Advanced Practice Provider Anesthesia

    • Duarte, CA

Thank you for your interest. Please note, the purpose of this posting is to recruit for on-going and future positions.

About City of Hope
City of Hope, an innovative biomedical research, treatment and educational institution with over 6,000 employees, is dedicated to the prevention and cure of cancer and other life-threatening diseases and guided by a compassionate, patient-centered philosophy.

Founded in 1913 and headquartered in Duarte, California, City of Hope is a remarkable non-profit institution, where compassion and advanced care go hand-in-hand with excellence in clinical and scientific research. City of Hope is a National Cancer Institute designated Comprehensive Cancer Center and a founding member of the National Comprehensive Cancer Network, an alliance of the nation’s leading cancer centers that develops and institutes standards of care for cancer treatment.

Position Summary
An advanced practice provider of anesthesia (APPA) practices both autonomously and in collaboration with a variety of health providers on the interprofessional team to deliver high-quality, holistic, evidence-based anesthesia and pain care services. The APPA cares for patients at all acuity levels across the lifespan in a variety of settings for procedures including, but not limited to, surgical, obstetrical, diagnostic, therapeutic, and pain management. An advanced practice provider of anesthesia (APPA) is a member of a health care team that works in a medically directed model with other anesthesia providers in a collaborative and collegial manner to deliver high-quality, holistic, evidence-based anesthesia and pain care services. The APPA will care for all oncologic patients needing anesthesia services from pediatrics to geriatrics with emphasis in the adult population. Patient acuity ranges for minimal to complex. The APPA will provide anesthesia services for neurosurgical, ENT, thoracic, upper and lower abdomen, orthopedics, and plastic and reconstructive surgery. Our surgical services provide advanced care in minimally invasive surgery with multiple robotic and laparoscopic cases. We have an active endoscopy service for both GI and pulmonary cases. We provide “offsite” anesthesia services for interventional radiology, radiation oncology, CT and MRI scans. We staff in patient surgical OR’s and an outpatient surgical center. The APPA will have the opportunity to provide services for all oncologic patients requiring anesthesia.

Key Responsibilities include:

  • Clinical responsibilities of the APPA are delineated by his or her clinical privileges and may include:
  • Perform and document the preanesthesia assessment and evaluation of the patient.
  • Review, request, and order (as permitted by state law), laboratory/diagnostic studies.
  • Obtain informed consent for anesthesia and related services.
  • Select, obtain, order, and administer preanesthesia medication or treatment.
  • Develop and implement an anesthesia care plan.
  • Select, obtain, prepare, and use equipment, invasive and non-invasive monitors, supplies, and drugs for the administration of monitored anesthesia care, anesthesia, and pain management service; perform safety checks as needed.
  • Select, order, obtain, and administer analgesic and anesthetic agents, adjuvant drugs, accessory drugs, fluids, or blood products necessary to provide anesthesia services.
  • Perform all aspects of airway management, including fiberoptic intubation.
  • Facilitate emergence and recovery from anesthesia by evaluating patient response, and selecting, ordering, and administering medications, fluids, and ventilator support to maintain patient stability during transfer.
  • Initiate and administer post-anesthesia pharmacological or fluid support of the cardiovascular system.
  • Initiate and administer respiratory support to ensure adequate ventilation and oxygenation in the postanesthesia period.
  • Evaluate the patient’s response to anesthesia and surgery; take appropriate corrective action during the postanesthesia period.
  • Provide postanesthesia follow-up evaluation and care.
  • Discharge the patient from the postanesthesia care unit.
  • Implement acute pain management modalities.
  • Manage emergency situations by assessing, stabilizing, and determining disposition of patients, including providing airway management, administration of emergency drugs and fluids, and using basic and advanced cardiac life support techniques.
  • Place and manage regional anesthetic techniques, as delineated by his or her clinical privileges or granted special privileges, and may include:
  • Subarachnoid
  • Epidural
  • Caudal
  • Plexus, major and peripheral nerve block
  • Intravenous regional anesthesia
  • Upper and lower extremity block
  • Diagnostic and therapeutic nerve block
  • Transtracheal, topical, and local infiltration block
  • (no ocular blocks)
  • Intracapsular, intercostal,
  • TAP block
  • Insert and manage peripheral, arterial, pulmonary catheter, or central venous lines and catheters.
  • Provide care to patients in intensive care in accordance with facility policy.
  • Provide patient and caregiver education.
  • Perform arterial puncture to obtain arterial blood samples.
  • Consult with respiratory care providers and implement respiratory and ventilator care.
  • Using an interdisciplinary approach, including consultation or referral to another clinician, as appropriate, integrate non-pharmacologic pain management treatment modalities (e.g., hypnosis, acupuncture, massage, mediation, reflexology, relaxation techniques, biofeedback, counseling, physical therapy, occupational therapy, or therapeutic manipulation).
  • Perform advanced and interventional pain management using drugs, regional anesthetic techniques or other accepted pain relief modalities.
  • Utilize ultrasound, CT guidance, or emerging imaging technology, as appropriate.
  • Use of fluoroscopy in conjunction with a licensed fluoroscopist.
  • Increased clinical responsibilities may be added as additional education and experience is obtained by the individual practitioner.
  • Additional nonclinical responsibilities of the APPA may include, but are not limited to:
  • Quality assessment and quality assurance.
  • Didactic and clinical education of students and staff.
  • Appointment to facility committees and related activities.
  • Interdepartmental liaison responsibilities.
  • Clinical or administrative oversight of other departments (e.g., respiratory therapy, PACU).
  • Supports patient safety when performing his or her job functions and through participation in facility, departmental or unit patient safety initiatives.
  • Takes action to correct observed risks to patient safety.
  • Reports adverse events and near misses to appropriate management authority.
  • Identifies possible risks in processes, procedures, devices and communicates the same to those in charge.

Basic education, experience and skills required for consideration:

  • Graduate of a nurse anesthesia educational program accredited by the Council on Accreditation of Nurse Anesthesia Educational Programs or its predecessor.
  • Is currently certified or recertified by the National Board of Certification and Recertification for Nurse Anesthetists.
  • Insurable by an appropriate medical malpractice insurer for the limits required by this institution or state.
  • Demonstrates current competency in the clinical responsibilities specified below.

Required Certification/Licensure:

  • Holds current active state licensure as a registered nurse in the state of California and complies with any applicable state statutory and regulatory requirements concerning APPAs
  • Is currently certified or recertified by the National Board of Certification and Recertification for Nurse Anesthetists.
  • Insurable by an appropriate medical malpractice insurer for the limits required by this institution or state.

Additional Information:
  • Shift: Days
  • Hours: 8hrs
  • Job Status: Full-time

City of Hope is committed to creating a diverse environment and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex, sexual orientation, gender identity, age, status as a protected veteran, or status as a qualified individual with disability.

City of Hope is a leading nonprofit clinical research center—fighting major life-threatening diseases and delivering hope with exceptional treatment, prevention, and educational programs.

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