Nurse Practitioner (Intensivist)

This position is eligible for the Education Debt Reduction Program, a student loan payment reimbursement program. You must meet specific eligibility requirements per VHA policy and submit your EDRP application within four months of appointment. Program Approval, award amount (up to $200,000) & eligibility period (one to five years) are determined by the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible to apply.

Qualifications:

Advanced Practice Nurse (Nurse Practitioner) Basic Requirements

• Education: A post-master's certificate or master's or doctoral degree as a Nurse Practitioner. (Applicants pending the completion of educational requirements may be referred and tentatively selected but may not be hired until the education requirements are met.) Must be a 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).
  • NOTE: Foreign Education. Graduates of foreign schools of professional nursing programs, the nurse practitioner degree equivalency must be validated through an Agency recognized degree equivalency evaluation agency, such as the International Consultants of Delaware (ICD). Candidates with equivalent nurse practitioner masters or doctorate level degrees who possess current, full, active, and unrestricted registration and certification will meet the requirement of graduation from an approved school of professional nursing to warrant appointment.
• License - All APN (NPs) must possess and maintain an active, current, full, and unrestricted APN license to practice as an NP in a State, Territory or Commonwealth of the United States, or in the District of Columbia.
• Basic Board Certification - All APN (NPs) must maintain full and current basic board certification in one of the following: Acute Care Nurse Practitioner (ACNP) or Adult-Gerontology Acute Care Nurse Practitioner (AGACNP) from one of the following: the American Nurses Credentialing Center (ANCC), American Academy of Nurse Practitioners Certification Board (AANPCB), or other nationally recognized certifying body in the area in which the Nurse Practitioner is academically prepared.

NOTE: Grandfathering Provision - All persons currently employed in VHA in 0610 series and an APN (NP) assignment that are also 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.

The following Scope, Education and Experience, and Dimension criteria must be met to qualify for Advanced Practice Nurse (Nurse Practitioner) II:
Exception to Licensure for Graduate Nurse Technicians. Candidates who otherwise meet the basic requirements, but do not possess the required licensure and/or certification, may be appointed at the entry step of the Nurse II, as a Graduate Nurse Technician - Nurse Practitioner on a temporary appointment up to any period not-to-exceed one year and a day under the authority of 38 U.S.C. § 405(c)(2)(B).

• Scope: Demonstrates leadership in delivering and improving holistic care through collaborative strategies with others
• Education and Experience Requirement: Meets basic education requirement for APN (NP). Nurse II is considered the entry grade level for APN (NPs); no experience is required.
• Dimension Requirement: APNs (NPs) at level II are expected to meet the following dimension requirements:
  • Clinical Practice. Delivers evidence-based health care, demonstrating proficiency in the ability to manage a patient panel, population, or program.
  • Outcome Focus. Utilizes research and evidence-based practice to evaluate the patient care delivery system within a patient panel or program, presents findings and contributes to changes that enhance the quality and timeliness of veteran/patient care.
  • Leadership. Works effectively as a leader within a team/unit/group and seeks interdisciplinary collaboration as appropriate to enhance patient care.
  • Professional Development. Acquires knowledge and skills to develop expertise in area of practice.
  • Professionalism/Collegiality. Demonstrates effective communication skills and professional behavior, promoting cooperation and teamwork. Participates in interdisciplinary teams and processes that positively impact patient outcomes.

The following Scope, Education and Experience, and Dimension criteria must be met to qualify for Advanced Practice Nurse (Nurse Practitioner) III:

• Scope: Executes position responsibilities that demonstrate leadership, experience, and creative approaches to management of complex client care.
• Education and Experience Requirement: Meets basic education requirement for an APN (NP) AND one year of specialized APN (NP) experience equivalent to the Nurse II grade level.
• Dimension Requirement: APN (Nurse Practitioners) at grade III are expected to meet the following dimension requirements:
  • Clinical Practice. Influences and models the delivery of evidence- based health care, demonstrating expertise in the ability to manage a patient panel, population, or program.
  • Outcome Focus. Leads and implements changes that enhance the quality and timeliness of Veteran/patient care applying research and evidence in the delivery of healthcare for patient populations.
  • Leadership. Initiates and leads interdisciplinary teams informed by structured approaches and processes to improve outcomes that positively impact care for a patient panel, population, or program.
  • Professional Development. Acquires knowledge and skills, then disseminates acquired information within and/or outside the medical facility.
  • Professionalism/Collegiality. Initiates and leads interdisciplinary teams developing systems that positively impact outcomes at the panel, population, or program level. Demonstrates effective communication skills and professional behavior, promoting cooperation and teamwork

