The LTC Charles S. Kettles VA Medical Center is seeking an Intermittent Advanced Practice Nurse -Certified Nurse Anesthetist aligned under the Anesthesiology Service.

Duties

Assignment to the Certified Registered Nurse Anesthetist (CNA) (APN) is an advanced practice nurse who utilizes specialized clinical skills and education to administer anesthesia care throughout the medical center. Major Duties Include, but are not limited to: Direct patient care, administration, educational, and research activities. Collaboration with other health care professionals in a collegial relationship to achieve common goals for care, safety, and welfare of patients. Pre-anesthesia preparation and evaluation that includes a patient history, physical examination, and the collection of preoperative consults and data, from which an anesthetic plan can be formulated. Select and administer pre-anesthetic medication according to established protocols. Anesthesia induction, maintenance, and emergence. Post anesthesia care. Peri-anesthetic and clinical support functions outside the OR suite include post operative evaluations, responding to emergency situations, and facilitating care to meet the needs of the service. Request and evaluate pertinent laboratory studies and tests ( ABGs, EKG, PFTs) and other appropriate studies under established protocols. Insert intravenous catheters, according to established protocols. Insert arterial catheters; perform puncture for blood gases. Utilize all current techniques in monitoring. Perform endotracheal intubation and extubation. Select and administer anesthetic techniques (intravenous, regional, various field blocks, or inhalational), medications and adjunct drugs appropriate to the individual patient's condition and procedure (surgical or non-surgical) within established protocols in the operating suite and any off-site location (i.e. Endoscopy, Radiology, Cardiology, MRI, etc.). Manage fluid, blood, and electrolyte therapy within a medical care plan. Initiate and modify therapies, including drug and pain therapy within established protocols. Examine patients in post-anesthesia recovery and other hospital units to assess patient's reaction to anesthetic management. Identify any complications or abnormal patient responses to anesthesia or to adjunct medication and implement appropriate management techniques. Assist in the management and treatment of emergency airway problems as needed throughout the hospital. Participate in cardiopulmonary resuscitation by performing airway management including endotracheal intubations when necessary. Serve as code captain in the absence of a physician according to established protocols. Provide anesthetic consultation to physicians, nurses, and other hospital staff as necessary. Make post-operative rounds and record on the patient's permanent record the presence or absence of anesthesia-related-complications. Take an active role through the attendance and participation in the departmental in-service program. Take call as assigned per the Chief Nurse Anesthetist or another designed person and respond in a timely fashion per department guidelines. Responsible for patient care activities for adult and geriatric patients. Responsible for understanding the aging process and to modify treatment plans to accommodate the changes that occur with aging. Follows applicable regulations and instruction regarding access to computerized files, release of access codes, etc., in alignment with provisions of the Privacy Act of 1974 and other applicable laws, federal regulations. VA statutes and policies. Participates in competency training. Uses equipment appropriately and demonstrates and/or verbalizes the proper use, reprocessing and maintenance. VA offers a comprehensive total rewards package: VA Nurse Total Rewards Pay: Competitive salary, regular salary increases, potential for performance awards Licensure: 1 full and unrestricted license from any US State or territory Work Schedule: Intermittent Telework: Not Available Virtual: This is not a virtual position. Financial Disclosure Report: Not required

