Physician Assistant- Palliative Care

Full Job Description

The Palliative Care Physician Assistant specializes in providing comprehensive, holistic care to veterans experiencing serious illness across the continuum of care.

This involves conducting medical assessments, developing care plans, managing medications and non-pharmacological methods for palliating symptoms related to serious illness, and coordinating with other health care providers to ensure veterans receive care that addresses their physical, emotional, social, and spiritual needs.

Applicants pending the completion of educational or certification/licensure requirements may be referred and tentatively selected but may not be hired until all requirements are met.

Physician Assistant Basic Requirements Master's degree in any discipline or a bachelor's degree in any discipline with one year of experience as a Physician Assistant ~AND~ Successfully passed the PA National Certifying Exam (PANCE) (or are you in the process to taking the exam) ~AND~ Currently hold, or will hold, a full and unrestricted license to practice in a State, Territory, or Commonwealth of the United States or in the District of Columbia.

Grade Determinations: Physician Assistant-I (PA-I) a) Experience and Education. None beyond the basic requirements b) Demonstrated Knowledge, Skills, and Abilities.

The following list of knowledge, skills, and abilities (KSA) present the minimum skill set expected of an Entry Level PA. This practice may include, but is not limited to: i.

Ability to utilize the principles of PA practice in the care of assigned patients to provide appropriate care. ii. Ability to perform patient history and physical. iii.

Ability to formulate a plan and provide treatment to the patient. iv. Ability to provide patient care that is abreast of changing concepts and advancements in the profession.

Physician Assistant-II (PA-II)a) Experience and Education.

The PA at this grade is at the intermediate grade level and has had progressively increasing responsibility and experiences as indicated in the KSAs listed below.

Individuals will have demonstrated the ability to analyze and solve more complex medical problems than at the entry level grade and can utilize their training in the successful practice of patient care and participate in team problem solving.

Individuals demonstrate the KSAs of PA-II intermediate level by: i. Two years of successful practice as a PA.OR ii.

Successful completion of a PA post-graduate residency program sponsored by VHA Office of Academic Affiliations or other postgraduate residency programs accredited by VA, ARC-PA, U.S.

Armed Forces, or another accrediting agency. OR iii. A doctoral degree in a health-related field from an accredited college or university recognized by the U.S. Department of Education.

b) Demonstrated Knowledge, Skills, and Abilities (KSAs).PAs at this level are not required to meet each individual KSA listed below to qualify, but should be able to demonstrate, develop, or acquire those not met upon appointment for PA-II: i.

Skills to analyze and solve complex medical problems. ii. Ability to function autonomously and make independent medical decisions. iii.

Skill to incorporate training and experience into the successful practice of patient care including telehealth medical care. iv.

Ability to work effectively in an interdisciplinary environment for improvement of services for patient care. v. Ability to practice with colleagues and peers collaboratively.

Physician Assistant-III (PA-III) a) Experience and Education.

PAs at the PA-III grade are at the full performance level and lead and organize patient care independently, practice within multi-disciplinary teams, and coordinate all aspects of patient care across the health care system.

They utilize advanced clinical knowledge and judgment in decision-making and evaluating outcomes.

They function as experts in clinical practice and/or in areas related to the assigned roles and responsibilities, may serve as mentors for transitioning PAs, and may provide training for health care students.

Individuals can demonstrate the KSAs for the full performance level by: i. Three years of successful practice as a PA.OR ii.

Successful completion of a PA post-graduate residency program sponsored by VHA Office of Academic Affiliations or other postgraduate residency programs accredited by VA, ARC-PA, U.S.

Armed Forces, or another accrediting agency and one year of professional practice as a PA.OR iii.

A doctoral degree in a health-related field from an accredited college or university recognized by the U.S. Department of Education and one year of professional practice as a PA.

b) Demonstrated Knowledge, Skills, and Abilities.

PAs at this level are not required to meet each individual KSA listed below to qualify, but should be able to demonstrate, develop, or acquire those not met upon appointment for PA-III: i.

Ability to clinically evaluate facility patient care delivery systems and validate or identify barriers to safe and effective patient care. ii.

Skill to consistently demonstrate an elevated level of expertise and autonomy in diagnosing and treating seriously ill, multi-symptomatic patients through facility Focused Professional Practice Evaluation (FPPE) and Ongoing Professional Practice Evaluation (OPPE).

iii. Ability to present clinical findings and recommendations to appropriate management officials. iv.

