Summary

This position will serve as part of the El Paso VAHCS and William Beaumont Army Medical Center (WBAMC) Surgical Expansion pilot to expand WBAMC surgical services to VA beneficiaries to include increased capabilities in Orthopedic - General Surgery - and Neurosurgery clinics and operative procedures. Responsible and accountable for all elements of the nursing process when providing and/or supervising direct patient care.

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.) HPTs who are on track to graduate/complete the requirements should respond as if they have met the requirements
• Provide details in the narrative sections of the assessment
• 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/12861926
• 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
• Preferred Experience: Minimum 1-2 years of recent PACU experience or in a similar critical care setting (ICU - ER) Experience with post-operative patient monitoring - including airway management and pain control
• Familiarity with recovery processes Proficiency in vital signs - and recognizing early signs of complications Reference: For more information on this qualification standard - please visit https://www.va.gov/ohrm/QualificationStandards/
• Physical Requirements: Lifting up to 35·pounds for 8-12 hours - intermittently - moderate carrying (15-35 pounds) for 8 to 12 hours - intermittently - lifting over 35 pounds with assistive devices in accordance with the Safe Patient Handling Policy except in emergent situations requiring prompt patient care - pulling for 8 to 12 hours intermittently - pushing for 8-12 hours - intermittently - reaching above the shoulders for 8-12 hours - intermittently - both hands required - walking 8-12 hours - intermittently - standing 8-12 hours intermittently - kneeling 8 to 12 hours - intermittently - repeated bending for 8-12 hours - intermittently - climbing and use of both legs and arms for 8-12 hours - intermittently - both legs required - near vision at 13 to 16" Jaeger 1 to 4 - far vision correctable in one eye to 20/20 and to 20/40 in the other eye - ability to distinguish basic colors - hearing aid permitted - twisting - simple grasp and fine manipulation.

Duties

• The Post Anesthesia Care Unit (PACU) Registered Nurse (RN) provides specialized care in the assessment - planning - implementing and evaluation of care throughout the peri anesthesia continuum to include the Pre anesthesia Phase - Post anesthesia Phase I - Post anesthesia Phase II - and extended care from sedation/analgesia and/or anesthesia for surgical - diagnostic - or therapeutic procedures
• The PACU RN possesses knowledge related to the physiology associated with various anesthesia techniques and surgical interventions
• The PACU RN assesses and prepare patients for procedures appropriately
• Performs clinical assessment of the patient and readily recognizes contraindication for anesthesia and/or surgical intervention
• The PACU RN applies the appropriate post sedation scoring and assesses the patient's postoperative status to include cardiovascular and respiratory systems and airway management needs - neurological system - hemodynamic stability - pain - and comfort needs and mental status - implementing appropriate interventions to maintain or return all physiological system to baseline or above
• EPVAHCS/ WBAMC Surgical Expansion Pilot Duties: Performs recovery duties for patients recovering from a wide variety of routine to highly complex surgical procedures
• Independently determines and develops post anesthesia care requirements based upon - written protocols - nursing staff skill mix - post anesthesia recovery score (PARS) - ASA categories
• Administers and monitors the use of therapeutic agents (medications) in accordance with the Department of Nursing and unit operating instructions - the American Society of Peri Anesthesia Nurses (ASPAN) and American Society of Anesthesiologists (ASA)
• Uses sophisticated - specialized and highly complex patient care equipment to include ventilators - cardiac monitors - infusion pumps for emergent medications - and epidural pumps during the nursing care and management of the post-operative patient
• Provides care pre - during and post-procedure patients
• Monitors post-operative patient's condition based upon the method of anesthesia provided (i.e
• general - regional - local and/or sedation analgesia)
• for complications and/or adverse reactions such as such as laryngospasm - pulmonary edema - hypoventilation - hypoxia - aspiration pneumonitis - nausea/vomiting - acute pain - hypo/hyperthermia - etc
• and takes immediate counteractions as required to restore condition
• Assesses spinal anesthesia level of patients receiving regional anesthesia
• Assists health care providers with examinations and procedures
• Prepares and administers oral - subcutaneous - intra-muscular and intravenous medications
• Reviews records/reports - interpreting signs and symptoms of patients' changing status and takes corrective action
• Facilitates obtaining timely lab tests - X-rays - and Electrocardiograms (EKGs) as needed
• Administers oxygen - Intravenous (IV) fluid - blood transfusion and ordered oral - subcutaneous - intramuscular and intravascular medications - including potent narcotics
• Assesses post-procedure patients prior to their release
• Identifies life-threatening changes to the patient's condition
• institutes required emergency measures - including Cardiopulmonary Resuscitation (CPR) and/or Advanced Cardiac Life Support measures as needed
• Sets up - operates and monitors specialized medical equipment such as cardiac monitors - defibrillators - suction devices - pulse oximeter - etc
• Advises physicians of actions taken and ensures proper documentation of nursing care provided on standardized nursing forms
• Counsel's patients - family members and/or care givers regarding information on possible reactions to medications - health maintenance and illness preventions - addressing concerns - or questions that the patient may have
• 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: M-F 0830-1700 and M-F 1200-2030 Telework: Not Available Virtual: This is not a virtual position
• Relocation/Recruitment Incentives: Not Authorized Permanent Change of Station (PCS): Not Authorized