PHYSICIANS ASSISTANT/NURSE PRACTITIONER

Job Specifications

Class Code:	PJ3
Analyst: JAD

Date Originated:

4/88

SANTA CRUZ COUNTY

DEFINITION

Under direction, to provide professional level primary health care to patients with complex chronic and acute health conditions in a variety of outpatient clinics and detention facilities; to perform physical examinations and to diagnose and treat patients; and to do other work as required.

DISTINGUISHING CHARACTERISTICS

This broad class specification combines the professions of Physicians Assistant and Nurse Practitioner. Positions in this class are responsible for providing, under a Physician's supervision, primary outpatient diagnosis, treatment, rehabilitation and support services for a wide variety of high risk patients with complex chronic and acute health and psycho- social conditions. Positions in this class receive medical direction from a Physician and administrative supervision from a program manager. This class is distinguished from the class of Public Health Nurse and Clinic Nurse in that this class is licensed to perform diagnostic and therapeutic procedures which are not within the scope of the Registered Nurse license or the Public Health Nurse certificate. Physician's Assistants must complete a Primary Care Physician's Assistance Training Program and are required to work under the medical supervision of a licensed physician who is approved by the Board of Medical Quality Assurance. Nurse Practitioners must possess a Registered Nurse license, complete training for Nurse Practitioner certificate(s), function within the scope of their license and certification, and perform under standardized procedures.

TYPICAL TASKS

Assesses the health of patients to determine physical and psycho-social status by taking a complete and detailed history, by performing a physical examination, by ordering screening and diagnostic procedures such as EKG's, X-rays and scans, and by identifying abnormalities; evaluates results of clinical findings and laboratory tests; develops diagnosis; records and presents pertinent data to the supervising/ collaborating physician if necessary, develops treatment plans, treats conditions and coordinates follow-up care; makes referrals for further diagnosis and for treatment in difficult or specialized cases as appropriate; performs routine therapeutic and minor surgical procedures such as administering injections, incising and draining skin infections, caring for superficial wounds, lacerations and burns, removing foreign bodies and lesions from the skin, and administering subcutaneous local anesthesia; performs routine laboratory and screening techniques such as drawing venous blood and interpreting laboratory findings, taking cultures, performing pulmonary functions tests, tonometry, and audiometry, performs pelvic examinations, takes PAP smears and performs other appropriate procedures; provides family planning counseling and prescribes contraceptives and birth control devises; cares for pregnant women including assessing normal and abnormal fetal and maternal well-being; pro vides treatment for communicable diseases, i.e., sexually transmitted diseases and tuberculosis; provides counseling, testing and follow-up for individuals with AIDS, or those at-risk for acquiring AIDS; assess and manage temporarily and permanently disabled patients; recognizes and evaluates patients who require the immediate attention of a physician; administers emergency medical treatment as required; instructs and counsels patients regarding matters pertaining to their physical and psycho-social health, such as diets, social habits, family planning, normal growth and development, aging, and their diagnosis and long-term management of their disease; serves as a multi-discipline team member to manage high-risk health cases; manages patients in crises including physical or sexual abuse cases using an inter- disciplinary network of psychological and social services; provides direction concerning the medical management of patients to nursing and other treatment team staff; coordinates and facilitates referrals to other County agencies and other community services or resources; maintains records, prepares reports; may input, access and analyze data using a computer; attends meetings; may prepare in-service training; may prepare schedules; assists in updating clinic protocols or standardized procedures.

EMPLOYMENT STANDARDS

Knowledge:

• Working knowledge of the principles, practices and procedures used to detect, diagnose and treat common health problems;
• Working knowledge of medication and drugs commonly prescribed, including medications therapeutic effect, side effects, reactions and contraindications;
• Working knowledge of the scope of responsibilities, diagnosis and treatment techniques and procedures applicable within specific licensure and assignments (note: licensure and certification requirements may vary depending on assignments);
• Working knowledge of the control and care of chronic and communicable disease, illness and handicapping conditions;
• Working knowledge of the normal and abnormal values of laboratory tests and their clinical significance;
• Working knowledge of medical laws and regulations and the ethics of patient care;
• Working knowledge of basic interviewing and counseling techniques;
• Some knowledge of community resources and referral systems;
• Some knowledge of the services provided by local health agencies.

Ability to:

• Assess health status of patient;
• Take complete medical history, perform physical examinations, evaluate results and identify abnormal health conditions;
• Identify and manage health problems;
• Develop and implement treatment plans for patients according to standardized procedures and protocols;
• Analyze and interpret health information and data including laboratory test results;
• Order laboratory procedures and appropriate prescriptions under standardized procedures and policies;
• Use specialized equipment such as doptone and microscope;
• Establish and maintain effective working relationships with others;
• Write clear and concise medical reports;
• Instruct and counsel patients on matters pertaining to health;
• Recognize and evaluate situations which call for the immediate attention of a physician;
• Work effectively under pressure in stressful and emergency situations;
• Deal effectively with manipulative, hostile and sociopathic behavior;
• Learn to access, input and analyze data using a computer terminal.

Training and Experience: Any combination of training and experience which would provide the required knowledge and abilities is qualifying. A typical way to obtain these knowledge and abilities would be:

Possess one of the following certificates or licenses:

• Pursuant to Section 3503 of the Business and Professions Code, possess a California license to practice as a Physicians Assistant.

OR

• Pursuant to Section 2835 of the Business and Professions Code, possess a California certificate to practice as a Nurse Practitioner.

OR

• Pursuant to Article 2.5 of the Business and Professions Code, possess a certificate to practice as a Nurse-Midwife.

SPECIAL QUALIFICATIONS

In addition to the core requirements for this class, incumbents may be required to possess credentials demonstrating specialties in any one of the following areas for certain positions.

Nurse Practitioners:

• Family Practice NP
• OB-GYN NP
• Family Planning NP
• Pediatric NP
• Geriatric NP
• Certified Nurse Midwife

Physicians Assistants:

• Women's Health Care Specialist

Bargaining Unit: 41
EEOC Job Category: 02
Occupational Grouping: 57
Workers Comp Code: 0290