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    Duties

    Summary

    The Advanced Practice Nurse is responsible and accountable for all elements of the nursing process when providing and/or supervising direct patient care.

    Patients managed in the Pacemaker clinic by the APN may have complex co-morbidities such as hypertension, CHF, COPD, diabetes, atrial fibrillation, valvular diseases, coronary artery disease, cerebral vascular disease, auto immune disorders and renal impairment

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    Responsibilities

    The Advance Practice Cardiology Nurse:
    1) Establishes a medical diagnosis based on comprehensive assessment
    2) Makes advanced clinical decisions
    3) Uses prescriptive authority, procedures, referrals, treatments and therapies in accordance with state and federal and laws and regulations
    4) Is credentialed as a provider in accordance with the regulations of the VA system
    5) provides leadership in coordination of multidisciplinary health care for an integrated delivery of care of the veteran
    6) facilitates/coordinates use of systems/community resources to implement and enhance care across the continuum
    7)Analyzes outcomes (related to organizational care delivery and populations served) to make recommendations for improvements in care delivery systems across the care settings
    8) Conducts, critically appraises or synthesizes research that discovers, examines and evaluates knowledge, theories, criteria and creative approaches to improve health care practices
    9) Provides leadership in developing care models to manage chronic care issues
    10) Develops and implements education programs for veterans, staff and other health care providers
    11) Responds to cardiology consult requests from within the hospital as well as from the VISN facilities
    12) Provides care to Veterans in the Pacemaker/Cardiology Clinic, delivering care primarily in the outpatient setting, by face to face, telephone and telemedicine visits
    13) Interacts with patients within acute care, emergency department, operating room and PACU, procedural areas, MRI, CBOC's and/or the community living centers (CLC) to assess patients and interrogate devices.

    Primary functions of this role include:
    - Ability to interrogate and evaluate function and identify normal or abnormal function
    - Sound knowledge of device function and ability to reprogram as necessary
    - Ability to identify rhythms and interpret all information
    - Download device interrogation by remote transmission and interpreting results
    - Complete surgical consults. For pacemakers/defibrillators, if seen routinely in the Pacemaker Clinic, will make note with recommendations for surgery, including device management perioperatively
    - Coordinate with anesthesia and/or surgical services for perioperative device reprogramming as necessary.
    - Evaluate and schedule patients for MRI. Includes making sure device is MRI compatible, older than 6 weeks and that there are no additional or abandoned leads through an x-ray. Devices are interrogated and reprogrammed prior to the MRI and the NP must monitor the rhythm and pulse oximeter during the MRI. Post MRI the device is again interrogated and tested and returned to normal settings.
    - Provide comprehensive guideline directed evidence-based care to patients with pacemaker devices
    - Implement assessment, diagnosis and management of patients with complex co-morbidities
    - Obtain health histories, perform physical exams and documents findings in the medical record.
    - Order appropriate diagnostic procedures, and acts on results
    - Prescribe individualized pharmacological and non-pharmacological interventions for treatment of heart conditions and related medical problems for the promotion of quality of life, wellness, and improved outcomes as demonstrated by reduction of hospitalizations and/or urgent care visits
    - Educate patient, significant others and affiliated medical center staff on health care issues (i.e. medications, diet, lifestyle changes and follow up)
    - Facilitate the completion of informed consents prior to the procedure
    - Admit and discharge patients to OBS status post invasive cardiac procedures
    - Mentor to APRN students
    - Acts as consultant and resource to other departments within and outside the medical center regarding Cardiology, and specifically pacemaker
    - Provides cardiology focused in-services and education programs to medical center staff and affiliates.
    - Participate in performance improvement initiatives
    - Collaborate with multiple other disciplines including primary care, hospice, palliative care and nephrology

    - Assesses, plans, implements and evaluates care based on age-specific components
    - Assumes responsibility for the coordination of care focused on patient transition through the continuum of care, patient and family education, and supporting factors that impact customer satisfaction
    - Considers all characteristics of the individual, including age and life stages, state of health, race and culture, values, and previous experiences. Influences care outcomes by collaborating with members of the interdisciplinary team.

    Core elements of performance include knowledge and active participation in unit/program level quality improvement processes and initiatives as well as customer service programs.

    Work Schedule: Full-Time, Monday - Friday, 7:30 am - 4:00pm
    Financial Disclosure Report: Not required

    Travel Required

    Not required

    Supervisory status

    No

    Promotion Potential

    None

  • Job family (Series)

    0610 Nurse

This job originated on www.usajobs.gov. For the full announcement and to apply, visit www.usajobs.gov/GetJob/ViewDetails/581477500. Only resumes submitted according to the instructions on the job announcement listed at www.usajobs.gov will be considered.