Clarification from the agency

This Vacancy Announcement is open to current, permanent LTC Charles S. Kettles VAMC employees and Community Based Outpatient Clinics (CBOCs), Federal Employees in the Excepted Service, Veterans, and the Public.

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Major Duties Include, but are not limited to:

• Pre-anesthesia preparation and evaluation that includes a patient history, physical examination, and the collection of preoperative consults and data, from which an anesthetic plan can be formulated. Patient assignments per the Chief CNA or another designated person.
• Anesthesia induction, maintenance, and emergence. Utilizes all current techniques in monitoring.
• Post anesthesia care
• Peri-anesthetic and clinical support functions outside the OR suite include post operative evaluations, responding to emergency situations, and facilitating care to meet the needs of the service.
• Provides and directs others in Veteran/patient driven care that optimizes the patient's experience, satisfaction, and/or safety for a team of patients.
• Models high reliability principles and I CARE values to improve patient outcomes.
• Demonstrates knowledge over a wide range of job responsibilities, effectively communicating with individuals and groups to build a strong sense of teamwork and purpose.
• Request and evaluate pertinent laboratory studies and tests ( ABGs, EKG, PFTs) and other appropriate studies under established protocols.
• Insert intravenous catheters, according to established protocols.
• Insert arterial catheters; perform puncture for blood gases.
• Perform endotracheal intubation and extubation.
• Select and administer anesthetic techniques (intravenous, regional, various field blocks, or inhalational), medications and adjunct drugs appropriate to the individual patient's condition and procedure (surgical or non-surgical) within established protocols in the operating suite and any off-site location (ie. Endoscopy, Radiology, Cardiology, MRI, etc.).
• Examines patients in post-anesthesia recovery and other hospital units to assess patient's reaction to anesthetic management. Identify any complications or abnormal patient responses to anesthesia or to adjunct medication and implement appropriate management techniques.
• Assists in the management and treatment of emergency airway problems as needed throughout the hospital. Participate in cardiopulmonary resuscitation by performing airway management including endotracheal intubations when necessary. Serve as code captain in the absence of a physician according to established protocols.
• Provides anesthetic consultation to physicians, nurses, and other hospital staff as necessary.
• Makes post-operative rounds and record on the patient's permanent record the presence or absence of anesthesia-related-complications.
• Takes an active role through the attendance and participation in the departmental in-service program.
• Takes calls as assigned per the Chief Nurse Anesthetist or another designed person and respond in a timely fashion per department guidelines.
• Responsible for patient care activities for adult and geriatric patients. Responsible for understanding the aging process and to modify treatment plans to accommodate the changes that occur with aging.
• Protects printed and electronic files containing sensitive data in accordance with the provisions of the Privacy Act of 1974 and other applicable laws, Federal regulations, VA statutes and policy, and VHA policy.
• Shares knowledge and learning opportunities that enhance current nursing practice and self-evaluation for self and others on the team.
• Applies evidence-based practice/research, considering patient preferences, to improve quality of care and resource utilization, participating in established improvement activities.
• Sets up, uses, reprocesses, and maintains all unit/department-specific equipment that is designed by the manufacturer to be reused for multiple patients.
• Participates in training in the setup, use, reprocessing and maintenance of their unit/department-specific equipment leading to the initial competency and validation of ongoing competency at least annually.

Conditions of employment

• U.S. Citizenship; non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy.
• 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.
• English Language Proficiency. In accordance with 38 U.S.C. 7402(f), no person shall serve in direct patient care positions unless they are proficient in basic written and spoken English.
• Selective Service Registration is required for males born after 12/31/1959.
• 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. Acceptable form(s) of identification will be required to complete pre-employment requirements (https://www.uscis.gov/i-9-central/form-i-9-acceptable-documents). Effective May 7, 2025, driver's licenses or state-issued dentification cards that are not REAL ID compliant cannot be utilized as an acceptable form of identification for employment.
• 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

Advanced Practice Nurse (Certified Nurse Anesthetist) Basic Requirements

• Education. A masters or doctoral degree in nurse anesthesia. (Applicants pending the completion of educational requirements may be referred and tentatively selected but may not be hired until the education requirements are met.) Nursing education must be from a school of professional nursing anesthesia accredited by Council on Accreditation of Nurse Anesthesia Education Programs (COA) at the time the program was completed by the applicant.
• Licensure and Certification. The following licensure and certification requirements are considered conditions of employment.
  • License. All APN (CNAs) must maintain an active, current, full and unrestricted license to practice as a CNA or equivalent, in a State, Territory or Commonwealth of the United States or in the District of Columbia.
  • Basic Certification. All APN (CNAs) must maintain full and current certification by the National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA) or an equivalent Nurse Anesthetist certification recognized by the COA.

