The Licensed Practical/Vocational Nurse (LVN) performs assigned duties in a manner that promotes quality health care, positive customer service and the maintenance of an environment committed to serving the veteran. The primary focus of The Behavioral Mitigation Intervention Team (BMIT) is to prevent and mitigate behavioral events for Veterans with neurocognitive disorders admitted to acute care units. The position is located at the Audie L. Murphy Memorial Veterans Hospital in San Antonio, TX.

Duties

The incumbent will be responsible for the implementation of the interventions defined in the Behavioral Mitigation Intervention Team (BMIT) Care Plan. The LVN in this role will work in conjunction with interdisciplinary teams to assist in the mitigation and implementation of a care plan of disruptive behaviors displayed by Veterans with neurocognitive disorders and dementia who are admitted to the inpatient acute care wards. The LVN contributes to the plan of care by collaborating with interdisciplinary team members and the Veterans' family. This position will require experience and knowledge of de-escalation techniques for patients with disruptive behaviors. The LVN will assist in Code Greens in de-escalating situations and provide education/guidance to front line staff. This will aid in improving morale on the acute care units by having a dedicated resource to respond to Code Greens, thereby improving staff's sense of safety when interventions are needed. This individual will report to the BMIT Nurse Manager. The incumbent is responsible for the following duties/responsibilities: Applies principles of evidence-based practice, while using sound clinical judgment in the nursing process, based on the ANA Standards of Nursing Practice and alignment with the Joint Commission Standards/VHA Directives. Executes BMIT nursing care plan interventions to assist Veterans in curbing unwanted, dangerous, or disruptive behavior and providing a more therapeutic milieu. Collaborates with BMIT RN and interdisciplinary team on progress of care plan and communicates any concerns. Serves as part of the Code Green Team that responds to inpatient Medical/Surgical units only. Assists in de-escalation techniques, assist with physical holds, provides guidance to acute care staff, and reduces risk of undue harm to patients and staff in these scenarios. Recognizes, reports, and records relevant patient information. Demonstrates knowledge of human behavior, motivations, and reactions to situations and uses this knowledge in working effectively with patients, family, and other staff members. Demonstrates courteous, compassionate, caring, and respectful behavior when interacting with all others. Demonstrates understanding for age- and population-specific characteristics that affect the health care needs of the Veteran. Serves as Prevention Management of Disruptive Behavior (PMDB) instructor. Performs other related duties as assigned. Work Schedule: Rotating Shifts. This position requires flexibility in schedule and assignments. 24-hour operations to include weekends/holidays. Telework: Not Available Virtual: This is not a virtual position. Functional Statement #: 000000 Relocation/Recruitment Incentives: Not Authorized Permanent Change of Station (PCS): Not Authorized Financial Disclosure Report: Not Required

