Pediatric Epilepsy Nurse Practitioner - MG-Neurology (1.0 FTE, Days)

Nursing Advance Practice

1.0 FTE, 8 Hour Day Shifts

Work Locations: Primarily Palo Alto, Menlo Park, and Sunnyvale.  Other locations as required for patient care.

Lucile Packard Children's Hospital Stanford is the heart and soul of Stanford Children’s Health. Nationally ranked and internationally recognized, our 311-bed hospital is devoted entirely to pediatrics and obstetrics. Our six centers of excellence provide comprehensive services and deep expertise in key obstetric and pediatric areas: brain & behavior, cancer, heart, pregnancy & newborn, pulmonary and transplant. We also provide an additional, wide range of services for babies, kids and pregnant moms.

The Advanced Practice Provider (APP) is an integral part of the pediatric epilepsy program.  The APP plays an important role in providing care to children with epilepsy. The pediatric epilepsy group is currently composed of six pediatric epileptologists, an epilepsy fellow, epilepsy nurse coordinator, epilepsy care coordinator and a registered dietician. The epilepsy group is integrated within the pediatric neurology division with over 20 practitioners and 4 other nurse practitioners, as well as residents and rotating medical students.    The patient population is a mix of pediatric epilepsy patients with about 60 patients using the ketogenic diet as a therapy for epilepsy.  

When not in clinic, the practitioner will return staff and patient phone calls, email, and MyChart messages, check laboratory and imaging results, assist with complex medication refills, forms for camp, sports and other activities, and school notes. Conversations with school nurses occur weekly. They will coordinate the inpatient video EEG program, scheduling patients for admission and educating families about how to prepare for successful video EEGs. They will assist in coverage for out of town physician patient phone calls and MyChart messages.  Once or twice per month they will teach an inpatient family and pediatric neurology team how to safely initiate the ketogenic diet. With the assistance of the dietician they will teach how to develop a meal plan, assess compliance, order and review laboratory studies, assess for complications and alter medications as needed to obtain ketosis.

Learning and career growth opportunities: Neurology and Pediatric grand rounds, weekly journal club, EEG record review, and epilepsy surgery conference. Nationally, the Association of Child Neurology Nurses meets every October in conjunction with the Child Neurology Society as well as annual and biannual conferences focused on the ketogenic diet. There is opportunity for teaching and program improvement in the care of children with epilepsy.

The APP, following a training period, will evaluate and treat pediatric patients with epilepsy or suspected epilepsy.  They will obtain complete H&P and performs pertinent physical exams with assessment of normal and abnormal findings on new and return patients. Performs or requests and evaluates diagnostic studies, prescribes medications, referrals to physical, occupational, dietary and nursing services, and makes appropriate referrals to other subspecialty services. Adjust setting of the vagal nerve stimulator for treatment of epilepsy.  In collaboration with team, initiates arrangements for hospital admissions and discharges.  Effectively communicates & interacts with patients, families, staff and members of the community from diverse background. Recognizes situations which require immediate attention of the physician, and triages accordingly. The APP will carry out independent visits, 5 half day clinics per week, triaging outpatient calls from families/providers, coordination of care, reviewing clinic lists and triaging new referrals, program development of the ketogenic diet program.  Process improvement, dietitian education, nursing staff education, precepting APP students, designing clinical pathways, local/national presentations, and membership in professional organizations and involvement in these organizations are encouraged and supported.  The APP facilitates collaboration between providers and coordination of community resources, including school nurses, and provides and coordinates patient and family teaching and counseling.

The Nurse Practitioner (NP) functions under this Nurse Practitioner Job Description approved by the Interdisciplinary Practice Committee (IDPC). The NP provides medical evaluation and management of the patient with acute and chronic complaints/conditions, in collaboration with the supervising physician, and through implementation of standardized procedures. Specific functions pertaining to the Service, Clinic or Department are established by the NP and his/her supervising physician(s), and approved by the appropriate medical and nursing administrators, the IDPC, the Credentials & Privileges Committee, the Lucile Packard Children’s Hospital and Clinics. Medical Executive Committee and the LPCH Board Credentials, Policies and Procedures Committee.

Essential Functions

The essential functions listed are typical examples of work performed by positions in this job classification. They are not designed to contain or be interpreted as a comprehensive inventory of all duties, tasks, and responsibilities. Employees may also perform other duties as assigned. 

Employees must abide by all Joint Commission Requirements including but not limited to sensitivity to cultural diversity, patient care, patient rights and ethical treatment, safety and security of physical environments, emergency management, teamwork, respect for others, participation in ongoing education and training, communication and adherence to safety and quality programs, sustaining compliance with National Patient Safety Goals, and licensure and health screenings. 

Must perform all duties and responsibilities in accordance with the Service Standards of the Hospital(s).

A. An NP may provide only those medical services which he/she is competent to perform, which are consistent with the NP's education, training and experience, and which are performed in collaboration with a physician.

B. An NP shall consult with a physician regarding any task, procedure or diagnostic problem which the NP determines exceeds his/her level of competence or shall refer such cases to a collaborating physician.

C. Scope of Practice of the NP:

• Evaluates and treats patients with acute, chronic complaints and health maintenance concerns related to specialty, according to written standardized procedures.

• Obtains complete histories and performs pertinent physical exams with assessment of normal and abnormal findings on new and return patients.

