The Advanced Practice Registered Nurse (APRN) is a registered nurse with national certification and a master's degree in nursing or higher. Responsible for assessing, diagnosing, planning, implementing, and evaluating direct and indirect health and quality of care for patients under their care. The care can be provided in a primary, secondary, or tertiary care setting. Works under a collaborative practice agreement that is endorsed by the APRN collaborating provider and organizational leadership

Duties

FUNCTIONS Preoperative nurse practitioners (NPs) evaluate patients requiring anesthesia for procedures and surgery. Preoperative NPs each complete >100 consults monthly. The goal of these consults is to minimize patients' risk for adverse perioperative events and to optimize their chance to have safe and positive anesthetic outcomes. Preoperative NPs work with providers over multiple disciplines in developing and implementing patient care plans. Clinical responsibilities: - Work with anesthesia practitioners on the preoperative evaluation and care of patients of various surgical and procedural services, including but not limited to: head and neck surgery, plastic surgery, podiatry, gynecology, orthopedics, urology, general surgery, vascular surgery, neurosurgery, thoracic surgery, dental, gastroenterology, cardiology, and interventional radiology - Perform medical risk stratification, which includes a detailed review of a patient's medical problems, a physical exam, and a review of laboratory, radiologic, and other diagnostic studies such as EKG's, cardiac stress tests, and pulmonary function tests. - Work with anesthesia providers in determining if a patient needs additional preoperative testing or subspecialty referral and then arranging for those tests and referrals - Follow up on any pending labs, studies, or consults that may affect a patient's perioperative course - Identify any urgent medical, surgical, or psychiatric needs and assist in the timely development and execution of plans to avoid cancellation or delay of the surgery or procedure - Work with anesthesia providers to establish recommendations for perioperative care and medication management - Provide patient education regarding preoperative instructions and perioperative medication management - Follow the clinic's standard operating procedures (SOPs) - Advocate for patients and ensure that they receive all necessary care, which may require coordination of follow up with primary care or referral to a specialist - Evaluate, promote, and strive to protect the health, safety, and rights of patients throughout the perioperative process Additional opportunities: - Participate in practice improvement projects - Participate in interdisciplinary care pathways and initiatives - Make contributions throughout the medical center through professional presentations, academic teaching, and active participation in professional organizations III. SUPERVISORY CONTROLS The APRN is responsible to the first level supervisor both clinically and administratively. The APRN collaborates with others involved in patient care, including but not limited to Licensed Vocational Nurses (LVN's), Nursing Assistants (NA's), social workers (LSW's), and other Registered Nurses (RN's). The Approving Official is the second level supervisor. Patient Centered Care VAGLAHCS's customer service delivery model is Patient Centered Care (PCC). This center endorses a team- oriented, customer-driven, professional environment that promotes access to care for all veterans. Components of this model include educating and empowering patients and their families, providing support for all aspects of a patient's health, and maintaining integrity and accountability in order to ensure a high quality of care. The incumbent is responsible for implementing Patient-Centered Care principles in their work area. VI. AGE, DEVELOPMENT, AND CULTURAL NEEDS OF PATIENTS The population of veterans served ranges from the young adult, age 18, to the elderly adult, age 65 and over. VAGLAHCS is a major interdisciplinary teaching facility serving medical, surgical, and psychiatric inpatients and outpatients. The incumbent should be sensitive to the various needs of several veterans' populations served: - Young Adults (20 to 40): developing a career, fanning intimate relationships, selecting a healthy life style, and acquiring problem-solving skills - Middle Age (40 to 65): attaining personal growth and meaning; maintaining balance in terms of family life, work, and community involvement; health maintenance/prevention of illness. - Senior Adults (65 to 75): adaptation to retirement, adjustment to decreased body functioning, and dealing with inevitable losses - Middle Old Adults (74 to 84): adaptation to declines in speed of movement, reaction time, and sensory abilities that may lead to increased dependence on others - Elder Adults (85+): safety issues related to a decrease in sensory, motor, and cognitive functioning, chronic medical conditions, maintenance of social relationships to avoid isolation o Maintain Activities of Daily Living (ADL) and self-care o Establish fiduciaries/beneficiaries - Gender spectrum: includes male, female, transgender, nonbinary, gender fluid, among others - Service/Time: veterans of various eras and wars and many more not listed above Work Schedule: To be determined Financial Disclosure Report: Not required

