Lucile Packard Children's Hospital Stanford Physician Assistant/Nurse Practitioner - Neurosurgery - John Muir (1.0 FTE, Days) in Palo Alto, California

Nursing Advance Practice

1.0 FTE, 8 Hour Day Shifts

Note: This position is located at John Muir Medical Center, Concord, CA.

Lucile Packard Children's Hospital Stanford is the heart and soul of Stanford Children’s Health. Nationally ranked and internationally recognized, our 311-bed hospital is devoted entirely to pediatrics and obstetrics. Our six centers of excellence provide comprehensive services and deep expertise in key obstetric and pediatric areas: brain & behavior, cancer, heart, pregnancy & newborn, pulmonary and transplant. We also provide an additional, wide range of services for babies, kids and pregnant moms.

Position Summary

This is a unique position in which the NP/PA utilizes knowledge and clinical expertise in providing specialized health care services to patients and families in the outpatient, inpatient and operating room settings. Diagnostic reasoning, advanced therapeutic interventions and education are key elements in the direct provision of care using a collaborative model. The APP works closely with physician, patient care staff, patients and families to manage plan of care. Works as an autonomous practitioner or in collaboration with a physician, and is directly accountable for making clinical judgments using independent and interdependent decision-making skills. Writes medical orders (medications, tests and invasive procedures) and may perform invasive procedures, and perform or assist with surgical procedures; subject to internal and external rules and regulations credentialing. Functions as a consultant, educator, researcher, resource and role model for patient, families, community, nursing personnel and other health care providers. Evaluates the quality of care rendered; analyzes and promotes system changes to enhance quality of care and organizational effectiveness/efficiency; conducts/utilizes research to promote health and improve health care delivery. Appropriate privileges are required to prescribe pharmacological and medical interventions. The APP obtains privileges to practice within the Stanford Children’s Hospital and John Muir Medical Center as an Allied Health Professional through the Medical Center Medical Staff Organizations with both institutions, according to internal and external rules and regulations. Registered Nurse First Assist certification or privilege for surgical first assist preferred or willingness to complete a formal RNFA program.

The Team: The Advanced Practice Provider (APP) position is part of a collaborative team model of care consisting of Attending Physicians and clinic coordinator who provide care for patients in Pediatric Neurosurgery.

Common Diagnoses: include Brain tumors, hydrocephalus, Spina Bifida, head traumas, craniofacial abnormalities, Chiari malformation.

Common Procedures: include ventricular taps via shunt or reservoir, lumbar punctures, assist with placement and management of EVDs.

Schedule: Full TimeDays (No weekends, nights, calls or holidays)

Learning Opportunities: Include joint meetings with Pediatric Neurosurgery Service at Stanford Children’s Hospital, continuing education through Stanford Hospital and Stanford Children’s Hospital, APP lectures, MD Grand Rounds, etc.

Additional Opportunities: APP Council and Task forces, process improvements.

Essential Functions

The essential functions listed are typical examples of work performed by positions in this job classification. They are not designed to contain or be interpreted as a comprehensive inventory of all duties, tasks, and responsibilities. Employees may also perform other duties as assigned.

Employees must abide by all Joint Commission Requirements including but not limited to sensitivity to cultural diversity, patient care, patient rights and ethical treatment, safety and security of physical environments, emergency management, teamwork, respect for others, participation in ongoing education and training, communication and adherence to safety and quality programs, sustaining compliance with National Patient Safety Goals, and licensure and health screenings.

Nurse Practitioner (NP): The Nurse Practitioner functions under the general Nurse Practitioner Standardized Process Protocol approved by the Interdisciplinary Practice Committee (IDPC). The Nurse Practitioner provides routine care and management of the patient with acute and chronic complaints, in collaboration with the supervising physician and through implementation of standardized procedures. Specific functions pertaining to the Service, Clinic or Department are established by the Nurse Practitioner and the supervising physician(s), and approved by the appropriate medical and nursing administrators, the IDPC, and the Stanford Hospital and Clinics (SHC) Medical Executive Board and Board of Directors.

Physician Assistant (PA): The Physician Assistant functions under the general Physician Assistant Role Description approved by the Interdisciplinary Practice Committee (IDPC). Specific functions pertaining to the Service, Clinic or Department are established by the Physician Assistant and his or her supervising physician(s), and approved by the appropriate medical and nursing administrators, the IDPC, and the Stanford Hospital and Clinics (SHC) Medical Board and Board of Directors.

Must perform all duties and responsibilities in accordance with the Service Standards of the Hospital(s).

A. An NP/PA may provide only those medical services which he/she is competent to perform, which are consistent with the NP/PA's education, training and experience, and which are performed in collaboration with a physician.

B. An NP/PA shall consult with a physician regarding any task, procedure or diagnostic problem which the NP/PA determines exceeds his/her level of competence or shall refer such cases to a collaborating physician.

C. Scope of Practice of the NP/PA:

  • Evaluates and treats patients with acute, chronic complaints and health maintenance concerns related to specialty, according to written standardized procedures.

  • Obtains complete histories and performs pertinent physical exams with assessment of normal and abnormal findings on new and return patients.