Preferred Experience: Prefer at least 1 year Intensivist/ICU in Surgical ICU Units. Must be willing to work rotating 8-12 hour shifts. Overtime may be required at time to ensure coverage of the Surgical ICU Patients.

Physical Requirements: The individual must be able to perform all activities of the position without restriction. This position involves considerable standing, walking, stooping, bending, reaching, lifting and turning. It requires repositioning patients and assisting with transferring patients to wheelchairs/stretchers. Mechanical devices when available are required to be used for heavy or difficult to lift patients. The work may involve pushing or lifting weight in excess of 50 pounds and going up and down flights of stairs. The position requires visual and auditory acuity at a level to provide safe and effective nursing care. The positions requires the nurse to work for periods of time with arms above shoulder level or with the neck in a fully flexed or extended position and the ability to physically control or protect him/herself from physically abusive patients.

Responsibilities:

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Duties include, but not limited to:

• Independently manages a panel of patients with acute and chronic health conditions with an emphasis on health promotion and disease prevention using evidence-based practice.
• Develops and implements an individualized plan to achieve optimal population health and disease management.
• Demonstrates leadership and works collaboratively with the interdisciplinary team.
• Orders and interprets labs, tests, and diagnostic studies.
• Prescribes pharmacologic and non-pharmacologic interventions.
• Initiates referrals and consults to specialty services.
• Provides education to patients and their families.
• Assesses and adjusts the plan of care as needed to achieve optimal patient outcomes.
• Exemplifies the ICARE core values of-Integrity, Commitment, Advocacy, Respect, and Excellence.
• Obtains and documents relevant health and medical history
• Documents in Computerized Patient Record System (CPRS).
• Performs a physical examination based on history.
• Orders and interprets diagnostic tests.
• Identifies medical and health risks and needs of the patient/family based on data collection.
• Formulates the appropriate differential diagnosis based on the history, physical examination and clinical findings.
• Establishes a plan of care to achieve the identified medical and health goals.
• Prescribes medications which may include controlled substances per licensure.
• Identifies patient education needs and provides for relevant education.
• Initiates referrals and/or consultations as appropriate to achieve an interdisciplinary plan of care including referrals to community agencies.
• Determines effectiveness of the plan of care through documentation of client (patient) care outcomes.
• Is proactive in identifying potential emergency/crisis situations and providing appropriate interventions.
• Performs procedures within the approved scope of practice and based on documented competencies:
• Performing diagnostic and stabilization procedures based on ACLS protocol including oral endotracheal intubation/airway management, needle thoracostomy and cricothyrotomy.
• Placing and maintaining Peripherally Inserted Central Catheters (PICC), including de-clotting procedure.
• Placing and maintaining enteral feeding catheters.
• Placing, maintaining and managing internal jugular, subclavian and femoral central lines.
• Placing, maintaining and managing percutaneous arterial lines.
• Placing and managing Swan Ganz catheters.
• Placing pleural pigtail or chest tubes.
• Rewiring central line catheters (Cordis to triple lumen).
• Removal of chest tubes (pleural and mediastinal),epicardial pacer wires, and femoral arterial sheaths, including IABP catheter sheaths.

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: Rotating Schedule, 6:00am to 6:30pm or 6:30pm to 6:00am; must be willing to work rotating shifts to cover the SICU 24/7.
Compressed/Flexible: May be available
Telework: Not Available
Virtual: This is not a virtual position
Relocation/Recruitment Incentives: Not Authorized
EDRP Authorized: Former EDRP participants ineligible to apply for incentive. Contact Joshua.Titensor@va.gov, the EDRP Coordinator for questions/assistance. Learn more
Permanent Change of Station (PCS): Not Authorized

Salary : $115,928 - $200,000