Summary

Incumbent functions as a clinical expert and is responsible and accountable for all elements of the nursing process when providing or supervising direct patient care. Assesses - plans - implements - and evaluates delivery of care based on age specific components. Assumes responsibility for the coordination of care focused on patient education - self-management - and customer satisfaction throughout the continuum of 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.) 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/13100270
• 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
• Applicants pending completion of educational or certification/licensure requirements may be referred and tentatively selected but may not be hired until all requirements are met
• Preferred Experience: BSN or MSN preferred 3-5 years Med Surg/ER Case Management Experience Outpatient Clinic Experience 3-5 years Nurse Manager or Assistant Nurse Manager Leadership/Supervisory Experience Experience in leading and organizing program/classes Computer skills required
• knowledge in Excel - PowerPoint and Electronic Medical Records Continued from Duties Section: Provides Care Management to patients with Ambulatory Care Sensitive Conditions (ACSCs) including reviewing the patient record - deciding if the patient needs more in-depth education (formal and/or informal)
• nursing visits and/or telephone calls between provider visits to assist in care management
• Collaborates with the High­Risk Care Coordinators - Home Telehealth - social work - and/or dieticians for referrals and care management
• Promotes health promotion - quality patient care - and risk reduction strategies for patients through the assessment and utilization of SAIL - HEDIS - Specialty Productivity Report and Quadrant Tool (SPARQ) - EQm - DataMart - and EPRP data
• Cultivates an environment of professionalism - excellence and conflict resolution at the team level
• Assists the Nurse Manager in guiding and evaluating staff in development of plans of care - prioritization of client diagnosis/needs - relevance of nursing diagnosis - individualization of interventions - expected client outcomes - and quality of documentation
• Assists Nurse Manager in promoting professional development and motivation for employees to work at optimal efficiency
• Assists Nurse Manager in providing overall management of a clinic/area
• Collaborates with other healthcare professionals in coordinating care
• Assists Nurse Manager in managing nursing staff in delivering nursing care
• Demonstrates sound administrative judgment in making decisions
• Reference: For more information on this qualification standard - please visit https://www.va.gov/ohrm/QualificationStandards/.

Duties

• Major Duties: Uses the nursing process and evidence-based practice to collaborate with the Team to meet patient care needs
• Provides patient and family health education with a focus on self-management - prevention - wellness - and Whole Health based on the patient's goals
• Demonstrates advanced clinical knowledge in assessing - planning - implementing - documenting - and evaluating care for a designated group of patients
• Educates patients regarding clinic procedures and what to expect during the procedure
• Assists with clinic procedures - monitors patient for any adverse effect
• Triages and applies a collaborative team approach in identifying - analyzing - and resolving patient care problems
• Collaborates with the interdisciplinary team - patients - and caregivers
• Monitors progress using clinical guidelines and/or pathways - analyzes variations and initiates appropriate actions
• Documents own interventions - including observations - treatments - care provided - education and patient/caregiver understanding
• Maintains current knowledge of multidisciplinary resources - programs and services
• Refers patients for community resources as appropriate
• Performs daily review of charts in preparation for scheduled patient appointments
• Ensures results are available for the provider and obtains medical records - when applicable
• Confirms appointment modality is suitable for the patient - including performing VA Video Connect testing if needed
• Documents accordingly
• Reviews options with patients and families - including costs - alternatives - risks/benefits and services
• Educates the patient and family on disease process - resources - plan of care - treatments and procedures
• Advocates fiscal responsibility in the management of patient care through effective utilization of resources
• Screens patients for social service - home care - and other community care needs
• Ensures the provider is aware of the patient's progress - as well as any issues or concerns
• Evaluates needs and facilitates the patient's ability to learn the principles of self­care
• utilizes appropriate resources if the patient is unable to grasp the knowledge/skills needed for self-care
• Participates in care delivery with priority attention to patient preference
• Facilitates nursing autonomy by utilizing approved standing orders and guidelines
• Promotes cost effective use of resources including non-face-to-face approaches such as telehealth
• CVT - VA Video Connect - and telephone appointments
• Applies skills - such as motivational interviewing - to promote patient self-­management
• Fosters health promotion and risk reduction strategies utilizing a Whole Health approach
• Actively participates in policies - procedures - and quality standards to promote evidence-based patient-driven care
• Completes and documents secure messages within 72 hours - as applicable
• Escalation of secure messaging does not exceed the VHA standard (10% or less) and a surrogate is identified at all times
• Performs duties - within scope of practice - as requested by providers or supervising nursing personnel as appropriate
• Demonstrates flexibility and adapts to work demands or adjustment of assignments
• Provides patient and family health education with a focus on self-management - prevention - and wellness - based on the patient's goals
• Performs as a role model in the provision of excellent customer service
• Reviews Message Manager timely
• Assists the team to complete pending alerts communicated throughout tour of duty within 48 hours
• Completes and documents Nursing Notes in the electronic health record - as applicable - in a timely manner and closes the Encounter Notes for patients not seen by a provider
• Notes will be closed by the end of tour of duty daily
• Areas to be addressed include Encounters: reasons for visit- Service Connection
• Primary Assignment-Service connected conditions under the \"Diagnosis\" tab
• Procedures - ACSC conditions - Immunization tab - etc
• Duties Continued in Qualification Section 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: Monday - Friday - 8:00am - 4:30pm Telework: Not Available for Telework Virtual: This is not a virtual position
• Relocation/Recruitment Incentives: Not Authorized Permanent Change of Station (PCS): Not Authorized