Jennifer Melman

Independent Clinical Management

• Managed 30–45 high-acuity post-operative HPB patients daily during peak census, including Whipple procedures, total pancreatectomies, major hepatectomies, and complex biliary reconstructions.
• Performed daily rounding, interval assessments, post-op monitoring, drain output analysis, and management of surgical complications (delayed gastric emptying, fistulas, bile leaks, PTC drain issues, post-ERCP complications, post-op hemorrhage, etc.).
• Interpreted and trended imaging (CT/MRI/PET), labs, fluid balance, and hemodynamics to guide treatment plans. Procedural and clinical tasks included performing comprehensive H&P, progress notes, discharge summaries, and consult documentation.
• Managed tube feeds, insulin regimens in brittle diabetics, anticoagulation adjustments, electrolyte replacement, and ERCP/PTC-related complications.
  Collaborated closely with GI, IR, Oncology, Infectious Disease, Endocrinology, and Cardiology.

Care Coordination & Multidisciplinary Role

• Participated in daily sign-outs with fellows, residents, and attendings.
  Presented patients and contributed to decision-making regarding operative planning, re-imaging, ERCP/PTC needs, and return-to-OR decisions.
• Coordinated pre-op optimization, peri-op orders, and safe discharge planning for highly complex surgical patients.

Communication & Patient Counseling

• Delivered difficult updates regarding progression, pathology, and changes in surgical candidacy.
• Educated patients and families on post-operative expectations, drain care, diet advancement, wound care, and warning signs.

OUTPATIENT RESPONSIBILITIES:

• Independent NP Clinics (Telehealth + In-person) conducted full NP clinics, including review of new imaging, labs, pathology, post-op follow-up, ERCP/PTC follow-up, and long-term surveillance for pancreatic cysts and hepatic lesions.
• Managed 20–30 complex patients weekly in video and in-person settings.

Attending Clinics

• Ran high-volume HPB attending clinics (Dr. Nissen, Dr. Kosari averages 18–22 patients per session, including new oncology consults, urgent imaging reviews, post-op visits, recurrence workups, and complex treatment-decision visits involving surgery, radiation oncology, histotripsy, or GI interventions.
• Diagnostic Ordering and Treatment Planning: Ordered and interpreted MRI, MRCP, CT, PET, tumor markers, and interventional procedures.
• Initiated referrals to Oncology, GI, IR, Radiation Oncology, Genetics, and survivorship pathways.
• Reviewed cases in the HPB GI Multidisciplinary Conference, documented recommendations, and communicated plans to patients. Care Coordination Note Authoring produced comprehensive care coordination notes summarizing: diagnosis and staging, treatment history, imaging timeline, surgical and oncologic plans, and follow-up recommendations. Ensured clarity for downstream providers, including oncology and GI.
• Program Development / System Navigation helped operationalize HPB workflow during integration from the Transplant Center to the Cancer Center.
• Identified and escalated systemic issues with scheduling, overbooked clinics, and order-entry workflows.
  Collaborated with leadership on template design, NP clinic structure, and improved patient triage.

KEY SKILLS DEVELOPED

• High-acuity surgical oncology management
• Advanced imaging interpretation (CT/MRI/PET)
• Complex drain management (JP, PTC, internal/external biliary drains)
  Post-Whipple complication management
• Oncology coordination & peri-treatment surveillance
• Multidisciplinary communication
  Independent telehealth management
• Advanced EMR proficiency (Epic) including care coordination notes, order workflows, and smart templates

• Independent NP managing inpatient GI consults and coordinating procedural care across three hospitals in a high-volume private practice. Functioned as the sole advanced practice provider supporting daily rounds, diagnostic assessment, and coordination of endoscopic interventions.

INPATIENT RESPONSIBILITIES
• Performed fully independent daily rounds across Valley Presbyterian, Northridge Hospital, and Community Medical Center for a high-volume private GI practice.
• Assessed and managed complex inpatient GI cases including GI bleeds, pancreatitis, obstructive jaundice, suspected malignancy, acute abdominal pain, and cirrhosis-related complications.
• Conducted comprehensive histories, physical exams, progress notes, and care plans without resident or fellow support.
• Identified patients requiring urgent or elective GI procedures and coordinated EGD, colonoscopy, ERCP, and EUS directly with endoscopy and anesthesia teams.
• Ordered and interpreted CT, MRI, ultrasound, labs, stool studies, and serologies to support diagnostic and treatment decisions.
• Stabilized acute GI conditions including GI bleeding, cholangitis, diverticulitis, hepatic encephalopathy, ascites, and electrolyte disturbances.
• Developed bowel prep and NPO plans, initiated antibiotic therapy when indicated, and monitored clinical response.
• Collaborated closely with hospitalists, surgeons, radiology, and interventional radiology for procedural planning and diagnostic clarification.
• Provided clear bedside education to patients and families regarding procedures, plans of care, and follow-up needs.
• Ensured continuity of care by communicating updated findings to the attending physician throughout the day.

WOUND CARE NURSE – VALLEY PRESBYTERIAN HOSPITAL
• Conducted fully independent inpatient wound care rounds across med/surg, telemetry, ICU, and step-down units, identifying and managing acute and chronic wounds.
• Completed comprehensive skin assessments, staging of pressure injuries, and differential diagnoses for complex wounds including vascular ulcers, diabetic foot ulcers, surgical wounds, and moisture-associated skin damage.
• Performed bedside treatments including debridement preparation, dressing selection, negative-pressure therapy management, and advanced wound product application.
• Provided real-time consultative recommendations to hospitalists, intensivists, podiatry, plastics, general surgery, and vascular surgery.
• Co-managed wound care program with dedicated wound care RN, contributing to the development and refinement of skin integrity protocols and HAPI (Hospital-Acquired Pressure Injury) prevention bundles.
• Initiated treatment orders per institutional protocol and communicated recommendations to primary teams to ensure timely plan execution.
• Participated in interdisciplinary wound care clinic alongside podiatry, plastics, and vascular surgery, evaluating patients and developing longitudinal treatment plans.
• Educated nursing staff on wound staging, prevention strategies, moisture-barrier protocols, and early identification of skin breakdown.
• Documented detailed wound assessments, progress notes, and serial measurements to support quality improvement metrics and regulatory compliance.

