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Cardiologist

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Cardiologist

Job ID R1005
Job Location Nellis AFB, NV
Category
Full-Time/Part-Time Full-Time

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SUMMARY

The Cardiologist provides care to all DOD Service members, dependents, Veteran Administration Services, other beneficiaries and civilian patients in the Nellis AFB vicinity. The Internist - Cardiology is responsible for cardiology including the evaluation, diagnosis, treatment and provision of consultation to patients of all ages presenting with diseases of the heart, lungs and blood vessels. This position manages complex cardiac conditions and may provide care to patients in the intensive care setting. The Cardiologist also supports inpatient service consultation during normal scheduled hours, pacemaker insertion (if credentialed), percutaneous coronary interventions, as well as teaching programs.

ESSENTIAL DUTIES AND RESPONSIBILITIES

Essential duties and responsibilities include the following. Other duties may be assigned.

Responsible for the integration of CNI Core Competencies into daily functions, including: commitment to integrity, knowledge/quality of work, supporting financial goals of the company, initiative/motivation, cooperation/relationships, problem analysis/discretion, accomplishing goals through organization, positive oral/written communication skills, leadership abilities, commitment to Affirmative Action, reliability/dependability, flexibility and ownership/accountability of actions taken.

Demonstrates experience in using pharmacological agents in patient treatment and cardiac testing, the desired effects, side effects and complications of their use, as well as the accurate administration of the pharmacologic agent, including dosage calculations.

Demonstrates the performance and interpretation of noninvasive cardiology evaluation including ECG’s, Ambulatory ECG’s, treadmills and Echocardiograms.

Completes all casework and documentation of care in accordance with approved protocol and applicable Air Force, DoD and Federal regulations while promoting the safety and confidentiality of patients and their data at all times.

SPECIFIC TASKS & REQUIREMENTS FOR: INTERNIST-CARDIOLOGY –CATHETERIZATION LABORATORY:

Demonstrates knowledge of interpersonal relationships and the ability to maintain composure and react appropriately while relating to patients, families, physicians, coworkers and ancillary staff. Maintains positive rapport with all individuals involved in patient care.

Subspecialists in Interventional Cardiology performing a range of procedures to include angioplasty and percutaneous intervention of atherosclerotic disease.

Conducts initial evaluation, consultation and follow up care, including pacemaker clinic.

Performs transesophageal echocardiograms.

Performs diagnostic cardiac catheterizations.

Follows and provides medical care for the internal medicine problems of cardiology patients.   

Provides proper care and evaluation of post procedural patients.

Administers prescribed medications to include multiple medication drips and intravenous push drugs (e.g., sedatives, narcotics, vasoactive medications, neuromuscular blockades, antidysrythmics, antihypertensives, thrombolytics and emergency drugs). Administration consideration based on protocols, policy and recommendations by medical references.

Performs placement and management of an intra-aortic balloon pump.

Assesses and documents patient response to medications administered and intervenes if desired response is not achieved. 

Instructs patient/family regarding prescribed medications/therapies and invasive/diagnostic procedures that must be accomplished.

Maintains open communication lines, both intra-departmentally and interdepartmentally, to provide for total needs of the patient. 

Conducts preoperative and postoperative visits. Discusses Cardiac Catheterization and diagnostic cardiac testing procedures with patients and informs them of what to expect during procedures.

Consults with the physician performing the procedure and establishes priorities of care for each patient.

Coordinates with other hospital units, which include recovery room, intensive care and nursing units on patients’ progress and any special equipment or supplies that will be needed for the patient post procedure.

Demonstrates ability to interpret cardiac rhythms and their implications, intervenes on emergent changes.

Cares for patients with a variety of hemodynamic monitors to include pressure lines/transducers, Swan Ganz catheters, central venous lines/sheaths and arterial lines. Obtains hemodynamic parameters and interprets results. 

Participates in Discharge Planning as appropriate.

Demonstrates knowledge specific to the Catheterization Laboratory population to include all ages from young adult to geriatrics.

