Placer County

To perform clinical services as a nurse practitioner or physician assistant; to assess and manage the medical care needs of patients in a clinic setting; to perform physical examinations and procedures; to interpret laboratory and other diagnostic tests; to make routine diagnosis of injury or illness; to arrange consultations as required; and when assigned to outlying areas, to provide lead supervision to staff and oversee clinic operations.

Mid-Level Practitioner I
This is the entry level class in the Mid-Level Practitioner series.  This class is distinguished from the journey level by the performance of the more routine tasks and duties assigned to positions within this series.  Employees at this level are not expected to perform with the same independence of direction and judgement on matters allocated to the journey level.  Since this class is typically used as a training class, employees may have only limited or no directly related work experience.  Employees work under immediate supervision while learning job tasks.

Mid-Level Practitioner II
This is the full journey level class within the Mid-Level Practitioner series.  This class is distinguished from the Mid-Level Practitioner I by the assignment of the full range of duties.  Employees at this level receive only occasional instruction or assistance as new or unusual situations arise and are fully aware of the operating procedures and policies within the work unit.  Positions in this class are flexibly staffed and are normally filled by advancement from the entry level.
This class is distinguished from the Senior Mid-Level Practitioner in that the latter assesses and manages the most difficult and complex medical care needs of patients in a clinic setting and exercises first-line, direct supervision over professional, technical and clerical personnel.

Mid-Level Practitioner I
Receives general supervision from Deputy Director, Public Health Nursing, Medical Services Manager and Health Officer, or a Senior Mid-Level Practitioner; may receive technical and functional supervision from other professional medical staff.

Mid-Level Practitioner II
Receives direction from Deputy Director, Public Health Nursing, Medical Services Manager and Health Officer, or a Senior Mid-Level Practitioner; may receive technical and functional supervision from other professional medical staff.

May exercise technical and functional supervision over technical and clerical staff.

• Provide for the care of superficial wounds and burns, removal of foreign bodies from the skin, incision and drainage of infections, suturing of wounds and incisions, casting or splinting of sprains and simple fractures.
• Order and interpret electrocardiography and radiography.
• Assist and consult with physicians regarding treatment of patients.
• Assess medical histories, perform comprehensive physical examinations, record findings and make evaluations.
• Order, interpret and may perform laboratory and other diagnostic testing.
• Perform routine and specialized therapeutic procedures.
• Diagnose, instruct and counsel patients and family members as appropriate, regarding medical problems.
• Develop and implement treatment plans under protocol.
• Evaluate basic dental diseases for referral.
• Provide emergency services in the absence of a physician, including life saving emergency procedures in order to stabilize a patient sufficiently to transport to a hospital facility.
• Participate in clinical investigations, collaborate with physician staff and appropriately refer complex medical conditions to a physician.
• Perform other related work as required within the guidelines established by the State of California Board of Registered Nursing and/or Medical Quality Assurance.
• Aid in the prevention and control of communicable disease through the instruction of preventive health measures.
• Participate in interagency conferences.
• When assigned to outlying areas, may provide lead supervision to staff and oversee clinic operations.
• Build and maintain positive working relationships with co-workers, other County employees and the public using principles of good customer service.
• Perform related duties as assigned.

Mid-Level Practitioner I

Experience and Training
Any combination of experience and training that would provide the required knowledge and abilities is qualifying.  A typical way to obtain the required knowledge and abilities would be:

Experience: One year of professional nursing experience in a public health or primary care setting is desirable.

Training: Equivalent to completion of a formal Nurse Practitioner or Physician Assistant training program at an accredited educational institution.

Required License or Certificate:

• Possession of a valid license as a Registered Nurse and Nurse Practitioner, Pediatric Nurse Practitioner, Family Nurse Practitioner or Family Planning Nurse Practitioner; or a valid Certificate or Letter of Approval to practice as a Physician Assistant issued  by the State of California Board of Medical Quality Assurance.
• May need to possess a valid driver's license as required by the position.  Proof of adequate vehicle insurance and medical clearance may also be required.

Mid-Level Practitioner II

Experience and Training
Any combination of experience and training that would provide the required knowledge and abilities is qualifying.  A typical way to obtain the required knowledge and abilities would be:

Experience: Two years of responsible Nurse Practitioner or Physician Assistant experience performing duties similar to a Mid-Level Practitioner I with Placer County.

Training: Equivalent to completion of a formal Nurse Practitioner or Physician Assistant training   program at an accredited educational institution.

Required License or Certificate:

• Possession of a valid license as a Registered Nurse and Nurse Practitioner, Pediatric Nurse Practitioner, Family Nurse Practitioner or Family Planning Nurse Practitioner; or a valid Certificate or Letter of Approval to practice as a Physician Assistant issued by the State of California Board of Medical Quality Assurance.
• May need to possess a valid driver's license as required by the position.  Proof of adequate vehicle insurance and medical clearance may also be required.

Mid-Level Practitioner I

Knowledge of:

• Current principles, practices, methods and techniques in the field of medicine.
• The role of various health care professionals both in the Department and the community.
• Medications and their desired effects, side effects, contra-indications and complications.
• Medical symptoms and findings for the purpose of determining treatment or referral.
• Principles and practices of work safety, especially as related to communicable diseases.
• Differing cultural, religious, economic and social groups and their relationships to the delivery and acceptance of health care services.

Ability to:

• On a continuous basis, know and understand all aspects of the job; intermittently analyze work papers, patient charts, reports and special projects; identify and interpret technical and numerical information; observe and problem solve operational and technical policies and procedures; explain medical procedures.
• On an intermittent basis, sit at desk for long periods of time while reviewing patient charts and histories and preparing patient charts and reports; intermittently walk, stand, bend and reach while examining/treating patients or conducting tests.  Intermittently twist to reach equipment surrounding desk or the treatment area; perform simple grasping and fine manipulation; use telephone and write or use a keyboard to communicate through written means; see and hear with sufficient acuity to examine patients and make diagnoses; and lift moderate weight.
• Understand and carry out complex written and oral directions.
• Work with various cultural and ethnic groups in a tactful and effective manner.
• Act quickly and calmly in emergency situations.
• Obtain information through interviews; deal fairly and courteously with the public; handle multiple cases; and work effectively with interruption.
• Analyze situations quickly and objectively and determine proper course of action.
• Use equipment and supplies appropriate to medical diagnosis and treatment.
• Communicate clearly and concisely, both orally and in writing.
• Establish and maintain effective working relationships with those contacted in the course of work.

Mid-Level Practitioner II

In addition to the qualifications for Mid-Level Practitioner I:

Knowledge of:

• Policies and procedures of a health services department, especially as related to the Medical Care Services and Public Health Nursing Divisions.

Ability to:

• Exercise independent judgement and perform journey level duties in an independent manner.