The Ambulatory Surgery Unit (ASU) Nurse Practitioner is a professional Registered Nurse (RN) with advanced education from a university-based Nurse Practitioner (NP) program and has attained experience in evidence-based nursing care for a specific patient population in the ASU. The ASU NP is responsible and accountable for all elements of the nursing process when providing and/or supervising direct patient care in the VA San Diego Healthcare Systems.
Advanced Practice Nurse (Nurse Practitioner) Basic Requirements Education: A post-master's certificate or master's or doctoral degree as a Nurse Practitioner. (Applicants pending the completion of educational requirements may be referred and tentatively selected but may not be hired until the education requirements are met.) Must be a 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). NOTE: Foreign Education. Graduates of foreign schools of professional nursing programs, the nurse practitioner degree equivalency must be validated through an Agency recognized degree equivalency evaluation agency, such as the International Consultants of Delaware (ICD). Candidates with equivalent nurse practitioner masters or doctorate level degrees who possess current, full, active, and unrestricted registration and certification will meet the requirement of graduation from an approved school of professional nursing to warrant appointment. License - All APN (NPs) must possess and maintain an active, current, full, and unrestricted APN license to practice as an NP in a State, Territory or Commonwealth of the United States, or in the District of Columbia. Basic Board Certification - All APN (NPs) must maintain full and current basic board certification in one of the following: Family Nurse Practitioner (FNP), Adult Nurse Practitioner (ANP), Adult-Gerontology Primary Care Nurse Practitioner (AGPCNP), Acute Care Nurse Practitioner (ACNP), Adult-Gerontology Acute Care Nurse Practitioner (AGACNP), or Gerontology Nurse Practitioner (GNP) from one of the following: the American Nurses Credentialing Center (ANCC), American Academy of Nurse Practitioners Certification Board (AANPCB), or other nationally recognized certifying body in the area in which the Nurse Practitioner is academically prepared. NOTE: Grandfathering Provision - All persons currently employed in VHA in 0610 series and an APN (NP) assignment that are also 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. The following Scope, Education and Experience, and Dimension criteria must be met to qualify for Advanced Practice Nurse (Nurse Practitioner) II: Exception to Licensure for Graduate Nurse Technicians. Candidates who otherwise meet the basic requirements, but do not possess the required licensure and/or certification, may be appointed at the entry step of the Nurse II, as a Graduate Nurse Technician - Nurse Practitioner on a temporary appointment up to any period not-to-exceed one year and a day under the authority of 38 U.S.C. § 405(c)(2)(B). Scope: Demonstrates leadership in delivering and improving holistic care through collaborative strategies with others Education and Experience Requirement: Meets basic education requirement for APN (NP). Nurse II is considered the entry grade level for APN (NPs); no experience is required. Dimension Requirement: APNs (NPs) at level II are expected to meet the following dimension requirements: Clinical Practice. Delivers evidence-based health care, demonstrating proficiency in the ability to manage a patient panel, population, or program. Outcome Focus. Utilizes research and evidence-based practice to evaluate the patient care delivery system within a patient panel or program, presents findings and contributes to changes that enhance the quality and timeliness of veteran/patient care. Leadership. Works effectively as a leader within a team/unit/group and seeks interdisciplinary collaboration as appropriate to enhance patient care. Professional Development. Acquires knowledge and skills to develop expertise in area of practice. Professionalism/Collegiality. Demonstrates effective communication skills and professional behavior, promoting cooperation and teamwork. Participates in interdisciplinary teams and processes that positively impact patient outcomes. The following Scope, Education and Experience, and Dimension criteria must be met to qualify for Advanced Practice Nurse (Nurse Practitioner) III: Scope: Executes position responsibilities that demonstrate leadership, experience, and creative approaches to management of complex client care. Education and Experience Requirement: Meets basic education requirement for an APN (NP) AND one year of specialized APN (NP) experience equivalent to the Nurse II grade level. Dimension Requirement: APN (Nurse Practitioners) at grade III are expected to meet the following dimension requirements: Clinical Practice. Influences and models the delivery of evidence- based health care, demonstrating expertise in the ability to manage a patient panel, population, or program. Outcome Focus. Leads and implements changes that enhance the quality and timeliness of Veteran/patient care applying research and evidence in the delivery of healthcare for patient populations. Leadership. Initiates and leads interdisciplinary teams informed by structured approaches and processes to improve outcomes that positively impact care for a patient panel, population, or program. Professional Development. Acquires knowledge and skills, then disseminates acquired information within and/or outside the medical facility. Professionalism/Collegiality. Initiates and leads interdisciplinary teams developing systems that positively impact outcomes at the panel, population, or program level. Demonstrates effective communication skills and professional behavior, promoting cooperation and teamwork Preferred Experience: 2 years of NP experience. Physical Requirements: Lifting maximum of 35 pounds for patient care (animate); non patient care (inanimate objects) maximum lifting is 50 pounds. Pulling, pushing and reaching above shoulder may be required; use of fingers, both hands required, walking and standing for the duration of your tour; repeated bending; Ability for rapid mental and muscular coordination. Safe patient handling and management modalities are required at all times. VA Directive and Handbook 5019, Employee Occupational Health Service.
The ASU NP assumes the following roles and responsibilities: Performs pre-operative history/physical exams for all non-emergent Ambulatory Surgery patients, including reviewing medical records, monitoring lab/diagnostic tests, writing treatment & medication orders as appropriate, responding to telephone inquiries from patient, family members as well as providers and outside physicians/care givers. Physician consultation will be obtained as indicated based on the patient's illness/co-morbidities. Electronic progress notes will being the standardized history and physical template. Physician co-signature will be assigned by the NP at time of pre-op evaluation based on the referring service. Performs approved standardized procedures in areas that will allow for the collaborating physician to be available to the NP by telephone or in person, including, but not limited to, all VA facilities. Assesses the need for medications and prescribes them according to approved standardized procedures in case of preoperative illness and/or other medical condition(s) requiring medications/intervention prior to surgery. Consults appropriate service(s) regarding identified issues in pre-op process, i.e. untreated hypertension, new and/or abnormal findings, patients on anticoagulation regiments, etc. Orders blood/blood products if not previously done during pre-op visit. Serves as a consultant and expert to other staff in resolving patient care problems, providing patient education and coordinating patient care. All patient contacts and visits with physician involvement must include the name of the physician in the progress notes. Monitors and evaluates the quality of care delivered through performance improvement processes. Works with others. Demonstrates active membership in local or national nursing organizations related to the clinical specialty or nursing profession with active participation in related local and national conferences. Contributes to the learning experience of nurse practitioner students and/or other students through preceptorship. Utilizes interdisciplinary, interdepartmental and community resources as appropriate to meet patient care goals. Maintains mandatory and clinical competencies of the position. 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: Full Time Compressed/Flexible: Not Authorized Telework: Not Authorized Virtual: This is not a virtual position.