Pediatric Cardothoracic Surgical Physician Assistant - (1.0 FTE, Days) - Full-time

Nursing Advance Practice

1.0 FTE, 10 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 Physician Assistant functions under the general Physician Assistant Job Description and Standardized Procedures/Delegation of Services approved by the Interdisciplinary Practice Committee (IDPC).  Specific functions pertaining to the Service, Clinic or Department are established by the physician assistant and his or her supervising physician(s), and approved by the appropriate medical and nursing administrators, the IDPC, and the Lucile Packard Children's Hospital Medical Board and Board of Directors.

Supervision

• Supervision is provided by attending physicians in the Clinic, Service or Department.  The supervising physician has continuing responsibility to follow the progress of the patient and to make sure that the physician assistant does not function autonomously, and is responsible for all medical services provided by a physician assistant under his or her supervision.  A physician may not supervise more than four physician assistants.  The specific mechanisms of supervision used may be:

• A supervising physician shall be available in person or by electronic communication at all times when the physician assistant is caring for patients.

• Medication orders are transmitted according to an approved formulary protocol.

• The supervising physician examines the patient the same day as care is given by the physician assistant.

• All order and notes by the physician assistant are signed and dated by a supervising physician with fourteen days.

• 5% of notes written by the physician assistant may be signed and dated by a supervising physician within (30) days.  Note: If this method of supervision is chosen, the department is responsible for submitting quarterly chart completion audits to Health Information Management Services (HIMS) to verify compliance. Additionally the physician must adopt protocols to govern the diagnosis and management of patients as per California Code of Regulations.

Essential Functions

• Takes a patient history, performs a physical examination and makes an assessment consistent with physical findings.  Develops a treatment plan and provides documentation in the patient record.

• The PA shall notify his/her supervising physician when performing tasks of executes treatment not delineated in the protocols set forth for the PA, the supervising physician will sign such medical records.

• Reviews and revises treatment and therapy plans as needed.

• Administers medications according to the formulary protocol or upon patient-specific orders from the supervising physician, or transmits orally or in writing on a patient¿s record, a prescription from the supervising physician to a person who may furnish such medication.  All controlled substances in Schedules II-V inclusive must have a patient-specific order by a supervising physician in advance of transmittal of the order or administration of the medication.

• Orders and collects specimens for routine laboratory tests.

• Orders physical therapy, occupational therapy, respiratory therapy, radiology examinations and nursing services.

• Initiates and facilitates patient referrals to other physicians, clinics and health care facilities, using clinic procedures.

• 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.  Medications that are not FDA-approved or are used for a non-FDA-approved indication (off-label use) require a patient-specific order in advance from the supervising physician.

• Initiates arrangements for hospital admissions and completes appropriate paperwork.

• Instructs and counsels patients regarding matters that pertain to their physical and mental health.

• Records pertinent data in the patient medical record.

• Performs clinical procedures that have been approved by a supervising physician without the presence of a supervising physician, except as otherwise noted.  These may include procedures that are usually performed under local anesthesia.  Any procedures requiring other forms of anesthesia may be performed only in the personal presence of a supervising physician.

• See Appendix B.

• After appropriate training, assists the supervising physician in the operating room.

• a. Acts as first or second assistant under the supervision of an approved supervising physician.

• b. Performs surgical procedures in the personal presence of an approved supervising physician.

• Recognizes situations which require the immediate attention of a physician, and initiates life-saving procedures when necessary.

Minimum Qualifications

• Graduate of a Physician Assistant Program accredited by the Accreditation Review Commission on Education for the Physician Assistant, Inc.

• Demonstrated ability to function in collaboration with other health care professionals.

Licensure/Certification

• Current licensure as a Physician Assistant in the State of California required.

•  If authorized by the supervising physician to issue drug orders for controlled substances, the physician assistant must be registered with the United States Drug Enforcement Administration (DEA).

• Team member in one of the top pediatric cardiothoracic surgery programs performing over 500 surgeries a year. 

• First and second assist in pediatric cardiothoracic surgeries, adult congenital cardiothoracic surgeries, heart and lung transplants, and ventricular assist devices.

• Provide comprehensive pre-operative evaluation to patients with congenital and acquired heart disease including medical and anesthetic history, physical exam, medication interactions, diagnostic test interpretation including labs, xrays, ECHO and ECG in inpatient and outpatient settings.

• Patient/Family education of complex cardiac disease including anatomy and physiology of congenital and acquired heart disease; education on surgical plan, postoperative hospital course, risks and benefits of surgery.

• Post-operative care of pediatric and adult patients including wound care, management of surgical lines and tubes, discharge planning, and post operative teaching.

• Function in a team environment with all hospital and clinic wide sub specialties, departments, and inpatient units.

• Precept and mentor multiple physician assistant students each year.

• Cardiac surgery experience preferred but not necessary.  Willing to train the right candidate.

• Position requires four 10 hour shifts which alternate between days and evenings. 

• Service requires coverage 24/7 with call expectations approximately 1 week each month.

Job Classification Standards

Exposure Risk to Blood-Borne Pathogens:

Category 1: Tasks regularly involve exposure to blood, body fluids or tissues.  The potential for spills or splashes of blood, body fluids or tissues exists in job-related tasks.

Physical Demands and Work Environment:

The work involves considerable physical exertion such as frequent lifting of patients and equipment, bending and stooping, and walking.  The work environment involves moderate risks or discomforts which require special safety precautions, e.g., working with risk of exposure to contagious disease, radiation or infection, or working with emotionally disturbed patients.  Precautions are routine for nearly all situations.  The employee may be required to use protective clothing or gear.

Equal Opportunity Employer

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 gender identity, religion, age, national or ethnic origin, political beliefs, marital status, medical condition, genetic information, veteran status, or disability, or the perception of any of the above. People of all genders, members of all racial and ethnic groups, people with disabilities, and veterans are encouraged to apply. Qualified applicants with criminal convictions will be considered after an individualized assessment of the conviction and the job requirements, and where applicable, in compliance with the San Francisco Fair Chance Ordinance.