Physician Assistant - Surgical Intensive Care Unit

Kidney transplant :

Understand the etiology of chronic kidney disease, utilization of dialysis (peritoneal vs hemodialysis) and associated complications, genitourinary dysfunction symptoms (neurogenic bladder, incontinence, BPH, UTIs, stones, hematuria.

Understand the indications for kidney transplant, the necessary components of pre-transplant evaluation and workup. Understand PRA, DSA & KDPI. Understand different types of donors including living donor, PHS increased risk, DCD. Understand the indications, contraindications, complications, risks, benefits and techniques for kidney transplant. Understand the expected postoperative course for a living donor kidney transplant and deceased donor kidney transplant recipient. Understand kidney transplant recipient & donor pathways. Display ability to manage slow graft function & delayed graft function. Manage hypertension, diabetes, hyperkalemia. Formulate a differential diagnosis based on history, physical exam and diagnostic evaluations for postoperative complications in the kidney transplant population. Understand management of immunosuppression and infection prophylaxis.

Liver transplant

Understand the etiology of liver disease and prior treatment, MELD score, symptoms of liver disease including hepatic encephalopathy, jaundice, ascites, GI bleeding, secondary bacterial peritonitis, secondary organ damage including hepatorenal syndrome, portopulmonary hypertension, hepatopulmonary syndrome

Understand the indications for liver transplant, the necessary components of pre-transplant evaluation and workup. Understand MELD scoring & common complications of cirrhosis. Understand different types of donors including living donor, PHS increased risk, DCD. Understand the indications, contraindications, complications, risks, benefits and techniques for liver transplant. Understand the expected postoperative course for a living donor liver transplant and deceased donor liver transplant recipient. Understand liver transplant recipient & donor pathways. Manage acute postoperative bleeding post liver transplant. Understand indications for ICU vs floor management following surgery. Formulate a differential diagnosis based on history, physical exam and diagnostic evaluations for postoperative complications in the liver transplant population. Understand management of immunosuppression and infection prophylaxis. Demonstrate knowledge of postoperative management including fluid management, electrolyte disturbances, postoperative bleeding, airway management (ventilator), pulmonary function, management of postoperative infection, fever workup, and postoperative nutrition.

Understand the surgical anatomy, steps, and potential intraoperative complications, including first / second assist in each of the following transplant surgeries : Kidney transplant recipient, Laparoscopic donor nephrectomy, Liver transplant recipient, Living donor hepatectomy, Organ procurement, Dialysis access surgery (arteriovenous fistula / graft, peritoneal dialysis catheter)

Demonstrate the following procedural skills : JP drain removal, bedside skin suturing, hemodialysis catheter removal, central line placement etc.

• Responsibilities : In addition to standard APP duties, responsibilities include performing comprehensive assessments, formulating management plans, ordering / interpreting diagnostic tests, performing invasive bedside procedures (such as arterial lines, central lines, chest tubes, and intubations), and participating in daily multidisciplinary rounds, management of patients transferred to the floor.
• Team Support : APPs in the SICU work closely with critical care physicians and surgical teams to ensure continuity of care and contribute to teaching residents, fellows, and nursing staff.
• Professional Growth : Opportunities to participate in quality improvement projects, protocol development, and research initiatives. Ongoing education, simulation training, and support for advanced certifications are provided to enhance clinical expertise.

Job Profile Summary

A professional individual contributor role that may direct the work of other lower level professionals or manage processes and programs. The majority of time is spent overseeing the design, implementation or delivery of processes, programs and policies using specialized knowledge and skills typically acquired through advanced education. A senior level role that requires advanced knowledge of job area typically obtained through advanced education and work experience. Typically responsible for : managing projects / processes, working independently with limited supervision, coaching and reviewing the work of lower level professionals, resolving difficult and sometimes complex problems. These roles focus on providing high-quality patient care and promoting wellness. APCs work collaboratively with physicians and other healthcare professionals to diagnose and treat a variety of acute and chronic conditions. In addition, this role focuses on care under the supervision of licensed physicians including conducting comprehensive patient assessments, ordering and interpreting diagnostic tests, diagnosing and treating acute and chronic conditions, injuries, and illnesses, developing and implementing treatment plans in collaboration with supervising physicians, prescribing medications and performing procedures, educating patients and families on treatment options, health maintenance, and preventive care and adjusting treatment plans as necessary.

