HEALTH CARE PRACTITIONER
(NURSE PRACTITIONER) (PHYSICIAN ASSISTANT)

DEFINITION

This is advanced professional nursing/physician assistant work performing health care services for patients/residents in a state facility or program under a collaborative or supervision agreement with a physician.

An employee in this class provides health assessments, develops and implements healthcare plans, prescribes medications, and consults with other health care staff in providing general medical care.  Under a collaborative or supervision agreement and jointly agreed upon protocols or standing orders that are specific to clinical conditions being treated by the collaborating/supervising physician and collaborating nurse practitioner or physician assistant, the employee functions in the advanced nursing role of nurse practitioner or in the advanced physician assistant role.  Work involves performing diagnostic procedures requiring advanced training and skills, performing physical examinations, initiating screening and diagnostic procedures, taking health histories and initiating treatments.  Work may include teaching, supervising, or orientating health care staff.  Work performed is highly independent within the limits of established policies of the agency and the Nurse Practice Act and/or other state statutes.  General supervision is received from a Medical Director or other designated superior.

Any one position may not involve all of the specified duties or knowledges, skills and abilities, nor are the listed examples exhaustive.

EXAMPLES OF WORK

Functions as an advanced nurse practitioner and applies advanced nursing principles to effectively diagnose and treat patients/residents in collaboration with a physician, or functions as an advanced physician assistant and applies professional standards to effectively diagnose and treat patients/residents under physician supervision.

Assesses health care status, in collaboration with patients and their families, by obtaining a complete health data base that includes health history, physical examination and diagnostic procedures to determine current and/or potential health needs.

Initiates and interprets laboratory tests; initiates treatments and provides follow-up care as indicated according to professional standards and the collaborative/supervision agreement.

Prescribes medications related to the medical conditions of patients.

Makes rounds of unit and/or facility to determine status of patients; reviews medical records and nursing reports and consults with patients.

Directs and supervises the work of subordinate staff.

Provides professional expertise and technical assistance to health care staff.

Participates in consultation, referral and collaboration activities with other health care staff.

Develops and implements health care plans by examining patients, diagnosing illness and determining the course of treatment.

Participates in additional professional responsibilities of monitoring quality assurance and attending meetings involving departmental staff and/or professional organizations.

Establishes and signs a practice agreement annually with the collaborating/supervising physician.

May provide on-site preceptorship for student nurse practitioners.

Performs other related duties as assigned.

KNOWLEDGE, SKILLS AND ABILITIES

Considerable knowledge of current professional medical practice and nursing theory and practice.

Considerable knowledge of and clinical competence in, nursing or physician assistant assessments of health and illness conditions, prevention and treatment.

Knowledge of current medications, including administrations and their actions and use.

Skill in identifying patients’ problems, symptoms, behavioral changes, and deviations from the normal.

Skill in making physical and developmental assessments and developing nursing care or medical care plans including conducting histories, initiating diagnostic tests, interpreting test results, making diagnoses, initiating appropriate treatments and/or making referrals.

Ability to function in the primary care advanced practice-nursing role of nurse practitioner or to function in the primary care physician assistant role and to follow professional standards, agency policies, state statutes and collaborative/supervision agreements.

Ability to supervise professional and technical health care staff.

Ability to develop and maintain effective working relationships with patients, staff and other health care professionals.

EXPERIENCE AND EDUCATION QUALIFICATIONS

(The following entrance requirements are used to admit or reject applicants for merit system examinations, or may be used to evaluate applicants for employment in positions not requiring selection from merit system registers. When applicable, equivalent substitution will be allowed for deficiencies in experience or education.)

Possession of a current Document of Recognition as a Nurse Practitioner from the Missouri State Board of Nursing and possession of a current Missouri license as a Registered Nurse.

OR

Possession of current Certification by the National Commission on Certification of Physician Assistants, and possession of a current Missouri license as a Physician Assistant from the Missouri State Board of Registration of Healing Arts.

(Revised 5/1/05)