Summary

Responsible and accountable for all elements of the nursing process when providing and/or supervising direct patient care. Assumes responsibility for the coordination of care focused on patient education - selr-management - and customer satisfaction throughout the continuum of care. Administers medications and procedures per established policies and guidelines. Influences care outcomes by collaborating with members of the interdisciplinary team.

Qualifications

Basic Requirements:

• English Language Proficiency
• In accordance with 38 U.S.C. 7403(f) - no person shall serve in direct patient care positions unless they are proficient in basic written and spoken English
• Graduate of a school of professional nursing approved by the appropriate accrediting agency and accredited by one of the following accrediting bodies at the time the program was completed by the applicant: The Accreditation Commission for Education in Nursing (ACEN) or The Commission on Collegiate Nursing Education (CCNE)
• OR Individuals attending a master's level bridge program in nursing who have completed coursework equivalent to a bachelor's level degree in Nursing may have opportunity to become registered as a nurse with a state licensing board prior to completion of the bridge program
• Upon achievement of a State license - the individual may be appointed on temporary basis and later converted to a permanent appointment upon successful completion and graduation from the bridge program
• (Reference VA Handbook 5005 - Appendix G6)
• OR In cases of graduates of foreign schools of professional nursing - possession of a current - full - active - and unrestricted registration will meet the requirement for graduation from an approved school of professional nursing to warrant an appointment as a Nurse who has completed an associated degree/entry level Nursing education program
• Credit for foreign nursing education higher that associate degree/entry level requires a formal degree equivalency validation from a recognized equivalency evaluation accepted by VA such as International Consultants of Delaware (ICD)
• Current - full - active - and unrestricted registration as a graduate professional nurse in a State - Territory or Commonwealth (i.e. - Puerto Rico) of the United States - or the District of Columbia
• Graduate Nurse Technician (GNT) Exception: Candidates who otherwise meet the basic education requirements - but do not possess the required licensure - may be appointed at the entry step of the grade and level applicable to the completed nursing education as a GNT on a 120-day temporary appointment while actively pursuing licensure (may be extended up to two years on a case-by-case-basis.) NOTE: Grandfathering Provision - All persons currently employed in VHA in 0610 series and performing the duties as described in the qualification standard on the effective date of the standard (1/29/2024) are considered to have met all qualification requirements for the grade held including positive education and licensure/certification
• Grade Determinations: The following Scope - Education and Dimension criteria must be met in determining the grade assignment of candidates - and if appropriate - the level within a grade
• The Dimension requirements (Practice - Veteran/Patient Driven Care - Leadership - Professional Development and Evidence-Based Practice/Research) are detailed for each grade and level within the online assessment: https://apply.usastaffing.gov/ViewQuestionnaire/12975026
• Grade/Level Scope Education Nurse I - Level I Delivers fundamental - knowledge-based care to assigned clients while developing technical competencies
• An Associate Degree (ADN) or Diploma in Nursing - with no additional professional nursing required
• Nurse I - Level II Demonstrates integration of biopsychosocial concepts - cognitive skills and technically competent practice in providing care to clients with basic or complex
• An ADN or Diploma in Nursing AND 1 year of specialized nursing experience equivalent to Nurse I - Level 1 ;OR a Bachelor of Science in Nursing (BSN) with no additional professional nursing experience required
• Nurse I - Level III Demonstrates proficiency in practice based on conscious and deliberate planning
• Self-directed in goal setting for managing complex client situations
• An ADN or Diploma in Nursing AND 2 years of professional nursing experience in which one year is equivalent to Nurse I - Level 2
• OR a BSN and 1 year of professional nursing experience equivalent to the Nurse I - Level 2
• OR a Master's degree in nursing (MSN) and no additional professional nursing experience
• OR a Master's degree in a *related field with a BSN and no additional professional nursing experience
• Nurse II Demonstrates leadership in delivering and improving holistic care through collaborative strategies with others
• A BSN with 2 years of professional nursing equivalent to Nurse I - Level 3
• OR an MSN with one year of specialized nursing experience equivalent to Nurse I - Level 3
• OR a Master's degree in a *related field with a BSN and one year of specialized nursing experience equivalent to Nurse I - Level 3
• OR a Doctoral degree in Nursing with no professional nursing experience
• OR a Doctoral degree in a *related field with a BSN with no additional professional nursing experience
• Nurse III Executes position responsibilities that demonstrate leadership - experience and creative approaches to management of complex client care beyond the immediate practice setting
• MSN and 2 years of specialized nursing experience - one of which is equivalent to Nurse II and meets all dimension requirements for Nurse III
• OR a Master's degree in *related field with BSN and two years of specialized nursing experience - one of which is equivalent to Nurse II and meets all dimension requirements for Nurse III
• OR a Doctoral degree in Nursing with and one year of specialized nursing experience equivalent to Nurse II and meets all dimension requirements for Nurse III
• OR a Doctoral degree in a *related field with a BSN and one year of specialized nursing experience equivalent to Nurse II and meets all dimension requirements for Nurse III
• *Note: Foreign education programs/degrees are not creditable as related degrees
• Reference: For more information on this qualification standard - please visit https://www.va.gov/ohrm/QualificationStandards/
• Preferred Experience: Ambulatory sugery/Outpatient surgery experience
• Physical Requirements: The population of male and female veterans served ranges from the adult - age 18 - to the elderly adult - age 65 and over
• James H Quillen Veterans Affairs Medical Center (JHQVAMC) is a major interdisciplinary teaching facility - serving medical - surgical - and neurological inpatients and outpatients
• There is a large outpatient psychiatric population - with admissions for medical comorbidities
• This position requires visual acuity - keen hearing - clear distinctive speech - and manual dexterity
• This position requires potentially long periods of continued walking - standing - stooping - sitting - bending - pulling - lifting more than 10 pounds - and pushing
• Transferring patients and objects may be required
• The NA may be exposed to infected patients and contaminated materials and may be required to don protective clothing in isolation situations or operative/invasive procedures
• The NA may occasionally be exposed to patients who are combative secondary to delirium - dementia - or psychiatric disorders
• The NA must be a mature - flexible - sensible individual capable of working effectively in stressful situations - able to shift priorities based on patient needs
• The employee may on occasion - be assigned to other Veteran care areas throughout the medical center where certain healthcare services are available 24/7.

