Clarification from the agency

This announcement open to current, permanent North Florida/ South Georgia VA Healthcare System employees only.

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The Physician Assistant is authorized to perform the following core duties. The core Physician Assistant privilege elements are based on nationally standardized training by PA training programs accredited by the Rulemaking Authority and laws established by the state of current licensure and provide evidence of board certification as a PA by a national certification agency vetted by the VA and listed on the Office of Nursing (ONS) website.

Duties:

• Obtain medical histories and perform physical examinations.
• Provide and coordinate medical care for assigned patients, including establishing diagnoses, formulating and implementing care plans, and providing follow-up care.
• Evaluate outpatients to determine the need for further health care.
• Order and interpret diagnostic testing results and therapeutic modalities, including but not limited to laboratory tests, ECG, radiological studies, hemodynamic monitoring, treatments, IV fluids/electrolytes, oxygen, etc.
• Order ancillary services, including but not limited to, pharmacy, social services, physical medicine and rehabilitation therapies, prosthetic services, etc.
• Order VA specialty service consults and initiating requests for non-VA medical care and consults in accordance with VHA and local facility policy and procedures.
• Order or prescribe devices, supplies, and durable medical equipment.
• Order or prescribe medications for patients under their care. a. All medication orders or prescriptions written by CNPs must be consistent with their field of practice as listed in the Physician Assistant privileges. b. Physician Assistant's may prescribe or order all medications listed in the VA National Formulary consistent with the Physician Assistant's level of prescribing authority and practice setting. Exceptions include medications restricted to specific clinical services outside of the Physician Assistant's practice setting and those specifically restricted by VHA or local VA medical facility policy. An individual medication formulary included in the privileges is not required.
• May initiate and renew non-formulary medications when established non-formulary drug request pharmacy procedure is followed.
• Admit and discharge patients in consultation with, and on behalf of, the attending physician, obtain admission history and performing physical examinations, conducting patient rounds, documenting progress notes and summaries in the patient record, and writing patient orders on assigned patients.
• Other patient record entries by Physician Assistant's , including progress notes, service consults, Compensation and Pension, and patient orders do not require physician co-signatures unless specifically required by Federal law, VA policy, local Medical Staff Bylaws or the standards of applicable external accrediting bodies. At this institution, History & Physical Examinations and discharge summaries require attending physician co-signature.
• Obtain and document informed consent for treatments and procedures for which the Physician Assistant is responsible according to the Hospital Policy Memorandum on Informed Consent.
• Provide education and counsel patients and families in preventive care, medical conditions, and the use of prescribed treatments and drugs.
• May conduct Goals of Care Conversations with high-risk patients regarding any desired limitation in life-sustaining treatments and choice of surrogate as well as enter the Life-Sustaining Treatment Decisions (LSTD) progress note and corresponding orders when veteran is under their care or if delegated by the attending physician.
• Telehealth Modalities may be utilized for the provision of care by an authorized provider pursuant to Service level guidance, required training and instruction, and in collaboration with the Facility Telehealth Coordinator (FTC).
• Perform certain minor surgical/therapeutic procedures including but not limited to: suturing/closure of lacerations, removal of sutures and staples, obtaining biopsies, incision and drainage of abscess or superficial thrombosis, skin and soft tissue biopsies, removal or exchange of indwelling drains or tubes, insertion or removal of peripheral venous or arterial catheters, removal of central venous catheters, wound debridement/cultures/VAC dressing application and changes, nitrogen skin applications, insertion and irrigation of Foley catheters, insertion and irrigation of nasogastric tubes, administration of local and topical anesthesia.

Work Schedule: Various work schedules available. May require rotating call coverage, weekdays, nights, weekends and/or holidays. The supervisor will determine the actual work schedule (FT, PT, Intermittent & the hours worked) upon selection based on the needs of the organization.
Telework: Not Available
Virtual: This is not a virtual position.
Relocation/Recruitment Incentives: Not Authorized
Permanent Change of Station (PCS): Not Authorized
Financial Discloser Report: Not required

Conditions of employment

You must select the location(s) that you wish to be considered for at your facility. If a vacancy becomes available, you will only be referred for the location(s) you select when you apply. You may select 1 or multiple locations.

