The Perianesthesia clinical area is a collaborative critical care level, inter-disciplinary practice setting that provides veterans with complex care modalities. All RN staff are required to maintain ACLS/BLS and moderate sedation certification/competency. Perianesthesia RNs provide pre/post-operative care in the unit and moderate sedation throughout the San Francisco VA Health Care Facility.

Duties

Perianesthesia duties: Providing patient and family teaching, patient and family support, pre/post operative and Anesthesia pre-op clinic phone calls. Pre-op patient preparation, Phase 1, and Phase 2 recovery. Perianesthesia nurses are required to be capable of working in all possible areas of the unit (Pre-op, Phase 1 & 2). All RNs will also be trained to administer and monitor moderate sedation in settings outside the unit area such as, but not limited to Dental, Bronchoscopy suites. All Perianesthesia nurses will adhere to the American Society of Perianesthesia Nurses (ASPAN) standards and guidelines for care as well as VA facility and VA National requirements, standards, and guidelines for patient care. Perianesthesia nurses must be capable of providing ICU level care to patients coming out of anesthetic required procedures and serves as the backup ICU for the facility. Perianesthesia RN's may also help to recover moderate sedation patients coming for other areas in the facility when it is needed. All ASU/PACU/Sedation float nurses need to ensure that bays are stocked and there are zero out of date materials in the stocked carts and all areas not monitored by logistics, as well as cleaning and making gurneys for the following shifts. Pre-op duties: Check in patient, gather vital signs, assist patient to change for surgery, administer pre operative/procedural medication. Check to ensure proper surgery documentation (attending note, H&P, consent, ancillary testing completed). Start IV's PRN, obtain labs and other specimens. Phase 1 PACU duties: Attaining report from anesthesia provider and surgical team. Stabilizing patient upon arrival from operating suite or procedure. Assuring airway, breathing, circulation within normal limits. Administer medication to help achieve hemostasis, control pain and nausea. Attain vital signs q15min x4, q30x2 then q1hr based upon patient stability, to include level of conscious (LOC), motor function, sensation, incisional approximation, and hematoma presence, pain level. Drain and line care, functionality, and proximity. Apply post-operative appliances, draw labs, and obtain EKC's PRN. Check and print discharge instructions for phase 2 recovery. Check floor orders for correct disposition and accuracy. Give verbal/telephone report to ordered disposition. Phase 2 PACU duties: Attain report from Phase 1, Operating Room, Pain clinic, Interventional Radiology, or other area giving moderate Sedation or Monitored Anesthesia Care (MAC) that no longer requires patient monitoring beyond 30 minutes. Prepare patient for discharge to Hotel, Rideshare, or home. Acquire at least one set of vital signs: BP, HR, O2 Saturation, and pain level to ensure patient meets criteria for discharge. Offer food and/or beverage to patient. Check discharge orders and medications to be sent home with patient, call pharmacy as needed if patient medication is not brought up prior to arrival to Phase 2 area. Call patients ride to give time for pick up. Assist patient to get dressed, if necessary. Remove IV, patient identification band, and apply slings/ appliances as indicted. Assure surgical dressing is intact. Go over discharge instructions and medications with patient or caregiver (if needed). Sedation duties: Check for appropriate credentialing for provider doing the case. Assure required medication is removed from pyxis and IV fluids are available. Confirm that emergency equipment is available (Crash cart, suction, oxygen, airways, reversal medication). Complete the first page of the moderate sedation form (baseline vital signs, pain level, weight, temp, and pre-procedure assessment) prior to time-out. Administer medication per moderate sedation guidelines and/or physician direction. Take vital signs at least q5 minutes throughout the procedure. Assessing LOC, skin color, HR & rhythm, BP, respiration, O2 saturation (route and liters per minute if indicated), End-tidal CO2 if available. Utilize the moderate sedation form for Phase 1 PACU or Phase 2 PACU as indicated. Give verbal report to accepting RN. 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: Full-time, Variable Telework: Not Available Virtual: This is not a virtual position. Relocation/Recruitment Incentives: Not Authorized Permanent Change of Station (PCS): No 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/12464986. 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: Previous PACU or ICU 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: https://sites.ed.gov/international/recognition-of-foreign-qualifications/.

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]