Duties

• Duties include: Provides pre-operative/procedural care - including (but not limited to) the nursing assessment of patients - consent - and H&P validations - the starting of intravenous fluids including venipuncture - assisting with peripheral nerve blocks - assuring all lab work and other pre-operative/procedural testing is completed and communicated to team members - confirms surgical sites are prepared and marked - and the administration of medications as ordered
• Provides clear and concise preoperative teaching and reviews discharge instructions to patients and families with written and verbal communication
• The Ambulatory RN monitors post-operative patient's level of consciousness after the recovery of anesthesia/sedation
• Closely observes signs of side effect of post residual anesthesia medications
• The Ambulatory RN maintains knowledge of current American Society of Peri anesthesia Nurses (ASPAN) standards - VHA Directive and service level standard operating procedures
• The Ambulatory RN is responsible for ensuring comprehensive documentation of all phases of care and is timely - complete - and accurate in the electronic health record
• Responsible for functioning independently and in performing other responsibilities/duties as assigned
• Is self-directed and requires little supervision
• It is expected that the Nurse readily identifies opportunities for improvement in the assigned area(s) AND develops and implements action plans to address these opportunities
• Responsible for providing safe - effective - quality care to patients and has the management skills necessary to function as charge nurse
• This nurse is responsible for guiding - directing - and appraising the performance of support staff and providing education for support staff - students - and new employees
• Responsible for the nursing process to implement patient care for self and others The registered nurse possesses the knowledge and skills to effectively apply all aspects of the nursing process with collaborative - interdisciplinary - evidence-based practice - which will enable effective care coordination and implementation of health promotion and disease prevention practices
• He/she provides education to patient - families - and significant others
• administers medications and treatment
• participates in the quality improvement process
• and is attuned to the needs of adult and geriatric patients
• Possesses expertise of assigned surgical clinics - clinic flow and those factors that can impede flow
• They implement measures/procedures that directly impact and improve flow
• They will cover all surgical clinics as assigned and maintain all required procedural and core competencies
• They possess the ability to assist each patient from check-in to check-out and other responsibilities as assigned
• Actively seeks additional assignments that are geared toward improvement in the clinic areas
• Responsible for practicing in accordance with and adhering to regulations such as the Nurse Practice Act - VHA policies and procedures the ANA Standards of Nursing Practice and other duties as assigned by the Nurse Manager
• The nurse demonstrates dedication to the nursing profession and represents nursing in the community and professional activities
• Moderate Sedation: This position will administer moderate sedation/analgesia under the immediate direct supervision of a physician who is clinically privileged to perform moderate sedation
• Individuals administering and monitoring moderate sedation must have documented competency-based education and training
• VA offers a comprehensive total rewards package: VA Nurse Total Rewards Pay: Competitive salary - regular salary increases - potential for performance awards Paid Time Off: 50 days of paid time off per year (26 days of annual leave - 13 days of sick leave - 11 paid Federal holidays per year) Retirement: Traditional federal pension (5 years vesting) and federal 401K with up to 5% in contributions by VA Insurance: Federal health/vision/dental/term life/long-term care (many federal insurance programs can be carried into retirement) Licensure: 1 full and unrestricted license from any US State or territory Work Schedule: Rotational Payscale: NG42 Functional Statements: 60693F through 60697F