Summary

The Registered Nurse in the Emergency Department at VA San Diego Health Care Systems executes position responsibilities that demonstrates leadership - in delivering and improving holistic care through collaborative strategies with others.

Qualifications

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/12973161
• 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: BSN - 2 years of recent ED RN experience
• Reference: For more information on this qualification standard - please visit https://www.va.gov/ohrm/QualificationStandards/.

Duties

• VA offers a comprehensive total rewards package: VA Nurse Total Rewards The ED RN assumes the following major duties and responsibilities: Leads and organizes delivery of care to assure continuity of care and peer accountability for practice - including access to care and discharge planning
• Uses advance clinical knowledge/judgment to promote staff involvement in planning - decision making - and evaluating outcomes
• Functions as an expert in clinical practice and/or areas related to the assignment of roles and responsibilities
• Systematically evaluates current practice and formulates outcomes for groups of patients and/or organizational processes within an area of expertise
• Guides - develops - and supports staff from a leadership perspective
• Uses professional standards of care - scientific evidence - and practice to evaluate programs and/or service activities
• Participates in orientation - unit-based in-services - and mandatory education activities in a self-directed manner
• Evaluates unit performance as measured against The Joint Commission standards and takes action to correct deficits to ensure compliance as part of continued readiness
• Supports and encourages others to read and correctly interpret medical center and service-level policies and procedures
• Assumes leadership role in identifying policies - procedures - standards - guidelines - and protocols requiring review or revision
• Applies and directs others to apply infection control measures appropriately in delivering care
• Identifies and analyzes systems problems which effect/impede patient care and initiates their resolution
• Provides leadership in coordinating patient care and collaborating with other disciplines/departments to achieve patient care outcome
• Performs procedures or seeks help when needed - such as phlebotomy - IV insertion - 12 lead ECG - blood transfusions - urinary catheter insertion and care
• Administers medications as ordered by physicians
• Performs Point of Care laboratory testing - including glucometer - ISTAT - and urine hCG
• Safely and effectively uses equipment required for patient care
• Reports equipment in need of repair
• Takes and records vital signs
• Recognizes subtle abnormal signs and symptoms and/or changes in patients' condition and responds appropriately
• Makes assignments and directs activities of other unit staff - (RNs - LVNs/LPNs - students - MSAs - other team members)
• Formulates a plan of care based on nursing assessments based on the ANA Standards of Nursing Practice and seeks assistance as needed
• Completes initial assessment of patient condition - screenings and response to treatment and initiates follow-up as needed
• Triages patients using the Emergency Severity Index (ESI) and initiates established protocols
• Provides leadership in establishing goals - evaluating the plan of care - and in discharge planning
• Initiates referrals to other disciplines and/or services as appropriate Updates plan of care with assistance as needed
• Assesses patient's learning needs - learning preference - and readiness to learn
• Develops and implements a plan to meet learning needs - instructing patients and families in basic health teaching and discharge planning
• Documents the nursing process
• Evaluates and documents patient response to interventions and progress towards attainment of goals and expected outcomes
• Revises plan of care according to evaluations of patient responses
• Uses the Computerized Patient Record System (CPRS) or currently used electronic medical record - Bar Code Medication Administration (BCMA) - Bed Management System (BMS) - and the Emergency Department Integrated Software (EDIS) per policy
• Assigns patient care responsibilities based upon triage level - patient care needs - and competencies of staff
• Functions as charge nurse/team leader in providing direction to staff in meeting patient care needs
• Follows-up to ensure that assigned delegated tasks are completed by team members Responds to emergencies as a member of the Rapid Response Team (RRT) and Code Blue Team
• Utilizes all available safe patient handling equipment
• Transports patients via wheelchair - gurney - and electric emergency vehicle
• Performs other Duties as assigned
• 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: Full Time - to be determined during interview Telework: Not available Virtual: This is not a virtual position
• Financial Disclosure Report: Not required