Requirements

Qualifications

Advanced Practice Nurse (Nurse Practitioner) Basic Requirements English Language Proficiency. In accordance with 38 U.S.C. 7402(f), no person shall serve in direct patient care positions unless they are proficient in basic written and spoken English. Education: A post-master's certificate or master's or doctoral degree as a Nurse Practitioner. (Applicants pending the completion of educational requirements may be referred and tentatively selected but may not be hired until the education requirements are met.) Must be a 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). NOTE: Foreign Education. Graduates of foreign schools of professional nursing programs, the nurse practitioner degree equivalency must be validated through an Agency recognized degree equivalency evaluation agency, such as the International Consultants of Delaware (ICD). Candidates with equivalent nurse practitioner masters or doctorate level degrees who possess current, full, active, and unrestricted registration and certification will meet the requirement of graduation from an approved school of professional nursing to warrant appointment. License and Certification: License. All APN (NPs) must possess and maintain an active, current, full, and unrestricted APN license to practice as an NP in a State, Territory or Commonwealth of the United States, or in the District of Columbia. Basic Certification. All APN (NPs) must maintain full and current board certification in an area of clinical specialty from one of the following: the American Nurses Credentialing Center (ANCC), American Academy of Nurse Practitioners Certification Board (AANPCB), or other nationally recognized certifying body in the area in which the Nurse Practitioner is academically prepared. NOTE: Grandfathering Provision - All persons currently employed in VHA in 0610 series and an APN (NP) assignment that are also 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. The following Scope, Education and Experience, and Dimension criteria must be met to qualify for Advanced Practice Nurse (Nurse Practitioner) II: Exception to Licensure for Graduate Nurse Technicians. Candidates who otherwise meet the basic requirements, but do not possess the required licensure and/or certification, may be appointed at the entry step of the Nurse II, as a Graduate Nurse Technician - Nurse Practitioner on a temporary appointment up to any period not-to-exceed one year and a day under the authority of 38 U.S.C. § 405(c)(2)(B). Scope: Demonstrates leadership in delivering and improving holistic care through collaborative strategies with others Education and Experience Requirement: Meets basic education requirement for APN (NP). Nurse II is considered the entry grade level for APN (NPs); no experience is required. Dimension Requirement: APNs (NPs) at level II are expected to meet the following dimension requirements: Clinical Practice. Delivers evidence-based health care, demonstrating proficiency in the ability to manage a patient panel, population, or program. Outcome Focus. Utilizes research and evidence-based practice to evaluate the patient care delivery system within a patient panel or program, presents findings and contributes to changes that enhance the quality and timeliness of veteran/patient care. Leadership. Works effectively as a leader within a team/unit/group and seeks interdisciplinary collaboration as appropriate to enhance patient care. Professional Development. Acquires knowledge and skills to develop expertise in area of practice. Professionalism/Collegiality. Demonstrates effective communication skills and professional behavior, promoting cooperation and teamwork. Participates in interdisciplinary teams and processes that positively impact patient outcomes. The following Scope, Education and Experience, and Dimension criteria must be met to qualify for Advanced Practice Nurse (Nurse Practitioner) III: Scope: Executes position responsibilities that demonstrate leadership, experience, and creative approaches to management of complex client care. Education and Experience Requirement: Meets basic education requirement for an APN (NP) AND one year of specialized APN (NP) experience equivalent to the Nurse II grade level. Dimension Requirement: APN (Nurse Practitioners) at grade III are expected to meet the following dimension requirements: Clinical Practice. Influences and models the delivery of evidence- based health care, demonstrating expertise in the ability to manage a patient panel, population, or program. Outcome Focus. Leads and implements changes that enhance the quality and timeliness of Veteran/patient care applying research and evidence in the delivery of healthcare for patient populations. Leadership. Initiates and leads interdisciplinary teams informed by structured approaches and processes to improve outcomes that positively impact care for a patient panel, population, or program. Professional Development. Acquires knowledge and skills, then disseminates acquired information within and/or outside the medical facility. Professionalism/Collegiality. Initiates and leads interdisciplinary teams developing systems that positively impact outcomes at the panel, population, or program level. Demonstrates effective communication skills and professional behavior, promoting cooperation and teamwork. 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: Straight pulling and pushing; reaching above shoulder; use of fingers; both hands required; walking up to 8 hours; repeated bending; Ability for rapid mental and muscular coordination simultaneously; hearing aid permitted.

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 Jerry L Pettis Memorial Veterans Hospital 11201 Benton Street Loma Linda, CA 92357 US
• Name: Robin Sandoval
• Phone: (909) 583-6138
• Email: [email protected]