Critical Care APP - Nocturnist

Holy Cross Medical Group is seeking an experienced Critical Care Physician Assistant or Nurse Practitioner to join our established inpatient team at Holy Cross Hospital in Ft. Lauderdale, FL. This is an excellent opportunity to practice high acuity medicine in a supportive, physician-led environment that values teamwork, clinical excellence, and work life balance.

Position Highlights

• Closed ICU model with 24/7 Intensivist coverage
• Full Time
• Collaborative, experienced multidisciplinary team
• Opportunity to manage a mixed Cardiac and Medical ICU with emphasis on Cardiothoracic Surgery

Role Responsibilities:

• Provide comprehensive assessment, diagnosis, and management of critically ill adult patients, including bedside procedures, physical exams, and diagnostic testing
• Collaborate closely with intensivists, specialists, nurses, respiratory therapists
• Participate in daily multidisciplinary rounds and contribute to care planning
• Ensure high-quality, evidence-based patient care and documentation

Direct Patient Care:

• Perform comprehensive assessment, differential diagnosis, and evidence-based management of critically ill adult patients across the NSCCU and Cardiovascular Surgery ICU (CVICU).
• Independently manage patients with multi-organ system failure, acute respiratory failure, shock states, complex arrhythmia, sepsis, post-operative complications, and advanced hemodynamic instability.
• Perform and interpret bedside diagnostics, including Point of Care Ultrasound, EKGs, hemodynamic monitoring, ventilator waveforms, and radiographic studies.
• Initiate and titrate medications, including vasoactive agents, sedatives, analgesics, antiarrhythmics, insulin infusion, and critical drips according to protocols and patient condition.
• Provide end-of-life support and assist with goals-of-care conversations, in collaboration with attending intensivists.

Procedures (as credentialed)

• Perform ICU procedures, including:
• Central Venous Catheter Placement
• Arterial line placement
• Temporary pacing wire management (CV surgery patients)
• Chest tube/mediastinal drain management and/or removal
• Intubation and airway management
• Bedside ultrasound-guided procedures (paracentesis, thoracentesis, vascular access)
• Swan-Ganz catheter interpretation and management (if applicable for CV surgery ICU)
• Manage advanced devices such as IABP, Impella, CRRT, and ECMO in collaboration with specialists (based on your hospitals scope).

Night Coverage & Collaborative Decision-Making

• Collaborates with the intensivist to provide overnight care for both NSCCU and CVICU, responding rapidly to changes in patient condition.
• Communicate significant overnight changes to the daytime multidisciplinary team to ensure continuity and safe handoff.
• Triaging with intensivist urgent consults from ED, floors, and post-operative areas for potential ICU admission.

Interdisciplinary Collaboration

• Partner with intensivists, cardiovascular surgeons, anesthesiologists, cardiologists, nurses, respiratory therapists, pharmacists, and dietitians to deliver coordinated, high-quality care.
• Collaborate with CV surgery teams regarding post-operative protocols, including management of chest tubes, pacing wires, anticoagulation, hemodynamics, and early complication recognition.
• Support bedside nurses with real-time clinical decision-making, hemodynamic adjustments, and emergent interventions.

Rounding, Handoff, and Documentation

• Participate in structured evening rounds, ensuring accurate and thorough transitions of care.
• Complete timely, clear, and compliant documentation, procedure notes, critical care time, and billing within the EHR.
• Update families when clinically appropriate and ensure communication of changes to daytime providers.

Quality, Safety, and Protocol Adherence

• Adhere to and help optimize ICU evidence-based protocols, including:
• Ventilator liberation
• Sepsis management
• Glycemic control
• DVT and stress ulcer prophylaxis
• Early mobility and sedation minimization
• Identify and escalate safety concerns, near misses, or system issues to leadership.
• Participate in ICU quality initiatives, morbidity & mortality reviews, and performance improvement projects.

Education, Leadership & Professional Development

• Serve as a clinical resource for night shift staff, providing education on complex hemodynamics, troubleshooting ventilators, and device management.
• Maintain competency in all required critical care procedures, certifications (ACLS, BLS), and continuing medical education.
• Contribute to protocol updates, workflow optimization, and critical care operational improvements.

Qualifications

• Physician Assistant or Nurse Practitioner with Critical Care experience required
• Current or eligibility for Florida licensure
• Ability to thrive within a collaborative, closed ICU model
• Strong communication, clinical reasoning, and teamwork skills

COMPENSATION & BENEFITS

• Competitive salary based upon experience
• Health, Dental, and Vision Insurance
• 403(b) with employer match
• Paid time off
• CME allowance
• Malpractice insurance coverage
• Supportive team environment with…