• Education and Experience Requirement. Meets basic education requirement for an APN (CNA). Nurse II is considered the entry grade level for APN (CNAs); no experience is required.
• Demonstrated Knowledge, Skills, and Abilities. The following list of knowledge, skills and abilities present the minimum skill set expected of an Entry Level CNA. Entry level into practice may include but are not limited to the following:
  • Ability to translate into anesthesia care the principles of professional nursing practice including the patients' rights to autonomy, dignity, privacy, and safety.
  • Knowledge of current research and practice guidelines to frame anesthesia practice including up to date techniques, pharmacology, and equipment.
  • Ability to obtain, document and verify informed anesthesia consent and perform a pre-anesthetic patient history and physical, which includes managing pre-operative consults and interpreting data.
  • Ability to formulate a patient-specific anesthetic plan and describe salient anesthetic risks, benefits, and options to the patient.
  • Ability to administer inhalational, regional, intravenous, local, and topical anesthetics.
  • Skill in detecting and treating anesthesia or surgically related physiologic changes and ability to treat accordingly in order to maintain homeostasis.
  • Skill in assessing patient status for appropriateness of transfer of care to another healthcare provider and communicating essential patient information to other providers effectively.
  • Ability to participate in collaborative responsibility for proper patient positioning, physiologic monitoring, infection control and anesthesia documentation.
  • Skill in responding to emergency situations by providing airway management, fluid and medication administration, invasive line insertion and management and the use of advanced cardiac life support techniques.
  • Ability to provide patient care that is abreast of changing concepts and advancements in the profession, (e.g., ultrasound techniques.)
  • Ability to practice anesthesia in an interdisciplinary environment utilizing a collaborative concept of anesthesia care.
  • Knowledge of quality improvement processes to maintain ongoing review and evaluation of anesthesia care to improve outcomes.
  • Ability to demonstrate a practice emphasis on safety, current established guidelines and protocols while recognizing the duty to report unsafe conditions or errors.

• Education and Experience Requirement: Meets basic education requirement for an APN (CNA) AND One year of specialized APN (CNA) experience equivalent to the APN (CNA) II grade level.
• Demonstrated Knowledge, Skills, and Abilities: Progressively responsible experience in the administration of anesthetics as indicated in the knowledge, skills and abilities listed below.
  • Ability to plan, administer and manage anesthesia for a broad range of complex surgical procedures skillfully employing continuous assessment and anesthetic adaptation based on patient response and comorbidities. Work assignments will vary by facility.
  • Ability to participate in assignments that are technically challenging, encompass a variety of anesthetizing locations and utilize advanced equipment and procedures while adapting techniques to solve various complex anesthesia problems including the development of individualized programs of post-op anesthesia care.
  • Skill in responsibility and accountability to perform to the extent of the CNA standards of practice as a licensed healthcare professional in any model of anesthesia practice.
  • Ability to contribute to the educational mission as a mentor or preceptor providing didactic and clinical instruction in anesthesia to student nurse anesthetists, medical and dental residents, and other health care trainees.
  • Knowledge to participate in the development, implementation and maintenance of auditing processes that ensure and improve the quality and consistency of anesthesia and associated documentation.
  • Ability to contribute to departmental administrative processes through quality assurance, shared governance, or committee representation as applicable.
  • Ability to serve as a representative on interdisciplinary teams to establish and maintain guidelines and communication.
  • Skill demonstrated in the ability to embrace the safety culture emphasis by continuously assessing for safety risks, actively reporting safety concerns, and maintaining a just culture by identifying faults in systems rather than individuals.

• Moderate Lifting, 15-45 pounds
• Light Carrying, under 15 pounds
• Straight pulling
• Pushing ; use of fingers
• Walking & standing
• Hearing (aide permitted)
• Working closely with others; & working alone
• 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, resume, C.V., and/or supporting documentation will be verified. Please follow all instructions carefully. Errors or omissions may affect consideration for employment. Please list hours worked per week and beginning and ending dates for all positions listed on the resume. Please give a detailed list of knowledge, skills, and abilities that apply to grade requirements for each position listed on the resume for qualification purposes.

NOTE: Candidate's education, scope, and length of nursing practice (experience) will be considered in determining the grade and salary of the applicant selected. The recommended 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.

It is the policy of the VA to not deny employment to those that have faced financial hardships or periods of unemployment.

Veterans and Transitioning Service Members: Please visit the VA for Vets site for career-search tools for Veterans seeking employment at VA, career development services for our existing Veterans, and coaching and reintegration support for military service members.