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The APP Pediatric Heart Failure & Transplant Hospitalist provides direct patient care services and performs medical acts under the supervision of the supervisory physician to children 0-21 years of age in an in-patient and out-patient setting in collaboration with the attending physician, fellows, residents, and interns. There may be rare occasions for which it would be appropriate for a CPNP to provide care for a patient beyond the age of 21 for a limited/specified period of time. The APP performs physical exams, collects and documents data, conducts diagnostic and therapeutic procedures, orders and schedules laboratory studies and professional consultations, prescribes appropriate interventions and medications, and provides direct patient care services. The APP contributes to excellence in patient care, research, teaching, and provides leadership in the organization.


Primary hours will be 40 hours/week, Monday – Friday 8a-4p. Holiday schedule will be in accordance with the Duke recognized designated holidays. Schedule may be modified by the clinical or leadership team.

Responsible to

The APP Hospitalist will be responsible to the primary supervising physician, back-up physicians, and to the Duke Hospital Dept of Advanced Clinical Practice Team Leader and Director.

Process of Evaluation

Evaluation will be ongoing and will encompass the six general areas of competency as defined by The Joint Commission (patient care, medical/clinical knowledge, practice-based learning & improvement, interpersonal & communication skills, professionalism and systems-based practice). Annual and midyear evaluations using the ACP PPR process will be conducted by the Dept of Advanced Clinical Practice, in coordination with NP/PA’s primary supervising physician. Ongoing Review of Care and Quality Improvement meetings with supervising physician will be conducted and documented monthly for the first six months, in accordance with Duke University’s and the designated Board’s standards, then at least once every six months in accordance with the NC Medical Board.

Specific Job Responsibilities and Standards

Clinical Expert

  • In collaboration with attending surgeon(s) and/or residents, round daily on patients to assess, diagnose, plan treatment, set priorities and realistic outcomes, and evaluate the effectiveness and cost efficiency of patient care.

  • Provide and coordinate clinical care for service specific patients through established protocols and under the hospitalist supervising physician or back up physician who is either on site or available by pager.

  • Collaborate with the chief resident, residents, fellows, attending other APP colleague’s nurses, and patient resource managers to formulate treatment plans and monitor patient progress.

  • Perform procedures specific to the work environment after demonstrated competency and within the guidelines of scope of practice and credentialing protocols.

  • Assess patients for change in status and institute appropriate interventions. Initiate emergency interventions in an effort to stabilize the patient until physician support arrives.

  • Postoperative stabilization and management.

  • Develop patient care pathways, protocols and guidelines for the management of specific problems in conjunction with physicians and other members of the health care team.

  • Analyze clinical practice patterns so as to provide the best medical care and to increase effectiveness and efficiency.

  • Communicate verbally and in writing all pertinent patient information to supervising MD, nursing staff, patient resource manager, home health agency, and other relevant healthcare providers.

  • Document in the patients’ medical record all relevant data including but not limited to results of diagnostic tests; laboratory results; patients’ condition and response to therapies/interventions; communications with supervising MD.

  • Utilize prescriptive privileges only for identified patient population.

  • Prescriptive authority for prescribing, ordering, and or administering drugs; including (but not limited to) schedule II, III, IV, and V drugs and necessary medical devices.

  • Role model competence in all nurse practitioner / physician assistant advanced skills.

  • Give daily handoff to appropriate attending, resident and/or intern at the end of the shift.


  • Assess educational needs of the patient-care staff and provide one-on-one as well as formal education as needed.

  • Assess educational needs of the patients / families and provide culturally-sensitive patient/family education interventions as indicated.

  • Use non-technical language when educating patients and families. Document all education in patients’ medical record.

  • Implement and evaluate appropriate educational programs for DUHS patient care staff and other healthcare providers as appropriate.

  • Role model and precept healthcare learners through contractual agreements.

Research Utilization and Investigation:

  • Utilize current research and evidence-based decision-making in all clinical practice.

  • Support IRB approved clinical research/trials though a variety of activities.

  • Participate in interdisciplinary quality improvement and/or research activities.

  • Participate in measuring and documenting outcomes.


  • Provide expertise and resource information to other healthcare providers, patients and families, and the community at large related to pediatric diseases.

  • Implement and evaluate appropriate educational programs for referring MDs

  • Develop, implement and evaluate standards of care/practice guidelines/policies and procedures/care maps/protocols within area of specialization.

  • Develop programs and projects in areas of expertise.

Professional Leadership and Development:

  • Participate in at least one professional organization.

  • Meet Continuing Education requirements as designated by the NC Medical Board and/or NC Nursing Board. Maintain professional certification.

  • Enhance the body of knowledge in area of specialization through written publications, oral presentations, posters, continuing education, etc.

  • Maintain all professional requirements for licensure and certification





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Minimum Qualifications:

Duke University is an Affirmative Action/Equal Opportunity Employer committed to providing employment opportunity without regard to an individual's age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex, sexual orientation, or veteran status.

Duke aspires to create a community built on collaboration, innovation, creativity, and belonging. Our collective success depends on the robust exchange of ideas—an exchange that is best when the rich diversity of our perspectives, backgrounds, and experiences flourishes. To achieve this exchange, it is essential that all members of the community feel secure and welcome, that the contributions of all individuals are respected, and that all voices are heard. All members of our community have a responsibility to uphold these values.

Essential Physical Job Functions:

Certain jobs at Duke University and Duke University Health System may include essential job functions that require specific physical and/or mental abilities. Additional information and provision for requests for reasonable accommodation will be provided by each hiring department.


NP: Work requires completion of accredited graduate level Nurse Practitioner program.

PA: Work requires graduation from a Physician Assistant program accredited by the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA) or its predecessor agencies.


NP: Current licensure as a Registered Nurse in the state of North Carolina and approval to practice as an NP.

PA: Licensure as a Physician Assistant in the state of North Carolina.


NP: National certification as an NP

PA: National Commission on Certification of PAs (NCCPA) certification is required


A Master’s degree is required, with a preference for one year’s experience as an APP in an academic healthcare setting preferred.

Life support:



Physical and mental requirements:

Able to clearly articulate scope of practice, and practices within those guidelines as a Nurse Practitioner / Physician Assistant in the state of North Carolina and within the Duke University Health System.

Able to independently seek out resources and work collaboratively to solve complex problems

Able to communicate clearly with patients, families, visitors, healthcare team, physicians, administrators, leadership, and others.

Able to use sensory and cognitive functions to process and prioritize information, perform health assessments, treatment, and follow-up.

Able to use fine motor skills

Able to record activities, document assessments & interventions; prepare reports and presentations;

Able to use computer and learn new software programs

Able to provide leadership in clinical area of expertise and in meeting organizational goals

Able to navigate the Hospital and DUHS to provide clinical expertise to specific patient populations

Able to withstand prolonged standing and walking with the ability to move or lift at least fifty pounds

Able to remain focused and organized

Able to work collaboratively with all levels of personnel