Nurse Practitioner - Moses Lake Cardiology

Located in the heart of Washington, we enjoy open skies, snow-capped mountains, and the lakes and rivers of the high desert. We are the proud home of orchards, farms, and small communities. Confluence Health actively supports the communities we serve and their quality of life through our community support program and through our individual efforts as involved community members.

Full Time Employees of Confluence Health receive a wide range of benefits in addition to compensation.

• Medical, Dental & Vision Insurance
• Flexible Spending Accounts & Health Saving Accounts
• Paid Time Off
• Generous Retirement Plans
• Life Insurance
• Long-Term Disability
• Gym Membership Discount
• Tuition Reimbursement
• Employee Assistance Program
• Adoption Assistance
• Shift Differential

For more information on our Benefits & Perks, click here!

Provides appropriate specialized health care services to hospital and clinic patients. Performs examinations and provides treatment to routine clinical problems; performs or orders diagnostic testing; establishes diagnosis; prescribes medication; instructs patients and family members about continuing care.

Position Reports To: Practice Manager

1. Outpatient Practice Duties
   • Staff outpatient office clinic in Wenatchee
   • Staff outpatient office clinic in satellite locations (either Moses Lake or Omak)
     • 1-4 days per month
   • Provide comprehensive history and physical examinations on new cardiology patients
   • Provide comprehensive history and physical examinations for pre-operative clearance of non-cardiac surgery
   • Provide comprehensive history and physical examinations prior to cardiac procedures, in conjunction with cardiologist performing procedure
   • Provide post-operative evaluation (i.e after cardiac operations/procedures)
   • Order and/or perform pertinent diagnostic tests—ECG, echocardiogram, nuclear stress test, exercise stress test, chest x-ray, etc
   • Evaluate cardiac patient’s medical history, physical exam findings and diagnostic/laboratory data
   • Formulate cardiac care plan using established guidelines from ACC/AHA/NHLBI/HFS, and under the direction of a cardiologist
   • Initiate hospital admission orders after consulting with on-call cardiologist, including admission history and physical, on cardiac patients that require admission
   • Provide education and counseling to cardiac patients, patients families, and community groups on prevention and treatment of cardiovascular disease
   • Provide care in Areas of special interest may be assigned (ie HF, Lipid management, EP clinic)
   • Act as preceptor for physician assistant/nurse practitioner students
   • Actively recruit patients for cardiology-oriented research studies
   • Educate and communicate with patients and families regarding cardiac procedures, including cardiac catheterization, PCI, CABG, Pacemaker/ICD implantation, cardioversion, stress testing, echocardiography, etc
   • Educate Cardiac Rehab participants on cardiovascular disease and prevention
   • Participate in Community Wellness events, as schedule allows, with focus on cardiovascular disease Place referrals to other healthcare professional/specialties as needed
   • Participate in telemedicine clinic to outreach/satellite locations as needed and when travel is not possible
2. Inpatient Practice Duties
   • Staff hospital services as assigned, 4–10-hour shift rotation, including weekends
   • Complete comprehensive health history and physical examination of patients with acute or chronic cardiac conditions
   • Order and/or perform pertinent diagnostic studies, including ECG, echocardiograms, treadmill stress tests, nuclear stress tests (pharmacologic and exercise), stress echocardiograms (pharmacologic and exercise), chest x-rays, etc
   • Perform cardiac patient’s medical history, physical exam findings, and evaluate diagnostic/ laboratory data
   • Assist the on-call cardiologist with daily rounds, new consults, NSTEMI/STEMI triage in the ED
   • Generate daily progress notes to be used as shared-visits with on-call cardiologist
   • Notify on-call cardiologist of any change in patient condition
   • Evaluate and formulate treatment plan for new consults, in conjunction with on-call cardiologist
   • Generate discharge summaries, discharge orders, plus complete patient education and follow-up plans for NSTEMI/STEMI patients
   • Admit and perform History and Physical on Antiarrhythmic therapy patients
   • Monitor QTc interval on Antiarrhythmic patients, as directed by supervising physician
   • Perform medication reconciliation between hospital discharge and home medications, writing new prescriptions as appropriate
   • Complete daily patient education on cardiac conditions, treatment options, medications, and prognosis
   • Assist on-call cardiologist with triage of patients consults and needs
   • Communicate effectively with on-call cardiologist, hospital service, nursing staff, and other support staff
   • Order cardiovascular procedures (cardiac catheterizations, pacemaker implantations, etc.) as directed by attending cardiologist
   • Take weekend calls from nursing staff and from outpatient clinic cardiology line from Friday 1700 through Monday 0700
   • Assist in ACLS/BLS codes, as directed by supervising physician(s)
   • Perform device interrogations, reprogramming and deactivation of ICDs in the setting of end-of-life care, per physician recommendations
   • Perform Pacemaker interrogations and interpretation of rhythm data, as directed by supervising physician(s)
   • Assist in suturing pacemaker pockets and implanting loop recorders, as directed by supervising physician(s)
3. Stress Testing Practice Duties
   • Possess knowledge/competency of appropriate indications/contraindications for exercise and pharmacologic stress testing, plus review stress test orders, to assess for appropriate use criteria by non-cardiology providers
   • Possess knowledge/competency to promptly recognize and treat complications of exercise and pharmacologic stress testing
   • Possess knowledge/competency of appropriate contraindications, risk assessment of testing
   • Possess knowledge/competency of BLS/ACLS on an annual basis
   • Possess knowledge/competency of Cardiovascular and Exercise Physiology
   • Possess knowledge/competency of Exercise and Pharmacologic Stress testing Protocols
   • Possess knowledge/competency of Cardiac Arrhythmias, at rest and during exercise
4. Other duties as assigned