Requirements

Qualifications

Basic Requirements United States Citizenship: Non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy. Education. Graduate of a school of practical or vocational nursing approved by the appropriate State agency and/or accredited by the National League for Nursing Accrediting Commission (NLNAC) at the time the program was completed by the applicant. Verification can be obtained from the State approving agency or the National League for Nursing Accrediting Commission, 61 Broadway, 33rd Floor, New York, NY 10006. Additional information may also be obtained from the NLNAC Website. Exceptions include: (1) Health care education in the military service or training in the military service which is accepted by the licensing body in the jurisdiction in which the individual is licensed as qualifying for full LPN/LVN licensure will be accepted as meeting the education requirements for VHA employment. (2) VHA employees who were converted to appointments under 38 U.S.C. 7401(3) in implementation of Public Law 98-160, enacted November 21, 1983, and for VHA employees converted to appointments under 38 U.S.C. 7405 in implementation of Public Law 99-576, enacted October 28, 1986; and for their future personnel actions under this authority. The waiver will not apply to persons appointed under 38 U.S.C. 7401(3) or 7405 after these conversions. (3) Individuals granted a license by a jurisdiction that does not require graduation from an approved school. See paragraph 4, section C. Licensure. Full, active, current and unrestricted licensure as a licensed practical or vocational nurse in a State, Territory or Commonwealth (i.e., Puerto Rico) of the United States, or District of Columbia. English Language Proficiency. Licensed practical or vocational nurses appointed to direct patient care positions must be proficient in both spoken and written English as required by 38 U.S.C. 7402(d), and 7407(d). Grade Determinations: In addition to the basic requirements, the following qualification criteria must be met for each grade. The candidate's qualifications must clearly demonstrate the level of competence required for the grade. GS-03. None beyond the basic requirements. LPNs at this grade level are expected to perform all duties within the scope of their license (e.g., medication administration); however, completed work may require routine or detailed higher level review depending upon the complexity of the duties involved. GS-04. Employees may be appointed at or advanced to GS-4 if they meet any of the criteria in paragraphs 3b(2)(a) through (c) below: (a) Six months of qualifying experience as an LPN or LVN; or (b) Graduation from an approved school (which may be waived as provided in paragraph 4 of Section C) and one year of experience that involved nursing care work in a hospital, outpatient clinic, nursing home, or other supervised medical, nursing, or patient care facility that provided a practical knowledge of human body structure and sterile techniques and procedures; or (c) Graduation from an approved school of at least 24 months duration. (d) LPNs at the GS-4 grade level perform all duties expected of employees at the GS-3 grade level; however, they are expected to exercise greater judgment, require less supervision, and to operate in accordance with all established policies, procedure, and techniques. GS-05 (a) Completion of at least 1 year of qualifying experience at the GS-4 level or equivalent. (b) Demonstrated knowledge and ability to provide a full range of practical nursing care to patients with a variety of physical and/or behavioral problems. Works with the RN and/or MD/DO to appropriately orient/train less experienced LPNs/LVNs and/or Nursing Assistants (NAs)/Health Technicians (HTs) in relation to acceptable standards of practice in promoting optimal patient care delivery. Provides effective education to patients and/or family members in relation to common disease processes, medication, and /or prescribed treatment regimes. (c) Demonstrated ability to serve as a responsible member of the nursing team and interact in an appropriate manner with patients, family members, professional and other supportive personnel involved in the delivery of patient care, incorporating acceptable, established customer service standards into practice. (d) Knowledge and skill sufficient to prepare, administer, and appropriately document actions taken specific to commonly prescribed oral, topical, subcutaneous, intramuscular, and/or intravenous medications as permitted by approved local facility policies and procedures. Observation and documentation will include patient's response to medication administered and the reporting of any noted change in patient's condition to RN or MD/DO. (e) Knowledge and ability to recognize the need for and to institute emergency measures when indicated, promptly seek the assistance of the RN or MD/DO, and assist in resuscitation procedures in cardiac and/or pulmonary arrest. (f) Recognizes and appropriately responds to breakage/malfunction or loss of equipment, safety hazards, and supply deficiencies, promptly reporting to appropriate personnel for corrective action. (g) Completed work is under the general supervision of an RN or MD/DO. Individuals at this grade level are expected to have a broad working knowledge of practical nursing procedures. However, completion of more complex practices or procedures may be subject to closer higher-level review.

