Career Opportunities

DUTIES AND RESPONSIBILITIES:

Professional 

• Demonstrates collaborative efforts with health team members such as nurses, social workers, infection control staff, etc. 

• Demonstrates compassion and professionalism and a commitment to excellent patient care.

• Demonstrates compliance to the hospital’s Code of Conduct and Employee Standards of Behavior.

• Must be able to work with autonomy within Massachusetts law under direction of supervising physician.

Clinical 

• Performs comprehensive and problem focused history and physical exams (where indicated) on surgical patients admitted through the Emergency Department and on those held for observation , initiates appropriate lab, radiology tests or other special tests required for evaluation of illness, and scrutinizes lab data on new and former patients and hospital admissions to establish a record of the patient's current health status and to develop a working diagnosis and treatment plan, with direct review by a physician. 

• Performs and interprets, at least to the point of recognizing deviations from normal, common laboratory, radiologic, cardiographic and other routine diagnostic procedures used to identify pathophysiologic processes, as privileged.

• Interprets and correlates subjective and objective data to formulate a differential diagnosis and establishes a working diagnosis. 

• Formulates a treatment plan for medical problems within scope of practice.

• Writes initial orders in coordination with the attending physician.

• Implements therapeutic intervention for specific conditions, when appropriate. 

• Exercises judgment on problems requiring consultation, referral, or evaluation by the supervising surgeon or other health care professionals.

• Performs routine procedures such as injections, immunizations, suturing and wound care, managing simple conditions produced by infection or trauma, assisting in the management of more complex illness and injury which may include assisting surgeons in conducting operations and taking initiative in performing evaluation and therapeutic procedures in response to life-threatening situations, as privileged.

• Performs specialized procedures (as requested and under the direction of an attending surgeon), including suturing/stapling of major lacerations, wound debridement, splinting, anterior and posterior nasal packing, bone marrow aspirations/biopsies/harvest, blood draws, designated IV starts, lumbar puncture, central venous line placement, arterial line placement, venous cut downs, chest tube insertions, thoracentesis, paracentesis, foley catheter insertion +/- bladder irrigation, as well as other specific procedures in the Emergency Department and on the inpatient units, with the approved delineation of privileges.

• Provides information and answers routine questions of patients regarding their disease, including preventive health maintenance topics such as diet, weight, smoking and topics related to medical specialty, with basic recommendations.

• Educates patients regarding their disease, treatments, related drug and treatment side effects and hazards. 

• Assists with record keeping, completes appropriate patient medical chart, transcribes lab data and routine correspondence, as directed and reviewed by physician.

• Refers patients to physicians as appropriate for consultation or for specialized health resources and treatment.

• Participates in rounds in ICU and on all in-house surgical patients as required, upon arrival for duty.

• Responds to all Codes.

• Assists Emergency Department physicians in cases of surgical consultation in the Emergency Department, in the evaluation of trauma victims in the ED, and with procedures within the physician assistant’s scope of practice.

• Evaluates and manages the acute care needs of surgical patients in concert with the patient's attending physician.

• Oversees the management of mechanical ventilation  for periods of  <24 hours with supervision from Anesthesia, Pulmonary and/or Critical Care physicians.

• Handles a broad variety of surgical specialty and subspecialty procedures.

• Ensures continuity of care by serving as a liaison between patient and other members of the multi-disciplinary care team or with other specialty areas as necessary.

• Facilitates appropriate length of stay, transfers, discharge planning and compliance with regulatory standards for inpatient management.

• Assists in the operating room, as determined by the ChiefSurgical PA and Chief of Surgery or his/her designee.

• Participates in quality monitoring thru the review of records and treatment plans for patient outcomes on a periodic basis to assure quality care.

• May serve as clinical preceptor for PA students and other health professionals.

• Instituting any major therapeutic intervention with a patient, except in emergencies, only in cooperation and consultation with the patient's attending surgeon.

• Not undertaking any significant change in the management of a patient (i.e., transfusions, change in medications, such as antibiotics in use), except in emergencies, without the knowledge and consent of the patient's attending surgeon.

• Instituting all medically appropriate measures in an emergency situation when the life of the patient is at risk

• Notifying a patient's private physician in the event of the nighttime emergency department admission of the patient.

• Discussion with the Chief of Surgery or designee, as the case may be, of any problems that may arise with regard to physicians' duties and responsibilities.

Major therapeutic intervention can be instituted only in consultation and under the direction of the attending surgeon.

Reporting

• When signing out to day or evening PA, face-to-face reporting is required, along with the completion of sign-out reports.

Medical Records

• Surgical PAs are responsible for dictating & signing

• Discharge summaries and procedure notes, as authorized by attending surgeons

• Daily progress notes

• Consultation notes, as requested by attending surgeons

• All verbal, telephone, and written orders (verbal & telephone orders MUST be signed within 48 hours of original order)

Meetings/Grand Rounds

• Surgical PAs are required to attend appropriate conferences, including Department of Surgery M & M's, Patient Safety & Quality Committee, etc