• All qualified candidates encouraged to apply. Open to U.S. Citizens but non-citizens may be appointed when it is not possible to recruit qualified citizens.
• All applicants tentatively selected for VA employment in a testing designated position are subject to urinalysis to screen for illegal drug use prior to appointment. Applicants who refuse to be tested will be denied employment with VA.
• Selective Service Registration is required for males born after 12/31/1959.
• Must be proficient in written and spoken English.
• You may be required to serve a probationary period.
• Subject to background/security investigation.
• Selected applicants will be required to complete an online onboarding process.
• Must pass pre-employment physical examination.
• Participation in the seasonal influenza vaccination program is a requirement for all Department of Veterans Affairs Health Care Personnel (HCP).
• Participation in the Coronavirus Disease 2019 (COVID-19) vaccination program is a requirement for all Veterans Health Administration Health Care Personnel (HCP) - See "Additional Information" below for details.

Qualifications

Basic Requirements:

• United States Citizenship: Non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy.
• Graduate of a training program which is accredited by the Accreditation Review Commission on Education of PA (ARC-PA) or one of its predecessor organizations. Additionally, candidates must meet one of the following: (1) Master's degree in any discipline; OR (2) Bachelor's degree in any discipline with one year of experience as a PA.
• Must have successfully passed the PA National Certifying Exam (PANCE).
• PAs must possess an active, current, full, and unrestricted license to practice in a State, Territory, or Commonwealth of the United States, or in the District of Columbia. PAs must maintain current registration in the State of licensure if this is a requirement for continuing active and current licensure in that State.
  • Exceptions for Graduate PAs.
  • (a) PAs who otherwise meet the basic requirements, but do not possess the required licensure, may be appointed, pending licensure, as a graduate PA on a temporary full-time appointment not-to-exceed two years under the authority of 38 U.S.C. § 7405(c)(2)(B).
  • (b) Graduate PAs may only be appointed at the entry grade level and may not be promoted/converted until certification is obtained.
  • (c) Temporary graduate PA appointments may not be extended beyond two years or converted to a new temporary appointment.
  • NOTE: Individuals who have or have had multiple licenses and had any such license revoked for professional misconduct, professional incompetence or substandard care, or who surrendered such license after receiving written notice of potential termination of such license by the State for professional misconduct, professional incompetence, or substandard care, are not eligible for appointment to the position unless such revoked or surrendered license is fully restored (38 U.S.C. § 7402(f)). This requirement does not apply to licensed PAs currently employed by VA as of November 30, 1999, provided they maintain continuous appointment and are not disqualified for employment by any subsequent revocations or voluntary surrenders of State license, registration or certification.

Grade Determinations: In addition to the basic requirements stated above, the following qualification criteria must be met in determining the appropriate grade assignment of candidates:
(1) Physician Assistant-I (PA-I)
(a) Experience and Education. None beyond the basic requirements. This is the entry level for PAs.(b) Demonstrated Knowledge, Skills, and Abilities. The following list of knowledge, skills, and abilities (KSA) present the minimum skill set expected of an Entry Level PA. This practice may include, but is not limited to:
i. Ability to utilize the principles of PA practice in the care of assigned patients to provide appropriate care.
ii. Ability to perform patient history and physical.
iii. Ability to formulate a plan and provide treatment to the patient.
iv. Ability to provide patient care that is abreast of changing concepts and advancements in the profession.

(2) Physician Assistant-II (PA-II)

(a) Experience and Education. The PA at this grade is at the intermediate grade level and has had progressively increasing responsibility and experiences as indicated in the KSAs listed below. Individuals will have demonstrated the ability to analyze and solve more complex medical problems than at the entry level grade and can utilize their training in the successful practice of patient care and participate in team problem solving. Individuals demonstrate the KSAs of PA-II intermediate level by:
i. Two years of successful practice as a PA.
OR
ii. Successful completion of a PA post-graduate residency program sponsored by VHA Office of Academic Affiliations or other postgraduate residency programs accredited by VA, ARC-PA, U.S. Armed Forces, or another accrediting agency.
OR
iii. A doctoral degree in a health-related field from an accredited college or university recognized by the U.S. Department of Education.

