This position is eligible for the Education Debt Reduction Program (EDRP), a student loan payment reimbursement program. You must meet specific individual eligibility requirements in accordance with VHA policy and submit your EDRP application within four months of appointment. Approval, award amount (up to $200,000) and eligibility period (one to five years) are determined by the VHA Education Loan Repayment Services program office after complete review of the EDRP application. Applicants pending the completion of educational or certification/licensure requirements may be referred and tentatively selected but may not be hired until all requirements are met. 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. English Language Proficiency. In accordance with 38 U.S.C. 7402(d), 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 State-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). In cases of graduates of foreign schools of professional nursing, possession of current, full, active and unrestricted registration will meet the requirement of graduation from an approved school of professional nursing. OR The completion of coursework equivalent to a nursing degree in a MSN Bridge Program that qualifies for professional nursing registration constitutes the completion of an approved course of study of professional nursing. Students should submit the certificate of professional nursing to sit for the NCLEX to the VA along with a copy of the MSN transcript. (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. 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. Certification: On and after May 4, 1993, certification by the Council on Certification of Nurse Anesthetists is a requirement for employment. This requirement does not apply to non-certified nurse anesthetists employed by VA as a nurse anesthetist prior to May 4, 1993 and continuously thereafter. Any nurse anesthetist who leaves VA employment or vacates the nurse anesthetist occupation for another VA position, must meet the current requirement of certification for re-appointment as a nurse anesthetist. Preferred Experience: Experience related to the position. Experience in Hospital setting Excellent communication skills (written and verbal) Grade Determinations: The following criteria must be met in determining the grade assignment of candidates, and if appropriate, the level within a grade: 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. Note regarding MSN degrees: If your MSN was obtained via a Bridge Program that qualifies for professional nursing registration, a BSN is not required. Reference: VA Regulations, specifically VA Handbook 5005, Part II, Appendix G-7 Nurse Anesthetist Qualification Standard. This can be found in the local Human Resources Office. Physical Requirements: Requires lifting 15-44 pounds; pushing (approx. 2 hours); reaching above shoulder; use of fingers & both hands; walking & standing from 3-5 hours and kneeling. Ability for rapid mental & muscular coordination simultaneously. Near vision correctable at 13" to 16" to Jaeger 1 to 4. Far visions correctable in one eye to 20/20 & to 20/40 in the other. Must have depth perception & ability to distinguish basic colors & shades of colors. Hearing aid is permitted ["VA offers a comprehensive total rewards package: VA Nurse Total Rewards The CRNA will provide anesthesia and anesthesia-related services as a part of an Anesthesia Care Team under the medical supervision of a staff anesthesiologist. Care includes preanesthetic evaluation, peri-operative anesthetic management, and post-operative care in the perioperative area. Practice settings include the acute medical and surgical inpatient and outpatient setting. The practice of each CRNA is based on individual knowledge, skills and experience and has a direct impact of patient outcomes. Scope of assigned duties include but are not limited to: a. Completes a thorough pre-operative evaluation of inpatients and outpatients i. Reviews available medical, surgical, and anesthetic records ii. Interviews the patient, explaining procedures, risks, benefits; provides informed consent, and solicits and answers questions iii. Performs and documents the medical history and pertinent physical examination findings including auscultation of the heart and lungs, and performs a thorough airway assessment iv. Writes appropriate pre-operative orders 1. Defines NPO status per policy 2. Requests necessary laboratory tests, ECG, chest radiographs, blood products, etc. and orders diagnostic tests and requests medical consultations as needed 3. Orders pre-operative medications to include, but not limited to, any of the following drug classes: a. H2 blockers and other antacids b. Antibiotics c. Insulin d. Anti-hypertensives or beta-blockers e. Analgesics f. Anxiolytics g. Antiemetics v. Discusses patient assessment and anesthetic plans including post-operative pain management plan with the attending anesthesiologist vi. Performs thorough post-operative assessments for inpatients and outpatients b. Administers all types of anesthesia to adult and geriatric patients, ASA I-V in collaboration with the supervising attending anesthesiologist in the operating room and in off-site areas such as Radiology, Electrophysiology Lab, GI, and other remote areas as needed. Places necessary invasive monitoring devices and performs other advanced procedures as qualified for adult and geriatric patients with supervision i. Types of anesthetics 1. General Anesthesia 2. Monitored Anesthesia Care 3. Spinal Anesthesia 4. Epidural Anesthesia 5. Peripheral Nerve Blocks 6. IV Regional Anesthesia ii. Intraoperative management of patients 1. Completes a proper safety check of all equipment and medications before each case 2. Performs tracheal intubations and uses other supraglottic airway devices; provides manual and mechanical ventilation consistent with the needs of the patient, and extubates patients 3. Practices proper and safe positioning of the patient 4. Manages the anesthetic, promptly detects problems, and implements corrective action, with timely communication with the supervising anesthesiologist a. Manages resuscitation with fluids and blood products, manages electrolyte and acid- base disturbances in an evidence-based manner b. Monitors and interprets invasive monitoring data c. Documents all aspects of the anesthetic care on the anesthetic record d. Manages emergence from anesthesia, recognizes problems and requests appropriate and timely assistance e. Maintains contact with the attending anesthesiologist as required throughout the anesthetic, especially at critical portions of the case iii. Adheres to infection control guidelines set forth by the Medical Center Infection Control Committee 1. Utilizes recommended barrier precautions commensurate with exposure, complying with mandatory standard precautions 2. Employs safe, recommended practices to prevent needle sticks or other sharps injuries 3. Cleans or pre-cleans reusable medical equipment to manufacturer's specifications and sends to Sterile Processing & Supply (SPS) for sterilization. Performance of this standard will be addressed in the employee's annual Proficiency Report c. Participates in the post-anesthetic management of the patient d. Specialty Skills i. Operates all point-of-care testing equipment as qualified ii. Operates the blood gas analyzer Work Schedule: 12 hour shifts with rotating on-call Telework: Not Available EDRP Authorized: Contact Caronda.Slocum@va.gov, the EDRP Coordinator for questions/assistance. Learn more Permanent Change of Station (PCS): Not Authorized Financial Disclosure Report: Not required"]

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