Physician Assistant I/ Nights /SICU - Division of Trauma, Burn, Surgical Critical Care and Emergency General Surgery

The SICU physician assistant (PA) is a member of the multidisciplinary SICU provider team with patient care and management responsibilities similar to those of the junior residents who have month-long rotations in the SICUs. This multidisciplinary group covers approximately 50 inpatient beds daily in the trauma/burn, general surgery, thoracic surgery, and cardiac surgery ICUs. On a daily basis, 4-5 SICU teams each manage 8-12 critically ill surgery patients. The group consists of intensivist attendings from Surgery, Anesthesiology, Pulmonary Medicine, and Emergency Medicine; resident and fellow trainees from Surgery, Anesthesiology, Pulmonary Medicine, Emergency Medicine, and Obstetrics; and Physician Assistants.

SICU PAs report to the SICU Director, Chief PA, and administratively to the Administrative Director, Trauma, Burn, and Surgical Critical Care. Their supervising physicians are surgeons in the Trauma, Burn, and Surgical Critical Care division. Daily supervision is provided by the attending intensivist covering each SICU.

Clinical Duties:

The PA should display the following skills and take part in the following tasks:

1. Performs patient admitting histories and physicals; records information accurately in patient record in a timely fashion.
2. Performs bedside procedures, e.g.: insertion of lines and tubes; performs postoperative wound care and removal of tubes, lines, sutures, etc.
3. Examines and evaluates patients and assists in development of their treatment plan with resident physicians and attending intensivists.
4. Appropriately responds to emergency situations; manages patient issues as they arise in the ICU, to the extent that the PA will obtain and evaluate studies/labs, write orders, obtain consultations and interpret lab values and x-rays with the assistance of the supervising physicians as necessary.
5. Provides age specific care to surgical intensive care patients from early adolescence through the geriatric ages.
6. Will work with physician trainees and will alternate with them in scheduled shifts for patient care.
7. Will work under the direction of supervising critical care attendings and fellows.
8. Provides teaching to medical students and physician assistant students and other health care personnel as appropriate.
9. Stays up to date on the latest literature in surgical critical care practice.
10. Participates in quality improvement, patient safety, and research efforts as directed by the service leadership. The PA should also initiate these efforts as appropriate.

Non-Clinical Duties:

1. Leadership
   
   
   
   1. Mentoring of various health care personnel.
   2. Being supportive of team members and offering additional help when needed.
   
   
   
   
2. Professionalism/Professional Development
   
   
   
   1. Attend continuing medical education courses as appropriate.
   2. Practice professional behavior at all times.
   3. Engage in activities to develop growth of self, team, and service.
   
   
   
   
3. Operations Support, Administrative Responsibilities
   
   
   
   1. Keep proficient in all IS systems appropriate to position.
   2. Maintain awareness of documentation and its effect on reimbursement.
   3. Continue to find ways to practice efficiently.
   
   
   
   

1. Education:
   
   
   
   1. Must have successfully completed a Graduate Level, accredited Physician Assistant Program approved by AMA Board of Approval and Certification of PA programs.
   2. Must have bachelor's degree or equivalent. (BS/MS joint programs are also acceptable).
   
   
   
   
2. License/Certification/Registration:

1. NCCPA certified.
2. License as a Physician Assistant in Massachusetts.
3. Maintain current DEA and Massachusetts Controlled Substance Licenses.
4. Maintain current BLS/ACLS certification.
5. Complete 100 hours of CME according to national and state regulations during each 2-year period of employment.
6. Complete BWH Professionalism Program within 3 months of date of hire.
7. FCCS certificate preferred.

1. Experience
   
   
   
   1. Previous experience in an academic surgical/medical environment strongly preferred.
   2. Three years full-time experience as a PA strongly preferred.
   3. Previous experience in surgery and/or critical care preferred.
   
   
   
   

The PA shall demonstrate the following clinical knowledge, skills and competencies:

1. Excellent patient-care skills.
2. Strong competency for the evaluation and treatment of critically ill surgery patients.
3. Ability to learn, perform, and assist with a variety of technical procedures requiring excellent manual dexterity.
4. Strong clinical knowledge of surgery and critical care.
5. Knowledge and skills necessary to provide care to adolescents and adults, ages 13 and above.

Physical and mental abilities required:

1. Proven ability to be a productive member of a cohesive team of peers and multidisciplinary colleagues, dedicated to providing optimum patient care.
2. Professional and appropriate attitude towards patients and families at all times.
3. Commitment to quality care, ethical judgment, and patient privacy.
4. Highest degree of professional judgment and discretion.
5. Excellent organizational skills and ability to prioritize duties appropriately.
6. Strong leadership and communication skills in order to work effectively with other members of the healthcare team, including physicians, trainees, dietitians, nurses, pharmacists, and administrative staff.
7. Understanding of procedures, policies and documentation required to ensure compliance with standards of care.
8. Receptive to feedback and strong ability to translate direction into improvement.
9. Understanding of own limitations in knowledge, skill, and experience.
10. Punctual and reliable.

The PA shall demonstrate the following professional knowledge and skills:

1. Proficient with BWH computer systems as needed to independently perform daily tasks such as order entry, EMAR, lab tests and results, incident reporting, etc.

2. Consistently provide high quality and timely documentation, including admission notes, progress notes, transfer notes, discharge summaries, and dictation.

Work areas will include the BWH Burn/Trauma, General Surgery, Thoracic Surgery, and Cardiac Surgery ICUs and affiliated areas of patient care (diagnostic units, Emergency Department, perioperative care areas, or any other areas where critical care is delivered for BWH surgical ICU patients). This job requires exposure to potentially infectious material and the use of needles and other sharp instruments.

PA team members will alternate with physician trainees in the scheduled shifts for patient care in the BWH surgical ICUs, including nights, weekends, and holidays. PAs' responsibilities will be physically demanding and may require shifts exceeding 12 hours. Hours per shift and shifts per week may vary week-to-week.

The PA, while not directly overseeing others, should take on leadership responsibilities as follows:

1. Assist in orientation and training of new hires. Be available for questions and support.
2. Assist in orientation, training and mentoring of students, when applicable.
3. Support other team members' performance and development.

The PA will be responsible for accurate, thorough, and compliant documentation to support proper reimbursement of encounters and procedures.

While the PA can expect a relatively predictable work schedule planned in advance whenever possible, scheduling variations may occur in order to cover clinical needs as they become apparent to the department/division/clinic. The PA may be asked to take call, pick up additional shifts, work variable hours, and/or provide backup coverage as needed.

Brigham & Women's Hospital is an Affirmative Action Employer. By embracing diverse skills, perspectives and ideas, we choose to lead. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment.