Registered Nurse (Specialty Care / Outpatient)

Full Job Description

The VA Texas Valley Coastal Bend Health Care System, Harlingen, TX is seeking a full-time Registered Nurse (Specialty/Outpatient Clinic) responsible and accountable for all elements of the nursing process when providing and/or supervising direct patient care.

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/12879229.

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: Case Management experience within last 5 years. Direct patient care within last 5 years.

Ambulatory Clinic experience within the last 5 years, including procedural assistance, patient education, care coordination, clinic operations, and collaboration w/ multidisciplinary specialty teams 1-3 years experience with Electronic Medical Records and other applications.

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.

Major Duties:

The Registered Nurse (Specialty/Outpatient Clinic) assesses, plans, implements, and evaluates 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.

Duties will also include the following: - Uses the nursing process and evidence-based practice to collaborate with the Teamlet and larger 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 and monitors patient for any adverse effect.

- Triages and applies a collaborative team approach in identifying, analyzing, and resolving patient care problems; documents own interventions.

- Monitors progress using clinical standing orders, analyzes variations, and initiates appropriate actions. - Maintains current knowledge of multidisciplinary resources, programs, and services.

Refers patients for community resources as deemed necessary. - Reviews options with patients and families, alternatives, risks/benefits, and services.

- Educates the patient and family on disease processes, resources, plan of care, treatments, and /or procedures.

- Screens patients for social service, home care, and other community care needs; and coordinates or makes referrals as appropriate; and seeks consultation when indicated.

- Ensures the patient's provider is aware of patient progress, issues, and/or problems.

- Evaluates needs and facilitates the patient's ability to learn the principles of self-care; utilizes appropriate resources if the patient is unable to grasp the knowledge/skills needed for self-care through the use of motivational interviewing.

- Utilizes approved Standing Orders and Guidelines to facilitate autonomy in providing care.

- Promotes cost effective use of resources and effective strategies including non-face-to-face approaches (including telehealth).

- Maintains privacy and confidentiality of all patient information, including electronic, print, and conversations.

- Applies skills, such as motivational interviewing to promote patient self-management. - Adheres to policies, procedures, and standards to promote evidence-based patient-driven care.

- Timely compliance of required web-based educational modules (Talent Management System TMS). - Completes and documents secure messaging within 72 hours. Surrogate is always identified.

Escalation of secure messaging must be maintained at 10% or less. Routes messages to appropriate care lines as needed.

- Performs other tasks as requested by providers or supervising nursing personnel within the scope of training and abilities.

- Demonstrates flexibility and adapts to work demands or adjustment of assignments.

- Performs as a role model in the provision of excellent customer service - Reviews Message Manager and assists Team to address/complete pending alerts Other duties as assigned.

Work Schedule: Monday - Friday (08:00am - 04:30pm) VA offers a comprehensive total rewards package: VA Nurse Total Rewards Telework: Not Available Virtual: This is not a virtual position.

Relocation/Recruitment Incentives: Not Authorized 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