Responsible and accountable for all elements of the nursing process when providing and/or supervising direct patient care. Assumes responsibility for the coordination of care focused on patient education, self-management, and customer satisfaction throughout the continuum of care.

Duties

Administers medications and assists in the performance of procedures per established policies and guidelines. Influences care outcomes by collaborating with members of the interdisciplinary team. Core elements of performance include knowledge and active participation in the unit/program level quality improvement process and initiatives as well as customer service programs. Executes position responsibilities that demonstrate experience and creative approaches to the management of complex patient care. Functions within the team framework to utilize critical thinking and communication skills with the interdisciplinary team. Performs diagnostic Doppler, 2D, and M-Mode Echocardiograms on out-patients, surgery and recovery patients. Recognizes intra-cardiac structures based on cross sectional anatomic images and motion characteristics during the cardiac cycle, both in normal and in disease states and to do so from a variety of different planes and angles for optimal image quality. Recognizes normal echocardiographic findings and deviations produced by a wide variety of diseases affecting the cardiovascular system. Retains observation skills to instantaneously recognize them on the Real-Time 2-dimensional images and Doppler. Performs complex procedures as: (a) cardiac studies of the four chambers of the heart and valves, utilizing M-mode and sector scanning (real-time) techniques, to detect stenotic and incompetent valves, chamber enlargement, chamber function, and pericardia! effusion, etc: (b) using Doppler imaging system, to derive pressure gradients across obstructed valves, post­operative evaluation of artificial valves, semi-quantitating valvular regurgitation, and determining the extent of narrowing degenerative aortic valves, intra-cardiac shunts, estimates of cardiac output and provide preliminary interpretation for the physician. Instantaneously differentiates normal echocardiographic findings from those produced by numerous pathologic states, or by technical or instrument related artifacts and appropriately correct for artifacts of further evaluate the findings depending on the situation. Recognizes need for intravenous contrast/Definity to better delineate endocardium. Utilizes physics, mathematics, and electrical circuitry, as they apply to echocardiographic imaging systems and techniques, if necessary, specifically: M-mode, 2-D phased-array, continuous wave Doppler, color flow Doppler techniques, and tissue velocity imaging.- Operates the actual instrumentation and trouble shoot problems. Understand the physical causes of artifacts and poor image quality and correct for them Evaluates quantitative function and structure of the different chambers and valves of the different chambers and valves of the heart, utilizing the various formulae involved. Such calculations are used in determining values such as: pressure gradients across stenotic valves, areas of valvular openings, the amount of regurgitation in natural as well as artificial valves, ejection fractions, size of the four chambers of the heart and thickness of the heart muscle itself.. Brings to the attention of the cardiologist any emergent findings and for notification of the patient's physician of important abnormal and life-threatening findings, which may affect management of patient care. Performs Head Up Tilt Test Performs Stress echocardiogram, dobutamine echocardiogram and assist in transesophageal echocardiograrm. IV lines and injection of echocardiogram contrast. Work Schedule: Day shift, Monday - Friday, Saturday/Sunday 7:00am to 5:00PM 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: 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/12511041. 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: (See Additional Information) Reference: For more information on this qualification standard, please visit https://www.va.gov/ohrm/QualificationStandards/. Physical Requirements: This position involves lifting, moving and transporting patients, assist with transferring patients from wheelchair to to stretcher or radiology suite table and vice versa. Also assist with transferring patients to wheelchairs and/or may need to escort a patient to other areas. This position involves exposure to blood borne pathogens, fine manipulation, standing, walking, bending, crouching and reaching patients. It requires dealing with the acutely ill, with patients who may display disturbed behaviors, and with stressful situations. Moving patients and weighing patients in excess of 50 kg. or more. Wearing of a respirator may be required at times in the performance of the duties of this position. When required to use respirator, employee cannot have facial hair or any condition that interferes with the face to face piece seal or valve function of the respirator. See VA Directive and Handbook 5019.

Contacts

• Address San Juan VA Medical Center 10 Calle Casia San Juan, PR 00921 US
• Name: Luis Burgos-Pena
• Email: [email protected]