CERTIFIED NURSE PRACTITIONER 42051

07/01/92 B

This is the first level class in the Certified Nurse Practitioner series for positions that provide specialized medical care and treatment to patients in health department clinics, mental health hospitals, and other facilities where physician coverage is typically readily available. Positions in this class assess the health status of patients; gather information for health histories; perform physical examinations and diagnostic procedures; order, interpret, and evaluate tests to identify and assess patients' clinical problems and health needs; record physical findings, develop the care plan, initiate treatment; formulate prognosis based on patient's condition; and manage a variety of acute and chronic health problems under the direction and supervision of a licensed physician. Positions in this class use independent judgment within the scope of protocols, policies, standards, and laws established by the state and the facility. This class is distinguished from the Certified Nurse Practitioner Senior class by the supervision this class receives and its closer working relationship with a licensed physician which places more limits on this class's independence and options when diagnosing and treating illnesses.

Complexity of Work: Performs work of moderate difficulty in providing specialized diagnostic and therapeutic procedures which includes treating a variety of general illnesses. Performs physicals and makes assessments; orders and interprets diagnostic studies; initiates treatment; recognizes complications and determines when the physician should be consulted; submits health care plans and the goals of the individual patients for periodic review and evaluation by the physician; may participate in pre-discharge planning with the patient; may determine when the patient has recovered and release the patient; may order medications with a physician's co-signature; initiates referrals and consultations to other disciplines and specialists; initiates emergency treatment in the absence of a physician; may conduct rounds as part of a multi-disciplinary treatment team; may suture, perform venipuncture, intravenous needle and nasogastric tube insertion and other diagnostic and therapeutic procedures; may coordinate patient care and follow up in large research projects; may counsel and teach health education to patients. Administrative duties may include making employee schedules, developing protocols on patient care, policy development, participation in quality assurance reviews, patient record reviews, and may act as a consultant to other nursing staff.

Supervision Given: Supervision is not typically a factor but positions may provide technical expertise. If supervision is a factor, usually those supervised are Registered Nurses, other ancillary health care classes, and office services support classes.

Supervision Received: Clinical direction is received from a licensed physician. Administrative supervision may be received from a physician or an administrator. Positions in this class are responsible for providing necessary diagnosis and treatment as overseen by a physician.

Scope: Provides diagnostic and therapeutic services to an assigned caseload.

Impact of Actions: The availability and oversight of a physician may typically limit severe complications and adverse actions and results. Good judgments will positively affect the patient's health and well-being, and generate public acceptance of the effectiveness of the treatment facility.

Personal Contacts: Frequent internal and external contacts with patients, families, and other professionals within the treatment setting and in the local community.

Knowledge: Working knowledge of assessment, diagnosis, treatment planning and execution in the area of certification. Working knowledge of supervisory techniques and/or teaching principles of assignment.

Skills: Considerable skill in performance of diagnostic and therapeutic procedures within the area of certification.

Abilities: Demonstrated ability to communicate effectively with patients and other professionals, to document findings accurately and thoroughly, to recognize legal limits in practice, to obtain and interpret clinical data and draw satisfactory conclusions, and to assess emergency situations and take appropriate action.

QUALIFICATIONS GUIDE*

License or Certification: Licensed as a Registered Nurse and certified as a Nurse Practitioner in the state of Virginia.

Education or Training: Successful completion of an approved Virginia Board of Nursing training program for nurse practitioners.

Level and Type of Experience: None.

An equivalent combination of training and experience indicating possession of the preceding knowledge and abilities may substitute for this education and experience.

This class, formerly titled Certified Nurse Practitioner A, was revised and retitled as part of the Classification Review/Specification Update Program, effective July 1992.