Career Center

Summary

The Registered Nurse in Ambulatory Care is responsible and accountable for all elements of the nursing process when providing and/or supervising patient care. They assess - plans - implements - and evaluates care based on age specific components. They assume 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
• Preferred Experience: Minimum two years of clinical nursing experience - preferably in primary care - ambulatory care - or family practice settings
• Experience working as part of an interdisciplinary team - including physicians - social workers - pharmacists - and other staff
• Experience with care coordination - chronic disease management - and patient education Ability to triage patients - perform telephone assessments - and respond to secure messaging
• Prior experience in population health management (e.g. - using CAN scores - registries - or proactive outreach for identified patient populations)
• Familiarity with the VA medical environment - electronic health records (CPRS) - and VA policies/procedures (preferred but not required)
• Strong communication - collaboration - and conflict resolution skills
• Experience implementing evidence-based practice and quality improvement initiatives Basic Life Support (BLS) certification required
• Advanced Cardiac Life Support (ACLS) preferred
• 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/12960024
• 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: The Registered Nurse's work may require encounters and care for unpredictable verbally and physically aggressive patients
• Completion - certification - and performance of Prevention and Management of Disruptive Behavior (PMDB) Parts 1 - 2 - and 3 courses annually is a requirement for direct patient care (Part 3 only applicable in areas deemed high risk)
• This position requires visual acuity - keen hearing - clear distinctive speech - and manual dexterity
• This position may require potentially long periods of continued walking - standing - stooping - sitting - bending - pulling - and pushing.The Registered Nurse may occasionally be exposed to patients who are combative secondary to delirium - dementia - or psychiatric disorders
• The incumbent who provides care in home settings or other off-site locations may be required to drive and/or ride in GSA-vehicles.

Duties

• Executes position responsibilities that demonstrate leadership - experience - and creative approaches to management of complex patient care
• Collaborates in the development - implementation - evaluation - and revision of policies - procedures - and/or guidelines
• RN practice includes the roles of direct care provider - educator - administrator - researcher - consultant - leader - and advocate
• Provides peers with formal or informal constructive feedback for improvement
• Supports colleagues and other nurses through knowledge sharing to provide safe - quality nursing care
• Fosters a safe and supportive environment conducive to the professional development of health care professionals
• Evaluates outcomes of evidence-based decisions and practice changes for individuals - groups - and populations
• Responsible for the documented outcomes at the program or service level
• Executes leadership in delivering and improving holistic care through collaborative strategies with others
• Demonstrates expertise in decision-making and using the nursing process for complex situations that effect performance outcomes at the point of care
• Practice is enhanced through development of collegial relationships
• Demonstrates leadership and collaboration by using the group process to solve problems
• The focus is on leadership in strategically planning long-term goals for the microsystem (unit - team - or workgroup) that impacts operations or resources
• Demonstrates critical thinking with efficiency and accuracy in assessing and managing situations
• Program or service level outcomes must be broad and complex and can be demonstrated at any organizational level within a facility
• An addendum is available for specific position duties
• 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 - 730-1600 or 0800-1630 Virtual: This is not a virtual position