The Certified Registered Nurse Anesthetist (CRNA) provides anesthesia care and counseling of persons during surgical procedures based upon the process which includes systematic data gathering, assessment, appropriate judgment, and evaluation of human responses. A Recruitment/Relocation Incentive may be authorized to highly qualified candidates. This position is eligible for the Education Debt Reduction Program (EDRP). 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. Graduate of an accredited nurse anesthesia educational program approved by the American Association of Nurse Anesthetists (AANA) at the time the program was completed by the applicant. 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 in providing range of anesthesia services Certified in specialty 1 year experience in administrative duties Experience in an ambulatory clinic environment Good working relationship with anesthesiologist Experience specifically with ophthalmology, podiatry, gastroenterology, orthopaedic cases Grade Determinations: The following criteria must be met in determining the grade assignment of candidates, and if appropriate, the level within a grade: The level that nurse anesthesia practice may be performed is based on a combination of education and experience. Beyond the minimum education requirements, grade determination upon appointment and advancement is dependent more on acquired knowledge, skills, and abilities than baseline education. As the nurse anesthetist acquires the knowledge and judgment that accrues with experience, the privilege of increased authority for patient care is expanded. In addition to the basic requirements stated above, the following qualification criteria must be met in determining the appropriate grade assignments of candidates: Entry Level: Nurse II Experience and Education: None beyond the basic requirements. 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: Ability to translate the principles of professional nursing practice in the care of assigned patients in order to provide appropriate care. Ability to do a pre-anesthetic patient history and physical, which includes collecting pre-operative consults and data. Ability to formulate an anesthetic plan and describe the anesthetic risks, benefits and options to the patient. 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. Ability to respond to emergency situations by providing airway management, administration of emergency fluids and drugs, and using appropriate resuscitation procedures for patient care. Ability to provide patient care that is abreast of changing concepts and advancements in the profession. Ability to work effectively in an interdisciplinary environment for improvement of services for patient care. Ability to practice nurse anesthesia with colleagues and peers utilizing a collaborative team concept of anesthesia care. Full Performance Level: Nurse III Experience and Education: In addition to meeting the requirements for Entry Level Nurse II, 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. Demonstrated Knowledge, Skills, and Abilities: Full Performance Level practice in nurse anesthesia includes but is not limited to the following: 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. 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. 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. Ability to effectively blend technology, skills, and competency for the advancement of anesthesia techniques, pharmacology, and equipment. Ability to apply new developments and theories to develop and demonstrate the ability to recognize and solve various complex anesthesia situations. Ability to practice nurse anesthesia with colleagues and peers in a team concept of anesthesia care and blend management skills with technical experience. 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. 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. Ability to participate in the development of anesthesia patient care audit processes involving in depth review and analysis of anesthesia records. Ability to provide guidance and instruction in preparing others for positions of leadership and ethical practices which impact patient care. 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: Moderate lifting, 15-44 pounds; Moderate carrying, 15-44 pounds; Pushing 1hr; Reaching above shoulder; Use of fingers; Both hands required; Walking (8hrs); Standing (8hrs); Both legs required; Repeated bending 1hr; 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; Both eyes required; Depth perception; Ability to distinguish basic colors; Ability to distinguish shades of colors; Hearing (aid permitted); Sitting (4hrs) ["The Certified Registered Nurse Anesthetist performs pre-anesthesia evaluations, prepares anesthesia plan, delivers all forms of anesthesia and follows up on all general anesthesia cases. Provides emergency airway and resuscitation management throughout the facility. The Nurse Anesthetist assists with quality assurance activities facility wide and specific to the Surgery department and conducts routine maintenance and cleaning of anesthesia equipment. The CRNA translates the principles of professional nurse anesthesia practice into appropriate patient care. Performs the pre-anesthetic patient history and physical, including the collection of preoperative consults and data, from which an appropriate anesthetic plan is formulated. The anesthetic risks, benefits, and options are described to the patient. Administers inhalation, regional, intravenous, local and topical anesthetics and continuously evaluates the patient's physical status and responses to anesthesia. Consistently monitors and accurately records on the anesthesia record. Performs post-anesthetic management of patients in order to optimize the recovery from anesthesia and minimize pain. Provides patient care that is abreast of changing concepts and advancements in the profession, while working effectively in an interdisciplinary environment for improvement of services for patient care. Appropriately responds to all codes and airway rescues. Practices with colleagues and peers utilizing a collaborative team concept of anesthesia care while demonstrating effective communication skills and professional behaviors that promote cooperation and interdisciplinary teamwork. VA offers a comprehensive total rewards package: VA Nurse Total Rewards Recruitment/Relocation Incentive (Sign-on Bonus): Authorized Education Debt Reduction Program (Student Loan Repayment): Authorized, see details in 'Education section' 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, 8:00am-4:45pm Financial Disclosure Report: Not required"]

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