Career Center | Indiana Nephrology & Internal Medicine

Career Center

Advanced Care Practitioner, NP or PA

Job Title
Advanced Care Practitioner, NP or PA
Job ID
27101069
Location
Indianapolis,  IN 46260
Other Location
Description

OVERVIEW:  The Advanced Care Practitioner is responsible for collaborating with the Nephrologists and to provide care to patients with chronic kidney disease and end-stage renal disease on, or progressing to, hemodialysis. The APRN will be expected to support and participate in quality assessment and performance improvement management, resulting in improved patient outcomes. The APRN will be expected to have an understanding of the CMS guidelines and regulations with regards to End Stage Renal Disease and dialysis care.

 

HOURS:   The APRN hours and schedules will be flexible to accommodate work assignment. Days of work will typically be Monday through Friday with one weekend of assigned on call per month. Staffing and operational demands may necessitate variations in beginning and ending times, as well as total hours scheduled per day and week. 

 

OUTPATIENT DIALYSIS RESPONSIBILITIES:

 

  • Collaborates with physicians to provide one (1) comprehensive and three (3) basic visits for each patient on hemodialysis.
  • Manage the hemodialysis and/or peritoneal dialysis patient per Kidney Dialysis Outcome Quality Indicators (KDOQI) guidelines.
  • Assess, diagnose, and manage systems-related complications of end-stage renal disease (ESRD) therapy including anemia, hypertension, bone disease, fluid and electrolyte imbalances, and vascular access.
  • Diagnose and manage episodic health problems of clients with ESRD.
  • Evaluate the client’s progress and appropriateness of the plan of care.
  • Encourage each client’s maximal rehabilitation through education and counseling.
  • Use an interdisciplinary team approach to plan comprehensive health care for the client.
  • Support the client and family in decisions regarding termination of treatment.
  • Perform annual physicals including health maintenance and preventative health counseling.
  • Provide leadership to the clinical staff through education and consultation by serving as a role model and expert clinical resource in the nursing care of clients with ESRD.
  • Assist the staff in preventing and treating complications of dialytic therapies.
  • Coordinate continuity of care between the outpatient dialysis unit and other healthcare settings.
  • Provide leadership for the establishment of nurse-driven protocols.

 

HOSPITAL RESPONSIBILITIES:

 

  • Perform a complete admission history and physical.
  • Write admission orders for routine hospitalizations.
  • Assess the client and family discharge needs, participate in discharge planning, coordinate referrals, and dictate discharge summaries.
  • Educate and counsel clients on treatment options and expected outcomes.
  • Provide leadership to the clinical staff, serving as a role model and an expert clinical resource concerning nursing care of clients with chronic kidney disease, ESRD, and acute renal failure.
  • Coordinate continuity of care between the hospital and other healthcare settings.

 

CLINIC RESPONSIBILITIES:

 

  • Manage patients with chronic kidney disease, focusing on care that promotes health and prevents further decline in renal function.
  • Coordinate a pre-ESRD client education program.
  • Develop or evaluate educational materials that will allow the patient to become an active participant in his/her care and foster decision making abilities regarding treatments.

 

ESSENTIAL DUTIES AND RESPONSIBILITIES:

 

  • Provides a physical assessment of patients focusing on potential complications of end-stage renal disease and management/titration of therapies related to the ESRD.
  • Updates history and physical forms as needed by clinic staff.
  • Completes medical forms as needed by patients including FMLA, insurance PA, and financial assistance forms.
  • Communicates with clinic staff (including nurses, technicians, managers, social workers, and registered dietitians) regarding patient plan of care and optimizing patient outcomes. 
  • Refers to transplant program, as appropriate, counsel patients about dialysis therapy options (including PD, and home hemodialysis) as well as the right to withdraw from dialysis therapy and transition to hospice care.
  • Communicates/collaborates with PCP, nursing home staff and other medical specialties to provide holistic patient care.
  • Monitors and interprets laboratory data as applicable to ESRD.
  • Adjust dialysis treatment parameters to reach therapeutic goals.
  • Monitors weight, blood pressure and fluid balance to maintain a euvolemic state and prevent fluid overload.
  • Works with Clinical Staff and peripheral vascular surgery services to establish and maintain permanent dialysis access.
  • Works with Clinical Staff to prevent, monitor for, and treat infections related to dialysis access.
  • Prescribes medication related to ESRD including but not limited to high blood pressure, renal osteodystrophy, diuresis, hyperparathyroidism, anemia and nutrition. Titrates these medications to meet established therapeutic goals.
  • Provides patient education on fluid restriction and management, dietary restrictions, medications, functions of the kidney, how dialysis works, anemia and treatment, dialysis access types and procedures, lab value goals, signs and symptoms of infection, and the importance of compliance with medications and restrictions.
  • Refers patients to the Emergence Medical Services as needed.
  • Refers patients to other medical specialties (Cardiology, peripheral vascular surgery, hematology etc.
  • Provides therapeutic communication to patients to promote compliance and allow expression of questions and concerns.
  • Reinforces adaptations to positive behaviors.
  • Addresses quality of life issues in collaboration with the healthcare team including constipation, mobility pruritus, appetite and pain with appropriate referral and lifestyle recommendations. Medication management provided for those directly associated with kidney disease.
  • Addresses concerns in person, via telephone, and email from clinical staff Monday – Friday and weekends when on call.  

