Clarification from the agency

This external vacancy announcement is open to all qualified individuals which includes Veterans and Federal Government employees (other than the VA Medical Center). There is a separate internal vacancy announcement that is open to current permanent employees of a VA Medical Center. The internal posting is located under vacancy announcement number CBSR-10782363-20-AMF. The internal posting is open from 3.30.2020 - 4.16.2020.

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The LPN works under the direction of a Registered Nurse (RN) or Primary Care Provider (PCP) and reports to the nurse manager assigned to his/her area of work. The LPN is responsible for observing, recording and reporting changes in the patient's condition, as well as assisting in the development and revision of the patient-driven holistic care plan for life. The LPN is a member of the larger Team. The LPN demonstrates active collaboration and communication with a Teamlet (Patient, PCP, RN Care Manager and Medical Support Assistant) and Larger Team (clinic, family/caregiver, internal and community-based services and disciplines involved in providing care to the patient).The LPN must be technically proficient in initiating, performing and completing assigned duties, and providing care to variable patient populations. Knowledge and ability to appropriately carry out assigned patient care based on the patients' conditions; to use judgment in selecting the appropriate order and sequence of procedures and treatments; and to accurately recognize, report and record relevant patient information. This LPN will be responsible for the treatment, observation and care of the Veterans within the scope of LPN functions and other duties as assigned. Assist in the overall PACT clinic management, functions and operations, facilitating patient flow, and thorough check in and checkout process. Provides patient education and/or instructions. Works with the care team and community resources. Participates in performance improvement activities and other activities that enhance patient care and clinic operations. Maintains patient's privacy and confidentiality. Documents pertinent information in the electronic medical record. Assists with coordination of all services for the patient with PACT Team and group visits. Works with the patient, significant other and health care team to establish patient centered short and long-term goals. Demonstrates satisfactory knowledge and skills. This position will support the Federal Government's response efforts to COVID-19.

Responsibilities include but are not limited to the following:

• Demonstrates nursing practice within the scope of practice of license under the general supervision of the RN or PCP
• Assists RN and/or PCP to appropriately prioritize overall patient care needs and adjust plans for care delivery.
• Makes astute observations of subtle, less obvious changes, both physical and emotional, in patient's condition, and accurately and thoroughly documents care delivered and patient's response to care that could require immediate modification of the patient's care plan. Appropriately seeks assistance and guidance by informing RN or PCP of changes in patient's condition requiring higher-level intervention.
• Administers medication accurately and promptly under the general supervision of a registered nurse.
• Transcribes doctors' orders, when necessary, under the supervision of a RN, and administers medications, including immunizations, following VA Medical Center policy and procedure.
• Demonstrates understanding of the effects and/or reactions caused by medications, treatments, and procedures. Records and reports these observations
• Instructs patients and family members on principles of health, self-care and protocols for treatments and /or medications.
• Utilizes teaching materials to promote self-reliance and independence including methods to prevent complications and facilitate recovery.
• Takes and records vital signs and measurements.
• Completes Clinical Reminders, documents and communicates results to team using established criteria
• Performs diagnostic and therapeutic procedures, which may include, but not limited to, bladder scan, spirometry, phlebotomy and EKG's Point of Care Testing (POCT).
• Utilizes educational resources to maintain clinical competency in areas described in the functional description, which may include EKG's, Telehealth modalities, and phlebotomy.
• Positions, turns, holds, ambulates, and transfers patients in and out of wheelchair, on and off litters and scales, using good body mechanics for safety of patient and self.
• Performs and participates in Telehealth activities which may include VA Video Connect (VVC) Store & Forward, Clinical Video Telehealth and/or Home Telehealth Modalities.
• Performs catheterization when assigned. Initiates Foley catheter care, according to procedure, and applies external catheter, as directed.
• Performs personal care, diagnostic support duties and treatments according to procedure under the direction of the RN in a timely manner. Responds to patient's nursing needs, including physical comfort, and emotional needs and recognizing deviations from the normal. Will involve patients and family to participate in the provision of care throughout the continuum.
• Other duties as assigned.

Financial Disclosure Report: Not required

Conditions of employment

• You must be a U.S. Citizen to apply for this job
• Designated and/or random drug testing may be required
• Selective Service Registration is required for males born after 12/31/1959
• You may be required to serve a probationary period
• Subject to a background/security investigation
• Must be proficient in written and spoken English
• Selected applicants will be required to complete an online onboarding process

Qualifications

To qualify for this position, applicants must meet all requirements by the closing date of this announcement.

Basic Requirements:

• United States Citizenship.
• Education: Graduate of a school of practical or vocational nursing approved by the appropriate State agency and/or accredited by the National League for Nursing Accrediting Commission (NLNAC) at the time the program was completed by the applicant; or Health care education in the military service or training in the military which is accepted by the licensing body in the jurisdiction in which the individual is licensed as qualifying for full LPN/LVN licensure; or Individuals granted a license by a jurisdiction that does not require graduation from an approved school.
• Licensure: Candidates must be currently licensed to practice as practical or vocational nurse in a state or territory of the United States or the District of Columbia, and must possess current, full active and unrestricted license registration of said license.
• English Language Proficiency: Applicants must be proficient in spoken and written English as required by 38 USC 7402(d) and 7407 (d). (No person that is not proficient in spoken and written English will be appointed under authority of 38 USC Chapter 73 or 74 to serve in a direct patient-care capacity.)

