There are two full-time Certified Registered Nurse Anesthetist (CRNA) positions available at the Oscar G. Johnson VA Medical Center, Iron Mountain, MI. To qualify for this position, applicants must meet all requirements by the closing date of this announcement, 06/04/2022. Basic Requirements: United States Citizenship: Non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy. Must be a US Citizen. Must be proficient in spoken and written English. Nurse Anesthetists must be proficient in spoken and written English in accordance with VA Handbook, Part II, Chapter 2, Section D, and Paragraph 5a. Must have a degree in nursing from a school of professional nursing approved by the appropriate accrediting agency and accredited by the National League for Nursing Accreditation Commission (NLNAC) or Commission on Collegiate Nursing Education (CCNE). In cases of graduates of foreign schools of professional nursing, possession of current, full, active and unrestricted registration and the possession of a Certificate from the Commission on Graduates of Foreign Nursing Schools (CGFNS) will meet the requirement of graduation from an approved school of professional nursing. Must be a graduate of an accredited nurse anesthesia educational program approved by the American Association of Nurse Anesthetists (AANA) at the time the program was completed. Must possess a current, full, active and unrestricted license as a graduate professional nurse in a State, Territory or Commonwealth (i.e., Puerto Rico) of the United States or the District of Columbia. The nurse anesthetist must maintain a current, full and unrestricted registration to continue employment with VA. Must be certified by the Council on Certification of Nurse Anesthetists and must maintain recertification by meeting the Council on Recertification of Nurse Anesthetist's requirements as a condition of employment. Experience refers to paid and unpaid experience, including volunteer work done through National Service programs (e.g., Peace Corps, AmeriCorps) and other organizations (e.g., professional; philanthropic; religions; spiritual; community; student; social). Volunteer work helps build critical competencies, knowledge, and skills and can provide valuable training and experience that translates directly to paid employment. You will receive credit for all qualifying experience, including volunteer experience. Grade Determinations: Entry Level (Nurse II) (a) Experience and Education. None beyond the basic requirements. (b) Demonstrated Knowledge, Skills and Abilities. The following list of knowledge, skills and abilities present the minimum skill set expected of an Entry Level Nurse Anesthetist. Entry level into nurse anesthesia practice may include but are not limited to the following: 1. Ability to translate the principles of professional nursing practice in the care of assigned patients in order to provide appropriate care. 2. Ability to do a pre-anesthetic patient history and physical, which includes collecting pre-operative consults and data. 3. Ability to formulate an anesthetic plan and describe the anesthetic risks, benefits and options to the patient. 4. Ability to administer inhalation, regional, intravenous, local, and topical anesthetics and to detect unfavorable reactions in order to continuously evaluate the patient's physical status. 5. Ability to respond to emergency situations by providing airway management, administration of emergency fluids and drugs, and using appropriate resuscitation procedures for patient care. 6. Ability to provide patient care that is abreast of changing concepts and advancements in the profession. 7. Ability to work effectively in an interdisciplinary environment for improvement of services for patient care. 8. Ability to practice nurse anesthesia with colleagues and peers utilizing a collaborative team concept of anesthesia care. Full Performance Level: (Nurse III) (a) Experience and Education. In addition to meeting the requirements for Entry Level, the CRNA has had progressively responsible experience in the administration of anesthetics as indicated in the knowledge, skills and abilities listed below. These individuals must demonstrate the ability to participate in a program for nurse anesthesia care and demonstrate knowledge of anesthetizing locations, methods, equipment and procedures. At this level, the CRNA has experience in the administration of anesthetics that has demonstrated the nurse anesthetist's ability to participate in team programs that are technically challenging and/or complicated. Typically candidates can demonstrate the knowledge, skills and abilities of Full Performance Level within 2 years from entering the occupation. (b) Demonstrated Knowledge, Skills, and Abilities. Full Performance Level practice in nurse anesthesia includes but is not limited to the following: 1. Skill in conducting and managing anesthesia for a broad range of complex surgical procedures. In addition, the CRNA must be able to adapt/modify anesthesia techniques in order to optimize patient care. 2. Ability to complete work assignments selected to add depth and breadth to their technical knowledge and skill competence. Work assignments will vary at each facility depending on the progressive acuity required for anesthesia care. 3. Ability to respond to emergency situations by providing airway management, administration of emergency fluids and drugs, and by the use of basic or advanced cardiac life support techniques in order to perform necessary resuscitation procedures. 4. Ability to effectively blend technology, skills, and competency for the advancement of anesthesia techniques, pharmacology, and equipment. 5. Ability to apply new developments and theories to develop and demonstrate the ability to recognize and solve various complex anesthesia situations. 