Advanced Practice Registered Nurses / Physician Assistants
Located in Boston and the surrounding communities, Dana-Farber Cancer Institute brings together world renowned clinicians, innovative researchers and dedicated professionals, allies in the common mission of conquering cancer, HIV/AIDS and related diseases. Combining extremely talented people with the best technologies in a genuinely positive environment, we provide compassionate and comprehensive care to patients of all ages; we conduct research that advances treatment; we educate tomorrow's physician/researchers; we reach out to underserved members of our community; and we work with amazing partners, including other Harvard Medical School-affiliated hospitals.
The Nurse Practitioner (NP) is an advanced practice nurse who demonstrates clinical expertise and leadership skills. The NP uses advanced skills in the evaluation, diagnosis and treatment of patients with diseases and adverse health conditions. The NP manages therapeutic regimens for acute and chronic problems associated with such diseases and conditions. The NP provides anticipatory guidance, patient and family education, and psychosocial and emotional support. The NP has prescriptive authority which includes Schedule II through V controlled substances in the Commonwealth of Massachusetts.
The NP meets all requirements of the registered nurse's responsibilities which include assessment, planning, implementation and evaluation of nursing care for a complex patient population. Patients have a wide range of ages, acuity, and hematological and/or oncological diagnoses.
The NP is a member of a multidisciplinary care team that requires effective communication and collaboration with co-workers and staff at the Institute and other collaborating institutions and agencies. The role requires critical thinking, an understanding of research principles and practices, and an expanded scope of clinical practice and leadership that improves the quality of care and advances the practice of nursing throughout the work setting and community. The Mission, Vision and Core Values of the Dana-Farber Cancer Institute are incorporated into all areas of practice.
The Physician Assistant (PA) is responsible for working with the Attending Physicians in the medical and/or surgical management of hematologic (including BMT) and solid tumor oncology patients. The PA has expert knowledge of medical and/or surgical oncology, incorporating knowledge of general internal medicine and medical complications unique to oncology patients in day-to-day management of patients. The PA works closely with the physician and multidisciplinary team to develop and coordinate a plan of care designed to meet the physical, psychological and social needs of patients and their families. Professional collaboration between inpatient and the ambulatory setting is expected by all PAs.
Delivers expert, scientifically based care to patients using advanced skills in the evaluation, diagnosis and treatment of patients with hematological-oncological diseases and adverse health conditions.
Assesses patient and family needs from a holistic viewpoint.
Performs comprehensive physical assessment. Differentiates between normal and abnormal physical findings, and interprets to determine the severity of illness. Recognizes and differentiates oncological emergencies associated with specific diseases and conditions.
Assesses pain and symptom management that includes side effects of chemotherapy and radiation therapy.
Formulates a multidisciplinary plan of care based on identified diagnoses. Continually reassesses plan based on patient's current condition.
Incorporates age-specific interventions related to safety, nutrition, physical limitations, polypharmacy, skin integrity, psychosocial needs and other areas as appropriate in the care provided.
Administers chemotherapy, medications and treatments in accordance with Institute policy and performs procedures as determined by disease center needs.
Documents care reflective of advanced practice, and complies with all Institute, collaborating institution and regulatory agency requirements.
Provides patient and family education, instruction and reinforcement to meet identified learningneeds.
Identifies appropriate community resources to provide continuity of care and makes appropriate referrals to homecare and hospice agencies.
Delegates responsibilities for the performance of selected patient care activities to assistive personnel within established regulations and policies. Provides appropriate and intermittent supervision.
Adheres to the Code of Ethics for Nurses with Interpretive Statements (ANA, 2001) in all aspects of professional practice.
Recognizes and responds to emergency situations appropriately. Maintains BLS certification.
Pursues active membership of local and national professional organizations.
Manages therapeutic regimes and appropriate follow-up care for acute and chronic problems associated with hematological-oncological diseases and conditions.
Prescribes medications, which may include chemotherapy, IV fluid, and blood component therapy in accordance with research protocols, Medical Staff Bylaws, Institute, state and federal regulations, and collaborating institution policies.
Evaluates the patient's response to therapy and appropriately modifies interventions as needed.
Orders consultations, diagnostic and laboratory tests and scans in accordance with research protocols and current practice standards. Completes all requisitions in accordance with DFCI policies and procedures.
Demonstrates awareness of protocols available in the disease center. Complies with clinical protocol requirements regarding appropriate collection and recording of data and information required.
Performs diagnostic and therapeutic procedures in accordance with practice guidelines, research protocols, Medical staff Bylaws, Institute and collaborating institution policies.
Coordinates elective and emergency admissions to collaborating institutions in accordance with the patient's medical condition, research protocols, Medical Staff Bylaws, Institute and collaborating institutions' policies and procedures.
Obtains required consents for treatment and procedures.
Practices according to written guidelines in compliance with the Massachusetts Board of Registration in Nursing. Maintains prescriptive privileges as defined by the Massachusetts Department of Public Health. Utilizes prescriptive authority responsibly for Schedule II through V controlled substances in the Commonwealth of Massachusetts.
Develops and maintains current practice guidelines that specifically describe the nature and scope of the nurse's practice; the circumstances in which physician consultation or referral is required; the use of established procedures for the treatment of common medical conditions which the nurse may encounter; and provisions for managing emergencies. Guidelines must also include a mechanism to monitor prescribing practices including documentation of review with a supervising physician at least every three months; protocols for the initiation of intravenous therapies and Schedule II drugs; specify the frequency of review of initial prescription of controlled substances. The initial prescription of Schedule II drugs must be reviewed within 96 hours.
Monitors prescriptive practice in collaboration with the supervising physician and submits quarterly reports to direct supervisor.
