Registered Nurse - Home Based Primary Care (HBPC)

Summary

Home Based Primary Care (HBPC) Outpatient Staff Registered Nurse (RN) is responsible for providing competent - evidence-based care to HBPC patients and oversight of licensed vocational nurses/nursing assistants - as appropriate to the setting. This nurse provides direct Veteran care and care coordination - as it pertains - to Veterans and their care within the HBPC Program.

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
• 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/13108967
• 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: Heavy lifting and heavy carrying 45 pounds and over - straight pulling 1 hours - pushing 1 hours - reaching above shoulder - use of fingers - both hands required - walking 7 hours - standing 7 hours - kneeling 1/2 hours - repeated bending 7 hours - both legs required - ability for rapid mental and muscular coordination simultaneously - near vision correctable at 13"" to 16"" to Jaeger 1 to 4 - far vision correctable in one eye to 20/20 and to 20/40 in the other - ability to distinguish basic colors and shades of colors - hearing without aid - mental and emotional stability - working with detergents and antiseptic solutions
• Environmental Factors: Outside and inside - dust - working around machinery with moving parts - working with hands in water - working closely with others - protracted or irregular hours of work.
  
  

Duties

• Registered Nurse - Home Based Primary Care (HBPC) duties include but are not limited to: Developing and coordinating the patient's plan of care to include ongoing assessment and reassessment - care planning - care coordination - monitoring - and evaluating clinical outcomes
• - Interacting - coordinating - and advocating for the patient/caregiver with other relevant parties across a continuum of care - beyond a single episode of care - ensuring seamless transitions
• - Providing individualized education and support to the patient and caregiver to optimize clinical outcomes and support quality of life decisions
• - Delegating and supervising the care given to the patient by licensed practical nurses - and home health technicians - as applicable
• - Providing intensive care management for assigned patients
• - Linking Veterans with resources
• - Coordinating resources for comprehensive care to avoid duplication of services and streamline staff interaction and services with the Veteran
• - Conducts assessments in the home to develop treatment goals and plans based on comprehensive interdisciplinary assessment of the patient and the caregiver
• - Participates in the development of the individual plan of care at interdisciplinary care meetings for assigned panel of patients
• - Implements the plan of care through home visits or Telehealth - as indicated
• - Reviews progress toward goals at regular intervals - as a team - on a quarterly basis - or more frequently when there is a change in the patient's condition
• - Assess and support the caregiver's capability to continue to provide care
• - Assesses clinical data for neurological - cardiac/vascular - respiratory - gastrointestinal - genitourinary - and skin and documents findings and reports abnormalities
• - Incorporates assessment findings into treatment plan
• - Coordinates care with other health care providers in assessing - planning - implementing - and evaluating treatment interventions
• - Coordinates transitions of care from outpatient to inpatient or emergency department settings through communication with outpatient facilities and the interdisciplinary team
• - Appropriate documentation as established by HBPC Standard Operating Procedures (SOP)
• - Administers medication safely and accurately
• - Identifies patients at high risk for harm to self and follows established SOPs on Suicide Risk
• - Establishes and maintains effective communication with patients - family members - and the interdisciplinary team
• - Assumes responsibility for telecare calls that can be handled by the RN - directing to the physicians those calls that must have physician response
• - Serves as liaison with physician and patient and discusses concerns with the physician and calls the patient back
• Establishes a rapport with patients to encourage them to call when a healthcare problem arises
• - Performs venipuncture in the home per competency and reviews lab and test reports and alerts the physician of significant findings and assists the physician with appropriate follow up and treatment
• - Identifies learning needs of the patient/family (diagnosis - medication - surgery - etc.) and implements teaching strategies or provides alternate methods of communication (e.g
• dry erase boards - picture charts - etc.) to patients with learning difficulties.- Understands the legal ethical implications of Patient Self Determination Act - Patient Bill of Rights - Advanced Directives - and Patient Abuse (protection)
• Serves as a resource for patients - families - and other staff when ethical issues arise
• Abides by and carefully adheres to Medical Center Policies for Ethics and Compliance
• Driving is required for this position
• 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 7:30 am - 4:00 pm
• Subject to change based on needs of the service
• Telework: available Virtual: This is not a virtual position
• Relocation/Recruitment Incentives: not authorized Permanent Change of Station (PCS): not authorized