What Should I Include in a Nurse Practitioner Job Description for a Position at a Cardiology Practice?

William Lane Edwards, Jr., MSN, ARNP, ANP

Disclosures

April 28, 2005

Question

I recently joined the cardiology practice of a 10-physician group as their first nurse practitioner (NP). I am searching for any suggestions on a job description. The partners seem to each have a different idea of how to utilize me, and I want to come to the table with something more definitive.

Response From the Expert

Response from  W. Lane Edwards, Jr., MSN, ARNP, ANP 
Nurse Practitioner, Internal Medicine, Ft. Myers, Florida

 

 

 

What an exciting time for you! This is your opportunity to carve out the job of your choice.

Thinking back 18 years ago on my first NP role in a cardiology practice, I was in the exact same spot you are in now, but with a much smaller practice. I started by becoming familiar with the types of patients that presented in the cardiology practice and the manner in which the physicians responded to the patients' needs. While observing the processes of inpatient care through office follow-up, I tried to see how daily inpatient assessment was performed, how patients were managed for selected disease processes, and how they arrived at discharge. I was looking for any gap in their care and how my knowledge and skills would fit in. Then I started asking myself a few questions: What is it that I really wanted to do in this practice -- specific tasks or define a role as an independent/interdependent practitioner in the whole process of the practice? What was missing from the care I saw that I could improve or enhance in this practice? What activities would place me as a valuable member of the team? What would make me happy and allow me to grow as a professional?

In writing your job description, I would be fairly nonspecific. For example, you could include "participates in the care of inpatient and outpatient clients in an independent and interdependent role." Rather than a list of tasks that you can perform, I would offer a list of abilities, including:

  • Managing specific disease processes for inpatients;

  • Providing patient education;

  • Performing stress testing;

  • Participating in a pacemaker clinic;

  • Providing postprocedural follow-up care;

  • Starting a specialty service within the practice such as a congestive heart failure clinic, lipid clinic, or anticoagulation clinic; and/or

  • Starting a cardiac rehabilitation program.

You may ask that your position be divided into inpatient and office responsibilities. Perhaps, as I did, you could suggest that you start in the hospital rounding on patients while the physicians are performing procedures. Your role could be assessing the patients' progress since the last inpatient visit, initiating or altering "the treatment plan," preparing patients for discharge, and participating in patient education during rounds. After your inpatient role is completed, you could go to the office and see patients in follow-up. Part of your schedule may be seeing those discharged patients that you are familiar with from their hospital course or performing pacemaker checks, supervising stress testing, or seeing specialized groups of patients on selected days.

The role you identify should have a trial period that is reassessed after a predetermined period of time, perhaps 4-6 months. By not limiting your role within the practice to a very small scope, you will learn more and have greater flexibility within the practice for future growth and variety.

Remembering that you cannot "please" all partners in your practice, you should pick a role that seems to meet the majority of the needs that you assess during your first period at work.

As an example, here are a few lines from my current job description altered for a cardiovascular NP role:

Job Summary: A licensed and credentialed NP provides diagnosis, treatment, consultation, and follow-up (depending on the state licensure) under the supervision of 1 or more physicians in the practice (name). The NP provides age and specialty appropriate medical care at the level of training achieved.

Job Duties:

  • Effectively identifies, evaluates, and addresses disease prevention and health promotion issues of the population in the practice while administering quality patient care.

  • Works in an independent and interdependent relationship with members of the medical staff, which allows for consultation, collaboration, or referral.

  • Responsible for the diagnosis and treatment of acute, chronic, and long-term healthcare issues.

  • Educates patients and/or families about preventive care, medical issues, and use of prescribed medical treatments and/or medications.

  • Maintains legible, accurate, and confidential medical records. Documents all medical evaluations, diagnoses, procedures, treatment, outcomes, education, referrals, and consultations consistent with NCQA (National Committee for Quality Assurance), JCAHO (Joint Commission on Accreditation of Healthcare Organizations), and state regulatory standards.

  • Facilitates evaluation of records by physician(s), peers, and Quality and Standards according to protocols, and receives and implements constructive directives.

  • Analyzes new knowledge gained from conferences, workshops, professional literature, or "hands-on training" and assimilates this knowledge into clinical practice.

 

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