TENTATIVE

Occ. Code 5505100

                                 NURSE PRACTITIONER (VARIOUS PARENTHETICS), GRADE 24                                                           

New York State Department of Civil Service

Classification Standard

BRIEF DESCRIPTION OF CLASS

            Nurse Practitioners are registered professional nurses who have been certified in a specialty area of practice. They are licensed healthcare professionals who provide primary healthcare services in the diagnoses of illness and therapeutic and corrective measures and may prescribe drugs, devices, and immunizing agents based on their education and specialized training.  Positions in this class work independently under their own license in collaboration with a physician and retain responsibility for professional tasks performed under their scope of practice.

            Positions in this class may be assigned to hospitals, clinics, infirmaries, and other medical care units located within various State institutions and facilities.

            Nurse Practitioners are required to specialize in one or more of the following parenthetics:  Acute Care, Adult Health, College Health, Community Health, Family Health, Gerontology, Holistic Nursing, Obstetrics and Gynecology, Oncology, Palliative Care, Pediatrics, Perinatology, Psychiatry, School Health, or Womens Health.

DISTINGUISHING CHARACTERISTICS

            NURSE PRACTITIONER (VARIOUS PARENTHETICS):  full performance level; requires licensure as a registered professional nurse in New York State in addition to graduation from a Nurse Practitioner or equivalent program registered by the New York State Education Department (NYSED) culminating in a certification to practice as a Nurse Practitioner in a given specialty.  Incumbents must maintain registration of their RN license and NP certification in order to practice.

            Part 64.4 of the NYSED Commissioners Regulations requires that certification must be in a specialty area of practice and must denote, when applicable, that prescriptive privileges have been granted.  Nurse Practitioners can apply for certification in more than one specialty area.  Positions in this class function as independent licensed health care professionals in providing primary health care to patients in accordance with written practice agreements and protocols with physicians known as collaborative agreements.

RELATED CLASSES

Licensed Practical Nurses provide direct nursing care in support of and under the close supervision of a registered professional nurse.  Positions in this title perform tasks and responsibilities within the framework of casefinding, health teaching, health counseling, and provision of care under the direction of a registered professional nurse, licensed physician, dentist, or other licensed health care provider.

Nurses 1 and 2 are registered professional nurses who diagnose and treat human responses to actual or potential health problems through such services as casefinding, health teaching, health counseling, and provision of care supportive to or restorative of life and well-being, and executing medical regimens prescribed by a licensed physician, dentist, or other licensed health care provider.  These positions bear the primary responsibility and accountability for the nursing care that patients receive.

Community Mental Health Nurses act as primary therapists to a caseload of mentally ill or developmentally disabled clients and their families in a community setting. While Nurses 1, Nurses 2, and Community Mental Health Nurses make nursing diagnoses and determine the nursing needs of clients, they do not make initial medical diagnosis or manage the medical care of clients as do Nurse Practitioner positions within established medical protocols.

Physicians Assistants provide healthcare services under the supervision of a physician.  Services are provided under the joint licensure and scope of practice of both the Physicians Assistant and the supervising physician, while Nurse Practitioners function independently under their own license in collaborative agreement with a physician.

ILLUSTRATIVE DUTIES

Develops a health profile by taking health and development history, performing physical examination, analyzing clinical laboratory data and other diagnostic tests.

• Reviews presenting problem, date of onset, and duration.
• Obtains information about prior areas of difficulty or disability; i.e. health history.
• Determines the extent of previous treatment modalities for each difficulty or disability identified.
• Performs complete physical examinations that may include vital signs, blood pressure, hydration status, otoscopic examination, retinal inspection, skin status, neurological testing, and review of the various body systems.
• Orders routine laboratory tests such as CBC, blood chemistry, urinalysis, serology, bacteriological testing, as well as those tests that are indicated by physical finding and/or patient complaints.
• Records findings of physical and developmental assessment in a systematic and accurate format and consistent with established protocols of the facility.

Assesses data, discriminating between normal and abnormal findings.

• Identifies abnormalities that require further study.
• Determines if results of laboratory tests are within normal limits.

Develops or assists in the development of a health plan for primary, acute, or long-term care.

• Initiates first line medical care plan within defined protocols, including medication, minor surgery, and diagnostic and corrective procedures.
• Initiates appropriate nursing care plan.
• Makes appropriate referrals to other healthcare providers, including physicians, for medication and consultation.
• Collaborates with other health disciplines to ensure continuity of care.

Initiates and provides emergency care services, as appropriate, in life threatening situations.

Coordinates disease prevention and health maintenance programs using available resources.

• Coordinates communicable disease control program for a facility, including immunizations, TB testing, epidemiologic follow-up, and takes appropriate actions such as making a referral or prescribing treatment in accordance with written practice agreements and protocols with physicians.
• Evaluates clients ability to perform self-care activities.
• Counsels client and family relatives as to the nature and course of illness or disability, medication regimen, test or treatment procedures, etc.
• Provides psychological support and counseling to client about health maintenance, stabilization of illness and prevention of future disability.

Evaluates the health plan for effectiveness, and institutes necessary adjustments or corrections.

• Assumes primary healthcare responsibilities for clients and monitors the coordination and implementation of such care.
• Develops and adjusts nursing plan and makes modifications in medically prescribed regimen, in consultation with the physician as necessary.
• Participates in team planning for the provision of total required services to clients.

