Registered Nurse (Ambulatory Care)

Full Job Description

The Fayetteville NC VAMC is searching for a few Registered Nurse (RN Staff - Outpatient) within the Ambulatory Care Department.

As a Member of PACT, the RN will function as an integral member of the interdisciplinary team in managing chronic diseases.

The RN must demonstrate outstanding communication skills with the ability to triage patient concerns and complaints in person or via telephone and applies the principles of advanced clinic access and PACT Principles with their daily work.

Basic Requirements: Citizenship: Citizen of the United States in accordance with section 7402(c) to title 38, United States Code (U.S.C.). 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/12898767.

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/. Physical Requirements: See VA Directive and Handbook 5019.

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, and pushing. Transferring patients and objects may be required.

Mechanical inpatient lifts are provided.

The incumbent may be exposed to infected patients and contaminated materials and may be required to don protective clothing in isolation situations, operative/invasive procedures, or home settings.

The incumbent may occasionally be exposed to patients who are combative secondary to delirium, dementia, or psychiatric disorders.

The incumbent must be a mature, flexible, sensible individual capable of working effectively in stressful situations, able to shift priorities based on patient needs.

Must complete annual Employee Health requirements, such as annual TB screening or testing, as a condition of employment.

The incumbent who provides care in home settings or other off-site locations may be required to drive and/or ride in GSA-vehicles. Major Duties:

The Patient Aligned Care Team (PACT) Registered Nurse demonstrates advanced clinical expertise in the nursing process (assessment, diagnosis, planning, implementing, and evaluation) when caring for the veteran population.

The RN possesses broad-based clinical knowledge and skills to effectively apply all aspects of the nursing process within a collaborative, interdisciplinary practice setting.

The RN effectively implements activities towards health promotion and disease prevention along with the management of acute and chronic illness.

Duties: The Patient Aligned Care Team (PACT) Registered Nurse demonstrates proficiency in practice based on conscious and deliberate planning and is self-directed in goal setting for managing complex client situations.

Duties of the position are, but are not limited to: Provides direct Veteran care and care coordination, as it pertains, to Veterans and their care within the Primary Care Department.

Administers medications and procedures per established policies and guidelines. Influences outcomes by collaborating with members of the interdisciplinary team.

Responsible for providing competent, evidence-based sex-specific care to primary care patients with oversight of licensed vocational nurses/nursing assistants as appropriate to the setting.

Manages assigned panel(s), utilizes registries, and ensures appropriate evaluation and access is provided to patient panels.

Provides health promotion, health education and coaching on wellness, disease prevention, and chronic care management.

Assist in directing the provision of nursing education, orientation, competencies and providing quality improvement and enhance outcomes utilization.

Integrates outpatient nursing knowledge, skills, abilities, and judgment and is self-directed in goal setting for managing complex PACT situations.

Validates understanding of the rationale for care processes and decisions. Demonstrate the ability to cope with and manage competing priorities.

Utilizes other registries to manage disease processes such as Diabetic, Mammography, Cardiovascular, and Opioid Registries to access data base for pain management Performs timely Post-Discharge/ ED/ Urgent Care and Walk-ins' using appropriate documentation templates/notes, codes, education.

Assesses and enrolls eligible patients into nontraditional modalities of care such as home telehealth and Telemedicine.

Utilizes Teach and Motivational Interviewing techniques to encourage positive health behavioral change and Health Promotion and Disease Prevention.

Reviews, tracks, and devises strategies to improve Healthcare Effective Data Information Sets (HEDIS) metrics, clinical reminders, panel access, timely encounter closures, and other performance metrics.

Facilitates continuity of care by partnering with multidisciplinary services, internal and external to the Department of Veterans Affairs.

Initiates and participates in various quality and process improvement activities that result in improved patient outcomes.

Enhances clinic access and team performance by pre-planning/ pre-appointment chart review daily huddles and weekly meetings with PACT team and other members of the extended PACT.

Utilizes facility approved Nursing Protocols and Guidelines to enhance patient care as appropriate.

Collaborates with PACT and Expanded PACT to participate/provide shared medical appointments/ group clinics for patients with specific chronic disease diagnoses.

Demonstrates leadership by serving as an advocate for patients and a team leader with colleagues as he/she continues to enhance his/her own professional growth, continuing education and development.

Completes any other nursing responsibilities as assigned by leadership. Demonstrates competence in primary care practice and decision-making, deliberate planning, and critical thinking skills.

Preferred Experience: One year of Primary/Ambulatory Care, Emergency or Urgent Care, or Med-Surg Experience preferred.

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, 8:00 am - 4:30 pm Telework: Not available Virtual: This is not a virtual position.

Relocation/Recruitment Incentives: Not authorized Permanent Change of Station (PCS): Not authorized