 

SUPERVISORY RESPONSIBILITIES:

  • This job has no supervisory responsibilities.

 

COMPETENCIES - To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required.

 

Intellectual

  • Synthesizes complex or diverse information.
  • Collects and researches data.
  • Uses intuition and experience to complement data.
  • Designs work flows and procedures.
  • Identifies and resolves problems in a timely manner.
  • Works well in group problem solving situations.
  • Uses reason even when dealing with emotional topics.
  • Assesses own strengths and weaknesses.
  • Pursues training and development opportunities.
  • Strives to continuously build knowledge and skills.
  • Shares expertise with others.

Interpersonal

  • Manages difficult or emotional customer situations.
  • Responds promptly to customer needs.
  • Responds to requests for service and assistance.
  • Meets commitments.
  • Focuses on solving conflict, not blaming.
  • Maintains confidentiality.
  • Listens to others without interrupting.
  • Keeps emotions under control.
  • Remains open to others' ideas and tries new things.
  • Speaks clearly and persuasively in positive or negative situations.
  • Listens and gets clarification.
  • Responds well to questions.
  • Demonstrates group presentation skills.
  • Participates in meetings.
  • Writes clearly and informatively.
  • Edits work for spelling and grammar.
  • Varies writing style to meet needs.
  • Presents numerical data effectively.
  • Able to read and interpret written information.

 

Leadership

  • Develops workable implementation plans.
  • Communicates changes effectively.
  • Builds commitment and overcomes resistance.
  • Exhibits confidence in self and others.
  • Inspires respect and trust.
  • Accepts feedback from others.
  • Displays passion and optimism.

 

Organization

  • Demonstrates knowledge of EEO policy.
  • Shows respect and sensitivity for cultural differences.
  • Educates others on the value of diversity.
  • Promotes a harassment-free environment.
  • Builds a diverse workforce.
  • Treats people with respect.
  • Keeps commitments.
  • Inspires the trust of others.
  • Works with integrity and ethically.
  • Upholds organizational values.
  • Follows policies and procedures.
  • Completes administrative tasks correctly and on time.
  • Supports organization's goals and values.

 

Self Management

  • Adapts to changes in the work environment.
  • Manages competing demands.
  • Changes approach or method to best fit the situation.
  • Able to deal with frequent change, delays, or unexpected events.
  • Is consistently at work and on time.
  • Ensures work responsibilities are covered when absent.
  • Arrives at meetings and appointments on time.
  • Follows instructions, responds to management direction.
  • Takes responsibility for own actions.
  • Keeps commitments
  • Commits to long hours of work when necessary to reach goals.
  • Completes tasks on time or notifies appropriate person with an alternate plan.
  • Volunteers readily.
  • Undertakes self-development activities.
  • Takes independent actions and calculated risks.
  • Asks for and offers help when needed.
  • Displays original thinking and creativity.
  • Meets challenges with resourcefulness.
  • Presents ideas and information in a manner that gets others' attention.
  • Displays willingness to make decisions.
  • Exhibits sound and accurate judgment.
  • Supports and explains reasoning for decisions.
  • Includes appropriate people in decision-making process.
  • Makes timely decisions.
  • Sets and achieves challenging goals.
  • Demonstrates persistence and overcomes obstacles.
  • Measures self against standard of excellence.
  • Prioritizes and plans work activities.
  • Uses time efficiently.
  • Plans for additional resources.
  • Sets goals and objectives.
  • Organizes or schedules other people and their tasks.
  • Develops realistic action plans.
  • Approaches others in a tactful manner.
  • Reacts well under pressure.
  • Treats others with respect and consideration regardless of their status or position.
  • Accepts responsibility for own actions.
  • Demonstrates accuracy and thoroughness.

 

Language, Math and Reasoning  

  • Ability to read, analyze and interpret common scientific and technical journals, financial reports, and legal documents.  Ability to respond to common inquiries or complaints from customers, regulatory agencies, or members of the business community.  Ability to write speeches and articles for publication that conform to prescribed style and format.  Ability to effectively present information to top management, public groups, and or boards of directors.
  • Ability to comprehend and apply principles of advanced calculus, modern algebra, and advanced statistical theory.  Ability to work with concepts such as limits, rings, quadratic and differential equations and proof of theorems.
  • Ability to define problems, collect data, establish facts, and draw valid conclusions.

EDUCATION, EXPERIENCE, and TRAINING:

  • Master’s degree (M.A.) or equivalent; and four to ten year’s related experience and/or training; or equivalent combination of education and experience.

 

CERTIFICATES, LICENSES, REGISTRATIONS:

  • ARNP State Licensure
  • MSN and Certification

COMPUTER SKILLS:

  • Must have excellent computer skills in a Microsoft Windows environment.
  • Acumen EHR.

 

PHYSICAL DEMANDS - The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

  • The employee must occasionally lift and /or move up to 25 pounds.
  • While performing the duties of this job, the employee is regularly required to walk, use hands to handle or feel, reach with hands and arms, talk, and hear.
  • While performing the duties of this job, the employee is frequently required to stand.
  • While performing the duties of this job, the employee is occasionally required to sit, climb or balance, stoop, kneel, crouch, or crawl.

 

VISION REQUIREMENTS

  • There are no special vision requirements.

 

WORK ENVIRONMENT - The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job.

  • This position works in an environment with moderate noise level. (Examples: business office with computers and printers, light traffic.)

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