The Ambulatory Care Clinic (ACC) Specialty Care Clinic Registered Nurse (RN) is a professional who provides high-quality, evidence-based care for Veteran patients who are cared for in the Specialty Care setting. They will demonstrate ICARE values when providing patient care and interacting with the interdisciplinary team. He/she will perform assessment, manage clinic flow, and performs clinic procedures/assist. 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. Preferred Experience: Out patient and/or Case Manager., and/or Discharge planner of 1 year Certified Diabetic Educator 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/12355103. 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: VA Regulations, specifically VA Handbook 5005, Part II, Appendix G-6 Nurse Qualification Standard. This can be found in the local Human Resources Office. Physical Requirements: Heavy lifting (45 lbs. and over); Moderate Carrying (15-44 pounds); Straight Pulling; Pushing; Reaching above Shoulder; Walking; Standing; Repeated bending; Ability for rapid mental and muscular coordination simultaneously; Near vision correctable at 13" to 16" to Jaeger 1 to 4; Hearing aid (permitted); Ability to distinguish basic colors; Ability to distinguish shades of colors; Depth perception; Both eyes required; Both legs required; Use of fingers and both hands required. For more information on these qualification standards, please visit the United States Office of Personnel Management's website at http://www.opm.gov/qualifications ["PRACTICE: Demonstrates proficiency using the nursing process in providing care for patients with complex nursing care needs. Guides and directs others who provide care. 1. Independently plans and delivers technically competent care to patient/residents with complex needs. 1.1. Safely and effectively uses equipment required for patient/resident care. Reports equipment in need of repair. 1.2. Recognizes subtle abnormal signs and symptoms and/or changes in patient/resident's condition and responds appropriately. 2. Makes assignments and directs activities of other unit staff, (RNs, LPNs, students, PSAs, other team members). 3. Formulates and implements a plan of care based on the ANA Standards of Nursing Practice. 3.1. Completes initial assessment of patient condition and response to treatment and initiates follow-up as needed. 3.2. Includes the patient/resident and family/significant other in developing the initial plan of care, establishing goals, and discharge planning 3.3. Updates plan of care as needed based on patient responses. 3.4. Assesses patient/resident's learning needs, learning preference, and readiness to learn. 3.5. Develops and implements a plan to meet learning needs, instructing patient/residents and families in educational needs and discharge planning. 4. Documents the nursing process. 4.1. Documentation is technically informative, consistent, accurate, concise, and timely manner. 4.2. Evaluates and documents patient/resident response to interventions and progress towards attainment of expected outcomes. 4.3. Revises plan of care according to evaluations of patient/resident responses. 4.4. Uses the Computerized Patient Record System (CPRS) and the Bar Coded Medication Administration (BCMA) software per policy. (if applicable) 5. Manages nursing care of patients. 5.1. Functions as charge nurse/team leader in providing direction to staff in meeting patient/resident care needs. 5.2. Ensures that assigned delegated tasks are completed by team members. 5.3. Organizes and completes own assignments in a safe and timely manner, assisting team members as necessary. 5.4. Organizes and prioritizes in order to meet changing patient/resident care needs and staff assignments. 5.5. Assigns patient care responsibilities based upon patient needs and competencies of staff. 6. Demonstrates grade-appropriate and consistent critical thinking skills. 6.1. The nurse can recognize the patient/resident has a problem. 6.2. The nurse can manage the problem safely and effectively, recognizing his/her scope of practice. 6.3. The nurse has a relative sense of urgency. 6.4. The nurse takes the right action for the right reason (del Bueno). 7. Role-specific Competency Checklist is complete and is rated competent in all measured areas. 8. Ability to recognize EKG changes. 9. Assess non-scheduled patients using Ambulatory Care Policy/NSM and utilizes WAVE guidelines 10. Place consults and order lab/ diagnostic testing per Ambulatory Care Policy/NSM 11. Provide immunomodulating biologic or Kenalog IM injections. 12. Practicing common nursing care procedures in respective clinical areas. 13. Team leading for the flow of the Clinic 14. Answer view alerts/secure messages within 24-48 hours. 15. Perform reminders as appropriate (influenza, audit-c, depression, PTSD, etc.) 16. Perform daily huddle with team 17. Promote non-face to face visit support (MHV/secure messaging, telephone access/ appointments, VVC) 18. RN to cover duties of Case Manager upon absence 18.1 Track and manage patient's paperwork 18.2 Use database resources for chronic care management (i.e., Dashboard, etc.) 18.3 Case management of the patient (e.g., follow-up with patient for continuity of care purposes/assessment, coordinating with external departments for care benefit of the Specialty Clinic) 19. Ensure daily clinic opening and closing duties have been completed (e.g. collect lidocaine syringes for dermatology clinic, EKG check, hand hygiene, Accu-chek controls, fridge temperature checks, EOC room checks, expired supplies, clean rooms, Safe Patient Handling equipment checks, clean and dirty utility room checks, specimens have been sent to the lab, rooms stocked with supplies, rooms locked upon clinic being closed for the day, verify no patients are remaining in the clinic) 20. There is an expectation that clinic nurses and case managers will be expected to cover for each other as needed. 21. Duties as assigned. and many more not listed above Work Schedule: Mon-Fri 7:30 AM to 4:00 PM Financial Disclosure Report: Not required"]
The Veterans Health Administration (VHA) is the largest integrated health care system in the United States, providing care at 1,321 health care facilities, including 172 VA Medical Centers and 1,138 outpatient sites of care of varying complexity (VHA outpatient clinics) to over 9 million Veterans enrolled in the VA health care program. At VA Long Beach Healthcare System, our health care teams are deeply experienced and guided by the needs of Veterans, their families, and caregivers. Our medical center provides primary care and specialty health services, including cardiology, mental health care, treatment for spinal cord injuries and disorders, suicide prevention, women’s health services, and more.