Job Overview

This Physician Assistant - Critical Care position is responsible, within the legal limitations, for assisting the physician staff of the Department in the provision of medical services to patients. The position performs complete, detailed and accurate initial evaluations including medical histories, reviews patient records to develop comprehensive medical status reports, and order laboratory, radiological and diagnostic studies appropriate for complaint, age, race, gender, and physical condition of the patient. Assumes responsibility to coordinate treatment plans, monitors progress, refers patient as necessary to appropriate sources for care under the direction of the supervising physician. The position understands the philosophy, objectives, policies and procedures of Nursing Service and provides for their implementation. Works cooperatively within department and other services to create a system of quality health care.

Job Description

Minimum Qualifications :

1. Bachelor's degree.

2. Successful completion of a Physician's Assistant program.

3. Physician's Assistance Licensure within the first three months following the receipt of a complete application for medical staff membership and privilege.

4. Physician's Assistant Certification.

5. Basic Life Support (BLS) certification.

Preferred Qualifications :

1. State and federal controlled substances registration.

Duties and Responsibilities : The duties and responsibilities listed below are intended to describe the general nature of work and are not intended to be an all-inclusive list. Other duties and responsibilities may be assigned.

1. Manages a broad spectrum of patients and performs a wide range of clinical, diagnostic and therapeutic procedures.

2. In collaboration with the healthcare team, assesses the health status of patients by obtaining complete and thorough medical histories and performing physical examinations, laboratory and diagnostic studies. Diagnose health and developmental problems and care for patients suffering from acute and chronic diseases.

3. Assesses patient / family psychosocial needs, educational needs, learning readiness, and barriers to learning during admission process.

4. Examines patients, records, and discriminates between normal and abnormal findings to recognize early stages of a serious physical or emotional problem. Consult with physician concerning patient evaluation and condition.

5. Develops an effective, comprehensive plan of care individualized to the age and needs of each patient using established standards of care, knowledge of disease entities, and human growth and development and emotional, social and spiritual needs and following hospital standards.

6. Communicates professionally with patient / family, other practitioners, physicians, and co-workers.

7. Sets priorities and modifies patient care in response to changing situations. Demonstrates judgment in consulting MD regarding all patient encounters. May triage and refer to appropriate source when primary care patients present with new symptoms.

8. Orders appropriate labs and radiological testing based on assessment of needs.

9. Maintains required records, reports and statistics. Maintains accurate patient records, charts and documentation for administrative purposes.

10. Demonstrates appropriateness of prescribing habits (i.e. agents, volume, and refill).

11. Encourages preventative medicine through patient education and counseling. Recognizes that patient and family teaching are an integral part of the role and follows through on teaching that has been initiated with appropriate documentation.

12. Interpret patient needs to other clinical personnel participating in the care through direct communication and input into care plans.

13. Works collaboratively with physician to manage care of patients in a cost-effective manner. Utilize appropriate resources across the system including nursing interventions. Utilize organizational skills to complete assigned work effectively and on time.

14. May orient and train new Physician Assistants, coordinate staff schedules, assist with performance evaluations, and provide guidance on effective team building.

15. May participate in rounds with residents, completes daily patient management assignments and assists with patient care and disposition. Handles medical emergencies during regular working hours on the inpatient service.

Physical Requirements :

1. Lifting and turning patients of 30-35 lbs.

2. Prolonged standing and walking.

3. Occasional twisting, bending, reaching, pushing / pulling, sitting, kneeling, and squatting.

4. Exposure to infectious disease and possible carcinogenic chemicals and blood-borne pathogens.

5. Requires manual dexterity using fine hand manipulations for performing procedures and computer keyboard.

6. Requires ability to see computer screen, reports, and perform assistance in procedures with accuracy. 7. Requires ability to hear instructions from physician.

Skills & Abilities :

1. Ability to assess the needs of patients of all different age groups and to provide care appropriately.

2. Effective Interpersonal skills needed for interacting with physicians, staff, patients and their families, and so forth.

3. Excellent analytical skills needed for evaluating patients and coordinating treatment plans.

4. Possess the maturity, self-confidence, and ability to follow complex patient management plans as directed by the attending physician.

At Tufts Medicine, we want every individual to feel valued for the skills and experience they bring. Our compensation philosophy is designed to offer fair, competitive pay that attracts, retains, and motivates highly talented individuals, while rewarding the important work you do every day.

The base pay ranges reflect the minimum qualifications for the role. Individual offers are determined using a comprehensive approach that considers relevant experience, certifications, education, skills, and internal equity to ensure compensation is fair, consistent, and aligned with our business goals.

Beyond base pay, Tufts Medicine provides a comprehensive Total Rewards package that supports your health, financial security, and career growth-one of the many ways we invest in you so you can thrive both at work and outside of it.

Pay Range :

$124,800.00 - $156,000.00