The Advanced Practice Nurse (APN) II Certified Nurse Anesthetist (CNA) is a Certified Registered Nurse Anesthetist (CRNA). The CRNA provides a full range of services emphasizing quality, timeliness and advancement of the Veterans Affairs (VA) mission. The CRNA practices to the full extent of their education, training, and certification. Core functions are outlined in the clinical privileges or scope of practice. The CRNA provides advanced clinical practice, consultation and management.

Duties

Major Duties (To include but not limited to): Collaborate with a variety of health care professionals to achieve common goals for care, safety, and welfare of patients. Foster high levels of confidence and satisfaction among patients and staff, as well as meet and exceed compliance standards. Provide anesthetic services within five general categories to include: pre-anesthesia evaluation and preparation; anesthesia induction, maintenance, and emergence; post anesthesia care; peri-anesthetic and clinical support functions; and emergency response techniques. Develops and implements a comprehensive anesthesia plan of care for patients requiring local, regional, general, and monitored anesthesia both inside and outside the Operating Room (OR) suite. Ensures anesthetic services delivered throughout the facility are of the highest quality to promote patient safety, satisfaction, and improve outcomes and efficiencies. Functions as resource for staff education and is willing to be a preceptor and adjunct clinical faculty for health care trainees rotating through the facility. Develops and implements evidence-based practices that are essential to the delivery of the highest quality anesthesia care. Prescribe appropriate preoperative, intra-operative and postoperative orders and medications. Exemplifies the ICARE core values of-Integrity, Commitment, Advocacy, Respect, and Excellence. 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: Monday - Friday; 6:45am to 3:15pm Telework: Not Available Virtual: This is not a virtual position. Relocation/Recruitment Incentives: Not Authorized Permanent Change of Station (PCS): Not Authorized

Requirements

Qualifications

Advanced Practice Nurse (Certified Nurse Anesthetist) 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 masters or doctoral degree in nurse anesthesia. (Applicants pending the completion of educational requirements may be referred and tentatively selected but may not be hired until the education requirements are met.) Nursing education must be from a school of professional nursing anesthesia accredited by Council on Accreditation of Nurse Anesthesia Education Programs (COA) at the time the program was completed by the applicant. Licensure and Certification. The following licensure and certification requirements are considered conditions of employment. License. All APN (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. Basic Certification. All APN (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. NOTE: Grandfathering Provision - All persons currently employed in VHA in 0610 series and an APN (CNA) 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 Education, Experience, and Knowledge, Skills and Abilities must be met for Advanced Practice Nurse (Certified Nurse Anesthetist) II: Exception to Licensure for Graduate Nurse Technicians. Candidates who otherwise meet the basic requirements, but do not possess the required APN (CNA) licensure and/or certification, may be appointed at the entry step of the Nurse II, as a Nurse Anesthetist on a temporary appointment up to any period not-to-exceed one year and a day under the authority of 38 U.S.C. § 7405(c)(2)(B). Education and Experience Requirement. Meets basic education requirement for an APN (CNA). Nurse II is considered the entry grade level for APN (CNAs); no experience is required. Demonstrated Knowledge, Skills, and Abilities. 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. The following Education, Experience, and Knowledge, Skills and Abilities must be met for Advanced Practice Nurse (Certified Nurse Anesthetist) III: Education and Experience Requirement: Meets basic education requirement for an APN (CNA) AND One year of specialized APN (CNA) experience equivalent to the APN (CNA) II grade level. Demonstrated Knowledge, Skills, and Abilities: 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. Reference: For more information on this qualification standard, please visit https://www.va.gov/ohrm/QualificationStandards/. Physical Requirements: Heavy lifting, 45 pounds and over; Moderate lifting, 15-44 pounds; Light lifting, under 15 pounds; Light carrying, under 15 pounds; Straight pulling (1-2 hours); Pushing (1-2 hours); Reaching above shoulder; Use of fingers; Both hands required; Walking (4-6 hours); Standing (4-6 hours); Kneeling (1-2 hours); Repeated bending (1-2 hours); Both legs required; Ability for rapid mental and muscular coordination simultaneously; Near vision correctable at 13" to 16" to Jaeger 1 to 4; Far vision correctable in one eye to 20/20 and to 20/40 in the other; Ability to distinguish basic colors; Ability to distinguish shades of colors; Hearing (aid permitted); Wear Protective Clothing and equipment to include radiation safety PPE (apron, googles, thyroid shield) on frequent basis.

Education

Preferred Experience:

• A candidate with extensive training/experience with thoracic, cardiac (including open heart) and robotic cases, vascular, neurosurgery anesthesia and training and familiarity in regional anesthesia.
• Training and familiarity in the electronic anesthesia record keeping system (ARKs).
• Ability to perform scheduling and supervise staff, students, or ancillary personnel to include conducting performance evaluations to effectively execute responsibilities.
• Ability to serve on committee meetings, departmental reviews, problem-focused studies, problem solving, interventions, and process oversight to justify program goals and motivate assigned personnel.
• Ability to exercise independent judgment, perform tasks of unusual difficulty along special technical, supervisory, or administrative liens. These practitioners may develop protocols of anesthesia practice.
• Ability to provide leadership in the application of the nursing process to patient care, organization processes and/or systems, improving outcomes at the program or service level.

Contacts

• Address Michael E DeBakey VA Medical Center 2002 Holcombe Boulevard Houston, TX 77030 US
• Name: Ann Martin
• Phone: 210-617-5300
• Email: [email protected]