The Ambulatory Procedure (A/P) Registered Nurse uses the Nursing process and evidence based practice to care for Ambulatory Procedure patients during all phases- pre procedure, intraoperative and post procedure stages. The A/P RN provides safe, prompt, skillful nursing care for patients requiring an invasive diagnostic or treatment procedure. The acuity of patients is within the range of those appropriate for outpatient ambulatory care having surgical procedures.
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/12795916. 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: 2-3 years APU/Endoscopy/OR/Peri-operative experience preferred. Supporting experience in med-surg/critical care. Reference: For more information on this qualification standard, please visit https://www.va.gov/ohrm/QualificationStandards/. Physical Requirements: This position requires visual acuity, keen hearing, manual dexterity, and clear distinctive speech. This position requires potentially long periods of continued walking, standing, stooping, sitting, and bending. Bending, lifting and carrying of light items may be required. The Incumbent must be able to demonstrate nursing procedures requiring technical skills.
The Ambulatory Procedure Registered Nurse (RN), demonstrates advanced clinical knowledge in assessing, planning, implementing, documenting, and evaluating care for a designated group of patients across the continuum of care. Responsibilities include, but are not limited to, Provides care as a member of the core A/P care team performing comprehensive circulating and scrubbing duties according to Medical Center Policy and Association of Perioperative Registered Nurses Standards and Recommended Practices. Complies with standard operating principles for Reusable Medical equipment (RME), demonstrates knowledge of instrumentation, equipment specific to the procedure to ensure seamless progression of the procedure. Performs nursing activities, to include patient evaluation, documentation during of all phases of the procedure, creating and maintaining a sterile and safe ambulatory procedure environment, pre and post procedure education, monitoring the patient's physical and emotional wellbeing, integrating and coordinating patient care throughout the procedural care continuum. Participates in the time out prior to any intervention in A/P. Responds appropriately to the patient in an emergency or physically distressful situation and takes appropriate action. Looks for opportunities to improve practice or function at the unit level for a group of patients, using group process to accomplish this by organizing, leading or facilitating team meetings. Functions as a preceptor, assuming accountability and responsibility of the orientee's clinical development. Responsible for the care of the patient in all A/P roles- circulator, scrub nurse, PACU, radiology nurse, clinic nurse, pre and post procedure calls. Caring for the patient undergoing various ambulatory procedures, endoscopic, dermatology, GU BCG installation, urology, paracentesis, pain procedures, ENT, surgical, radiology CT/MRI, clinics etc. Demonstrates consistent clinical competence in providing nursing care using equipment safely, correctly. Evaluates performance as measured against TJC standards and takes action to correct deficits to ensure compliance as part of continued readiness. Actively interpreting data recognizing subtle changes in patient's condition and responds timely using critical thinking in identifying, analyzing, and resolving patient care issues. Performs ongoing assessment of patient's condition and response to treatment. Provides care for patients in all A/P clinics, using technology, secure messaging, telephone, CPRS etc. Monitors patients using cardiac monitors to identify normal EKG rhythms as well as lethal dysrhythmias with ability to describe to provider and intervene to support emergency treatment procedures. Assists with specimen collection and handling with correct labeling per policy. Acts as a patient advocate when patient self determination is questioned. Checks supply levels and equipment in preparation for procedures. Obtains, reads, and follows Standard Operating Procedures (SOPs) for all reusable medical equipment (RME) in use in the clinical area and consults Sterile Processing and/or Infection Control as needed. Supports others doing research. This position is eligible for the Education Debt Reduction Program (EDRP), a student loan payment reimbursement program. You must meet specific eligibility requirements per VHA policy and submit your EDRP application within four months of appointment. Program Approval, award amount (up to $200,000) & eligibility period (one to five years) are determined by the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible to apply. 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: Day Tour - 8am-4:30pm Telework: Not Available Virtual: This is not a virtual position. EDRP Authorized: Former EDRP participants ineligible to apply for incentive. Contact VISN2edrpcoordinators@va.gov, the EDRP Coordinator for questions/assistance. Learn more Permanent Change of Station (PCS): Authorized