Maintains current Collaborative Practice Agreement signed by NP and supervising physician.
Establishes rapport with patients and families from a variety of cultural, ethnic and religious backgrounds.
Interacts with patients and families in a caring and compassionate manner.
Provides patient and family education related to the disease process, treatment plan, alternatives, symptom management, care and follow up.
Provides care based on the age-specific needs of the patient.
Fosters an environment that is sensitive to the needs of diverse populations, including but not limited to culture, ethnicity, gender, and age.
Manages the environment for patient care providing leadership in the identification and integration of resources to achieve desired outcomes.
Monitors the environment of care with attention to patient safety, and assures compliance with regulatory agency standards.
Complies with Institute, nursing, and collaborating institutions' unit policies, procedures, work rules and standards of conduct.
Develops collaborative relationships with colleagues which facilitate mutual involvement in planning care. Acknowledges and uses expertise of others through formal and informal consultation in planning and evaluating patient care.
Provides leadership in the development and implementation of an integrated plan of care.
Provides leadership in the formulation and achievement of unit goals within Nursing and Patient Care Services, the Disease Center, the Institute and the community.
Assists in defining goals and developing systems and work processes for the unit, Nursing and Patient Care Services, the Institute and collaborating institutions.
Participates in and provides leadership to committees, councils, and initiatives.
Works collaboratively and functions as an effective member of the health care team.
Demonstrates flexibility and the ability to set and change priorities.
Participates in QA/QI projects in the disease center and the Division of Nursing and Patient Care Services.
Fosters and promotes an environment that facilitates professional communication and collaboration with colleagues.
Supports research activities within the Division of Nursing and Patient Care Services, the Institute, and collaborating institutions.
Nurse Practitioner Qualifications
Authorization to practice in an expanded role as a Nurse Practitioner in the Commonwealth of Massachusetts
Current certification from a nationally recognized accrediting body approved by the Massachusetts Board of Registration in Nursing for Nurse Practitioners
Minimum of 24 contact hours beyond generic education in pharmacotherapeutics
Masters degree in Nursing
Minimum of 1 year oncology nursing experience or 1 year Nurse Practitioner experience
Oncology Nurse Practitioner experience preferred
In possession of Massachusetts Department of Public Health and Federal DEA numbers
Certification in Oncology Nursing preferred - OCN, AOCN, CPON
Demonstrated ability to work as an effective member of an interdisciplinary team.
Demonstrated critical thinking, problem solving skills and ability to make independent decisions.
Physician Assistant Qualifications:
A Masters Degree and successful completion of an AAPA/NCCPA accredited Physician Assistant Studies program are required. Must be NCCPA Certified and licensed to practice as a Physician Assistant in Massachusetts. Must maintain current DEA and Massachusetts Controlled Substance Licenses, and complete 100 hours of CME according to national and state regulations during each 2 year period of employment.
A minimum of 2 years of professional experience in an oncology setting, including at least 1 full year of ambulatory oncology experience at DFCI are required.
PA PRIMARY DUTIES AND RESPONSIBILITIES:
Manages all aspects of patient care in collaboration with his/her supervising MD.
Examines patients to obtain information about their physical condition.
Orders and interprets diagnostic test results to obtain pertinent medical information.
Obtains, compiles, and records patient medical data which may include previous notes, consultations, treatment flow sheets, and laboratory, radiology and pathology data.
Prescribes therapy or medications and performs procedures according to DFCI privileges, this may include chemotherapy ordering in a medical oncology practice.
Demonstrates ability to work collaboratively with all members of the care team and all DF/BW staff to promote excellence in patient care.
Responds appropriately to difficult situations, personalities, and is able to maintain composure and work with all members of the healthcare team
Attends disease center staff meetings, tumor boards, and conferences. Completes required training/PA program activities.
Practices in an efficient manner without compromising high level of patient care
Completes documentation of notes based on standard practice of institute.
PA will always ensure coverage for themselves when they are out of the hospital.
The PA will work collaboratively with MD on new patient visits to establish MD/PA team concept and expectations with patient early in care.
At 3 months (earlier if applicable), the PA will begin to see patients independently and will develop and maintain an independent schedule. 30 – 32 hours per week of scheduled clinical time is expected with remainder of the time for administrative tasks/documentation/patient follow-up and coordination of care.
At 6 months (earlier if applicable), the PA will provide coverage for MD when he/she is out of the hospital. They will see acute/walk-ins independently, cross cover for NP/PA disease center team.
Shows excellence in clinical work and participates in program enhancement
Acts as a role model to less experienced PAs
Displays flexibility and a willingness to adapt to the needs of the PA program and disease center as a whole
PA KNOWLEDGE, SKILLS, AND ABILITIES REQUIRED:
Expert knowledge of general medicine and hematology/oncology. Ability to incorporate knowledge of general internal medicine and medical complications unique to oncology patients in day-to-day management of patients.
Must be professional, quality driven, and have the ability to work well within a cohesive group of peers. Exercises highest level of professional judgment and will apply independent originality in solving programs.
Strong communication skills.
Possesses maturity and confidence to work closely with clinicians, therapists, and team members across the organization. Demonstrates ability to work collaboratively with all members of the care team and DF/BWH staff.
Demonstrates a commitment to ongoing clinical education and training.
Able to accept instruction and guidance and assume graded responsibility in complex teamwork, while demonstrating an understanding of procedures, policies, and documentation required to facilitate PA compliance with standards of care.
Dana-Farber Cancer Institute is an equal opportunity employer and affirms the right of every qualified applicant to receive consideration for employment without regard to race, color, religion, sex, gender identity or expression, national origin, sexual orientation, genetic information, disability, age, ancestry, military service, protected veteran status, or other groups as protected by law.