function as a scrub nurse.
Recognizes and considers age-specific needs of patients.
Effectively communicates and interacts with patients, families, staff and members of the community from diverse backgrounds.
Recognizes situations which require the immediate attention of a physician, and initiates life-saving procedures when necessary.
Facilitates the coordination of inpatient and outpatient care and services as needed.
Facilitates collaboration between providers and coordination of community resources.
Ensures compliance with legal, regulatory and clinical policies and procedures.
Participates in quality improvement initiatives.
Provides and coordinates patient teaching and counseling.
Other duties as assigned.
Department Specifics
Common Procedures:
Evaluate patients with acute and chronic conditions with variable acuity
Provide anesthesia focused clinical assessment to patients and families coming in for surgery. Obtain complete H&P and perform pertinent physical exams with assessment of normal and abnormal findings
Administer, order and prescribe medications
Order and evaluates diagnostic studies, labs
Assess and manage anesthesia clinic patients
Perform comprehensive review of systems to ensure patient safe to proceed with anesthesia by record review and/or anesthesia clinic patient
Common Diagnosis: All pediatric surgical specialty services and age spectrum
Primary Location: LPCH main hospital. Mainly outpatient with inpatient and OR.
Schedule: Full time, Days, rotational coverage of Saturdays and possible evenings.
Team Members: Collaborative team of MDs, Fellows, Residents, Nursing, Child Life Specialist, and Ancillary Staff.
Learning opportunities: APP lectures, Grand rounds, noon conferences, division meetings, journal club, fellow lectures, annual or semi-annual staff retreat, morbidity and mortality rounds
Additional opportunities: APP Council, task forces, process /quality projects, clinical preceptorships, ancillary faculty PA/NP programs
Minimum Qualifications
Any combination of education and experience that would likely provide the required knowledge, skills and abilities as well as possession of any required licenses or certifications is qualifying.
A. Education:
1. Master's or doctoral degree in nursing from an accredited college or university.
2. Graduate of an NP program accredited by the National League of Nursing Accrediting Commission (NLNAC) or the Commission on Collegiate Nursing Education (CCNE).
B. Licensure/Certification:
1. Licensure as a Registered Nurse (RN) in the State of California.
2. Certification as a Nurse Practitioner (NP) in the State of California.
3. National Board Certification as a Nurse Practitioner (NP) from an agency accredited by the American Board of Nursing Specialties (ABNS).
a. Note: New graduate NPs will be allotted six (6) months from their graduation date to obtain national board certification.
4. Certification in Basic Life Support (BLS) from the American Heart Association (AHA).
5. Furnishing license issued by the Board of Registered Nursing (BRN), required only if furnishing medications.
a. NPs with six (6) months or more experience, who will need to furnish medications, shall obtain a current furnishing license within six (6) months of hire.
b. New graduate NPs, who will need to furnish medications, must complete a minimum of 520 hours of physician-supervised experience in furnishing drug and/or devices to obtain a furnishing license. These hours must be accumulated during a period of time that is no less than six (6) months from hire.
6. An individual Drug Enforcement Agency (DEA) license issued by the United States DEA for Schedule II-V controlled substances, required only if prescribing controlled substances to outpatients.
a. NPs with six (6) months or more experience, who will need to prescribe medications to outpatients, shall obtain a current DEA license within six (6) months of hire.
b. New graduate NPs, who will need to prescribe controlled substances to outpatients, must first obtain a furnishing license and then obtain an individual DEA license.
c. Note: Controlled substances ordered for immediate patient use in inpatient/outpatient settings will be covered under LPCH's DEA license.
7. Additional board certification(s) may be required by certain specialties/departments.
C. Supervision:
1. Supervision is provided by the supervising/sponsoring physician with clinical privileges at LPCH, or designated attending physicians in the Clinic, Service or Department. Standardized procedures, approved by the supervising physician(s) and the IDPC, are a mandatory mechanism of supervision. Other mechanisms of supervision used may be:
2. Direct on-site, electronic or phone supervision by a supervising physician. A physician
cannot supervise more than four (4) NPs at one time.
3. Chart screens on random charts by the supervising physician or designee.
4. Chart audits on random charts as an integral part of selected quality improvement programs.
5. Ongoing Professional Practice Evaluation (OPPE) through tracking of performance indicators.
6. The NP will receive a formal annual performance evaluation by the Lead Advanced Practice Provider (Lead APP), Director of Advanced Practice or supervising manager/director with input from the Lead APP, supervising physician(s) and/or physician delegates, APP peers and the supervising manager/director. Ongoing Professional Practice Evaluation (OPPE) also occurs through tracking of performance indicators.
Lucile Packard Children’s Hospital Stanford strongly values diversity and is committed to equal opportunity and non-discrimination in all of its policies and practices, including the area of employment. Accordingly, LPCH does not discriminate against any person on the basis of race, color, sex, sexual orientation or identity, religion, age, national or ethnic origin, political beliefs, marital status, medical condition, genetic information, veteran status, or disability. Women and men, members of all racial and ethnic groups, people with disabilities, and veterans are encouraged to apply.