6. Ability to practice nurse anesthesia with colleagues and peers in a team concept of anesthesia care and blend management skills with technical experience. 7. Ability to recognize clinical and technical aspects of anesthesia care and has in-depth knowledge of anesthesia methods and techniques for the practice of anesthesia. 8. Ability to perform as a mentor, preceptor, or nurse educator providing didactic and clinical instruction for graduate-level nurse anesthesia students and/or other anesthesia care providers. 9. Ability to participate in the development of anesthesia patient care audit processes involving in depth review and analysis of anesthesia records. 10. Ability to provide guidance and instruction in preparing others for positions of leadership and ethical practices which impact patient care. Reference: VA Handbook 5005/37, Part II, Appendix G7 NURSE ANESTHETIST QUALIFICATION STANDARD. This can be found in the local Human Resources Office. Physical Requirements: The CRNA has to be able to carry an 8-10 pound code blue box within the entire facility in order to respond to emergency situations by providing airway management, administration of emergency fluids and drugs, and using basic or advanced cardiac life support techniques. The CRNA will be required to take call. ["Assessment of, consultation for, and preparation of patients for anesthesia and the management of homeostasis in the critically ill, injured, or otherwise seriously ill patient:\n(1) Documents pertinent physical examination and medical history, including auscultation of heart and lungs and thorough airway assessment.\n(2) Interviews the patient, explaining procedures, risk factors, and solicits questions.\n(3) Writes appropriate pre-anesthesia orders. (a)Defines NPO status. (b) Requests routine necessary diagnostic tests (e.g., EKG, CXR, and blood tests otherwise not ordered. (c) Orders pre-anesthesia medications to include any of the follow drug classes: - Analgesics, including narcotics - Sedative/Hypnotic drugs (e.g., Benzodiazepines) - Antiemetics - Antisialogogues - Blockers and other antacids (4) Discusses patient's assessment and anesthetic plans with attending surgeon. Administers all types of anesthetics/places necessary invasive monitoring lines with supervision by operating surgeon.\n(1) Types of anesthetics: General Anesthesia Monitored Anesthesia Care IV Regional Anesthesia Regional Neuromuscular Blocks, eg. ankle, scalene, etc. (2) Interoperative management of patients. Completes proper safety check of ALL equipment for all cases. VA Great Lakes Health Care System (VISN 12) November 2021 Oscar G. Johnson VAMC Iron Mountain, Michigan 49801 Performs tracheal intubation, extubating, and provides ventilation consistent with needs of patient. Practices proper and safe positioning of patient. Manages the anesthetic, promptly detects problems, and implements corrective action with timely follow-up communication to the operating surgeon. - Manages fluid, blood, electrolyte and acid-base balance. - Monitors and interprets invasive monitoring information. - Documents all aspects of patient care on the anesthesia record in legible penmanship and/or electronically. - Evaluates patient, manages emergency from anesthesia, recognizes problems, and requests appropriate and timely assistance. Adheres to infection control guidelines set forth by the Infection Control Committee. - Utilizes recommended barrier precautions commensurate with exposure, complying with mandatory standard precautions (e.g., protective eyewear, gloves). - Employs safe recommended practices to prevent needle sticks. Post-anesthesia management of patient.\n(1) Practices proper and safe transport of patient after recovery.\n(2) Provides post recovery with thorough documentation of patient's medical history and anesthetic course.\n(3) Completes post-anesthesia evaluation of patients and plans follow-up if complications are detected.\n(4) Provides acute post-op pain management of patients with narcotic, NSAIDS, or other agents as indicated. Emergency Duties CRNA must be able to respond to situations of life-threatening nature on a daily basis. They must act promptly, recognizing the need for supervisory assistance and support, and summoning same forthwith. Prescriptive Privileges CRNAs write medication orders on the patient's chart to the extent spelled out in the Medical Staff Bylaws. These are limited to in-house administration and are not to be continued beyond the CRNA's follow-up care of the patient in the PACU and/or ICU. Such orders may include narcotics for pre-medication and for post-operative pain in its acute phase. The countersignature of the operating surgeon on the intraoperative anesthesia record and/or CRPS chart shall serve as the co-signature for all CRNA orders related to the specific administration of anesthesia they accompany. Additional Duties CRNAs are expected to participate in the instruction of staff and students in the manual skills for which they have especial dexterity. The Chief, Surgical Service, may assign such additional responsibilities as may be considered beneficial and contributive to the efficiency VA Great Lakes Health Care System (VISN 12) November 2021 Oscar G. Johnson VAMC Iron Mountain, Michigan 49801 and productivity of the Service. CRNAs may also function as support personnel in the pain clinic and provide pre-surgical screening. Work Schedule: Monday - Friday 0700-1530\nTelework: Not Available\nVirtual: This is not a virtual position.\nRelocation/Recruitment Incentives: Recruitment/Relocation Incentive may be authorized for highly qualified candidates\nPermanent Change of Station (PCS): Not Authorized\nFinancial Discloser Report: Not required"]