CERTIFIED NURSE PRACTITIONER SENIOR 42052

07/01/92 B

This is the second level class in the Certified Nurse Practitioner series which provides specialized medical care and treatment to patients in health department clinics, mental health hospitals and other facilities where physician availability is typically limited. 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 and develop the care plan; initiate treatment; formulate prognosis based on the 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 facility. This class is distinguished from the Certified Nurse Practitioner class by its limited access to physician oversight and greater independence in diagnosis and treatment for a large variety of illnesses. This class is distinguished from the Registered Clinical Nurse Specialist class by its responsibility for medical diagnosis, and responsibility to initiate medical treatment in the absence of a physician in accordance with established protocol.

Complexity of Work: Performs work of considerable difficulty in providing specialized diagnostic and therapeutic procedures which includes treating a variety of general illnesses and providing special care. Performs physicals and makes assessments; orders and interprets diagnostic studies; recognizes complications and determines when the physician should be consulted; submits health care plans and the goals of 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 multidisciplinary 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 classes.

Supervision Received: General clinical direction is received from a licensed physician. This involves carrying out responsibilities with little supervision. Positions in this class are responsible for providing necessary diagnosis and treatment with the approval of a physician in accordance with protocol. Administrative supervision may be received from a physician or an administrator.

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

Impact of Actions: Negligent actions may result in death or other severe complications for the patients and negative publicity or lawsuits from the public. Good judgments will positively affect the patients' health, 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: Considerable knowledge of assessment, diagnosis, and treatment planning and execution in the area of certification. Working knowledge of supervisory techniques and/or teaching principles of assignment.

Skills: Considerable skill in the 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 Commonwealth of Virginia.

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

Level and Type of Experience: Some experience as a Certified Nurse Practitioner.

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

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