Assesses patients' conditions for potential or life threatening crises. Distinguishes between normal and abnormal physical findings (from physical assessment and vital sign assessment).

Coordinates patient care though a continuum and facilitates the achievement of optimal outcomes in relation to care, quality and cost effectiveness.

Demonstrates the ability to react with alertness and skill in any emergency situation, (e.g., cardiac or respiratory arrest, hemorrhage and shock). 

Ensures compliance with standards of care and practice in accordance with all established policies, procedures and guidelines used in the medical treatment facility. Provides care within ethical and legal boundaries.

Assesses patient/family knowledge level, implement plan of instructions and records patient/family demonstrated level of understanding.

Provides professional medical care to patients undergoing Cardiac Catheterization Laboratory and diagnostic cardiac testing procedures.

Communicates effectively and collaborates with a diverse group of people for the purpose of informing the healthcare team of plans/actions, for teaching/education to benefit the patient/family and organization. Effectively uses appropriate communication format in addressing professional issues.

Obtains patient history, pertinent family history and documents in patient’s medical record.

Utilizes appropriate nursing personnel to assist in delivery of care when indicated (e.g., paraprofessionals).

Demonstrates knowledge of laboratory test values.

Participates and complies with quality and process improvement activities and events, including, but not limited to, post procedure follow-ups, morbidity and mortality studies and research studies to ensure compliance with national standards and guidelines.

Serves and participates in committees, functions and other meetings as directed. Provides relevant and timely information to these groups, and assists with decision-making and process improvement.

Participates in quality customer service.

Demonstrates the ability to initiate life saving measures.

Completes orientation, competency verification and educational programs in accordance with unit guidelines.

Independently performs pericardiocentesis.

Participates in multi-disciplinary rounds; conducts education rounds with the residents and students to include supervising office and consultations and giving academic lectures.

Facile/expert with ultrasound/cardiac echo for arterial access, pericardiocentesis and diagnosing emergent cardiac conditions.

Facile/expert with determining the ASA and Mallampati scores/determinations.

Facile/expert with conducting time-out and pre-procedural verification before any procedure, invasive or not.

Reviews MDGI 44-110 and 44-118 on an annual basis. Signs off with Flight-Commander on an annual basis.

Reviews/conducts code cart training on a semi-annual basis. Participates with the cardiac catheterization laboratory staff in this endeavor.

Responds to STEMI activation in accordance with ACC Chest Pain Accreditation requirements.

Supports cardiac catheterization laboratory inventory management by helping to give guidance on required type and quantity of items.

Demonstrates routine use of IVUS for coronary stent implantation to assess quality of stent implantation.

Participates in cardiac catheterization lab quality improvement and accreditation processes to include the ACC Chest Pain with PCI Accreditation.

Participates in Peer Review and OPPE.

INPATIENT SERVICES:

Conducts inpatient consultation services during normally scheduled hours and on-call hours of performance.

Performs temporary pacemaker insertion.

Participates in teaching programs, which includes the following:  Provide one-on-one instruction for adult nurse practitioner students, physician assistant interns, medical students, interns and residents in the form of clinical rotations as requested by the Director of Education.

Manages critically ill cardiac patients in the ICU.

Consults with appropriate specialists.

Writes initial admission orders.

Utilizes paraprofessionals, as appropriate.

Responds to and provides management of cardiopulmonary arrests.

Interprets:  electrocardiograms, exercise stress tests, ambulatory ECG’s, cardiac monitoring, stress echocardiograms and transesophageal echocardiograms.

Performs and interprets echocardiograms.

Provides basic radiographic interpretation.

Performs arterial puncture.

Performs infiltration of local anesthesia.

Prescribes and administers drugs.

Supervises dobutamine stress echocardiograms.

Supervises vasoactive medications for coronary computed tomography angiography.

Facile/expert use of iFR, FFR at the time of coronary revascularization.

Facile/expert use of coronary intravascular ultrasound at the time of coronary revascularization

Deployment and management of arterial closure and compression devices.

Responsible for aiding in own self-development by being available and receptive to all training made available by the company.

