Description

I.  PURPOSE OF JOB:

To perform, under the responsibility and supervision of the surgeon, diagnostic and therapeutic tasks to allow the physician to extend his services through the more effective use of his knowledge in the sphere of decision-making required to establish diagnosis and to plan therapy.  He/she may assist in gathering the data necessary in implementing the therapeutic plan of the surgeon.  A major role will be as a patient’s advocate in the medical care system serving as confidant, advisor and liaison between patients and physicians. 

II. ESSENTIAL FUNCTIONS:

A.          Assists the surgeon in the preoperative care and work-up of patients.

B.          Assists the surgeon in each surgical procedure. 

C.          Participates in postoperative care of patients, being especially knowledgeable in the recognition of postoperative complications.

D.          Performs therapeutic procedures and assignments as directed by the surgeon and as indicated by his/her training and experience.

III. JOB CRITERIA AND PERFORMANCE STANDARDS:  

A.          Assists the surgeon in the preoperative care and work-up of patients.

1.           Performs and records History and Physical Examination.

2.           Writes routine admission orders and arranges appropriate laboratory and x-ray studies and consultations as per protocol or after consultation with the supervisory/attending physician.

3.           Confirms operating schedule and availability of blood and summarizes appropriate data prior to surgery.

4.           Writes routine preoperative orders.  All orders will be part of a pre-arranged cardiothoracic Surgery protocol or otherwise directed by attending/supervisory physicians. Completes informative discussion with patient and family regarding the planned procedure and hospital course.

5.           Obtains patient’s signature on consent form for procedures to be performed by the cardiothoracic surgeon or PA.

B.          Assists the surgeon in each surgical procedure.

1.      Appropriate prep of patient in OR.

2.           Insertion of monitoring catheters, intravenous lines, and foley catheters.

3.           Performs harvest of saphenous vein and radial arteries for grafting.

4.           Exposes femoral artery and vein for cannulation.

5.           Performs opening and closure of sternotomy incision at the discretion of the surgeon.

6.           Transfer of patient to CVICU.

7.           Completes procedure note in patient’s chart.

8.           Completes postoperative orders.

C.          Participates in postoperative care of patients being especially knowledgeable in the recognition of postoperative complications.

1.           Informs the surgeon of all changes in the patient’s condition.

2.           Assesses the patient’s postoperative course, and transcribe/implement indicated therapy as determined by the cardiothoracic surgery protocol.

3.           Communicates patient progress to appropriate consultants.

4.           Collects data and writes pertinent progress notes on charts.

5.           Communicates with nursing staff to gather information and discuss patient care.

6.           Summarizes details of patient’s hospitalization in discharge summary, including operative procedures and follow-up of complications.

7.           Makes routine rounds as directed by the surgeon.

8.           Communicates appropriate information to family members.

9.           Provides patient with discharge instructions and follow-up appointment.

10.       Responds to phone calls from discharged postoperative patients.

D.          Performs therapeutic procedures and assignments as directed by the surgeon and as indicated by his/her training and experience.

1.           Wound care/debridement and dressings.

2.           Venipuncture and percutaneous arterial catheterization.

3.           Venous and arterial cutdowns.

4.           Arterial punctures for arterial blood gas analysis.

5.           Insertion, use, and removal of intravenous lines, central venous pressure lines and pulmonary artery catheters.

6.           Nasogastric intubation.

7.           Bladder catheterization – insertion and irrigation of Foley catheters.

8.           Insertion, removal, and suctioning of chest tubes.

9.           Management of volume-controlled ventilators.

10.       Assist in the placement of IABP and the management and removal of IABP.

11.       Thoracentesis.

12.       Tube thoracostomies.

13.       Cardiac resuscitation, defibrillation/cardioversion, and overdrive cardioversion.

14.       Record 12-lead ECG and inspect for arrhythmias.

15.       Management and removal of left atrial lines.

16.       Removal of temporary epicardial pacing wires.

17.       Adjustment and removal of surgical drains.

18.       Suture/staple removal.

19.       Emergency sternotomy

20.       Endotracheal intubation/extubation.

21.       Operate Doppler measure equipment.

22.       Available by pager and/or telephone at all times when on call.