Registered Nurse- Critical Care

Full Job Description

The Critical Care Registered Nurse (RN) is responsible for providing competent, evidence-based care to assigned patients and oversight of licensed vocational nurses/nursing assistants, as appropriate to the setting.

The nurse will assist in directing the provision of nursing education, orientation, competencies and providing quality improvement and outcomes utilization consultation Applicants pending the completion of educational or certification/licensure requirements may be referred and tentatively selected but may not be hired until all requirements are met.

Basic Requirements: United States Citizenship: Non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy. English Language Proficiency.

In accordance with 38 U.S.C. 7402(d), 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 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).

The approving official may authorize a waiver of the requirement for ACEN or CCNE accreditation of any degree in nursing provided the college or university has regional accreditation from an accrediting body recognized by the Department of Education at the time of the candidate's graduation and the composite qualifications of the applicant warrant such consideration.

In cases of graduates of foreign schools of professional nursing, possession of current, full, active and unrestricted registration will meet the requirement of graduation from an approved school of professional nursing.

OR The completion of coursework equivalent to a nursing degree in a MSN Bridge Program that qualifies for professional nursing registration constitutes the completion of an approved course of study of professional nursing.

Students should submit the certificate of professional nursing to sit for the NCLEX to the VA along with a copy of the MSN transcript.

(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.

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.

Grade Determinations: The following criteria must be met in determining the grade assignment of candidates, and if appropriate, the level within a grade: Nurse I Level I - An Associate Degree (ADN) or Diploma in Nursing, with no additional nursing practice/experience required.

Nurse I Level II - An ADN or Diploma in Nursing and approximately 1 year of nursing practice/experience; OR an ADN or Diploma in Nursing and a bachelor's degree in a related field with no additional nursing practice/experience; OR a Bachelor's of Science in Nursing (BSN) with no additional nursing practice/experience.

Nurse I Level III - An ADN or Diploma in Nursing and approximately 2-3 years of nursing practice/experience; OR an ADN or Diploma in Nursing and a Bachelor's degree in a related field and approximately 1-2 years of nursing practice/experience; OR a BSN with approximately 1-2 years of nursing practice/experience; OR a Master's degree in nursing (MSN) or related field with a BSN and no additional nursing practice/experience.

Nurse II - A BSN with approximately 2-3 years of nursing practice/experience; OR ADN or Diploma in Nursing and a Bachelor's degree in a related field and approximately 2-3 years of nursing practice/experience; OR a Master's degree in nursing or related field with a BSN and approximately 1-2 years of nursing practice/experience; OR a Doctoral degree in nursing or meets basic requirements for appointment and has doctoral degree in a related field with no additional nursing practice/experience required.

Nurse III - Master's degree in nursing or related field with BSN and approximately 2-3 years of nursing practice/experience; OR a Doctoral degree and approximately 2-3 years of nursing practice/experience.

Note regarding MSN degrees: If your MSN was obtained via a Bridge Program that qualifies for professional nursing registration, a BSN is not required.

Physical Requirements: 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.

The incumbent 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 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. Major Duties:

The Critical Care Registered Nurse (RN) is responsible for providing competent, evidence-based care to assigned patients and oversight of licensed vocational nurses/nursing assistants, as appropriate to the setting.

The nurse will assist in directing the provision of nursing education, orientation, competencies and providing quality improvement and outcomes utilization consultation.

The job duties of the Professional Registered Nurse in this ICU/PCU position include but are not limited to: - Has knowledge in recalling arrhythmia events in both ICU/Telemetry, establishing and/or changing alarm parameters, and obtaining a rhythm strip each shift to be scanned into the electronic chart.

- Troubleshoots when signals are not coming in properly. Patients will be provided education on reasons, purpose and restrictions associated with cardiac monitoring and telemetry.

- Is responsible for providing nursing care to medical and surgical patients who require continuous and concentrated monitoring.

- Has knowledge and expertise in: - Arrhythmia interpretation - Invasive hemodynamic monitoring - Cardioversion - Cardiac resuscitation - Pacemakers, external and transvenous - Acute MI protocol - IV thrombolytic - Volume expanders - Chest tube - Mechanical ventilation - Post anesthesia patients - IV pain management - Rx of GI and renal patients - Rx of pulmonary edema - Rx of severe respiratory patients & CO2 monitoring - Overdose protocols - Immediate post-op care of vascular patients, abdominal surgery, neuro-surgery, orthopedic surgery, pacemaker surgery - Rx of patients with epidural catheters - Education of patients and significant others in their treatment in ICU/telemetry - Conscious sedation - Institute for Healthcare Improvement (IHI) bundles: Ventilator Associated Pneumonia (VAP)/Central Venous Line (CVL) - IV vasoactive and inotropic medication - Provides care to Telemetry patients.

- Maintains Advanced Cardiac Life Support (ACLS) and Basic Cardiac Life Support (BCLS) certification. - Provides care to acute stroke victims and patients with altered level of consciousness.

- Is knowledgeable in caring for psychiatric patients with acute medical illness including, but not limited to, patients on Suicide, Violence, Eloper (SVE) precautions.

- Is able to assess care for patients with Congestive Heart Failure (CHF), Pulmonary Edema, Sepsis, and Respiratory Distress Syndromes.

- Assesses patients need on admission with respect to developmental stage, age, sex, religion, ethnicity, socioeconomic status and illness.

- Assists Physician/Hospitalist with a variety of bedside procedures such as intubation, thoracentesis, CVL insertion, paracentesis, bone marrow aspiration.

- Provides Patient Health Education (PHE) to patients and families with regard to current treatment, health issues, and patient/family concerns in accordance with educational level of patient/family.

- Acts as a member of Code Blue, Code White, and Rapid Response Teams (RRT).

- Provides assistance to other areas such as Emergency Department (ED), Triage, 4 East, Ward 9, Community Living Center (CLC). - Demonstrates good judgment in determining need for safety devices.

- With a physician order, an ACLS RN will accompany patients on transfer to another VA or a private facility as needed.

This clinical position includes a level of physicality normally associated with direct patient care duties performed by nurses such as potentially long periods of continued walking, standing, sitting, moderate lifting, repeated bending, or kneeling.

Examples may include but are not limited to: -Significant amounts of time standing assisting assigned patients -Utilization of safe patient handling and mobility protocols.

Work Schedule: 8p-8a rotating weekends/holidays (6 shifts in a 2week period + 1 8hour shift) Telework: Not Available Virtual: This is not a virtual position.

Permanent Change of Station (PCS): Not authorized Financial Disclosure Report: Not required