Assists in providing learning experiences for nursing staff and appropriate others.

Participates in select studies that contribute to health care.

MINIMUM QUALIFICATIONS

Open-Competitive: New York State License to practice as a Registered Professional Nurse and certification by the New York State Education Department in a *specialty area to practice as a Nurse Practitioner. 

            Requirement for prescribing medication:  must meet the current requirements as prescribed by the New York State Board of Nursing.

*Specialty area must coincide with the scope of practice performed by an incumbent; this denotes the appropriate parenthetic.

NOTE:  Classification Standards illustrate the nature, extent and scope of duties and responsibilities of the classes they describe.  Standards cannot and do not include all of the work that might be appropriately performed by a class.  The minimum qualifications above are those which were required for appointment at the time the Classification Standard was written.  Please contact the Division of Staffing Services for current information on minimum qualification requirements for appointment or examination.

Date:  9/11

NURSE PRACTITIONER PARENTHETICS ATTACHMENT 

Positions of Nurse Practitioner are classified with the following parenthetics:

NURSE PRACTITIONERS (ACUTE CARE):  assess and manage acutely ill patients within the inpatient/hospital setting and across hospital-to-clinic settings, including emergency departments, intensive care units, specialty labs, acute and sub-acute care wards, specialty clinics, or any combination of the above.

NURSE PRACTITIONERS (ADULT HEALTH):  diagnose and manage common acute and chronic primary health care problems in a variety of settings such as community health clinics, health maintenance organizations, specialty clinics, correctional facilities, and private medical practices.  Many Adult Nurse Practitioners (ANPs) specialize in an area of interest, such as HIV/AIDS, pulmonary care, cardiovascular, occupational and environmental health or integrated complementary health care. 

NURSE PRACTITIONERS (COLLEGE HEALTH):  address the physical, mental, and emotional needs of an adolescent population.

NURSE PRACTITIONERS (COMMUNITY HEALTH): provide primary care to individuals in community settings and engage in population-based planning for groups of individuals within the community.

NURSE PRACTITIONERS (FAMILY HEALTH): meet the health care needs of families by providing health assessments, direct care, guidance, teaching, or counseling as appropriate, particularly around family self-care.  Positions may follow families in a variety of settings, such as school, home, work place, or hospital, dependent upon client need.

      NURSE PRACTITIONERS (GERONTOLOGY): focus on older adult clients and his/her response to actual or potential health care needs. This includes the comprehensive, coordinated first-contact care, and ongoing management as well as the nursing management of acute and chronic health problems.

     NURSE PRACTITIONERS (HOLISTIC NURSING): incorporate all aspects of the body, emotion, mind, and spirit into the treatment plan, focusing on personal development and self-healing.

     NURSE PRACTITIONERS (OBSTETRICS & GYNECOLOGY):  provide care, support, and education for female reproductive health, from menstruation cycle through menopause.  This field of nursing is often further specialized into Perinatal Nursing and Labor & Delivery Nursing.

     NURSE PRACTITIONERS (ONCOLOGY):  provide, guide, and evaluate nursing care for individuals with cancer, as well as for their families and communities.

    NURSE PRACTITIONERS (PALLIATIVE CARE): provide comprehensive and compassionate care to individuals and families who are living with or dying from an incurable, progressive illness.

    NURSE PRACTITIONERS (PEDIATRICS):  promote the health and development of children and adolescents by providing pediatric primary health care including health maintenance, anticipatory guidance, well-child examinations, developmental screening, and diagnosing and managing common and complex health/illness conditions.  

    NURSE PRACTITIONERS (PERINATOLOGY): promote quality care across the spectrum of birth experiences, ranging from ensuring a physiologic approach to birth that minimizes unnecessary intervention to coordinating the treatment plans for conditions typically associated with high-risk pregnancies.  They also work with new parents about concerns they may have that include breastfeeding, parenting, and stress related to their new role.

    NURSE PRACTITIONERS (PSYCHIATRY): conduct comprehensive assessments and utilize a range of psychobiological interventions.  Incumbents provide psychiatric assessment, triage, and crisis intervention for patients presenting mental health illness, including addictions, eating and sleep disorders, gender issues, HIV/AIDS, major psychiatric illnesses, and violent behavior.

    NURSE PRACTITIONERS (SCHOOL HEALTH):  are trained to work specifically with children. These positions develop healthcare plans for the school setting; train school-based staff in first aid, first response, dealing with epilepsy and asthma; educate students and teachers on different healthcare issues; provide support and counseling services to students with mental health issues; work closely with other Community Groups and Social Workers; educate parents on the importance of nutrition and exercise; and test hearing, eyesight and monitor weights and heights of children.

    NURSE PRACTITIONERS (WOMENS HEALTH):  provide ambulatory womens health services that encompass most of a womans health needs throughout her life,  including: adolescent health care, well woman exams; breast cancer screening and problem evaluation; pap smears and  HPV screening; health and wellness counseling; contraceptive care; STD screening, treatment, and follow-up; pregnancy testing; health management during childbearing; menstruation issues; fertility evaluation; evaluation and treatment of common infections; urinary tract problems like incontinence or infections; menopause; and screening for general health problems like heart disease, hypertension, and diabetes.