Requirements

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.) Graduate of an accredited nurse anesthesia educational program approved by The Council on Accreditation of Nurse Anesthesia Education Programs (COA). The COA is currently located at 222 South Prospect Avenue, Park Ridge, IL 60068. Additional information may be obtained from http://www.coacrna.org. (Masters or doctoral degree required for APN Certified Nurse Anesthetist). License and Certification for APNs (CNAs) (1) License. All APNs (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.(2) Basic Certification. All APNs (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. On and after May 4, 1993, certification by the Council on Accreditation of Nurse Anesthesia Education Programs (COA) is a requirement for employment. This requirement does not apply to non-certified nurse anesthetists employed by VA as a nurse anesthetist prior to May 4, 1993 and continuously thereafter. Any nurse anesthetist who leaves VA employment or vacates the nurse anesthetist occupation for another VA position, must meet the current requirement of certification for re-appointment as a nurse anesthetist. The COA is currently located at 222 South Prospect Avenue, Park Ridge, IL 60068. Additional information may be obtained from http://www.coacrna.org. 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 criteria must be met in determining the grade assignment of candidates, and if appropriate, the level within a grade. Knowledge, Skills, and Abilities (KSAs) Grade level requirements listed continued in the Education Section. https://apply.usastaffing.gov/ViewQuestionnaire/12407800. Grade/Level Education Experience APN (CNA) II A masters or doctoral degree in nurse anesthesia from a school of professional nursing anesthesia accredited by the Council on Accreditation of Nurse Anesthesia Education Programs (COA). Nurse II is considered the entry grade level for APNs (CNAs); no experience is required. APN (CNA) III A masters or doctoral degree in nurse anesthesia from a school of professional nursing anesthesia accredited by the Council on Accreditation of Nurse Anesthesia Education Programs (COA). One year of specialized APN (CNA) experience equivalent to the APN (CNA) II grade level. NOTE: Hours worked per week must be included on the resume for qualification purposes. *Note: Foreign education programs/degrees are not creditable as related degrees. Reference: VA Regulations, specifically VA Handbook 5005, Part II, Appendix G-6d Advanced Practice Nurse (Certified Nurse Anesthetist) Qualification Standard. This can be found in the local Human Resources Office. Preferred Experience: APN (CNA) III, at least 1 year of Certified Nurse Anesthetist Experience at the APN (CNA) II level. Physical Requirements: Physical and mental stamina sufficient to diligently monitor the anesthetized patient for prolonged periods of time and have the ability to manage many stressful situations.

Education

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.

APN (CNA) II Knowledge, Skills, and Abilities (KSAs): 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, infection control and anesthesia documentation.
• Skill in responding to emergency situations by providing airway management, fluid and medication administration, invasive line insertion and management and the use of advanced cardiac life support techniques.
• Ability to provide patient care that is abreast of changing concepts and advancements in the profession, (e.g., ultrasound techniques.)
• Ability to practice anesthesia in an interdisciplinary environment utilizing a collaborative concept of anesthesia care.
• Knowledge of quality improvement processes to maintain ongoing review and evaluation of anesthesia care to improve outcomes.
• Ability to demonstrate a practice emphasis on safety, current established guidelines and protocols while recognizing the duty to report unsafe conditions or errors.

APN (CNA) III Knowledge, Skills, and Abilities (KSAs): Progressively responsible experience in the administration of anesthetics as indicated in the knowledge, skills and abilities listed below.

• Ability to plan, administer and manage anesthesia for a broad range of complex surgical procedures skillfully employing continuous assessment and anesthetic adaptation based on patient response and comorbidities. Work assignments will vary by facility.
• Ability to participate in assignments that are technically challenging, encompass a variety of anesthetizing locations and utilize advanced equipment and procedures while adapting techniques to solve various complex anesthesia problems including the development of individualized programs of post-op anesthesia care.
• Skill in responsibility and accountability to perform to the extent of the CNA standards of practice as a licensed healthcare professional in any model of anesthesia practice.
• Ability to contribute to the educational mission as a mentor or preceptor providing didactic and clinical instruction in anesthesia to student nurse anesthetists, medical and dental residents and other health care trainees.
• Knowledge to participate in the development, implementation and maintenance of auditing processes that ensure and improve the quality and consistency of anesthesia and associated documentation.
• Ability to contribute to departmental administrative processes through quality assurance, shared governance or committee representation as applicable.
• Ability to serve as a representative on interdisciplinary teams to establish and maintain guidelines and communication.
• Skill demonstrated in the ability to embrace the safety culture emphasis by continuously assessing for safety risks, actively reporting safety concerns and maintaining a just culture by identifying faults in systems rather than individuals.

Contacts

• Address Ann Arbor VA Medical Center 2215 Fuller Road Ann Arbor, MI 48105 US
• Name: Angela Fleming
• Phone: 734-596-3185
• Email: [email protected]