Demonstrate Standards of Behavior and adhere to the Code of Conduct in all aspects of job performance at all times.

Required:

• Active Registered Nurse and ARNP licensure with prescriptive authority in the state of Washington, required by start date.
• CPR/ACLS Certification.

Desired:

• Related experience.
• Cardiology Specialty Certification.

O = Occasional, represents 1 to 25% or up to 30 minutes in a 2 hour workday.
F = Frequent, represents 26 to 50% or up to 1 hour of a 2 hour workday.
C = Continuous, represents 51% to 100% or up to 2 hours of a 2 hour workday.

Physical/Sensory Demands For This Position:

• Walking - F
• Sitting/Standing - F
• Reaching: Shoulder Height - F
• Reaching: Above shoulder height - O
• Reaching: Below shoulder height - O
• Climbing - O
• Pulling/Pushing: 25 pounds or less - O
• Pulling/Pushing: 25 pounds to 50 pounds - O
• Pulling/Pushing: Over 50 pounds - O
• Lifting: 25 pounds or less - F
• Lifting: 25 pounds to 50 pounds - O
• Lifting: Over 50 pounds - O
• Carrying: 25 pounds or less - O
• Carrying: 25 pounds to 50 pounds - O
• Carrying: Over 50 pounds - O
• Crawling/Kneeling - O
• Bending/Stooping/Crouching - O
• Twisting/Turning - O
• Repetitive Movement - O

Working Conditions:

• Work is performed at in patient exam and treatment rooms, where space may be limited and confined. Requires a combination of working independently and also working closely with others.

Job Classification:

• FLSA: Exempt
• Hourly/Salary: Salary

Physical Exposures For This Position:

• Unprotected Heights - No
• Heat - No
• Cold - No
• Mechanical Hazards - No
• Hazardous Substances - Yes
• Blood Borne Pathogens Exposure Potential - Yes
• Lighting - No
• Noise - No
• Ionizing/Non-Ionizing Radiation – No
• Infectious Diseases - Yes