Nurse Practitioner or Physician Assistant, OBAT (Office Based Addiction Treatment)

Job Description Summary

The APC (Advanced Practice Clinician) will be a primary member of the SSMC provider team with a matrixed secondary relationship to the subject matter expertise of the South Shore Health’s Addiction Medicine Service. The OBAT- APC is both a direct specialty as well as a consultative liaison service for the multiple SSMC sites and will provide direct care as well as consultations for management of addiction including management of withdrawal syndromes. A significant part of this work is starting and continuing medications for alcohol and opioid use disorders in a community setting with linkage as needed to other outpatient care such as individual therapy, group therapy and community supports. Imbedding this APC –OBAT role within SSMC is designed to support easy access at any of the sites for SUD patients requiring expert and dedicated treatment of substance use disorders. The APC-OBAT will perform intake assessments and perform follow-up visits in the clinic as well as work within a multidisciplinary team to help transition patients to other community treatment programs as needed. The APC-OBAT will work in an inter-disciplinary team to provide compassionate care to those suffering from substance use disorders. Responsibilities will include evaluation, diagnosis, and treatment of substance use. This role may also be involved in identifying and assessing for co-occurring medical and psychiatric conditions and work with the patient’s care team to ensure treatment of same. The APC-OBAT will educate other providers about SUD, medications for alcohol and opioid use disorders and provide local support to them as needed to treat patients with SUD via this OBAT delivery model of care. The APC-OBAT will work collaboratively with the designated SSMC physician provider. As noted above this is a matrixed position with a secondary relationship to the subject matter experts within Addiction Medicine. Of critical importance, the APC-OBAT will work to reduce SUD and medications for SUD stigma.

Job Description

Essential Functions:

  • Independently provide addiction care and treatment to patients in a community-based setting with collaborative support from the designated SSMC physician provider with a matrix secondary relationship to the Medical Director and APC nurse manager of Addiction Medicine.
  • Assessment and management of alcohol and opioid withdrawal and treatment of alcohol and substance use disorders for non-hospitalized and community based patients
  • Obtain medical history and pertinent labs, and perform focused physical exams for potential candidates for SUD medication management
  • Responsible for assessing withdrawal symptoms during buprenorphine induction, before and after buprenorphine dosing for those who receive in office induction
  • Provide patient education related to buprenorphine, including home induction, proper use of the medication, side effects, storage, and medical issues that may be of concern
  • Ongoing follow-ups and maintain ongoing contact with the patient (in-person or phone)
  • Remain available to patients for questions related to their medication and consult with primary and matrixed providers as necessary
  • Work collaboratively with clinicians (MDs, NPs, PAs, RNs LICWs, LADCs, MAs etc.) to triage needs of patients within the SSMC sites and across the health system and larger community specific to SUD needs.
  • Work in an interdisciplinary team of providers caring for patients across SSMC and the larger health system
  • Facilitate de-stigmatization of the disease of addiction and treatments through active education and support of SSMC providers so they feel comfortable initiating and maintaining medications for substance use disorders
  • Discuss risks/benefits of various addiction treatment options with patients and be comfortable with performing the informed consent process in shared decision making with patients
  • Assess, diagnose and treat complex, acute, and chronically ill patients for urgent and emergent conditions related to substance use disorder and associated medical conditions
  • Perform medically delegated aspects of patient care as agreed upon by nursing and medical administrators according to practice guidelines and under the supervision of the collaborating physician.
  • Discuss and review harm reduction techniques with patients and, with permission their social networks, including opioid overdose education and naloxone distribution
  • Administer Naltrexone ER (Vivitrol) depot intramuscular injections and injectable subcutaneous buprenorphine (Sublocade) monthly as needed to appropriate candidates
  • Demonstrate critical thinking and diagnostic reasoning skills
  • Provide expert consultation to other nursing, physician and hospital staff in order to maximize the opportunity to provide the most appropriate treatment.
  • Engage with and treat patients in all stages of readiness of change
  • Serve as a patient and family advocate, and facilitate ethical and patient-centered decision making
  • Attend and contribute to patient care rounds
  • Work in multidisciplinary team including doctors, nurses, and clinicians to coordinate treatment plan and help transition care to community based programs
  • Participate in activities that promote the education of health care professionals
  • Participate in and facilitate quality assurance and performance improvement activities for evaluation of structure, process, and outcome criteria as it relates to clinical practice.
  • Maintain familiarity with current trends in health care and their implications related to the treatment of substance use disorder and psychiatric illness. (This includes: appropriate pharmacologic and non -pharmacologic treatment modalities).
  • Integrate systems thinking, ethical reasoning, and problem solving in identifying interventions that facilitate quality, cost-effective patient care outcomes.
  • Facilitate patient movement through the system and efficient use of resources through interdepartmental collaboration. This includes the triage of patient consults to the appropriate interdisciplinary members
  • Negotiate conflict to promote collaboration.
  • Identify individual learning needs and goals and develop a plan to meet them.
  • Maintain clinical knowledge and skills based upon current nursing and health care practices.
  • Maintain membership in professional nursing organizations.
  • Maintain the standards and educational requirements specific to the nurse practitioner role and licensure.
  • Maintain and update clinical knowledge and skills based on current health care practice/research
  • Serve as clinical subject matter expertise in 42 cfr part 2 regulations to support SSMC care teams in compliance and understanding of same as related to patient care and information release/sharing

Education/Qualifications

  • Master of Science degree from a NLN accredited graduate program or….
  • Prior work experience at opioid treatment program, detox, SUD residential treatment program utilizing medications for SUD treatment, bridge program or office based addiction treatment program preferred. Strong preference for those with opioid treatment program, bridge program and/or office based addiction treatment program.