Summary

The Cardiothoracic Surgery Physician Assistant (PA) works directly under a supervising physician (SP) within the Surgery Section. They PA acts as an agent of his SP and will exercise no independent authority. The PA and a SP will be in daily communication regarding care of patients on the service.

Duties

• VA offers a comprehensive total rewards package
• Work Schedule: 8:00am to 4:30pm - Monday through Friday Relocation/Recruitment Incentives: Not Authorized The Cardiothoracic Surgery PA acts as an agent of his Supervising Physician (SP) and will exercise no independent authority
• Each Cardiothoracic surgery attending will supervise the PA which on call for the service
• The PA and a SP will be in daily communication regarding care of patients on the service
• The major duties and responsibilities include - but are not limited to: Perform initial and interim histories and physicals (H&Ps) on all inpatients and outpatients assigned to the Cardiothoracic Surgery Section
• Perform initial CT surgery consultations as requested by the Emergency Department - other inpatient services - and/or outside referrals in clinic
• Screen patients to determine the need for hospital admission and may so admit patients when indicated after informing SP or his designee of the decision to admit
• Order and initially interpret tests including but not limited to blood lab work - such as chemistry - CBC - liver function tests - lactate - BNP - HgbA1c - PT/PTT - INR - TSH and thyroid tests - type and cross - hepatitis screens - MRSA screens - hematologic panels - urinary analysis - micro - all cultures - pathology - ECG - medical imaging studies - such as x-rays - echocardiograms results - ziopatch results - catheterization results - as well as other procedures needed for ensuring adequate diagnosis - differentials - and continued health maintenance
• Initiate or expedite requests for consultation - special test and studies on assigned patients and will keep the SP or his designee apprised of results and progress
• Make rounds on assigned inpatients and write interim progress notes and may write or dictate the discharge summary
• Initiate social work consultation - work with social work on patient needs - initiate physical therapy and occupational therapy consultation - and work with therapists on patient care needs
• Initiate specialty consultation to include but not be limited to endocrine consultation for diabetes - vascular surgery consultation - general surgery consultation - infection disease consultation - hematology/anticoagulation consultation - neurology consultation - pulmonary consultation - and cardiology/CHF/EP consultation
• Provide necessary patient education and apply currently accepted preventive health care measures to our patients and/or their families
• Monitor and evaluate the need for reordering medications which are routinely required for maintenance of various chronic medical conditions including - but not limited to - HTN - DM - COPD and arthropathies
• Order or transmit an order for x-ray - other studies - therapeutic diets - physical therapy - occupational therapy - respiratory therapy - and nursing services and will be required to co-sign (certify) treatment plans developed by rehabilitation therapists
• Document in the medical record consultations required for initiating or continuing medications
• The PA will document controlled substances he/she administers or transcribes secondary to an order by a supervising physician for a particular patient
• The entry will include the name of the SP
• Evaluation of daily ECGs - adjustment of medications for heart rate and blood pressure with appropriate consultation - consultation with cardiology regarding pacemaker - treatment of atrial fibrillation with po and IV medication
• Evaluation of daily CXRs with adjustment of diuretics
• Adjustment of medications for glucose control under supervision of physician or endocrine consult
• Initiation of anticoagulation - po or IV and adjustment as needed to therapeutic dosing
• Reversal of anticoagulation as needed for over anticoagulation - therapeutic procedure - or preoperative planning.