Consultation-Liaison Psychiatric Nurse Practitioner

The Consultation-Liaison Psychiatric Nurse Practitioner is a board-certified Psychiatric Mental Health Nurse Practitioner who serves as the founding clinician of firsthand's hospital psychiatric consult service, and as the most visible representative of firsthand inside our partner hospital.

When an emergency physician or hospitalist places a psychiatric consult, you are the person who shows up the same day, performs the assessment at the bedside, and begins treatment in the room: medication management, long-acting injectable antipsychotics, medication for addiction treatment where indicated, and substantive therapeutic work — not a chart review and a medication reconciliation. You follow admitted patients to the floor, document in the hospital's EHR, and become known to the hospital teams by name. You practice alongside a consultation-liaison psychiatrist who provides supervision and escalation support for complex management; the two of you are introduced to the hospital as a named pair, not an anonymous service.

The second half of the role is what makes it unlike any other consultation-liaison job on the market: the same clinician carries the outpatient bridge. The patient you assess in the emergency department on Tuesday is the patient you see in a firsthand bridge appointment the following week. That continuity is not a staffing convenience, it will deliver superior clinical results.

As a Consultation-Liaison Psychiatric Nurse Practitioner, you will:

• Conduct same day psychiatric consultations for patients based on requests from emergency, medical, and surgical teams; 
• Collaborate closely with hospital teams including attending physicians, nursing staff, and case managers, to develop and implement treatment plans.
• Perform rapid assessment, crisis intervention, and stabilization for patients presenting in psychiatric crisis including suicide and violence risk assessments
• Escalate to the collaborating psychiatrist for complex management, and practice within your training and experience with a referral plan for complex cases and emergencies
• Provide outpatient services for stabilization, medication management and supportive psychotherapy
• Establish and maintain working relationships with hospital departments and community partners, and contribute to consult workflow and care pathway development in collaboration with the consulting psychiatrist

You will be a good fit if you have:

• A belief in the impact of early psychiatric involvement on the overall care plan for medically complex patients and a conviction that the patients who are hardest to place deserve the same urgency as anyone else in the hospital
• High emotional intelligence and genuine affability: the ability to walk into a hospital, and win over the charge nurse, the attending, and the patient in the same hour. Warm, unflappable, easy to work with, hard to rattle
• A sound, evidence-based clinical assessment framework: a clear, defensible approach to deciding when a patient in the emergency department needs further observation, inpatient admission, or safe discharge to the community, with respect to suicide risk, ability to care for self, and risk of danger to others
• Credibility with emergency physicians, hospitalists, and surgeons, and the communication skills to influence a team that is not your own 
• An owner's mindset and a tenacious, independent work ethic: you will build the workflows, the relationships, and the reputation of this service from zero. You will hear “that's not how we do it here” regularly, and you will treat it as information rather than an insult

Licensure and credentialing:

• Certification as a Psychiatric Mental Health Nurse Practitioner (PMHNP-BC)
• Active Virginia APRN license. Autonomous practice designation specific to psychiatric practice preferred
• National psychiatric APRN certification (ANCC or equivalent)
• DEA registration, including the ability to prescribe Schedule II–VI medications and buprenorphine
• Active Medicare enrollment via PECOS as an individual provider, and active Virginia Medicaid (DMAS) enrollment, strongly preferred
• Current, attested CAQH ProView profile
• No history of Medicare or Medicaid sanctions or exclusions, and no unresolved licensure disciplinary actions
• Active, unrestricted malpractice and professional liability coverage, or the ability to furnish a certificate of insurance upon offer

Schedule and on-call: 5, 8 hour shifts hours M-F, occasional weekend on-call