Physician Assistant

ABOUT SHERIDAN MEMORIAL HOSPITAL At Sheridan Memorial Hospital, we are proud to be ranked in the top 13.6% of hospitals rated by the Centers for Medicare and Medicaid Services. We believe that our ability to deliver excellent healthcare begins with our people, and we are proud of our more than 850 skilled, experienced, and caring employees. We have over 100 providers who specialize in 25 areas of expertise. Our facility is state-of-the-art, and we are dedicated to providing outstanding patient-centered care. · Nestled at the foothills of the Big Horn Mountains in northern Wyoming, spectacular scenery and outdoor activities abound. Our hospital has the latest technology and equipment comparative to that of many larger facilities, and you will find our staff is friendly, compassionate, caring, and courteous. We focus on creating and nurturing a workplace that encourages, recognizes, and rewards individual effort and creativity. Leadership is responsive to changing modes of healthcare delivery and adapts accordingly. We value effective communication and honesty and believe teamwork based on mutual respect is key to success. JOB SUMMARY

The Physician Assistant (PA) functions in an advanced clinical role and is primarily responsible for diagnosing and treating patients in the emergency department. The PA will provide medical services for patients in the emergency department under physician supervision, perform physical examinations within prescribed guidelines and practices of the physician. They must have the ability to diagnose and manage common acute and stable chronic diseases. Other responsibilities include, but are not limited to, ordering, interpreting and evaluating diagnostic and laboratory tests and prescribing pharmacological and non-pharmacological therapies. Documentation of physical findings and patient care plan will be recorded in the patient’s medical record each time the patient is seen. ESSENTIAL DUTIES/RESPONSIBILITIES

Assess, evaluate, diagnose, and initially treat patients of all ages who present to the Emergency Department with any symptom, illness, injury, or condition and provide services necessary to ameliorate minor illnesses or injuries; stabilize patients with major illnesses or injuries and assess all patients to determine if additional care is necessary.

The PA will discuss cases with the supervising physician and other health care professionals as needed to prepare patient care plans. All practice is performed under the supervision physician or their designee and in accordance with the Medical Staff Bylaws, Rules and Regulations and Policies and Procedures and as determined by established written protocols between PAC scope of knowledge and training and the supervising/collaborating physicians scope of practice.

This employee will participate in performance improvement and CQI activities as necessary. Excellent interpersonal skills and the ability to communicate with a multi-disciplinary team of professionals as well as healthcare consumers is a required skill. The PA will also provide clinic administrative support services as necessary.

PACs are allowed to perform only those procedures that are within the supervising physicians scope of practice.

PACs may not admit patients to the hospital. All newly admitted patients will be admitted to the supervising physician. PACs may write or dictate History and Physicals. History and Physicals must be countersigned by the supervising physician. Prior to any surgical procedure or endoscopy, the supervising physician must confirm and sign the H&P.

PACs may not discharge patients from the hospital without a written or verbal order from the physician at the time of discharge. PACs may write or dictate the discharge summary as long as it is reviewed and signed by the physician.

It is the responsibility of the supervising physician(s) to select/triage patients to the advanced practice clinician appropriate to their education, certification, licensure, and training background, which must be congruent in terms of role and patient care needs.

Initial and ongoing assessment of the patients medical, physical, and psychiatric status includes the following:

Perform physical examination, including rectal and pelvic examination, as indicated

Perform and document complete medical/social history,

Record diagnostic impressions,

Order and assess diagnostic and therapeutic modalities (e.g. EKG, laboratory, x-ray, nursing)

Activities, therapies, diet and vital signs; drugs; IV fluids; blood and blood products; oxygen;

Monitor and manage stable chronic illnesses of populations served

Order fluid and electrolyte replacement therapy

Perform routine immunizations

Prescribe or adjust medications (excluding controlled substances) only as an agent of the supervising physician

Schedule outpatient testing; arrange follow-up care Suture simple lacerations

Management of Patient Health/Illness Status

Triages patients health needs/problems.

Completes EMTALA-specified medical screening examination.

Responds to the rapidly changing physiological status of emergency care patients.

