SUMMARY:

The Post-Anesthesia Care Unit (PACU) Nurse Practitioner (NP) functions as an advanced practice provider within Perioperative Services and collaborates with the Department of Anesthesia to provide comprehensive care for postoperative patients and support specialized anesthesia services. The NP works closely with anesthesia, surgical, nursing, and primary care teams to promote safe recovery from anesthesia and facilitate appropriate patient disposition. The role encompasses advanced clinical assessment, critical care management, care coordination, education, quality improvement, research, and evidence-based practice.

Brown University Health employees are expected to successfully role model the organization's values of Compassion, Accountability, Respect, and Excellence as these values guide our everyday actions with patients, customers and one another.

RESPONSIBILITIES:

PACU Clinical Management
Demonstrates a fundamental grounding in advanced practice nursing, critical care, and post-anesthesia recovery. Independently manages PACU patients and collaborates with anesthesia attending physicians and residents, surgeons and surgical residents, surgical and medical NPs/PAs, primary admitting services, PACU staff and charge nurses, and perioperative nursing leadership to coordinate care, interventions, and disposition. Manages approximately 35 to 55 patients daily, depending on census and acuity.

Takes comprehensive histories, performs physical examinations, and evaluates and treats patients based on clinical assessment and diagnostic findings, pursuant to the applicable practice agreement and scope of practice. Identifies, prevents, diagnoses, and manages complex post-operative problems, including hypoventilation, apnea, hypoxia, hypercarbia, narcosis and opioid-induced sedation, altered mental status, delirium, pain, nausea and vomiting, hypotension, hypertension, bradycardia, tachycardia, arrhythmias, heart block, chest pain, surgical-site bleeding, stroke alerts, and other emergent events. Applies knowledge of anesthesia pharmacodynamics to the management of post-operative hemodynamic, respiratory, and neurological alterations.

Orders and manages medications and intravenous fluids; orders and adjusts CPAP/BiPAP therapy when indicated; orders and interprets laboratory studies, electrocardiograms, and chest radiographs, including evaluation of pulmonary conditions and confirmation of line or endotracheal tube placement. Performs arterial blood gas sampling and interpretation, utilizes point-of-care testing (iStat), and places PACU, medication, imaging, and laboratory orders as clinically appropriate. Performs procedures in accordance with approved privileges, skill, and proficiency; exercises prescriptive authority pursuant to licensure.

Assesses recovery from anesthesia and readiness for PACU sign-out, discharge, or transfer to the next level of care. Completes PACU/ICU NP notes documenting readiness for disposition and communicates patient status, required interventions, and sign-out readiness to the anesthesia attending. Initiates referrals and consultations as indicated, facilitates transitions across care settings, and documents and bills for direct care provided.

Education, Professional Practice, and Quality Improvement
Serves as a clinical resource for anesthesia residents rotating through the PACU and provides educational opportunities for PACU as appropriate. Teaches post-operative management, critical care assessment, regional anesthesia, acute pain management, lumbar drain management, care coordination, and patient disposition. Educates patients, families, and caregivers regarding procedures, post-procedural care, expected outcomes, and recovery progress.

Integrates scientific literature and clinical research into evidence-based practice and decision-making. Participates in departmental rounds, continuing education, and quality/performance improvement activities. Contributes to the development, validation, implementation, and evaluation of clinical standards, policies, procedures, protocols, order sets, and clinical pathways. Collaborates with departmental leadership to improve patient safety, outcomes, workflow efficiency, and service quality. Supports accreditation, compliance, and regulatory activities; works to eliminate communication barriers; and completes annual mandatory safety and infection-control requirements.

BASIC KNOWLEDGE
Master of Science degree; graduate of an accredited Nurse Practitioner program. Specialty certification required. Baccalaureate in Nursing. Licensure as a Registered Nurse in the State of Rhode Island by the Rhode Island Board of Nursing or in accordance with the Nurse Licensure Compact agreement of the National Council of State Boards of Nursing. Prescriptive privileges pursuant to licensure. Current Basic Life Support (BLS) certification and Advanced Cardiac Life Support (ACLS) certification.

EXPERIENCE
Two years of related RN experience in a surgical critical care hospital setting; one to two years of Nurse Practitioner experience preferred. Peri-procedural, emergency, or critical care experience preferred.

SUPERVISORY RESPONSIBILITIES
None.

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EEO Statement:

Brown University Health is committed to providing equal employment opportunities and maintaining a work environment free from all forms of unlawful discrimination and harassment.

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