The Spinal Cord Injury/Disorders (SCI/D) Home Care Program serves all SCI/D veterans within the SCI/D Center catchment area, on a consultative basis. Home visits are conducted for SCI/D veterans within a 100-mile radius of the SCI/D Center, or farther with the approval of the Chief, SCI/D. Telehealth modalities may be utilized to increase accessibility for veterans, as appropriate.
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/12724274. 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. Reference: For more information on this qualification standard, please visit https://www.va.gov/ohrm/QualificationStandards/. Physical Requirements: Heavy lifting (45 lbs. and over); Heavy carrying (45 lbs. and over); Straight pulling and pushing; reaching above shoulder; use of fingers; both hands required; walking and standing up to 8 hours; repeated bending; Ability for rapid mental and muscular coordination simultaneously; hearing aid permitted.
Duties include but not limited to the following: Demonstrates a high level of clinical expertise, leadership, and creative approaches to management of the complex care of patients with Spinal Cord Injuries/Disorders. Responsible for program development of the SCI/D Home Care program, in accordance with VA Directives, Handbooks and all applicable regulatory and accreditation standards. Promotes personal growth, continuing education, collaborative working relationships, creative problem solving and flexibility to support SCI/D hub and spokes home care program expansion. Ensures ongoing patient safety, dignity, and satisfaction. Able to coordinate and lead activities geared towards maintaining and improving existing home care programs. Takes initiative to develop new clinical home care programs in collaboration with the SCI/D Nurse Manager and SCI/D Chief, as the need arises. Able to establish SCI/D Home Care program objectives, standards of care and standards of practice for SCI/D subspecialty clinical populations. Maintains appropriate and timely documentation of patients' care and progress within the plan, in accordance with all applicable standards. Complete assessment/screens for: nutrition, pain, tobacco use, alcohol, depression, fall risk, and dementia, etc. Instruct patient/caregivers/families on fire safety; fire alarms, extinguishers, and exits. Perform proper infection control procedures including hand washing technique, bag technique, and protective equipment, disposal of hazardous waste, equipment care, and transport of items clean and dirty. Assess and document patient's compliance with medication regimen. Assess and document abnormal or non-therapeutic reactions to medications and initiate appropriate interventions. Assess and document care of SCI/D patient utilizing the Computerized Patient Record System (CPRS). Performs wound care according to treatment orders. Instructs caregivers in proper techniques for turning and positioning patients.\ Trains patient/caregivers in care for G-tubes. Performs foley catheter changes. Instructs patient/caregivers in proper care of in dwelling foley catheters, use of leg/bedside drainage bags, and monitoring of urine output and changes that could indicate an infection. Instructs patients/caregivers in proper technique for in and out foley catheterization. Screens, immunize and promote health activities. Performs phlebotomy/transport of lab draws. Completes required workload reports. Coordinates outcome focused interdisciplinary care plan that includes team's assessments, interventions, evaluations and follow ups. Implements appropriate nursing plan of care that reflects patient's functional capacity changes, living arrangements, and support systems. Performs Care Management duties: timely completion of screening tools, referrals to other services coordination with VA/Community providers and assessments and documentation of patient/family education. Reviews quality and performance measures for process improvement. Selects methods for measuring quality of services, measures patient satisfaction and takes appropriate corrective actions based on program evaluation results. Provides direct patient care, conducts follow-up assessments, provides patient/caregiver education and training in the home setting, collaborating with team members both within and outside of the SCI/D service in order to coordinate care. Travels to patient homes and private care facilities within a 100-mile radius or further with SCI Chief approval on a frequent basis in order to implement care activities and conduct follow-up assessments in the patient's residence. Conducts evaluations of home or institutionalized-living setting, focusing on safety and adequacy of available resources, with consideration for the patient's care needs. Shares findings/concerns with appropriate SCI/D team members and other agencies as appropriate. Maintains compliance with all rules and regulations related to the issuance and operation of VA vehicles and mileage/receipt logs. 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: 7:30 am - 4:00 pm Telework: Not available Virtual: This is not a virtual position. Relocation/Recruitment Incentives: Not authorized Permanent Change of Station (PCS): Not authorized Financial Disclosure Report: Not required