ICU REGISTERED NURSE – NORTHRIDGE HOSPITAL MEDICAL CENTER
• Provided comprehensive, high-acuity critical care in a 32-bed mixed ICU with an additional 8-bed overflow unit at a Level II Trauma, Stroke, and STEMI center.
• Managed full spectrum of critical illness: septic shock, DKA/HHS, massive GI bleeds, acute liver failure, ARDS, multisystem organ failure, cardiogenic shock, and complex postoperative surgical patients.
• Cared for trauma patients including polytrauma, TBI, spinal injuries, penetrating trauma, blunt force trauma, and multi-compartment hemorrhage.
• Managed cardiovascular critical care including post–open heart surgery patients, IABP (Intra-Aortic Balloon Pump), Impella, temporary pacemakers, transvenous pacing, vasopressors, and hemodynamic monitoring.
• Provided neurocritical care for stroke, SAH, SDH, post-craniotomy patients, intracranial pressure management, EVD monitoring, and neuro checks per protocol.
• Expertly stabilized STEMI patients, post-PCI patients, and complex arrhythmia cases requiring continuous cardiac monitoring and titration of antiarrhythmics.
• Responded to all in-hospital emergencies including rapid responses, code blues, massive transfusion activations, trauma activations, stroke alerts, and STEMI activations.
• Performed complex procedures and interventions including arterial line management, central line care, trach/vent care, chest tube management, and CRRT coordination.
• Led multidisciplinary coordination with intensivists, cardiology, neurosurgery, trauma surgery, GI, and anesthesia for fast-paced, minute-to-minute decision-making.
• Precepted new ICU nurses and cross-training staff, reinforcing best practices in ventilator management, sedation strategies, sepsis bundles, and evidence-based critical care.
• Provided compassionate, family-centered communication during high-acuity and end-of-life situations, including goals-of-care discussions and palliative coordination.
• Demonstrated advanced clinical judgment in rapidly deteriorating patients, anticipating complications and escalating interventions promptly.

REGISTERED NURSE – STEP-DOWN / TELEMETRY UNIT
Northridge Hospital Medical Center

• Delivered comprehensive nursing care on a high-acuity step-down/tele unit, managing complex patients requiring continuous cardiac monitoring and close hemodynamic assessment.
• Cared for tracheostomy and ventilator-dependent patients, performing airway management, suctioning, ventilator checks, and collaborating with RT for weaning strategies.
• Managed cardiac telemetry patients including CHF exacerbations, arrhythmias, post-PCI observations, chest pain rule-outs, hypertensive emergencies, and patients requiring titrated cardiac drips per protocol.
• Provided care for post-surgical patients including ortho, general surgery, spine, and trauma step-down cases requiring advanced assessment and early recognition of deterioration.
• Monitored and interpreted EKG rhythms, recognized early warning signs of decompensation, and initiated appropriate interventions and escalation.
• Delivered skilled nursing care for patients with diabetes complications, GI bleeds, COPD exacerbations, sepsis, renal failure, and other high-complexity medical conditions.
• Frequently floated to Med/Surg, Ortho, Oncology, and overflow units to support staffing needs, providing safe and efficient patient care across varied populations.
• Collaborated closely with interdisciplinary teams including hospitalists, cardiology, trauma, respiratory therapy, PT/OT, and case management to coordinate effective patient care plans.
• Demonstrated strong clinical judgment and rapid prioritization in managing 4–6 intermediate care patients, balancing acute needs with complex discharge planning.
• Served as a resource nurse for new staff and float nurses, assisting with questions, admissions, discharges, and clinical problem-solving.

UNIT SECRETARY – FLOAT POOL / STAFFING COORDINATOR
Northridge Hospital Medical Center

• Provided administrative and clinical workflow support across the entire hospital, floating to high-volume units including ICU, ER, L&D, Orthopedics, Oncology, Med/Surg, Psych, and Step-Down.
• Entered, transcribed, and processed all physician orders *before the implementation of EMR*, ensuring accuracy, timely communication with nursing staff, and regulatory compliance.
• Managed patient admissions, transfers, and discharges, coordinating documentation and communicating bed assignments with charge nurses in real time.
• Hand-wrote medication orders and treatment plans based on provider dictation, ensuring precise transcription during peak-volume hours; maintained high accuracy in extremely fast-paced environments.
• Served as the primary point of contact for providers, nurses, ancillary staff, and families; ensured seamless unit operations during high-acuity shifts.
• Cross-trained into the Nursing Staffing Office to support hospital-wide staffing and operations.
• Coordinated daily staffing needs for all inpatient units, attending staffing huddles and collaborating with charge nurses to match nurse skill sets with patient needs.
• Hired, scheduled, and onboarded agency/registry nurses; verified credentials, collected required documentation, and ensured assignments aligned with unit requirements.
• Anticipated staffing shortages and proactively filled vacancies across multiple units, maintaining safe ratios in accordance with California Title 22.
• Built strong relationships across disciplines, becoming a trusted resource for operational problem-solving and real-time crisis staffing adjustments.
• Gained foundational expertise in hospital operations, interdisciplinary communication, and the clinical workflow systems that later shaped advanced practice efficiency.