APC – Nurse Practitioner or Physician Assistant

Location: Wenatchee, WA
Facility: Wenatchee Valley Hospital
Schedule: Full Time
Shift: Day Shift
Hours: 8

Job Description

Confluence Health in Wenatchee, WA has an excellent opportunity for an Orthopedic PA-C or ARNP to join an established and collegial group of 9 Orthopedic Physicians and 7 APCs. This is primarily a M-F, 8a.m. – 5 p.m. out-patient position for new patient appointments, triage and provide same day access of ER and walk in patients as well as provide coverage in the OR for vacations of existing APCs. There is significant autonomy in the clinical schedule with excellent supervisory and collaborative support. Previous experience as an Orthopedic APC is desirable, but we are willing to train the right candidate who is motivated, committed, compassionate, and dedicated to patient care. New graduates are welcome to apply.


Education & Experience: Completion of program for the training of a Certified Physician’s Assistant.


1. Physician Assistant

a. Current licensure as a Certified Physician’s Assistant in the State of Washington at time of employment, OR

2. Advanced Registered Nurse Practitioner

a. Current licensure as a registered nurse in the State of Washington at time of employment,

b. Current licensure as an advanced registered nurse practitioner in the State of Washington at time of employment.

3. Current certification by a national certifying body.

4. Current prescriptive authority licensure, only if current practice includes:

a. Prescribing medications

b. WACs 246-839-300, 246-839-305, 246-839-320, 246-839-400 & 246-839-410.

5. ACLS verification

6. BLS certification



1. Direct Patient Services – Perform comprehensive and problem focused history and physical exams, interpret and correlate laboratory and diagnostic procedures. Interpret and correlate subjective and objective data to formulate a differential diagnosis and establish a working diagnosis. Formulate a treatment plan for orthopedic problems within scope of practice. Implement therapeutic intervention for specific conditions when appropriate. Exercise judgment on problems requiring consultation, referral, or evaluation by the supervising Orthopedic surgeon or other health care professionals.

a. Health education for individuals, families, and groups.

b. Counseling for individuals, families, and groups.

c. Obtain medical histories and perform physical examinations.

d. Perform sports physical, screening, and preoperative examinations.

e. Screening and diagnostic test interpretation.

f. Specific procedures in which the PA-C has been educated.

g. Providing Assistant Surgery duties.

h. Management of non-complex acute or chronic health problems.

i. Prescription of legend and over-the-counter medications (with appropriate licensure; see section 4, “Prescriptive Authority”).

j. Diagnose, treat, and monitor acute and chronic, non-complex diseases.

k. Utilizes medical references and resources as needed.

2. Physician Consultation/Collaboration

a. The PA-C will consult with a physician when a client presents with a complex medical health problem.

b. Consultation will occur if the PA-C is unfamiliar with performing a particular procedure required in any given situation.

c. Consultation will occur if controlled substances in Schedules I through IV are required in providing appropriate health care to clients.

d. Referrals will by made by the PA-C to physician specialists for those clients requiring medical or surgical care beyond the PA-C’s specialty.

3. Procedures Specific to Specialized PracticeOrder, collect and perform appropriate laboratory or diagnostic procedures, and studies including but not limited to blood and tissue specimens. Ordering or performing diagnostic studies such as but not limited to EMG, electrocardiogram, compartment pressure measurements, and x-ray examinations including special x-ray examinations CT, MRI, and bone scans etc.

4. Perform procedures such as but not limited to, digital blocks, regional anesthesia, and minor outpatient surgical procedures such as but not limited to: tendon repair, wound closure, wound management, wound debridement, incision and drainage, needle biopsy, percutaneous pinning of fractures, k-wire removal and hardware removal.

5. Perform diagnostic and therapeutic procedures including but not limited to joint and bursa aspirations, closed reduction of fractures and dislocations, injections of joints, tendons, trigger points and bursa, as well as brace, cast and splint applications.

6. Assist in surgery to include but not limited to first assist, deep and superficial tissue closures, application of appliances and any other action delegated by the surgeon. Conduct hospital, rounds, write orders, and take call for/ with the orthopedic surgeon. Evaluate and clarify clinical conditions, formulate and implement a treatment or therapeutic plan for hospitalized patients, dictate discharge summaries, histories and physicals.

7. Evaluate, screen and council patient on health maintenance and promote utilization of community resources. Design, conduct and/or participate in research studies, manage databases, and perform quality assurance.

8. Prescriptive Authority – Order, prescribe, dispense, and administer Medication, orthosis, orthotics, braces and other orthopedic devices as may be allowed by state legislation.

a. In order to prescribe medications, a PA-C must hold a current Washington State license for prescriptive authority.

b. All medication prescriptions must be signed by the prescriber, followed by the initials “PA-C”.

c. The PA-C may not prescribe controlled substances in Schedules I through IV.

d. The PA-C prescribing Schedule V controlled substances must register with the Washington State Board of Pharmacy and the Drug Enforcement Agency. (RCW 18.88.280(16), WAC 246-839-420)

9. Documentation

a. The following elements will be included by the PA-C, appropriate to each client encounter. Not all elements will need to be included when documenting every client encounter.

(1) Accurate identification of client

(2) Pertinent social data

(3) Pertinent past medical/surgical history

(4) Description of the health status

(5) Accurate record of client allergies and current medication use

(6) Descriptions of medical/nursing/health education needs

(7) Summary of encounters, disposition, and patient instructions

(8) Diagnostic and laboratory reports

(9) Reports of consultations; required consent forms

(10) Signature and credentials of mid-level provided

b. Physician Review/Co-signatures will abide by all current Confluence Health, CWH & C and WVH & C policies, bylaws and standards.

NOTE: This list of job functions is not intended to be all inclusive and may be expanded to include other functions that may be deemed necessary.

Nomenclature: If desired, the title or abbreviation designated by the approved national certifying body may be placed following “PA-C

Additional Information

About Confluence Health: Confluence Health was formed in 2013 as an affiliation between the Wenatchee Valley Medical Center and Central Washington Hospital to create an integrated, rural healthcare delivery system with 2 hospitals, multi-specialty care in 30+ service lines and primary care in ten communities across North Central Washington state. Over 225 physicians and 100 advanced practice clinicians serve an area of approximately 12,000 square miles and cover nearly every corner of this region through specialty outreach. Our Mission: We are dedicated to improving our patients' health by providing safe, high-quality care in a compassionate and cost effective manner. Our Setting and Lifestyle: We are located in the heart of Washington State and just 2.5 hours east of Seattle. Our region offers a diversity of recreational opportunities in breathtaking landscapes, from alpine country to the high desert, orchards to vineyards, cross country skiing to fly fishing and everything in between. Cycling, mountain biking, rafting, hiking; it is all right here. The region also offers a family friendly environment with good schools and opportunities for the entire family to be involved in culture and arts.