APP (Float)

Why Join Us? We are looking for talented and highly-motivated individuals who demonstrate a natural desire to support the meaningful work of community oncologists and the patients we serve.

APP provides care in a variety of settings served by Tennessee Oncology. APP provides quality care to specific populations in cancer prevention, screening, diagnosis, active treatment, and palliative care with the multidisciplinary healthcare team. The APP role includes the assessment, diagnosis, and management of cancer or related disorders. The APP uses evidence based literature and works toward evidence-based practice to effect a positive change in the health and healthcare delivered to the patient with a past, current, or potential diagnosis of cancer.

ESSENTIAL FUNCTIONS:

I) Clinical

• Assesses the physical and psychosocial status of patients.
• Obtains and documents comprehensive health history.
• Performs and documents complete, system-focused, symptom-specific physical exams. 
• Assesses for symptoms commonly seen in patients with cancer, impact of physical comorbidities on cancer symptoms and response to treatment, signs and symptoms of disease progression or recurrence, actual or potential late effects of cancer and its treatment in cancer survivors.
• Conducts a pharmacologic assessment, including prescriptions drugs, over-the-counter medications, nutritional supplements, and other complementary or alternative therapies.
• Recognizes deviations from normal in the physical assessment.
• Orders and interprets findings of ancillary data, including laboratory and diagnostic tests.
• Prioritizes findings identify urgent or highest priority patient problems.
• Identifies patients who may be eligible for entry into clinical trials based on clinical findings.
• Relays appropriate information regarding patient care to the collaborating physician.
• Communicates plan of care to patient, caregiver and other members of the health care team.
• Writes prescriptions for medication, blood products based of laboratory results, routine diagnostic and follow-up studies, therapeutic measures, and post-discharge care in accordance with written practice protocols.
• Administers therapeutic measures and obtains specimens in accordance with practice guidelines.
• Provides management for symptoms of cancer and side effects related to cancer treatment.
• Refers or requests consultation from physicians and other health care professionals
• Assists in the management related family dynamics and coping mechanisms during acute and chronic phases of patient care.
• Serves as resource to other members of the health care team regarding provision of quality care.
• Provides care for patients participating in clinical trials.
• Evaluates the quality of care provided and recommends changes for improvement.
• Performs procedures as warranted by clinic needs such as Bone Marrow Biopsies
• Take call as required by clinic need.

• May provide on call coverage mutually scheduled by supervising physician and Advanced Practice Providers.  (On-call coverage is not a mandatory requirement of “practice”.) Call responsibilities include but not limited to:
• Responding to patient/family phone calls

• Rounding in the hospital on Saturday and Sunday or as requested by the supervising physician.
• Responding to hospital phone calls
• Admitting patients to the hospital as needed
• Contacting supervising physician for appropriate back-up as needed
• Maintains certification through American Nursing Credentialing Center.
• Maintains current certification in Basic Life Support for the healthcare provider.  
• Other duties as requested by the supervising MD.  

II) Teaching

• Educates patient and family on treatment plan proposed.
• Utilizes a variety of age and cultural appropriate teaching methods such as diagrams, handouts, booklets.
• Facilitates patient decision making of discontinuing active cancer treatment while optimizing supportive care.
• Educates cancer survivors regarding their risk of long-term effects of cancer and its treatment.
• Provides formal and informal education to staff in oncology care.
• Participates in the development of educational materials for patients and healthcare providers.
• Presents updates in cancer care and specialty specific information to professionals at the local, regional, and national levels.
• Recognizes the value of providing oncology education and support to the lay community by participating in community discussions, support groups, and informal consultation.

 III) Communication

• Reports patient information in an accurate, timely manner.
• Edits dictation.
• Works effectively with others and utilizes the chain of command.
• Collaborates with other health disciplines to ensure continuity and quality of care.
• Represents the APP in department and board meetings and shares information with APP group.

KNOWLEDGE, SKILLS & ABILITIES:

• Current knowledge of oncology and primary care.
• Ability to work independently.     
• Knowledge of Tennessee Oncology Advanced Practice Provider Guidelines.
• Knowledge of the Advanced Practice Practitioner as outlined in the Tennessee Oncology Policy and Procedure Manual. 
• Tennessee Oncology skills certification as required by the APPs specific clinic including but not limited to, BMBx, skin punch biopsies, paracentensis, and specialized accessing of chemotherapy delivery devices.

EDUCATION & EXPERIENCE:

• License to practice as RN or PA in the state of Tennessee required.
• Master’s degree in nursing or certification as a Physician Assistant required.
• National certification as APP (American Nurses' Credentialing Center or American Academy of Nurse Practitioners)or Clinical Nurse Specialist who meets criteria for certificate of fitness to prescribe medications, including AOCN, AOCNP, AOCNS or Certification by the National Commission on Certification of Physician Assistants required
• Minimum of one year oncology nurse experience preferred - APPs without oncology experience are expected to work as a staff nurse for a minimum of 1 month before transitioning into APP role.
• APPs without sufficient experience as a Registered Nurse are required to work as a staff nurse for a minimum of 12 months.  

PHYSICAL REQUIREMENTS:

• Must be willing and able to lift up to 50 pounds
• Ability to remain upright on the feet most of the time.
• Must be able to remain in a stationary position half of the time.
• Ability to communicate, distinguish sounds, and visualize.
• Regular manual dexterity.
• Occasional reaching or stretching
• Occasional crouching or stooping