Family Practice Clinic

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Family Practice Clinic FNP Job Description (Hospital Privileges) General: The Family Nurse Practitioner (FNP) assesses, plans and provides comprehensive patient care independently or in autonomous collaboration with other health care professionals. The FNP provides comprehensive health assessment, medical diagnosis of acute and chronic illnesses, writes prescriptions, and formulates a treatment plan with an emphasis on health promotion, disease prevention, and disease management. The FNP is educated and trained at a nationally accredited university, at a graduate level. Nationally Board Certified in specialty area based on RN licensure and the State of Texas for advanced practice. The FNP is familiar with advanced concepts, practices, and procedures within the chosen field of expertise. Relies on experience and judgment to plan and accomplish goals requiring creativity and latitude. Also see APN/MD practice agreement. Function: The FNP functions as a member of the medical care management team. The FNP diagnoses medical conditions; plans and implements interventions, assist in the medical/surgical care and evaluates patient responses under the direction and in collaboration with attending and consulting physicians. The physician of record for the

FNP is M.D. and other services designated attending physicians. Qualifications: 1) Licensure as a professional nurse in The State of Texas 2) Certification as a nurse practitioner by a State approved National Credentialing Body at the time of employment. 3) Masters degree in nursing. 4) Advanced Cardiac Life Support Certification. 5) Qualifications are reviewed annually and clinical privileges authorized through the Medical staff credentialing process. Scope: Clinical privileges for individual FNP s are recommended by the supervising physician to the Allied Health Credentialing Committee through the Medical Staff approval process. FNP s may engage in activities that normally constitute the practice of nursing without credentialing, provided they have the preparation, knowledge and experience necessary to properly execute the practice. Medical, diagnostic, therapeutic and management functions will be instituted under medical supervision using protocols or guidelines developed by M.D. and other supervising physicians. Private Hospital Responsibilities: 1) Under the direction and in consultation/collaboration with the

attending/delegating physician, assembling a complete medical database including health history, chief complaint and physical exam upon admission to the hospital of selected patients and document findings in the patient s record. 2) Under the direction and in consultation/collaboration with the attending/delegating physician, ordering medical consultations, ordering other consultations including but not limited to, social services, PT/OT, dietary, diabetes education. Therapies and interventions including but not limited to, medications, diagnostic tests, respiratory care including ventilator management, nutrition, fluid and electrolyte support, and blood and blood products. Documenting these orders and directives in the patient record and communicating them to other members of the health care team. 3) Assessing selected patients using physically and technologically derived data, including the evaluation of diagnostic test results and documenting this assessment in the patient s record. 4) Under the direction and in consultation/collaboration with the attending/delegating physician, diagnoses medical conditions and planning medical therapeutics and interventions based on the medical data base. Documenting and communicating the diagnosis and plan to other health care team members. 5) Performing invasive diagnostic and therapeutic procedures based on the needs of specific patient population as determined collaboratively by the FNP, attending and collaborating physicians and approved by the Allied Health Credentialing Committee of the medical staff. Documenting the procedures and the patient responses and results in the patient record. 6) Evaluating and analyzing patient s responses to disease

processes and therapeutic interventions and determining the effectiveness of care and the need to alter the plan of care. 7) Provides telephone management: Uses clinical assessment and judgment to diagnose and treat reported symptoms with pharmacological and non- pharmacological therapies. 8) Providing information and support to patients and families. Facilitating communication between patients and family members and members of the health care team. 9) Collaborating with nurses and nurse managers to implement and evaluate holistic patient care delivery. 10) Serving as a resource to members of the health care team to facilitate patient care delivery by using an in-depth pathophysiological and psychosocial knowledge base. 11) Acting as a role model, and in selected cases, precepting other advanced practice nurses, students and nurse practitioners. 12) Promoting and practicing economical and effective health care. 13) Working with hospital case managers to provide for safe, effective, cost effective care and discharge planning. 14) Under the direction and in consultation/collaboration with the attending/delegating physician, formulate discharge planning, including but not limited to discharge diagnosis, discharge medications, discharge planning, discharge follow-up, including out-patient procedures and appointments, as well as the discharge summary. Documenting these orders and directives in the patient record and communicating them to other members of the health care team.

In addition: 1. Participating in or initiating activities necessary for annual reappointment and privileging. Documenting evidence of continuing competency in the areas of medical diagnosis, therapeutics, invasive procedures and management, as well as required certification(s). 2. Participating in activities that enhance professional development within role as an advanced practice nurse such as: Reading professional journals and texts to maintain currency on latest clinical and professional, legislative trends and sharing the knowledge gained with other team members. Attending continuing education programs. Participate in professional organizations. Serves as an ombudsman for the group and service for the hospital in professional functions. Participate in service specific research activities. 3. Performs other duties as determined collaboratively by the attending Physician that are within the scope of practice of the FNP. HCHD Hospital Responsibilities: 1. Facilitate and participate in efficient communication with regard to ongoing patient care, both inpatient and outpatient, to include: Communication with medical and nursing staff in person as well as via telephone at HCHD, about patient progress, and document

in PHC clinic notes. Access patient records from hospital visits or procedures done at HCHD sites via the secure EMR on epic web of inpatients, as well as outpatients who identify PHC as their PCP electronically from both inside as well as outside HCHD facilities. 1) Under the direction and in consultation/collaboration with the attending physician, and upon request of the patient, may perform daily exam, review of the chart, lab findings and consultant reports. 2) Under supervision provide orders for care and written notes documenting discussion with medical staff, including, but not limited to ordering medications, diagnostic imaging studies, procedures, and laboratory testing. 3) Write for HCHD prescriptions for any patients deemed eligible to receive district benefits. 4) Order imaging studies, procedures, laboratory testing on an outpatient basis for any patients deemed eligible to receive district benefits. 5) Refer patients directly into medical specialty clinics, as well as dietary, PT/OT, social workers, diabetes education and home health services. Signed: Nurse Practitioner: Date: Physician:

Date: Executive Director: Date: Chief of Staff: Date: