Advanced Practice Nurse (Certified Nurse Anesthetist)-Intermittent

Summary

The Advanced Practice Nurse (Certified Nurse Anesthetist (CRNA)) provides comprehensive, specialized anesthesia care to Veterans. The CRNA performs pre-anesthesia assessments, develops and implements individualized anesthesia care plans, administers and manages anesthesia, continuously monitors patients, and provides post-anesthesia and acute pain management. The CRNA provides anesthesia services for surgical and diagnostic procedures, including procedures at the San Francisco VA Medical Center.

Duties

**This is an OPEN CONTINUOUS ANNOUNCEMENT and will remain open until September 30, 2026. The initial cut-off date for referral of eligible applications will be September 25, 2026 with subsequent cut-off dates every 2 weeks. Eligible applications received after that date will be accepted on an ongoing basis and qualified candidates will be considered as vacancies become available.** The CRNA collaborates with anesthesiologists, surgeons, proceduralists, nurses, and other members of the interdisciplinary healthcare team to ensure safe, effective, evidence-based, and Veteran-centered care. The position requires sound clinical judgment in managing patients with varying levels of medical complexity and responding appropriately to changes in patient condition and perioperative emergencies. Duties include: Performs comprehensive pre-anesthesia assessments, including review of the Veteran's medical history, medications, allergies, laboratory and diagnostic results, physical status, and surgical/procedural needs. Develops individualized anesthesia plans of care based on the patient's condition, procedure, risk factors, and clinical needs. Provides anesthesia services for inpatient and outpatient surgical and procedural patients. Administers and manages general, regional, local, intravenous, and monitored anesthesia care/sedation, within the provider's approved scope of practice and clinical privileges. Performs anesthesia induction, maintenance, emergence, and recovery while continuously assessing the patient's physiologic response. Selects and administers appropriate anesthetic agents, analgesics, adjunct medications, intravenous fluids, and other medications necessary for safe anesthesia care. Establishes and maintains appropriate non-invasive and invasive monitoring to continuously evaluate cardiovascular, respiratory, neurologic, and other physiologic parameters. Performs and manages airway assessment and management, including intubation, ventilation, extubation, and emergency airway interventions as clinically indicated. Recognizes and promptly manages changes in the patient's condition, anesthesia-related complications, and other perioperative emergencies. Provides emergency response, including airway management, resuscitation, and BLS/ACLS interventions when required. Provides post-anesthesia care, including assessment of recovery from anesthesia, pain management, nausea and vomiting management, hemodynamic stability, and appropriate disposition. Performs post-anesthesia follow-up and evaluates patients for complications or additional anesthesia-related needs. Provides anesthesia services both inside and outside the operating room, as appropriate to the facility's services and the CRNA's clinical privileges. Collaborates with anesthesiologists, surgeons, proceduralists, nurses, and other interdisciplinary healthcare professionals to promote safe, coordinated, Veteran-centered care. Functions as a member of the anesthesia care team and contributes to perioperative decision-making based on education, experience, competency, and scope of practice. Prescribes or orders appropriate preoperative, intraoperative, and postoperative medications and treatments when authorized by applicable VA policy, state licensure, and clinical privileges. Maintains accurate and timely documentation of anesthesia assessments, care plans, medications, procedures, monitoring, interventions, and patient outcomes. Pay: Competitive salary, regular salary increases, potential for performance awards Licensure: 1 full and unrestricted license from any US State or territory Work Schedule: Not to Exceed one-year; intermittent schedule. Telework: Not Available. Virtual: This is not a virtual position. Relocation/Recruitment Incentives: Not Authorized. EDRP: Not Authorized. Permanent Change of Station (PCS): Not Authorized.

Qualifications

Advanced Practice Nurse (Certified Nurse Anesthetist) Basic Requirements Education. A masters or doctoral degree in nurse anesthesia. (Applicants pending the completion of educational requirements may be referred and tentatively selected but may not be hired until the education requirements are met.) Nursing education must be from a school of professional nursing anesthesia accredited by Council on Accreditation of Nurse Anesthesia Education Programs (COA) at the time the program was completed by the applicant. Licensure and Certification. The following licensure and certification requirements are considered conditions of employment. License. All APN (CNAs) must maintain an active, current, full and unrestricted license to practice as a CNA or equivalent, in a State, Territory or Commonwealth of the United States or in the District of Columbia. Basic Certification. All APN (CNAs) must maintain full and current certification by the National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA) or an equivalent Nurse Anesthetist certification recognized by the COA. NOTE: Grandfathering Provision - All persons currently employed in VHA in 0610 series and an APN (CNA) 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 Education, Experience, and Knowledge, Skills and Abilities must be met for Advanced Practice Nurse (Certified Nurse Anesthetist) II: Exception to Licensure for Graduate Nurse Technicians. Candidates who otherwise meet the basic requirements, but do not possess the required APN (CNA) licensure and/or certification, may be appointed at the entry step of the Nurse II, as a Nurse Anesthetist on a temporary appointment up to any period not-to-exceed one year and a day under the authority of 38 U.S.C. § 7405(c)(2)(B). Education and Experience Requirement. Meets basic education requirement for an APN (CNA). Nurse II is considered the entry grade level for APN (CNAs); no experience is required. Demonstrated Knowledge, Skills, and Abilities. The following list of knowledge, skills and abilities present the minimum skill set expected of an Entry Level CNA. Entry level into practice may include but are not limited to the following: Ability to translate into anesthesia care the principles of professional nursing practice including the patients' rights to autonomy, dignity, privacy, and safety. Knowledge of current research and practice guidelines to frame anesthesia practice including up to date techniques, pharmacology, and equipment. Ability to obtain, document and verify informed anesthesia consent and perform a pre-anesthetic patient history and physical, which includes managing pre-operative consults and interpreting data. Ability to formulate a patient-specific anesthetic plan and describe salient anesthetic risks, benefits, and options to the patient. Ability to administer inhalational, regional, intravenous, local, and topical anesthetics. Skill in detecting and treating anesthesia or surgically related physiologic changes and ability to treat accordingly in order to maintain homeostasis. Skill in assessing patient status for appropriateness of transfer of care to another healthcare provider and communicating essential patient information to other providers effectively. Ability to participate in collaborative responsibility for proper patient positioning, physiologic monitoring, in