(b) Demonstrated Knowledge, Skills, and Abilities (KSAs). PAs at this level are not required to meet each individual KSA listed below to qualify, but should be able to demonstrate, develop, or acquire those not met upon appointment for PA-II:
i. Skills to analyze and solve complex medical problems.
ii. Ability to function autonomously and make independent medical decisions.
iii. Skill to incorporate training and experience into the successful practice of patient care including telehealth medical care.
iv. Ability to work effectively in an interdisciplinary environment for improvement of services for patient care.
v. Ability to practice with colleagues and peers collaboratively.

(3) Physician Assistant-III (PA-III)

(a) Experience and Education. PAs at the PA-III grade are at the full performance level and lead and organize patient care independently, practice within multidisciplinary teams, and coordinate all aspects of patient care across the health care system. They utilize advanced clinical knowledge and judgment in decision-making and evaluating outcomes. They function as experts in clinical practice and/or in areas related to the assigned roles and responsibilities, may serve as mentors for transitioning PAs, and may provide training for health care students. Individuals can demonstrate the KSAs for the full performance level by:
i. Three years of successful practice as a PA.
OR
ii. Successful completion of a PA post-graduate residency program sponsored by VHA Office of Academic Affiliations or other postgraduate residency programs accredited by VA, ARC-PA, U.S. Armed Forces, or another accrediting agency and one year of professional practice as a PA.
OR
iii. A doctoral degree in a health-related field from an accredited college or university recognized by the U.S. Department of Education and one year of professional practice as a PA.

(b) Demonstrated Knowledge, Skills, and Abilities. PAs at this level are not required to meet each individual KSA listed below to qualify, but should be able to demonstrate, develop, or acquire those not met upon appointment for PA-III:

i. Ability to clinically evaluate facility patient care delivery systems and validate or identify barriers to safe and effective patient care.
ii. Skill to consistently demonstrate an elevated level of expertise and autonomy in diagnosing and treating seriously ill, multi-symptomatic patients through facility Focused Professional Practice Evaluation (FPPE) and Ongoing Professional Practice Evaluation (OPPE).
iii. Ability to present clinical findings and recommendations to appropriate management officials.
iv. Ability to clinically facilitate the delivery of patient care in collaboration with health professionals, health managers, and other health care personnel.
v. Ability to implement and initiate clinical changes to established treatment protocols based upon new medical literature research findings to enhance patient delivery care for improved patient outcomes.
vi. Ability to participate clinically in the development of the PA patient care audit processes involving in-depth review and analysis of medical records.

References: VA Handbook 5005/134, Part II, Appendix G8, Physician Assistant Qualification Standard.

Physical Requirements: The Physical requirements of this position include the following tasks which may be performed intermittently: lifting of up to 10 lbs., sitting 4 hours, standing 2 hours, walking 2 hours, bending/stooping 1 hour, twisting 1/2 hour, simple grasping 4 hours, fine manipulation 6 hours, reaching above the shoulder 1/2 hour, and operating machinery 1/2 hour.

How you will be evaluated

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

Your application, résumé, C.V., and/or other supporting documentation will be verified. Please follow all instructions carefully. Errors or omissions may affect consideration for employment.

NOTE: A formal pay-setting process will be used to determine your salary. The salary may be at any point in the range listed for this vacancy.

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.

The Department of Veterans Affairs performs pre-employment reference checks as an assessment method used in the hiring process to verify information provided by a candidate (e.g., on resume or during interview or hiring process); gain additional knowledge regarding a candidate's abilities; and assist a hiring manager with making a final selection for a position.

Veterans' Preference Note: Preference eligible candidates and other Veterans will be given preference when qualification of candidates are approximately equal for Title 38 positions in VHA. When applying for Federal Jobs, eligible Veterans should claim preference for 5pt (TP), 10pt (CP/CPS/XP), or for Sole Survivor Preference (SSP) in the questionnaire. You must provide a legible copy of your DD214(s) which shows dates and character of service (honorable, general, etc.). If you are currently serving on active duty and expect to be released or discharged within 120 days you must submit documentation related to your active duty service which reflects the dates of service, character of service (honorable, general, etc.), and dates of impending separation. Additionally, disabled veterans and others eligible for 10-point preference (such as widows or mothers of eligible Veterans) must also submit an SF-15 "Application for 10 Point Veteran Preference" with required proof as stated on the form. Documentation is required to award preference. For more information on Veterans' Preference, please visit Feds Hire Vets - Veterans - Job Seekers - Veterans' Preference.