Psychiatric Advanced Practice Clinician

At Sheridan Memorial Hospital, we proudly rank in the top 13.6% of U.S. hospitals, recognized by the Centers for Medicare and Medicaid Services. With over 850 dedicated employees and 100+ expert providers across 25 specialties, we are committed to exceptional, patient-centered care. Set in northern Wyoming’s stunning Big Horn Mountain foothills, Sheridan offers outdoor adventure and community charm. Our hospital combines cutting-edge technology with a collaborative, innovative culture. Join a team that values your skills, fosters growth, and empowers you to impact lives meaningfully. Apply today and be part of Sheridan Memorial Hospital’s mission of excellence!

JOB SUMMARY

The Psychiatric Advanced Practice Clinician (APC), a Nurse Practitioner (NP) or Physician Assistant (PA), provides psychiatric and medical care to patients in behavioral health crisis at The Path Behavioral Health Center across three levels of care: the Crisis Stabilization Unit (CSU), outpatient discharge follow-up, and adult inpatient psychiatric care. The APC diagnoses and manages acute psychiatric conditions, substance intoxication and withdrawal, and common co-occurring medical conditions.

Crisis Stabilization Unit (primary role). The APC is the primary on-unit provider for the CSU, a 24-hour observation unit serving adults and adolescents 13 years of age and older that uses the Emergency Psychiatric Assessment, Treatment and Healing (EmPATH) care delivery model. With the support of the psychiatrist, therapists and nursing staff, the APC leads the care team through assessment, medication support, supportive therapy, safety planning and disposition planning. The goal is to stabilize each patient in the least restrictive setting and, whenever safe, return the patient to home and community with a clear plan for follow-up.

Outpatient follow-up. When appropriate for the discharge plan, the APC provides time-limited follow-up in the outpatient Behavioral Health clinic to bridge patients to ongoing outpatient treatment.

Adult inpatient psychiatric care. The APC supports the psychiatrists in daily rounding and call duties. Psychiatrists lead admission, discharge and initial diagnostic assessments, and the APC does not autonomously admit or discharge patients.

Across all three levels, the APC collaborates with the psychiatrist, therapists and other health care professionals to prepare each patient’s plan of care. Excellent interpersonal skills and the ability to communicate with a multidisciplinary team and healthcare consumers are required, and a constructive team approach supports high quality care and a collaborative professional culture.

ESSENTIAL DUTIES

Professional Practice

• Adheres to organizational policies and procedures.
• Participates in focused and ongoing professional practice evaluation (FPPE/OPPE) as required by the SMH Medical Staff.
• Adheres to professional guidelines for practice such as defined by the Wyoming State Board of Medicine (PA), the Wyoming State Board of Nursing (NP) and Standards of Practice.
• Collaborates with other departments in a professional manner as needed to provide patient-centered care.
• Demonstrates effective communication, conflict resolution, team building, and leadership skills.
• Compliance with Sheridan Memorial Hospital’s Kindness First Service Standards.

Crisis Stabilization Unit (EmPATH Model)

• Serves as the primary on-unit provider for the CSU and leads the daily clinical work of the care team, in collaboration with the psychiatrist, therapists and nursing staff, applying the EmPATH care delivery model.
• Assessment: Completes a timely psychiatric evaluation and medical assessment for each patient on arrival, including suicide and violence risk assessment using standardized tools, substance use and withdrawal screening, and determination of medical stability for CSU care.
• Performs medical screening examinations as a qualified medical person designated under the SMH Medical Staff Bylaws.
• Medication support: Initiates and adjusts medications to relieve acute symptoms, favoring collaborative, voluntary and oral treatment. Responds to agitation using appropriate de-escalation and the least restrictive safe intervention.
• Non-pharmacotherapy support: Provides brief, trauma-informed supportive interventions (e.g., crisis counseling, motivational interviewing) and counseling and education for patients and families, and partners with therapists to deliver therapeutic care throughout the stay.
• Safety planning: Completes a collaborative, written safety plan (or relapse prevention plan as indicated) with each patient before discharge, including counseling on access to lethal means, and involves family or other supports as the patient permits.
• Disposition planning: Reassesses patients throughout the stay and determines the safest, least restrictive disposition within the observation period, including discharge with follow-up, voluntary admission or transfer. When necessary, initiates emergency detention and involuntary hospitalization under - Wyoming Title 25 per hospital policy and in accordance with Wyoming law.
• Serves as an examiner under Wyoming Title 25, completing emergency detention examinations, documenting the statement of facts, and reporting findings as required by statute and SMH policy.
• Provides developmentally appropriate care to adolescent patients, involving parents or legal guardians in assessment, consent, safety planning and disposition as required by Wyoming law and SMH policy.
• Consults the psychiatrist on high-risk, diagnostically complex or medically complicated patients, and as defined by department policy, and makes appropriate referrals to the psychiatrist or to specialized health resources.
• Coordinates clear handoffs with the Emergency Department, inpatient units, receiving facilities, outpatient providers and primary care.
• Participates in daily CSU huddles and visual management of patient flow, and escalates barriers to timely, safe disposition.

