Neurosciences - APP

The Inpatient Neurosciences APP provides comprehensive, team-based care for hospitalized patients across Neurology, Neurosurgery, and Stroke services. This role supports high-acuity inpatient management, consultative services, perioperative (pre- and post-operative) care, and select procedures. The position is integral to expanded neurosciences service lines and will help support inpatient operations as part of the opening and growth of the Adams Neuroscience Center. Schedule / Coverage Model

• 12-hour shifts
• Average 40 hours/week (variable based on staffing model and service needs)
• Participates in a 24/7 coverage schedule (days, nights, weekends, and holidays as assigned)
• Works collaboratively within an interdisciplinary model with attending physicians, residents/fellows, nursing, therapy, pharmacy, case management, and other services

Essential ResponsibilitiesInpatient Clinical Care (Neurology/Neurosurgery/Stroke)

• Manage inpatient care for a diverse neurosciences census, including acute neurologic conditions and neurosurgical patients.
• Perform daily rounds, ongoing assessments, and develop diagnostic and treatment plans.
• Provide inpatient management of pre-operative and post-operative patients, including risk stratification, optimization, monitoring for complications, and coordination of perioperative plans.
• Manage post-procedure and post-operative issues (e.g., neurologic status changes, pain control, DVT prophylaxis, wound and drain considerations per protocol, mobility restrictions, nutrition, and delirium prevention).

Consultative Services

• Respond to and manage inpatient consults across the hospital (e.g., altered mental status, seizures, focal deficits, headache, spine/brain pathology evaluation, and post-operative neurologic changes).
• Obtain focused histories, perform neurologic and/or post-operative assessments, interpret diagnostic data, and document consult recommendations.
• Coordinate with attending physicians to triage consult urgency and ensure timely follow-up and continuity of care.

Stroke Care

• Participate in acute stroke workflows and inpatient stroke management in collaboration with stroke neurology, emergency department teams, imaging, and nursing.
• Support evaluation and ongoing management of ischemic and hemorrhagic stroke patients, secondary prevention planning, and discharge readiness.
• Coordinate transitions of care, including rehabilitation placement and outpatient follow-up planning.

Procedures (as credentialed and trained)

Perform procedural work consistent with privileging and service needs, which may include:

• Lumbar puncture
• Arterial/venous access and ultrasound-guided peripheral IV placement (if applicable)
• Wound assessment and dressing changes; staple/suture removal
• Drain management support per protocol (e.g., monitoring outputs and escalating concerns)
• Other inpatient bedside procedures aligned with departmental privileges

Ensure informed consent (when applicable), procedural documentation, and post-procedure monitoring. Care Coordination, Throughput, and Quality

• Collaborate to optimize length of stay, safe discharge planning, and timely consult completion.
• Communicate effectively with patients and families, providing education on diagnoses, procedures, and care plans.
• Participate in quality, safety, and process improvement initiatives, particularly those supporting the Adams Neuroscience Center opening and ongoing growth.
• Support service line protocols, order sets, evidence-based practice guidelines, and documentation standards.

Documentation & Communication

• Complete accurate and timely documentation, including H&Ps, progress notes, consult notes, post-operative notes, and discharge summaries, as applicable.
• Provide thorough handoffs using standardized tools to ensure continuity of care across 24/7 coverage.
• Escalate clinical deterioration promptly and participate in rapid response events and codes as trained., Clinical Care
• Provide comprehensive overnight cross-coverage for surgical patients on inpatient floors
• Perform focused assessments, develop care plans, and implement appropriate interventions
• Respond to acute clinical changes, pages, and nursing concerns in a timely manner
• Manage post-operative patients, including monitoring recovery, pain control, and complications
• Evaluate new consults as assigned by supervising surgical teams

Procedures (as credentialed and applicable)

• Wound assessment and bedside management
• Removal or care of drains, lines, staples, or sutures
• Assist with minor bedside procedures as required

Care Coordination

• Communicate effectively with attending surgeons, residents (if applicable), and day teams
• Provide clear and concise sign-out to incoming day team providers
• Collaborate with nursing staff and interdisciplinary teams to ensure safe patient care

Documentation

• Complete timely and accurate documentation in the electronic medical record (EMR)
• Document cross-cover events, consult notes, progress notes, and clinical decisions, Reporting Structure
• Reports to: APP Manager / Clinical Manager
• Clinical supervision: Attending surgeons (Orthopedics, Neurosurgery, and consulting services)

Additional Notes

• This role is non-ICU, focusing strictly on floor-level care
• APP will act as a key overnight resource for nursing staff and consulting teams
• Opportunity to develop expertise in surgical cross-coverage and acute inpatient care

• Graduate of an accredited Nurse Practitioner (NP) or Physician Assistant (PA) program.
• Current licensure (or eligibility) as an NP or PA in the state of employment.
• National certification (AANP/ANCC for NPs; NCCPA for PAs).
• BLS and ACLS required.
• Inpatient Neurology, Neurosurgery, Stroke, ICU, or Hospital Medicine experience preferred; new graduates with strong clinical preparation and a demonstrated interest in neurosciences are encouraged to apply.

Knowledge, Skills, and Abilities

• Strong neurologic assessment skills and comfort managing high-acuity inpatients.
• Ability to independently evaluate patients, prioritize tasks, and manage multiple consults.
• Excellent interdisciplinary communication and a patient- and family-centered approach.
• Commitment to evidence-based care, patient safety, and continuous improvement.
• Willingness to work a rotating schedule supporting 24/7 coverage.

Work Environment / Physical Requirements

• Hospital-based inpatient setting with frequent walking and standing; occasional lifting and assisting patients in accordance with organizational policy.
• Exposure to infectious diseases and other inpatient hazards; use of appropriate PPE as required., * Graduate of an accredited Nurse Practitioner (NP) or Physician Assistant (PA) program
• Active state licensure as NP or PA
• Certification by appropriate national board (e.g., AANP, ANCC, NCCPA)
• Current BLS and ACLS certification
• Minimum 1 year of inpatient or surgical experience preferred

Preferred

• Experience in Orthopedics, Neurosurgery, or Surgical Hospital Medicine
• Strong clinical decision-making and triage skills
• Ability to work independently in a fast-paced overnight environment

Key Competencies

• Excellent clinical judgment and prioritization skills
• Strong communication and teamwork abilities
• Ability to manage multiple patients and urgent situations simultaneously
• Comfort with autonomous practice with physician support as needed

Work Environment

• Inpatient hospital setting
• Frequent walking between units
• Fast-paced overnight coverage with variable patient acuity

• Competitive sign-on bonus available for eligible candidates.
• Opportunity to be part of a growing neurosciences program with the opening of the Adams Neuroscience Center.
• Collaborative physician-APP model with strong interdisciplinary support.
• Professional development opportunities, including stroke education, procedural training, and quality improvement initiatives.
• Competitive compensation and comprehensive benefits package.