Plans daily activities within the guidelines of company policy, job description and supervisor’s instruction in such a way as to maximize personal output.

Responsible for keeping own immediate work area in a neat and orderly condition to ensure safety of self and co-workers. Will report any unsafe conditions and/or practices to the appropriate supervisor and human resources. Will immediately correct any unsafe conditions as the best of own ability.

EDUCATION/EXPERIENCE

Doctor of Medicine (MD) degree or a Doctor of Osteopathic Medicine (DO) degree and a minimum of eight (8) years’ of experience.

Must have worked a minimum of 12 months within the last 24 months, in the Cardiac catheterization lab and have met a minimum standard to perform interventions as dictated by the Society of Cardiac Angiography and Interventions/ACC (American College of Cardiology).

Must provide evidence of and maintain malpractice insurance compliant with applicable state and federal licensing authority of $1 million per incident and $3 million per total.

CERTIFICATES, LICENSES, REGRISTRATION

This position requires possession of or the ability to obtain and maintain a security clearance

Current board certification by the American Board of Internal Medicine or the American Osteopathic Board of Internal Medicine, in Cardiovascular Medicine or equivalent organization

Current (and maintain) certification in Basic Life Support (BLS) and Advanced Life Support (ALS) by either the American Heart Association or the American Red Cross or equivalent organization

JOB SPECIFIC KNOWLEDGE / SKILLS / ABILITIES

Must be able to stand while wearing up to 25 pounds of PPE for up to 4 hours

Excellent written communication skills to perform accurate documentation, both written and electronic, of all activity in accordance with requirements. Prepares all documentation to meet or exceed established standards of the MTF, to include, but not limited to, timeliness, accuracy, content and signature. Only MTF and Air Force-approved abbreviations will be used for documentation of the patient health record.

Knowledgeable in the proper selection of personnel protective equipment (PPE)

Skilled proficiency in the use of Microsoft Windows and Office programs (i.e., Word, Outlook, PowerPoint, etc.)

Excellent verbal and written communications skills with ability to prepare written documents and reports

Exceptional customer service skills

Excellent organization, critical thinking and problem-solving skills

Ability to interact, demonstrate tact and communicate effectively at all levels and across diverse cultures in a variety of situations

Ability to work effectively both individually and in a team environment

LANGUAGE SKILLS

Ability to read, analyze and interpret the most complex documents. Ability to respond effectively to the most sensitive inquiries or complaints. Ability to write speeches and articles using original or innovative techniques or style. Ability to make effective and persuasive speeches and presentations on controversial or complex topics to top management, public groups and/or boards of directors.

MATHMETICAL SKILLS

Ability to work with mathematical concepts such as probability and statistical inference, and fundamentals of plane and solid geometry and trigonometry. Ability to apply concepts such as fractions, percentages, ratios and proportions to practical situations.

REASONING ABILITY

Ability to apply principles of logical or scientific thinking to a wide range of intellectual and practical problems. Ability to deal with nonverbal symbolism (formulas, scientific equations, graphs, musical notes, etc.,) in its most difficult phases. Ability to deal with a variety of abstract and concrete variables.

PHYSICAL DEMANDS

The physical demands described here are representative of those that must be met by an employee to perform successfully the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this job. Work is primarily performed in an office/clinic/lab setting. Regularly required to use hands to finger, handle, or feel.  Regularly required to reach with hands and arms. The work requires light physical exertion. May be required to perform handling activities with lightweight or easily moved items (e.g. books, file folders, boxes of office supplies, small machine parts, lab samples etc.). May perform movement activities for brief periods. May operate light equipment. Must be able to perform repetitive motions for brief periods. May be confined to a work area. The work environment involves moderate hazards, risks or discomforts. Ability to sit, stand, walk, reach with hands and arms, and use hands along with fingers, to handle or feel. Ability to lift and/or move up to 25 pounds. Specific vision abilities required by this job include clarity of vision both near and far. Ability to speak and hear. Ability to identify and distinguish colors. Potential for exposure to toxic or caustic chemicals. Potential for exposure to blood borne pathogens. Required to wear safety and personal protective equipment.

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