To consult with, support and educate healthcare professionals caring for behaviorally complex patients and visitors within the University of Michigan Health System. Unlike the traditional psychiatric consultation model, this service is dedicated to improving the skills of medically trained nurses and providers when caring for patients whose behaviors interfere with or compromise medical care during hospitalization.
To assist with the psychiatric and behavioral care of general care inpatients including those who demonstrate agitated and aggressive behavior, have substance abuse or dependence, and/or other psychiatric or behavioral co-morbidities.
In the majority of cases, consultation will involve meeting directly with members of primary clinical team to help modify their approach to patient care and build a more effective rapport with patients/families with the goal of improved outcomes. In some cases, consultation will also involve direct patient assessment and treatment of psychiatric and behavioral symptoms.
Supervision of professional nursing practice is received from the designated nurse director
Supervision for delegated medical functions is received from Psychiatry designated physicians within the Adult Psychiatric Consultation Liaison Service.
Collaborative/Consultative relationships are maintained with other care providers, clinicians, disciplines, and departments.
General supervision will be received from the Director of Advanced Practice Nursing
Assessment of Medical/Psychiatric status
Clarifies consult question from primary team
Reviews current/past documentation
Determines whether consult requires patient assessment versus sole education with primary team and nursing staff.
Complete the following per chart review and/or direct patient assessment, pending consultation needs:
Obtain a relevant medical/psychiatric/substance abuse history
Review medications and diagnostic testing
Perform a mental status exam, including appropriate cognitive testing/bedside screening
Obtain collateral information from nurses, inpatient and outpatient providers, and friends/family as needed
Conduct risk assessments for self-harm and harm to others
Document findings, including assessment and plan, in the medical record
Formulates the appropriate psychiatric/medical differential diagnoses based on the history, chart review, collaboration with the Adult Psychiatric Consultation Liaison Service, mental status examination, and other clinical findings
Thoroughly educates primary team members on the rationale for the differential diagnoses.
Identifies psychiatric, behavioral and medical needs of the individual, patient's family/visitors and treatment team, as a result of the evaluation of collected data
Independently conducts daily rounds with adult inpatient medical units to identify inpatients and/or visitors whose behaviors are interfering with care and/or compromising safety of patient or staff. Such behaviors include verbal and physical escalation, substance abuse or dependence, and/or other psychiatric or behavioral co-morbidities that are limiting progression of care.
Attends daily Rounds with Adult Psychiatric Consultation Liaison Service to discuss coordination of care for shared patients, followed by both services.
Sees select patients with psychiatry consult attending.
Development of a Treatment Plan
Establishes priorities and a mutually acceptable plan of care to maximize the potential health of the individual patient, including delegated medical functions as designated in clinical privileges
Orders and interprets appropriate diagnostic tests
Identifies appropriate pharmacologic agents and educates primary team about how to use these agents most effectively.
Identifies non-pharmacologic interventions, including behavioral plans that involve other medical caregivers or patient supports.
Considers appropriate safety interventions (i.e. suicide precautions, need for 1:1 attendant, elopement concerns, agitation management)
Develops an education plan for primary team and patient/family as indicated.
Implementation of the Plan
Interventions are based upon established priorities and are consistent with the appropriate plan of care including:
• Conducting and interpreting diagnostic tests
• Prescribing pharmacologic agents
Help support non-pharmacologic interventions on medical units, including educating bedside nurses on how to enact behavioral plans
Ensure that safety recommendations are implemented
Provide relevant patient education
Make appropriate referrals to other health professionals and community agencies to improve transitions of care between inpatient and outpatient settings.
Continuous Quality Improvement and Research
Supports institutional and unit goals for quality improvement
Participates in quality improvement activities.
Participates in systematic reviews of records and/or treatment plans for the purposes of self-evaluation, outcome monitoring and/or quality improvement
Supports research by defining research questions, participating and/or conducting research in practice setting
Incorporates and applies research findings to clinical practice
Participates as a team member in the provision of medical and health care, interacting with professional colleagues to provide comprehensive care
Promotes a safe and healthful environment through compliance with regulatory standards and other measures
Education and Professional Development
Participate in the education of health care professionals through mentoring, precepting, teaching through in-services, seminars and other forums
Participate in professional activities that contribute to the advancement of nursing practice, such as participation in professional associations and publication
Develop own clinical knowledge and skills through continuing education programs, course work and professional literature
Participate in self performance evaluation and establishment of plan for self-development and learning.
