NNP/Physician Assistant-Neonatology-Backus Hospital, Norwich-Full-time

Serves as a recognized leader and expert resource in diagnosing the full breadth of clinical presentations. Effectively navigates the most complex or ambiguous circumstances with pediatric patients (from neonates to adolescents and young adults) and their families. Facilitates the interdisciplinary care of patients. Teaches and mentors staff in area of expertise. Promotes the role of the team as contributors to the broader organization’s overall effectiveness, well-being, and culture.

Medical knowledge

• Clinical knowledge. Applies breadth of medical knowledge that spans the continuum from simple to complex problems, incorporating evidence-based practice and current literature to support care. Teaches students and other less experienced APPs, providing education and oversight.
• Diagnostic Evaluation. Prioritizes and optimizes evaluation based on risks, benefits, indications, and alternatives to clarify the diagnosis(es). Interprets clinical significance of diagnostic study results while considering study limitations. Educates others about risks, benefits, indications, and alternatives to guide diagnostic decision-making. Teaches others to interpret clinically significant results and consider study limitations.

Patient History. Gathers, filters, prioritizes, and synthesizes patient history to develop a differential diagnosis in real-time for complicated or atypical presentations. Recognizes and probes subtle clues from patients and families; distinguishes nuances among diagnoses to efficiently drive further information gathering.

Patient care

• Clinical reasoning. Role models and coaches others in the organization and integration of clinical facts (e.g., history, exam, tests, consultations, etc.) to develop prioritized differential diagnoses, including life threatening diagnoses, atypical presentations, and complex clinical presentations. Reappraises in real time to avoid diagnostic error.
• Organize and prioritize patient care. Serves as a role model and coach for patient care responsibilities. Organizes, prioritizes, and collaborates with others even when patient volume approaches the capacity of the individual or facility; anticipates and triages urgent and emergent issues.
• Patient management. Serves as a role model and coach for development of management plans for complicated and atypical diagnoses, with the ability to modify plans as necessary.

Procedures as defined by clinical department. Applies full competency in core procedures. Coaches and mentors others in the performance of procedures. Please reference the “APP Procedures Listing” for those relevant to the Medical Specialty.

Interpersonal and Communication

• Patient and family centered communication. Mentors others in developing positive and culturally competent therapeutic relationships with patients/families, including those relationships involving ambiguity and/or conflict. Models and coaches others in patient and family centered communication. Elicits patient/family values and incorporates awareness of these in communications with patient/family and in patient care. Uses shared decision making with patient/family to make a personalized care plan.
• Interpersonal and team communication. Influences relationships with supervising physician(s) and referring providers that maximizes adherence to practice recommendations and fosters collaborative practice. Coaches others in effective communication within the inter-professional team.
• Communication within Health Care System. Models and coaches others in documenting diagnostic and therapeutic reasoning. Concisely documents updated, prioritized, diagnostic and therapeutic reasoning, including anticipatory (preventive) guidance, in the patient record. Identifies areas for preventive counseling. Aligns type of communication with message to be delivered (e.g., direct and indirect) based on urgency and complexity. Coaches others in written and verbal communication.

Practice–based learning and improvement

• Evidence-based and informed practice. Critically appraises data and applies evidence, even in the face of uncertainty and conflicting evidence, to guide care tailored to the individual patient, including integrating patient preference. Coaches others to critically appraise and apply evidence for complex patients. Contributes to evidence-based practice based on program needs.
• Reflective practice and commitme