Ability to clinically facilitate the delivery of patient care in collaboration with health professionals, health managers, and other health care personnel. v.

Ability to implement and initiate clinical changes to established treatment protocols based upon new medical literature research findings to enhance patient delivery care for improved patient outcomes.

vi. Ability to participate clinically in the development of the PA patient care audit processes involving in-depth review and analysis of medical records.

Preferred Experience: Experience in Geriatrics and Palliative Care Reference: For more information on this qualification standard, please visit https://www.va.gov/ohrm/QualificationStandards/.

The full performance level of this vacancy is VN-03. The actual grade at which an applicant may be selected for this vacancy is in the range of VN-01 to VN-03.

Physical Requirements: Heavy Lifting (45 lbs and over); Heavy Carrying (45 lbs and over); Pushing (1 hour); Use of fingers; Both hands required; Walking (up to 3 hours); Standing (up to 3 hours); Repeated bending (1-2 hours); Both legs required; Ability for rapid mental and muscular coordination simultaneously; Near vision correctable at 13" to 16" to Jaeger 1 to 4; Far vision correctable in one eye to 20/20 and to 20/40 in the other; ability to distinguish basic colors; ability to distinguish shades of colors; Hearing (aid permitted).

Major Duties:

Major duties and responsibilities: - Independently manages a panel of patients with terminal illness with an emphasis on symptom management related to illness and discussion of goals of medical care.

- Develops and implements an individualized plan to achieve improved quality of life. - Demonstrates leadership and works collaboratively with the interdisciplinary team.

- Orders and interprets labs, tests, and diagnostic studies. - Prescribes pharmacologic and non-pharmacologic interventions. - Initiates referrals and consults to specialty services.

- Provides education to patients and their families. - Assesses and adjusts the plan of care as needed to achieve optimal patient outcomes.

- Exemplifies the ICARE core values of-Integrity, Commitment, Advocacy, Respect, and Excellence. Clinical Focus: - Responds to all palliative care consults within 48 hours.

- Provides care to inpatient palliative and hospice patients. - Initiates Outpatient consults for Hospice care as needed.

- Provide goal setting with Veteran and family, by initiating, and chairing Veteran/family meetings and recording the outcome of the meeting in the veteran's record to communicate veterans/families' goals for all involved staff to understand.

These meetings may be in the inpatient or the outpatient setting. The veterans attending health care provider is encouraged to attend these family meetings.

Some issues of discussion may include code status, advanced directives, identification of resource needs.

These meetings will include the social worker, and chaplain to be in attendance as much as able.

- Collaborates with veterans and the medical providers caring for the veteran at the time (provider may be urgent care/ER , primary care, specialty care, or hospitalist) to be informed of the history and prognosis of the patient.

- Available to Emergency Medicine as needed, to assist with case-finding and goal setting - Has direct interaction with the veteran and family in various venues, such as primary care visits at the time of the veteran's appointment, Oncology Clinic, subspecialty clinics and acute care settings.

- Review ongoing pain and symptom management with evaluation and adjustments as needed for Veterans under the care of the SLCVHA.

- Special interest/skill in malignant acute pain management with availability to other medical providers for consultation.

- Fills scripts for opioids, palliative care medications and durable medical equipment requests as needed.

- Ensures that their clinical activities are within their Scope of Practice and are medically and ethically appropriate.

Administrative: - Demonstrates leadership and works collaboratively with the interdisciplinary team. - Attends palliative care /hospice team meetings.

- Attends palliative care memorial service, participating as requested. - Assists with evaluating requests made for inpatient palliative care admissions.

- Contributes to local, VISN, and National Palliative Care workgroups or QI as needed. Participating in conference calls as scheduled.

Works to strengthen and progress the overall Hospice and Palliative care service in VISN. This activity is above and beyond normal duties and would contribute to higher level evaluations.

- Other duties as assigned. VA offers a comprehensive total rewards package. Work Schedule: Typically M-F; 0730-1600 or as agreed upon with the needs of the VA.

Some weekend, early and/or late shifts may be required. Telework: Not available Virtual: This is not a virtual position.

Relocation/Recruitment Incentives: Not authorized Permanent Change of Station (PCS): Not authorized