Uses current evidence-based knowledge and skills in emergency care for the assessment, treatment, and disposition of acute and chronically ill and injured (e.g., physiologic, psychological, socio-economic, cultural) emergency patients.

Specifically assesses and initiates appropriate interventions for violence, neglect, and abuse (e.g., physical, psychological, sexual, substance).

Specifically assesses and initiates appropriate interventions and disposition for suicide risk.

Assesses patient and family for levels of comfort (e.g., pain, palliative care, end of life, bad news) and initiates appropriate interventions.

Recognizes, collects, and preserves evidence as indicated (e.g., forensic evidence).

Orders pharmacologic and non-pharmacologic therapies.

Orders and interprets electrocardiograms.

Orders and interprets radiographs.

Assesses response to therapeutic interventions.

Documents assessment, treatment, and disposition.

Privileges do not include long-term care of patients on an inpatient basis.

Privileges do not include ability to admit or perform scheduled elective procedures with the exception of procedures performed during routine emergency room visits.

Initiates referral to appropriate physicians or other healthcare professionals of problems that exceed the PACs scope of practice.

PA-C Emergency Medicine Core PROCEDURE List: This list is a sampling of procedures included in the core. This is not intended to be all-encompassing but rather reflective of the categories/types of procedures included in the core.

Administer analgesia; regional block anesthesia including double cuff method Bier block

Administer medications and perform other emergency treatment

Perform anoscopy

Apply, remove, and manage casts and splints

Apply, remove, and change dressings and bandages

Perform wound debridement, suturing, and general care for superficial wounds and minor superficial surgical procedures

Immobilize (spine, long bone, soft tissue)

Insert and remove nasogastric tubes

Manage epistaxis

Ocular tonometry

Perform arterial puncture and blood gas sampling (radial only or when not femoral)

Perform incision and drainage of superficial and complex abscesses

Perform interpretation of EKGs

Perform preliminary interpretations of simple plain X-ray films

Perform routine immunizations

Perform urinary bladder catheterization

Perform venous punctures for blood sampling, cultures, and IV catheterization (peripheral only)

Reduce joint dislocations

Perform removal of foreign body

Splint extremity fractures

Trephination and removal of nail

Perform lumbar puncture

Perform arthrocentesis

Performs Chest, Abdomen, Neck, Back, Gynecologic, Genitourinary, Rectal, Extremity, Head, Eye, Ear, Nose and Throat Procedures as directed by supervising physician and according to scope of practice and training

Skin and Wound Care Procedures (includes but not limited to: )

Performs ultraviolet examination of skin and secretions (e.g., Woods Lamp).

Treats skin lesions (e.g., foot callus, skin tag, plantar lesion, decubitus care).

Injects local anesthetics.

Performs nail trephination.

Removes toe nail(s) (e.g., partial or complete removal for ingrown toe nail).

Performs a nail bed closure.

Performs closures (e.g., single layer, multiple, staple, adhesive).

Revises a wound for closure.

Debrides minor burns (e.g., non-adhering blister).

Incises drains, irrigates, and packs wounds.

Suture simple lacerations

Suture and staple removal

MINIMUM REQUIREMENTS Education / Experience / License and Certifications

Completion of and certification in an accredited Physician Assistant program.

Licensed as a Physician’s Assistant by the State of Wyoming.

CSR, DEA Prescribing license, required.

Current NCCPA certification, required.

Current BLS and PALS certification, required.

Current ACLS certification, required.

Two years ER experience preferred.

Current ATLS and NRP, preferred

. Specific demands not listed: Possible exposure to blood and or body fluids / infectious disease / hazardous waste requiring the use of Personal Protective Equipment. Exposure to odorous chemicals / specimens and Latex products.

Pre-employment drug and alcohol screening is required.

Sheridan Memorial Hospital is an equal opportunity/Affirmative Action employer and gives consideration for employment to qualified applicants without regard to race, color, religion, age, sex, national origin, disability or protected veteran status. If you would like more information about your EEO rights as an applicant under the law, please click here (https://www.dol.gov/ofccp/regs/compliance/posters/pdf/eeopost.pdf)