Registered Nurse - Outpatient, Nursing Specialty

Summary

The Incumbent is responsible and accountable for all elements of the nursing process when providing and/or supervising direct patient care. Assumes responsibility for the coordination of care focused on patient education, self-management, and customer satisfaction throughout the continuum of care. Administers medications and procedures per established policies and guidelines. Influences care outcomes by collaborating with members of the interdisciplinary team.

Duties

Major Duties: Uses the nursing process and evidence-based practice to collaborate with the Teamlet and larger Team to meet patient care needs. Provides patient and family health education with a focus on self-management, prevention, wellness, and Whole Health, based on the patient's goals. Demonstrates advanced clinical knowledge in assessing planning, implementing, documenting, and evaluating care for a designated group of patients. Educates patients regarding clinic procedures and what to expect during the procedure. Assists with clinic procedures and monitors patient for any adverse effect. Triages and applies a collaborative team approach in identifying, analyzing, and resolving patient care problems; documents own interventions. Monitors progress using clinical standing orders, analyzes variations, and initiates appropriate actions. Maintains current knowledge of multidisciplinary resources, programs, and services. Refers patients for community resources as deemed necessary. Reviews options with patients and families, alternatives, risks/benefits, and services. Educates the patient and family on disease processes, resources, plan of care, treatments, and /or procedures. Screens patients for social service, home care, and other community care needs; and coordinates or makes referrals as appropriate; and seeks consultation when indicated. Ensures the patient's provider is aware of patient progress, issues, and/or problems. Evaluates needs and facilitates the patient's ability to learn the principles of self-care; utilizes appropriate resources if the patient is unable to grasp the knowledge/skills needed for self-care through the use of motivational interviewing. Utilizes approved Standing Orders and Guidelines to facilitate autonomy in providing care. Promotes cost effective use of resources and effective strategies including non­face-to-face approaches (including telehealth). Maintains privacy and confidentiality of all patient information, including electronic, print, and conversations. Applies skills, such as motivational interviewing to promote patient self-management. Adheres to policies, procedures, and standards to promote evidence-based patient­ driven care. Timely compliance of required web-based educational modules (Talent Management System TMS). Completes and documents secure messaging within 72 hours. Surrogate is always identified. Escalation of secure messaging must be maintained at 10% or less. Routes messages to appropriate care lines as needed. Performs other tasks as requested by providers or supervising nursing personnel within the scope of training and abilities. Demonstrates flexibility and adapts to work demands or adjustment of assignments. Performs as a role model in the provision of excellent customer service Reviews Message Manager and assists Team to address/complete pending alerts communicated throughout tour of duty to facilitate care and address needs of the caller within 48 hours or before being cognizant of the Veteran awaiting response Completes and documents Nursing Notes in CPRS, as applicable, in a timely manner and closes the Encounter Notes for patients not seen by a provider. Notes will be closed by the end of tour of duty daily. Areas to be addressed include: Encounters: reasons for visit- Service Connection; Primary Assignment-Service connected conditions under the Diagnosis tab; Procedures, ACSC conditions, etc. Provides Care Management to patients with Ambulatory Care Sensitive Conditions (ACSCs) including review of the patient record, deciding if the patient needs more in­depth education (formal and/or informal), nursing visits, and/or telephone calls between provider visits to assist in care management. Collaborates with the High-Risk Care Coordinators, Home Telehealth, social work, and/or dieticians for referrals and care management. Cultivates an environment of professionalism, excellence, and conflict resolutionat the team level. Promotes teamwork and is a resource for support staff, peers, and other clinical staff. Cleans equipment per RME policy after each use. Major Duties Continued Under Education. 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, 8:00am-4:30pm Telework: Adhoc Eligible Virtual: This is not a virtual position. Relocation/Recruitment Incentives: Not Authorized Permanent Change of Station (PCS): Not Authorized

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.