The Durham VA Health Care Systems Emergency Department (ED) is a level I unit with 27 beds, 2 triage rooms, with 4 beds designated for high-risk psychiatry patients. The Registered Nurse will provide 24-hour nursing care and monitoring of Emergency Department medical and psychiatric patients as well as those waiting for hospital admission.

Duties

The Registered Nurse assigned to the Emergency Department will require skills in triage, problem-focused assessments, psychiatric close monitoring, CIWA protocols, moderate sedation, AHA STEMI Protocol, and NIH Stroke Protocol. The Emergency Department primarily cares for Veterans and occasional civilian persons seeking emergent care. The census of patients seeking the Emergency Department services is an average of 25,000 patients per year. Registered Nurses, Licensed Practical Nurses and Nursing Assistants provide care in collaboration with other disciplines to offer a seamless transition of care throughout the VA continuum of care. InterQual guidelines and physician judgment are used to determine appropriate level of care and resource management patterns for Emergency Department patients requiring admission or transfer to other facilities. Policies, procedures, and clinical operations are based on EMTALA laws, ENA and ACEP guidelines. Quality improvement efforts are assessed and evaluated continuously to help achieve our mission and ensure patient satisfaction. Five Most Common Patient Problems Requiring Nursing Care within the Emergency Department: 1. Chest Pain 2. Respiratory Problems 3. Abdominal Pain 4. Psychiatric /Detoxification 5. Back Pain Preferred Experience: Minimum of 2 years successful practice in Medical Surgical Nursing. Minimum of 1 year of current Critical Care or Emergency Nursing. Minimum of 1 year of recent experience in Psychiatric Nursing. Demonstrated ability to work effectively with patients, families, and other members of the interdisciplinary team. Demonstrated skills in decision-making, sound clinical judgment and critical-thinking abilities. Demonstrated ability to use computer systems in support of patient care delivery. 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: Day/Evenings/Nights, 12-hour tours with rotating weekends/holidays. Tour subject to change based on the needs of the agency. Telework: Not Available Virtual: This is not a virtual position. 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. 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/12371461. 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. Preferred Level of Education: BSN Preferred Certifications: ANCC for Emergency Nursing ANCC for Psychiatric Nursing ANCC for Medical Surgical Nursing ACLS BLS The full performance level of this vacancy is Nurse III. The actual grade at which an applicant may be selected for this vacancy is in the range of Nurse I to Nurse III. Reference: VA Regulations, specifically VA Handbook 5005, Part II, Appendix G-6 Nurse Qualification Standard. This can be found in the local Human Resources Office. Physical Requirements: This position requires potentially long periods of continued walking, standing, and sitting, lifting, carrying, pushing, reaching above shoulder, use of fingers, both hands, both legs and repeated bending. Heavy lifting (45 lbs. and over); Heavy Carrying (45 lbs. and over); Straight Pulling (up to 4 hours); Pushing (up to 4 hours); Reaching above shoulder; Use of fingers; Both hands required; Walking (up to 8 hours); Standing (up to 8 hours); Repeated bending (up to 8 hours); Both legs required; Ability for rapid mental and muscular coordination simultaneously; Specific visual requirement: Read typed Chapters; Correctable vision :20/40 in one eye; Ability to distinguish basic colors and shades of colors; Hearing (aid permitted). The incumbent may occasionally be exposed to patients who are combative secondary to delirium, dementia, or psychiatric disorders; Emotional and Mental Stability: The incumbent must be a mature, flexible, sensible individual capable of working effectively in stressful situations, able to shift priorities based on patient needs. Must complete annual Employee Health requirements, such as annual TB screening or testing, as a condition of employment.

Education

Nursing Bridge Programs: Nursing bridge programs are accelerated nurse education programs which rely upon existing nursing knowledge and education. Graduates from nursing bridge programs that meet accreditation requirements specific grade level requirements in this standard must also be met in addition to the following:

(a) Master's Level Bridge Program Education Appointments Prior to Graduation. Individuals attending a master's level bridge program in nursing who achieve the level in their education in which they 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 a temporary basis for any period up to three years contingent upon full completion of the professional nursing education program, if education verification provided by the school supports the Bachelor of Science in Nursing (BSN) equivalency. Upon successful completion and graduation from the bridge program, the Nurse may be converted to a permanent appointment under the provisions of section 7401(a)(1) of title 38. Failure to complete the bridge program on which the temporary appointment was based will result in termination of the appointment.

Degree in a Related Field: A graduate level or doctorate degree in health care/management related fields from an institution accredited by the State and approved by the Department of Education at the time the candidate completed the program may be credited as specifically indicated in grade requirements. The graduate level or doctorate degree and coursework must provide evidence in support of the nursing role and duties associated with the assignment and grade level. Foreign education programs/degrees are not creditable as related degrees.

Dimension Requirement for Nurse III: Nurses at Nurse III must meet ALL the following dimension requirements to qualify for Nurse III.

• Practice. Demonstrates expertise in professional practice using the nursing process (assessment, diagnosis, outcome identification, planning, implementation and evaluation) with improved evidence-based and/or data-driven outcomes beyond the immediate practice setting.
• Veteran/Patient Driven Care. Leads initiatives to improve Veteran/patient experience. Satisfaction and/or safety beyond the immediate practice setting.
• Leadership. Communicates and collaborates as an effective leader of the interprofessional team, at the expert level, with improved evidence-based and/or data-driven outcomes beyond the immediate practice setting.
• Professional Development. Enhances knowledge base and practice evaluation, at the expert level, with improved outcomes beyond the immediate practice setting.
• Evidence Based Practice/Research. Leads the identification and integration of evidence-based practice/research with clinical expertise to improve quality of care and resource utilization at the expert level with improved outcomes beyond the immediate practice setting.

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: https://sites.ed.gov/international/recognition-of-foreign-qualifications/.

Contacts

• Address Durham VA Medical Center 508 Fulton Street Durham, NC 27705 US
• Name: Tierra White
• Phone: 919-827-2514
• Email: [email protected]