Advanced Practice Professional (PA) Geriatric and Palliative Medicine

Basic Function and Responsibility

Palliative Care is a specialized area of healthcare that focuses on relieving and preventing the suffering of patients. Palliative medicine is appropriate for patients in all disease stages, including those undergoing treatment for curable illnesses and those living with chronic diseases, as well as patients who are nearing the end of life. Palliative medicine utilizes an interdisciplinary approach to patient care, relying on input from physicians, nurses, social workers, chaplains, pharmacists and other allied health professionals in formulating a plan of care to relieve suffering in all areas of a patient's life. This interdisciplinary approach allows the palliative care team to address physical, emotional, spiritual, and social concerns that arise with advanced illness.

In general, day to day responsibilities will include 1) providing oversight of direct patient care in inpatient beds dedicated to palliative care, and 2) providing full consultative services when needed, both of which will be in collaboration with an assigned physician.

Palliative Care Inpatient Beds (PCIB)

This will include managing patients consistent with the collaborative practice agreement, to assess, diagnose and treat health problems associated with uncontrolled symptoms due to a life-limiting illness and/or end of life care that requires expert palliative care management. This will also include, exercising autonomy in medical decision-making and provide a moderate range of diagnostic and therapeutic services. Patients will be general floor care status, accommodating needs for telemetry monitoring, opiate infusions via secured pumps, high flow supplemental oxygen, stable BiPAP settings, palliative weaning of inotropes or LVAD discontinuation with guidance from the Cardiology service and nursing. While patients receiving symptom management may be full code, all end of life patients receiving comfort care must be DNAR, as is the policy in the rest of the institution. Evaluation from the Palliative Care Team will determine if PCIB admission is appropriate, based on bed availability.

Inpatient Consultation

This will include evaluating for medical needs surrounding life-limiting illness and/or end of life care which may include symptom management as well as clarification of goals. Many of our patients are approaching death and this position requires the ability to be present with patients and loved ones during times of strong emotion. Through empathetic communication, we help guide patients through determination of goals, redefining hope, reconciliation or other needs as deemed important to them as individuals. Symptom management may require appropriate prescribing of medications and use of complimentary therapies.

Characteristic Duties and Responsibilities

• Perform health assessments including patient history, physical examinations, diagnostic tests and appropriate interventions or referrals.
• Document patient care and progress, and maintain complete and detailed patient records.
• Serve as a preceptor for NP/PA students and fellows.
• Participate in the development of policies, procedures and protocols including standards of care.
• Present workshops, lectures and in-service programs.
• Participate in research projects.
• Perform other related duties as assigned.
• May exercise functional supervision over support staff.

Required Qualifications — NP

• Current licensure to practice as a Registered Nurse and Nurse Practitioner specialty certification in the State of Michigan.
• Current specialty certification to practice as an Adult-Gerontology Acute Care Nurse Practitioner or Adult Gerontology Primary Care Nurse Practitioner and Family Nurse Practitioner.
• Graduate of an accredited Nurse Practitioner program or who has successfully completed all required Nurse Practitioner program coursework at an accredited Nurse Practitioner program to qualify to take their specialty certification exam.
• Certification as a Nurse Practitioner recognized by the National Council of State Boards of Nursing (NCSBN).
• Current DEA registration required.
• AHA approved BLS certification.
• A minimum of two (2) years of experience as an Advanced Practice Professional in subspecialty inpatient palliative care.
• HPNA palliative care certification within 2 years of start date.

Required Qualifications — PA

• Current license to practice as a Physician Assistant in the State of Michigan.
• Satisfactory completion of a physician assistant program accredited by ARC-PA or one of its predecessor agencies.
• Certification by the National Commission on Certification for Physician Assistants (NCCPA).
• State of Michigan Controlled Substance License Required.
• Current DEA registration.
• AHA Approved BLS.
• A minimum of two (2) years of experience as an Advanced Practice Professional in subspecialty inpatient palliative care.
• HPNA palliative care certification within 2 years of start date.

Note: Employment is contingent upon successful completion of the credentialing and privileging process. In order to be considered for this position the applicant must have met or will have met all the required qualifications prior to the start date of employment. You must attach a complete and accurate resume to be fully considered for this position.

Desired Qualifications

• Completion of palliative specialty certification.
• Experience coordinating care of complex patients with chronic illnesses.
• Experience caring for patients with high symptom burden and/or complex conditions requiring multiple consultative services.
• Experience with advance pain therapies.
• Excellent communication, teamwork, and interpersonal skills.
• Flexibility, willingness to support team and program growth.
• Experience with serious illness communication and prognostication.

Work Schedule

Department: Geriatric and Palliative Medicine. Shift: Days. Job Type: Full-time. Rotating Weekends: Yes. Rotating Holidays: Yes.

Pay & Benefits

• Full Time Salary range: $130,630 - $200,734 / year.
• Flexible Health, Dental, and Vision Plans.
• Retirement Savings Plans with 2:1 Matching.
• Group Term Life Insurance.
• Long Term Disability Plan.
• Generous Time Off Allowances.
• $2500 Annual Professional Development Funds (0.5 FTE Appointment or above).
• Paid Release Time for Professional Education Activities.
• Medical Malpractice Insurance.
• Paid Maternity and Parental Leave.
• Tuition Support Program.
• Wellness Plans.
• Work/Life Resources.

Positions that are eligible for hybrid or mobile/remote work mode are at the discretion of the hiring department. Work agreements are reviewed annually at a minimum and are subject to change at any time, and for any reason, throughout the course of employment.

This position is covered under the collective bargaining agreement between the U-M and the United Physician Assistants of Michigan Medicine, which contains and settles all matters with respect to wages, benefits, hours and other terms and conditions of employment.

Michigan Medicine conducts background screening and pre-employment drug testing on job candidates upon acceptance of a contingent job offer and may use a third party administrator to conduct background screenings. Background screenings are performed in compliance with the Fair Credit Report Act. Pre-employment drug testing applies to all selected candidates, including new or additional faculty and staff appointments, as well as transfers from other U-M campuses.