Registered Nurse

Full Job Description

The National Tele-Critical Care Program provides critical care nursing and physician co-management to multiple VA medical centers across the country.

Continuous telemedicine patient care is provided 24 hours a day, 7 days a week, 365 days a year. Tele-Critical Care sub-hubs are established in VA facilities across the country.

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/12934686.

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/.

Preferred Experience: 5 years minimum of critical care bedside nursing experience required for this position Physical Requirements: This position includes a level of physicality normally associated with duties performed by nurses such as direct patient care, and potentially long periods of 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 Major Duties:

The Registered Nurse- Tele-Critical Care (TCC) position will execute the responsibilities that demonstrate leadership, experience, and creative approaches to management of complex client care.

You will provide care and counseling of persons or in the promotion and maintenance of health and prevention of illness and injury based upon the nursing process which includes systematic data gathering, assessment, appropriate nursing judgment, and evaluation of human responses to actual or potential health problems through such services as case finding, health teaching, and health counseling.

The position duties will include but is not limited to the following: The Nurse TCC Registered Nurse (RN) executes position responsibilities to improve patient and organizational outcomes.

Provides leadership in the application of the nursing process to patient care, organizational processes and/or systems, improving outcomes at the program or service level.

Provides leadership in identifying and addressing ethical issues that impact patients and staff, including initiating and participating in ethics consultation.

Manages program resources to facilitate safe, effective, and efficient care. Maintains knowledge of current techniques, trends, and professional issues.

Uses professional standards of care and practice to evaluate programs and/or service activities. Uses the group process to identify, analyze, and resolve care problems.

Initiates interdisciplinary projects to improve organizational performance. The TCC RN collects and analyzes patient and family data for the purpose of assessment, diagnosis, and management.

Efficiently assembles a focused assessment of physiological, psychological, and medical record data. Uses critical thinking skills in diagnosing clinical problems and in defining interventions.

Re-evaluates prior diagnoses and care plans at appropriate intervals in accordance to expected individual patient outcomes. Prioritizes clinical problems accurately and in a timely manner.

Uses clinical decision support tools in determining evidence-based practices for clinical problems.

Responds to routine, urgent, and emergent patient problems appropriately by demonstrating effective decision-making. Provides follow-up to ensure problem resolution.

Advocates needs and wishes of patients and family about health care. Formulates and articulates succinct and comprehensive assessments of real or potential patient problems to the TCC provider.

Solves clinical patient problems independently and in a timely manner and communicates unresolved problems.

Enters admissions, updates the discharge list and transfers or discharges patients in eCare manager. Utilizes Apache reports, builds reports and enters data.

Troubleshooting technical equipment in the support center and at the bedside via camera.

Works on multiple technical platforms at once, such as Computerized Patient Record System (CPRS), Joint Legacy Viewer (JLV), Vista, eCare Manager, Outlook, Cerner, Windows, etc.

Independently sets priorities and deadlines, adjusting the flow and sequencing of work to meet the patient and team needs.

Works independently making decisions based on guidelines, precedents and regulations and performs duties in such a manner that only minimal supervision is required.

Routinely communicates with physicians, case managers, and other allied health professional staff using sound interpersonal skills and is constantly aware of the sensitive information.

Performance is judged in terms of overall effectiveness of the operation through broad general objectives, the adequacy and accuracy of the work, timeliness, and conformance to established procedures, policies, and instructions.

Prevents clinical problems from occurring by direct observation via teleconferencing, proactive surveillance of adverse physiological trends, assurance of appropriate ordered prophylactic strategies, medical chart review, and appropriate reaction to alerts.

Updates ICU knowledge of pathophysiology, pharmacology, hemodynamics, bedside technology, and nursing care.

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 (with occasional weekends and holidays).

Tour to be dependent on needs of the program. Telework: Not Available Remote: This is not a remote position. Financial Disclosure Report: Not required