Education

**QUALIFICATION CONTINUED: Grade Determination:

• GS-06
  • (a) Completion of at least one (1) year of additional qualifying experience at the GS-5 level or equivalent, fully meeting all performance requirements for the GS-5 LPN/LVN.
  • (b) Technically proficient in initiating, performing and completing assigned duties in providing care to variable patient populations.
  • (c) Knowledge and ability to appropriately carry out assigned patient care based on the patients' conditions; to use judgment in selecting the appropriate order and sequence of procedures and treatments; and to accurately recognize, report and record relevant patient information. Completed work should need only a general review by a registered nurse (RN) or physician (MD/DO) for appropriateness and conformity with established policies/procedures.
  • (d) Ability to observe, identify and respond to the patient's needs for care, including medication, equipment-assisted care and patient/family education. In organizing and delivering care, the LPN/LVN recognizes and considers emotional, cultural, spiritual, socio-economic, and age-related factors.
  • (e) Prepares and administers prescribed medications (oral, topical, subcutaneous, intramuscular and/or intravenous) and performs treatments according to established policies/procedures. Observes for physical and/or emotional changes in patient's condition from prescribed medications/treatments, promptly and accurately documenting noted changes, and reporting any deviations from normal to RN or MD/DO.
  • (f) Knowledge and ability to recognize urgent or emergent patient care situations, seek assistance of the RN and/or MD/DO, and initiate appropriate emergency interventions as directed.
  • (g) Knowledge and understanding of human behavior, patient motivations and reactions to situations, and ability to appropriately utilize this knowledge in working effectively with patients, family members, and other staff.
  • (h) Establishes constructive relationships with individual patients and their families to elicit feelings and attitudes, and to promote positive relationships, communication and socialization skills. Fosters an environment of respect for individual patient and family rights to privacy and dignity in all aspects of care delivery. Effectively incorporates knowledge and understanding of established customer service standards in all interactions with patients, family members, and/or other internal/external customers.
  • (i) Knowledge and skill in performing support duties for complex diagnostic tests and/or specialized practices or procedures, which include preparing the patient, assisting in the diagnostic examination, preparing and handling specialized instruments or other specialized equipment, and monitoring the patient's condition before, during, and following the procedure. Serves as a preceptor in orienting, educating, and training less experienced LPNs/LVNs or NAs/HTs related to support duties for these more complex, specialized tests/procedures.
  • (j) Actively seeks out educational opportunities to enhance nursing knowledge and skills, sharing new knowledge gained with other staff to improve and advance nursing practice.

Preferred Experience:

• Acute Care Nursing Experience (2+ years)
• Nursing Experience with Patients with Neurocognitive Disorders (1+ years)
• Geriatric or Mental Health Nursing Experience (2+ years)
• PMDB Certified Trainer

References: VA Handbook 5005/3, Part II, Appendix G13, 4/10/2003

The full performance level of this vacancy is GS-06. The actual grade at which an applicant may be selected for this vacancy is in the range of GS-03 to GS-06.

Physical Requirements: This position requires Moderate lifting, 15-44 pounds, Moderate carrying, 15-44 pounds, Straight pulling (1 hour), Pushing (1-3 hours), Reaching above shoulder, Use of fingers, Both hands required, Walking (4 hours), Standing (2-7 hours), Kneeling (2 hours), Repeated bending (2 hours), Climbing, use of legs and arms, Both legs required, Ability for rapid mental and muscular coordination simultaneously, Near vision correctable at 13" to 16" to Jaeger 1 to 4, Specific visual requirement of 20/40 DVA; corrected, Both eyes required, Ability to distinguish basic colors, Hearing (aid may be permitted), Sitting (8 hours), Simple grasping (2-4 hours) Fine manipulation (including keyboarding 4-6 hours), Twisting (2 hours), Mental and emotional stability.

IMPORTANT: A transcript must be submitted with your application if you are basing all or part of your qualifications on education.

Note: Only education or degrees recognized by the U.S. Department of Education from accredited colleges, universities, schools, or institutions may be used to qualify for Federal employment. You can verify your education here: http://ope.ed.gov/accreditation/. If you are using foreign education to meet qualification requirements, you must send a Certificate of Foreign Equivalency with your transcript in order to receive credit for that education. For further information, visit: http://www.ed.gov/about/offices/list/ous/international/usnei/us/edlite-visitus-forrecog.html.

NOTE: If your school has changed names, or is no longer in existence, you must provide this information in your application.

Contacts

• Address Audie L Murphy Memorial Veterans Hospital 7400 Merton Minter Boulevard San Antonio, TX 78229 US
• Name: VISN 17 SSU USAS Group
• Email: [email protected]