• Performs or requests and evaluates diagnostic studies as indicated upon evaluation of the patient.

• Administers, orders, furnishes and prescribes medications.

• Orders and collects specimens for routine laboratory tests, screening procedures and therapeutic procedures, including blood and blood products.

• Orders physical therapy, occupational therapy, respiratory therapy, radiology examinations and nursing services.

• Performs designated procedures after demonstrated competency, according to written standardized procedures where applicable.

• Obtains informed consent, as indicated.

• Initiates arrangements for hospital admissions and discharges and completes appropriate paperwork.

• As directed by the supervising physician, enrolls patients in investigational studies approved by the Investigational Review Board (IRB), and orders the necessary tests and medications.

• After appropriate training, assists the supervising physician in the operating room. The RN First Assistant directly assists the surgeon and practices under the supervision of the surgeon during the intraoperative phase. The RN First Assistant must adhere to standardized procedures and not concurrently function as a scrub nurse.

• Recognizes and considers age-specific needs of patients.

• Effectively communicates and interacts with patients, families, staff and members of the community from diverse backgrounds.

• Recognizes situations which require the immediate attention of a physician, and initiates life-saving procedures when necessary.

• Facilitates the coordination of inpatient and outpatient care and services as needed.

• Facilitates collaboration between providers and coordination of community resources.

• Ensures compliance with legal, regulatory and clinical policies and procedures.

• Participates in quality improvement initiatives.

• Provides and coordinates patient teaching and counseling.

• Other duties as assigned.

D. Supervision:

• Supervision is provided by the supervising/sponsoring physician with clinical privileges at LPCH, or designated attending physicians in the Clinic, Service or Department. Standardized procedures, approved by the supervising physician(s) and the IDPC, are a mandatory mechanism of supervision. Other mechanisms of supervision used may be:

• Direct on-site, electronic or phone supervision by a supervising physician. A physician

• cannot supervise more than four (4) NPs at one time.

• Chart screens on random charts by the supervising physician or designee.

• Chart audits on random charts as an integral part of selected quality improvement programs.

• Ongoing Professional Practice Evaluation (OPPE) through tracking of performance indicators.

• The NP will receive a formal annual performance evaluation by the Lead Advanced Practice Provider (Lead APP), Director of Advanced Practice or supervising manager/director with input from the Lead APP, supervising physician(s) and/or physician delegates, APP peers and the supervising manager/director. Ongoing Professional Practice Evaluation (OPPE) also occurs through tracking of performance indicators.

Minimum Qualifications

Any combination of education and experience that would likely provide the required knowledge, skills and abilities as well as possession of any required licenses or certifications is qualifying.

Education: Master's or doctoral degree in nursing from an accredited college or university.

Education: Graduate of an NP program accredited by the National League of Nursing Accrediting Commission (NLNAC) or the Commission on Collegiate Nursing Education (CCNE).

Licensure/Certification: Licensure as a Registered Nurse (RN) in the State of California.

Licensure/Certification: Certification as a Nurse Practitioner (NP) in the State of California.

Licensure/Certification: National Board Certification as a Nurse Practitioner (NP) from an agency accredited by the American Board of Nursing Specialties (ABNS).
a. Note: New graduate NPs will be allotted six (6) months from their graduation date to obtain national board certification.

Licensure/Certification: Certification in Basic Life Support (BLS) from the American Heart Association (AHA).

Licensure/Certification: Furnishing license issued by the Board of Registered Nursing (BRN), required only if furnishing medications.

• NPs with six (6) months or more experience, who will need to furnish medications, shall obtain a current furnishing license within six (6) months of hire.

• New graduate NPs, who will need to furnish medications, must complete a minimum of 520 hours of physician-supervised experience in furnishing drug and/or devices to obtain a furnishing license. These hours must be accumulated during a period of time that is no less than six (6) months from hire.

Licensure/Certification: An individual Drug Enforcement Agency (DEA) license issued by the United States DEA for Schedule II-V controlled substances, required only if prescribing controlled substances to outpatients.

• NPs with six (6) months or more experience, who will need to prescribe medications to outpatients, shall obtain a current DEA license within six (6) months of hire.

• New graduate NPs, who will need to prescribe controlled substances to outpatients, must first obtain a furnishing license and then obtain an individual DEA license.

• Note: Controlled substances ordered for immediate patient use in inpatient/outpatient settings will be covered under LPCH's DEA license.

Licensure/Certification: Additional board certification(s) may be required by certain specialties/departments.

 

The Physical Requirements and Working Conditions in which the job is typically performed are available from the Occupational Health Department. Reasonable accommodations will be made to enable individuals with disabilities to perform the essential functions of the job.

 

Equal Opportunity Employer

Lucile Packard Children’s Hospital Stanford strongly values diversity and is committed to equal opportunity and non-discrimination in all of its policies and practices, including the area of employment. Accordingly, LPCH does not discriminate against any person on the basis of race, color, sex, sexual orientation or gender identity, religion, age, national or ethnic origin, political beliefs, marital status, medical condition, genetic information, veteran status, or disability, or the perception of any of the above. People of all genders, members of all racial and ethnic groups, people with disabilities, and veterans are encouraged to apply. Qualified applicants with criminal convictions will be considered after an individualized assessment of the conviction and the job requirements, and where applicable, in compliance with the San Francisco Fair Chance Ordinance.