Neurosurgery APP

Overview

To be part of our organization, every employee should understand and share in the Yale New Haven Health System Vision, support our Mission, and live our Values. These values - integrity, patient-centered, respect, accountability, and compassion - must guide what we do, as individuals and professionals, every day.

The Advanced Practice Provider (Nurse Practitioner or Physician Assistant) on the Inpatient Neurosurgery Service delivers high-quality, evidence-based care across the continuum—from the Emergency Department and OR to step-down and acute care floors. Covering a 24/7 service, the APP performs initial evaluations, daily management, and consultations for patients with cranial, spinal, trauma, and functional neurosurgical conditions in collaboration with neurosurgeons, intensivists, hospitalists, nursing, and interprofessional teams.

The role emphasizes clinical excellence, procedural competency (per privileging), patient safety, efficient workflows, and clear communication with patients, families, and teams.

• 1–2+ years of neurosurgery, neurocritical care, trauma, or ICU experience.
• ENLS (Emergency Neurological Life Support), NIHSS certification; FCCS or ATLS (for trauma centers) exposure preferred.
• Experience with CSF device management, postoperative spine pathways, and neurosurgical consult triage.
• Proficiency with EMR documentation and order entry; familiarity with structured handoff tools.

• Perform comprehensive history, neurologic and neurosurgical examinations for admissions, transfers, and daily rounding.
• Develop and implement plans of care for postoperative and non-operative cranial and spinal conditions (e.g., tumor, hemorrhage, hydrocephalus, spine trauma/degeneration, vascular lesions, Chiari, functional disorders).
• Manage neurosurgical emergencies and high-acuity conditions in collaboration with attending neurosurgeons and intensivists.
• Order, interpret, and integrate diagnostics (CT/MRI, CTA/MRA, ICP data, CSF studies, labs).
• Manage postoperative care, pain, DVT prophylaxis, wound and drain care, steroid and anticonvulsant protocols, antibiotics, and glycemic and hemodynamic targets.
• Coordinate care transitions (ED → ICU/floor, OR → ICU/floor, ICU → floor, inter-facility transfers) and discharge planning with robust patient/family education.

• Triage and respond to neurosurgical consults, including head injury, intracranial hemorrhage, hydrocephalus, spine trauma, cord compression, back pain with red flags, infection, and shunt malfunction.
• Provide differential diagnosis, initial stabilization plans, imaging recommendations, and disposition guidance.
• Communicate urgent findings and plans promptly to consulting teams and supervising neurosurgeon; document consults and follow-up assessments.

• Ventricular/CSF device management: EVD and lumbar drain setup, zeroing, troubleshooting, and weaning; shunt tap for diagnostic/therapeutic purposes.
• Intracranial pressure (ICP) monitoring and interpretation; bolt care and dressing changes (placement typically by surgeon).
• Wound management: dressing changes, staple/suture removal, drain removal (e.g., subgaleal/hemovac).
• Bedside neuro-epidural drain management (if applicable).
• Basic bedside ultrasound for line confirmation and volume assessment (if trained).

• Provide care across day, evening, night, weekend, and holiday shifts per service schedule; participate in handoffs and rapid-response activations.
• Support time-sensitive workflows (e.g., trauma alerts, postoperative checks, acute decompensation).
• Utilize standardized order sets/pathways and contribute to throughput (ED → bed, OR start-time readiness, discharge before target times).

Excellent work environment – Flexible schedules to ensure work-life balance. Keeping the patient at the center of everything we do, we focus on improving clinical care, outcomes, patient satisfaction, safety, value, clinical research, and education. Our efforts reach beyond the walls of our hospitals to care for our communities, too.

Career…