  • Performs or requests and evaluates diagnostic studies as indicated upon evaluation of the patient.

  • Administers, orders, furnishes and prescribes medications.

  • Orders and collects specimens for routine laboratory tests, screening procedures and therapeutic procedures, including blood and blood products.

  • Orders physical therapy, occupational therapy, respiratory therapy, radiology examinations and nursing services.

  • Performs designated procedures after demonstrated competency, according to written standardized procedures where applicable.

  • Obtains informed consent, as indicated.

  • Initiates arrangements for hospital admissions and discharges and completes appropriate paperwork.

  • As directed by the supervising physician, enrolls patients in investigational studies approved by the Investigational Review Board (IRB), and orders the necessary tests and medications.

  • After appropriate training, assists the supervising physician in the operating room. The RN First Assistant directly assists the surgeon and practices under the supervision of the surgeon during the intraoperative phase. The RN First Assistant must adhere to standardized procedures and not concurrently function as a scrub nurse.

  • Recognizes and considers age-specific needs of patients.

  • Effectively communicates and interacts with patients, families, staff and members of the community from diverse backgrounds.

  • Recognizes situations which require the immediate attention of a physician, and initiates life-saving procedures when necessary.

  • Facilitates the coordination of iNP/PAatient and outpatient care and services as needed.

  • Facilitates collaboration between providers and coordination of community resources.

  • Ensures compliance with legal, regulatory and clinical policies and procedures.

  • Participates in quality improvement initiatives.

  • Provides and coordinates patient teaching and counseling.

  • Other duties as assigned.

D. Supervision:

  • Supervision is provided by the supervising/sponsoring physician with clinical privileges at LPCH, or designated attending physicians in the Clinic, Service or Department. Standardized procedures, approved by the supervising physician(s) and the IDPC, are a mandatory mechanism of supervision. Other mechanisms of supervision used may be:

  • Direct on-site, electronic or phone supervision by a supervising physician. A physician cannot supervise more than four (4) NP/PAs at one time.

  • Chart screens on random charts by the supervising physician or designee.

  • Chart audits on random charts as an integral part of selected quality improvement programs.

  • Ongoing Professional Practice Evaluation (OPPE) through tracking of performance indicators.

  • The NP/PA will receive a formal annual performance evaluation by the Lead Advanced Practice Provider (Lead APP), Director of Advanced Practice or supervising manager/director with iNP/PAut from the Lead APP, supervising physician(s) and/or physician delegates, APP peers and the supervising manager/director. Ongoing Professional Practice Evaluation (OPPE) also occurs through tracking of performance indicators.

Minimum Qualifications

Any combination of education and experience that would likely provide the required knowledge, skills and abilities as well as possession of any required licenses or certifications is qualifying.

Physician Assistant (PA):

  • Bachelor’s degree or above from an accredited college or university.

  • Graduate of a PA program accredited by the Accreditation Review Commission on Education for the Physician Assistant, Inc.

Nurse Practitioner (NP/PA):

  • Master’s or doctoral degree in nursing from an accredited college or university.

  • Graduate of an NP/PA program accredited by the National League of Nursing Accrediting Commission (NLNAC) or the Commission on Collegiate Nursing Education (CCNE).


Physician Assistant (PA):

  • Licensure as a Physician Assistant (PA) in the State of California.

  • Certification as a Physician Assistant (PA) by the National Commission on Certification of Physician Assistants (NCCPA)

  • Certification in Basic Life Support (BLS) from the American Heart Association (AHA)

  • An individual Drug Enforcement Agency (DEA) license issued by the United States DEA for Schedule II-V controlled substances, required only if prescribing controlled substances to outpatients

  • Additional board certification(s) may be required by certain services/departments.

Nurse Practitioner (NP/PA):

  • Licensure as a Registered Nurse (RN) in the State of California

  • Certification as a Nurse Practitioner (NP/PA) in the State of California

  • National Board Certification as a Nurse Practitioner (NP/PA) from an agency accredited by the American Board of Nursing Specialties (ABNS).

Note: New graduate NP/PAs will be allotted six (6) months from their graduation date to obtain national board certification.

  • Certification in Basic Life Support (BLS) from the American Heart Association (AHA).

  • Furnishing license issued by the Board of Registered Nursing (BRN), required only if furnishing medications

  • An individual Drug Enforcement Agency (DEA) license issued by the United States DEA for Schedule II-V controlled substances, required only if prescribing controlled substances to outpatients.

  • Additional board certification(s) may be required by certain specialties/departments.

Licensure/Certification:Additional board certification(s) may be required by certain specialties/departments.

The Physical Requirements and Working Conditions in which the job is typically performed are available from the Occupational Health Department. Reasonable accommodations will be made to enable individuals with disabilities to perform the essential functions of the job.

Lucile Packard Children’s Hospital Stanford strongly values diversity and is committed to equal opportunity and non-discrimination in all of its policies and practices, including the area of employment. Accordingly, LPCH does not discriminate against any person on the basis of race, color, sex, sexual orientation or identity, religion, age, national or ethnic origin, political beliefs, marital status, medical condition, genetic information, veteran status, or disability. Women and men, members of all racial and ethnic groups, people with disabilities, and veterans are encouraged to apply.