Discharge Follow-Up (Outpatient Behavioral Health Clinic)

• Provides time-limited, in-person follow-up visits for patients recently discharged from the CSU until care is established with an ongoing outpatient provider.
• Reviews the safety plan, symptom response, medication adherence and side effects at each visit, and adjusts bridging medications as indicated.
• Partners with therapists and clinic staff to confirm linkage to ongoing behavioral health, primary care and community resources, and communicates the plan of care to receiving providers.
• Adult Inpatient Psychiatric Care (upon opening of the inpatient unit)
• Supports the psychiatrists in the care of adult inpatients, including hospital rounds, admission history and physical examinations, daily medical management, progress documentation and discharge planning, as directed by the attending psychiatrist. Participates in interdisciplinary treatment team meetings and contributes to individualized treatment plans.

Quality

• Performs all aspects of patient care in an environment that optimizes patient safety and reduces the likelihood of medical/health care errors.
• Completes a detailed patient assessment, including history, physical examination and ordering of laboratory, radiological and other routine diagnostic tests, with reassessments per policy and specific to the patient’s age group. Diagnoses actual or potential health problems from the data collected, screens and treats medical problems (consulting the psychiatrist on unusual problems), assesses and reassesses pain using non-pharmacological techniques where appropriate, and orders and initiates appropriate medication, treatment and consultation.
• Formulates and revises an individualized plan of care, appropriate to the patient’s disease condition and age, as indicated by the patient’s response to treatment. Evaluates the overall plan daily for effectiveness.
• Screens for suicide risk with a validated tool, documents the overall risk level and mitigation plan, and reassesses risk at transitions of care in accordance with SMH policy and Joint Commission standards.
• Ensures restraint and seclusion, when used, are a last resort and are ordered, applied and monitored safely in accordance with SMH policy, CMS ------- Conditions of Participation and accreditation standards.
• Reviews the Wyoming Prescription Drug Monitoring Program (PDMP) as required by law and prescribes controlled substances electronically.
• Documentation meets current standards, policies and the requirements of regulatory and accreditation agencies, and is complete to support accurate, optimized billing.
• Reports significant events such as near misses, adverse events, patient/family complaints, and any situation that affects the safe delivery of patient-centered care in a timely manner.
• Communicates clearly with all health care team members, consults other departments for an interdisciplinary approach to the patient’s needs, and participates in multidisciplinary rounds.
• Performs treatments and provides services within scope of practice, uses measurement-based care and standard work, and contributes to the CSU’s performance measures, performance improvement and CQI activities.
• Provides administrative support for The Path as necessary.

Service

• Treats patients and their families with respect and dignity.
• Identifies and addresses psychosocial, cultural, ethnic and religious/spiritual needs of patients and their families.
• Functions as liaison between the patient/family, physicians, other healthcare providers and administration.
• Maintains a good working relationship both within the department and with other departments.
• Assists in successful implementation of programs to improve coding and reimbursement for office-specific procedures.
• Demonstrates an ability to be flexible, organized and function well under stressful situations.

POSITION QUALIFICATIONS - Education, Experience & Licensure

• Completion of an accredited Nurse Practitioner or Physician Assistant program.
• Current licensure as an APRN or PA in Wyoming (or eligible for Wyoming licensure upon hire).
• For NPs: Master's or doctoral degree and national certification required. PMHNP certification preferred; candidates without PMHNP certification must obtain it within four (4) years of hire.
• For PAs: Current NCCPA certification required; psychiatric/behavioral health training or experience preferred.
• Current DEA registration, Wyoming controlled substance registration, and BLS certification required. ACLS preferred.
• Minimum one year of psychiatric advanced practice experience or three years of advanced practice clinical experience required. Psychiatric, emergency, crisis, or behavioral health experience preferred.
• Must be eligible for medical staff privileges and Medicare/Medicaid enrollment.

Additional Skills

• Able to communicate effectively in English, both verbally and in writing
• Additional languages desirable
• Basic computer knowledge
• Organizational skills
• Participates in continuing education activities within the department and organization
• Attends and actively participates in departmental staff meetings
• Keeps up to date with clinical practice and evidence-based practice guidelines
• Stays abreast of organizational policies and procedures
• Working knowledge of psychopharmacology, suicide and violence risk assessment, the management of substance intoxication and withdrawal, and - -- - Wyoming Title 25 emergency detention and involuntary hospitalization processes (or willingness to learn).
• Ability to apply trauma-informed, recovery-oriented and least-restrictive principles of care, to make sound, timely decisions in a fast-paced crisis setting, and to lead a multidisciplinary team.

Specific demands not listed: Possible exposure to blood and / or body fluids / infectious disease / hazardous waste requiring the use of Personal Protective Equipment. Exposure to odorous chemicals / specimens and Latex products. Pre-employment drug and alcohol screening is required.