The Ambulatory Care Outpatient Registered Nurse will work at the Oakland Community-Based Outpatient Clinic (CBOC) and will require flexibility in schedule and assignments as the CBOC provides both primary and specialty care. The RN functions as a Patient Aligned Care Team (PACT) care manager or an RN in support of the primary care clinic; when assigned to a specialty clinic, the RN provides care consistent with nursing process and scope.

Duties

The nurse is responsible and accountable for individual nursing practice and determines the appropriate delegation of tasks consistent with the nurse's obligation to provide optimal care (ANA Code of Ethics for Nurses). Provides a full range of nursing care to patients with complex care needs utilizing the nursing process based on the ANA Standards of Nursing Practice. Demonstrates consistent clinical competence in providing nursing care. Uses equipment correctly and accurately interprets data. Recognizes subtle changes in patient's condition and responds timely, choosing the correct interventions. Demonstrates evidence of critical thinking skills in identifying, analyzing, and resolving patient care problems on the unit. Initiates and implements an interdisciplinary plan of care based on assessments. Performs ongoing assessment of patient condition and response to treatment. Provides leadership in establishing goals, evaluating the plan of care, and in discharge planning. Initiates referrals to other disciplines and/or services as appropriate. Assesses the patient's learning needs, learning preference, and readiness to learn. Modifies teaching approach based on knowledge of human behavior, motivations, and reactions to situations. Accurately documents in the medical record patient findings, assessments, and care provided. Documentation is technically informative, complete, accurate, consistent, concise, and timely. Evaluates and documents patient response to interventions and progress towards attainment of goals and expected outcomes. Revises interdisciplinary plan of care based upon on-going patient assessment and evaluation. Uses the Computerized Patient Record System (CPRS) and the Bar Coded Medication Administration (BCMA) software per policy. Effectively functions as the charge nurse, team leader, or in other leadership role that guides and directs others who provide patient care. Makes assignments and directs activities of other unit staff, (RNs, LPNs, students, PSAs, other team members). Assigns patient care responsibilities based upon patient needs and competencies of staff. Organizes and completes own assignments in a safe and timely manner, assisting team members as necessary. Provides direction to staff for unit activities in meeting patient care needs. Ensures that delegated tasks as assigned are completed by other staff. Ensures the physician and/or the nurse manager/ immediate supervisor/coordinator are notified of untoward events involving patients and staff, either by assigned RN or by self. Uses a team approach to identify, analyze, and resolve patient care problems that result in improved patient outcomes. Demonstrates grade-appropriate and consistent critical thinking skills. The nurse can recognize the patient has a problem. The nurse can manage the problem safely and effectively, recognizing his/her scope of practice. The nurse has a relative sense of urgency. The nurse takes the right action for the right reason (del Bueno). Position-specific Competency Checklist is completed annually and is rated competent in all measured areas. 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: 8:00-16:30 varies on patient and facility needs Telework: Not Available Virtual: This is not a virtual position. Relocation/Recruitment Incentives: Not Available Permanent Change of Station (PCS): Not Authorized 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.) 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/12428680. 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 Experience: Two years of Registered Nurse experience. Salary for this position ranges dependent upon applicant qualifications Grade 1: $149,816-$199,250 annually Grade 2: $172,288-$221,900 annually Grade 3: $189,516-$221,900 annually 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 visual acuity, keen hearing, clear distinctive speech, and manual dexterity. This position requires potentially long periods of continued walking, standing, stooping, sitting, bending, pulling, and pushing. Transferring patients and objects may be required. Mechanical inpatient lifts are provided. The incumbent may be exposed to infected patients and contaminated materials and may be required to don protective clothing in isolation situations, operative/invasive procedures, or home settings. The incumbent may occasionally be exposed to patients who are combative secondary to delirium, dementia, or psychiatric disorders. 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. The incumbent who provides care in home settings or other off-site locations may be required to drive and/or ride in GSA-vehicles.

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.

Contacts

• Address San Francisco VA Medical Center 4150 Clement Street San Francisco, CA 94121 US
• Name: Angelica Ratliff
• Phone: (925) 356-5892
• Email: [email protected]