Abides by the standards of care and standards of practice established by the Department of Nursing, University of Michigan Health System.
Accepts and abides by the Ethical Code for Nursing as established by the American Nurses Association.
Practices within the regulations of the Michigan Public Health Code.
Maintains nurse practitioner specialty certification, both with the appropriate national certification agency (as listed in Required Qualification, below) and with the Michigan Board of Licensing and Regulation.
Incorporates guidelines and standards into practice as established by state and national regulatory bodies and professional organizations.
- Master's degree in clinical nursing
- Current licensure to practice as a registered nurse in the State of Michigan
- Graduation from an accredited Psychiatric/Mental Health Nurse Practitioner program
- Certification by the American Nurses Credentialing Center as a Psychiatric/Mental Health Nurse
- Practitioner Specialty Certification as a Nurse Practitioner by the State of Michigan
- 3 to 4 years of experience as a Registered Nurse, preferably in care of this patient population.
- Minimum of 2 to 3 years of experience as a Nurse Practitioner practicing in a direct patient care role, preferably for behaviorally complex patients.
* Employment is contingent upon successful completion of the credentialing and privileging process.
* Required qualifications must be met by the candidate in order to be interviewed and considered for the position.
** Under Michigan Law, a criminal history check including fingerprinting is required as a condition of employment or transfer for this position.
RESUME REQUIRED (for both internal & external applicants):
You must attach a complete and accurate resume to be fully considered for this position.
- Demonstrated ability to complete history and physical examination; order appropriate diagnostic studies; synthesize information and make informed clinical decisions; develop appropriate care plans responsive to patient and family preferences and needs.
- Demonstrated high level of critical thinking and medical knowledge by using current medical information and scientific evidence for patient care.
- Ability to prioritize assignments and manage a busy work environment
- Demonstrated interpersonal and communication skills that result in effective information exchange and collaboration with patients, families and health professionals.
- Demonstrated excellence and effectiveness as a team player
- Demonstrated excellent verbal and written communication skills, organization and problem solving skills
- Demonstrated ability to utilize the electronic medical record for accessing information, recording evaluations and progress notes
- Demonstrated ability to collaborate with clinical care across multiple patient care services and to communicate assertively as a patient advocate
- Demonstrated commitment to carrying out professional responsibilities, adherence to ethical principles, and sensitivity to diversity
- Demonstrated excellent interpersonal and patient service skills
- Demonstrated ability to prioritize, problem solve, and delegate effectively and efficiently
- Demonstrated ability to develop and maintain collaborative practice
- Demonstrated leadership in a professional healthcare setting and other professional activities
- Ability to work with minimal supervision and as part of a collaborative team with other Psychiatry providers
- Inpatient Psychiatric Nurse Practitioner experience
- Staff RN inpatient psychiatry experience
- Experience as an NP in ambulatory psychiatry
- Experience with psychotropic medication management
- Experience as primary therapist
- Experience as an NP in a medical setting
- Familiarity w/ various therapeutic modalities (CBT, DBT, & BT, etc.)
- Research experience
Employment is contingent upon successful completion of the credentialing and privileging process.
Hours: 40 hours per week
NP TIER: NP MEDICAL SUBSPECIALTY TIER 2
This position is covered under the collective bargaining agreement between the U-M and the Michigan Nurses Association and the U-M Professional Nurse Council union, which contains and settles all matters with respect to wages, benefits, hours and other terms and conditions of employment.
University of Michigan Health System conducts background screening and pre-employment drug testing on job candidates upon acceptance of a contingent job offer and may use a third party administrator to conduct background screenings. Background screenings are performed in compliance with the Fair Credit Report Act.
If you have questions regarding this posting or would like assistance with Advanced Practice Nursing opportunities please contact Nurse and Physician Assistant Recruitment at (734) 936-5183 or e-mail firstname.lastname@example.org. For a current listing of all open APRN job opportunities at UMHS, please visit www.UMnursing.org.
The University of Michigan Health System improves the health of patients, populations and communities through excellence in education, patient care, community service, research and technology development, and through leadership activities in Michigan, nationally and internationally.
Our mission is guided by our Strategic Principles and has three critical components; patient care, education and research that together enhance our contribution to society.
The University of Michigan is an equal opportunity/affirmative action employer.