Grade Determinations:
In addition to the Basic Requirements, the following qualification criteria must be met for each grade. The candidate's qualifications must clearly demonstrate the level of competence required for the grade.
GS-3: None beyond the basic requirements. LPNs at this grade level are expected to perform all duties within the scope of their license (e.g., medication administration).
GS-4: Employees may be appointed at or advanced to GS-4 if they meet any of the criteria in (a) thru (c) below: (a) Six months of qualifying experience as an LPN or LVN; or (b) Graduation from an approved school and one year of experience that involved nursing care work in a hospital, outpatient clinic, nursing home, or other supervised medical, nursing, or patient care facility that provided a practical knowledge of human body structure and sterile techniques and procedures; or (c) Graduation from an approved school of at least 24 months duration.(d) LPNs at the GS-4 grade level perform all duties expected of employees at the GS-3 grade level; however, they are expected to exercise greater judgment, require less supervision, and to operate in accordance with all established policies, procedure, and techniques.
GS-5: (a) Completion of at least 1 year of qualifying experience at the GS-4 level or equivalent. (b) Demonstrated knowledge and ability to provide a full range of practical nursing care to patients with a variety of physical and/or behavioral problems. Works with the RN and/or MD/DO to appropriately orient/train less experienced LPNs/LVNs and/or Nursing Assistants (NAs)/Health Technicians (HTs) in relation to acceptable standards of practice in promoting optimal patient care delivery. Provides effective education to patients and/or family members in relation to common disease processes, medication, and /or prescribed treatment regimes. (c) Demonstrated ability to serve as a responsible member of the nursing team and interact in an appropriate manner with patients, family members, professional and other supportive personnel [involved in the delivery of patient care, incorporating acceptable, established customer service standards into practice. (d) Knowledge and skill sufficient to prepare, administer, and appropriately document actions taken specific to commonly prescribed oral, topical, subcutaneous, intramuscular, and/or intravenous medications as permitted by approved local facility policies and procedures. Observation and documentation will include patient's response to medication administered and the reporting of any noted change in patient's condition to RN or MD/DO. (e) Knowledge and ability to recognize the need for and to institute emergency measures when indicated, promptly seek the assistance of the RN or MD/DO, and assist in resuscitation procedures in cardiac and/or pulmonary arrest. (f) Recognizes and appropriately responds to breakage/malfunction or loss of equipment, safety hazards, and supply deficiencies, promptly reporting to appropriate personnel for corrective action. (g) Completed work is under the general supervision of an RN or MD/DO. Individuals at this grade level are expected to have a broad working knowledge of practical nursing procedures. However, completion of more complex practices or procedures may be subject to closer higher-level review.
GS-6: (a) Completion of at least one (1) year of additional qualifying experience at the GS-5 level or equivalent, fully meeting all performance requirements for the GS-5 LPN/LVN. (b) Technically proficient in initiating, performing and completing assigned duties in providing care to variable patient populations. (c) Knowledge and ability to appropriately carry out assigned patient care based on the patients' conditions; to use judgment in selecting the appropriate order and sequence of procedures and treatments; and to accurately recognize, report and record relevant patient information. Completed work should need only a general review by a registered nurse (RN) or physician (MD/DO) for appropriateness and conformity with established policies/procedures. (d) Ability to observe, identify and respond to the patient's needs for care, including medication, equipment-assisted care and patient/family education. In organizing and delivering care, the LPN/LVN recognizes and considers emotional , cultural, spiritual, socio-economic, and age related factors. (e) Prepares and administers prescribed medications (oral, topical, subcutaneous, intramuscular and/or intravenous) and performs treatments according to established policies/procedures. Observes for physical and/or emotional changes in patient's condition from prescribed medications/treatments, promptly and accurately documenting noted changes, and reporting any deviations from normal to RN or MD/DO. (f) Knowledge and ability to recognize urgent or emergent patient care situations, seek assistance of the RN and/or MD/DO, and initiate appropriate emergency interventions as directed.

References: VA Handbook 5005/3, Part II, Appendix G6, License Practical or Vocational Nurse Qualification Standards dated 04/10/2003. This can be found in the local Human Resources Office.

Physical Requirements: The population of male and female veterans served ranges from adult, age 18, to the elderly adult, age 65 and over. The VA Medical Center is a major interdisciplinary teaching facility, serving medical, surgical, and neurological inpatients and outpatients. There is a large outpatient psychiatric population, with admissions for medical co-morbidities. This position requires visual acuity, keen hearing, clear distinctive speech, and manual dexterity. This position requires potentially long periods of continued walking, standing, stooping, sitting, bending, pulling, and pushing. Transferring patients and objects may be required. The incumbent may be exposed to infected patients and contaminated materials and may be required to don protective clothing in isolation situations or operative/invasive procedures. The incumbent may occasionally be exposed to patients who are combative secondary to delirium, dementia, or psychiatric disorders. The incumbent must be a mature, flexible, sensible individual capable of working effectively in stressful situations, able to shift priorities based on patient needs.

How you will be evaluated

You will be evaluated for this job based on how well you meet the qualifications above.

IN DESCRIBING YOUR EXPERIENCE, PLEASE BE CLEAR AND SPECIFIC. WE MAY NOT MAKE ASSUMPTIONS REGARDING YOUR EXPERIENCE. Your application, résumé, C.V., and/or supporting documentation will be verified. Please follow all instructions carefully. Errors or omissions may affect consideration for employment.

NOTE: The Professional Standards Board (a peer-review group) will review the selected candidate's education and experience and recommend the grade and salary at which the candidate will be placed. For internal selectees eligible for promotion, the board will recommend grade and HR will determine step in accordance with policy.

Experience refers to paid and unpaid experience, including volunteer work done through National Service programs (e.g., Peace Corps, AmeriCorps) and other organizations (e.g., professional; philanthropic; religions; spiritual; community; student; social). Volunteer work helps build critical competencies, knowledge, and skills and can provide valuable training and experience that translates directly to paid employment. You will receive credit for all qualifying experience, including volunteer experience.