Clarification from the agency

NOTE: The 2-page Resume requirement does not apply to this occupational series. For more information, refer to Required Documents below

Videos

• The Dialysis Nurse is a professional registered nurse (RN) with specialized knowledge and skills who demonstrates proficiency when providing and directing care for patients with end-stage renal disease (ESRD), acute kidney injury (AKI), and latestage chronic kidney disease (CKD). Collaborates with other disciplines/departments to achieve desired patient outcomes.
• Adheres to Centers for Medicaid Services (CMS) Conditions for Coverage (CfC) for ESRD facilities; VHA Handbook 1042.01, VA Dialysis Programs Standards and Criteria under authority 38 U.S.C. 1703, 1710, and 7301(b); Centers for Disease Control (CDC) Guidelines for Infection Control in Dialysis Settings, Association for the Advancement of Medical Instrumentation (AAMI) Standards as they relate to dialysis solutions and water purification, the Joint Commission, and all other regulatory requirements.
• Team leads unlicensed assistive personnel such as hemodialysis medical instrument technicians (HDMITs). Participates in peer reviews and evaluation of other nurse colleagues and technicians.
• Functions as primary nurse for ESRD patient panel and serves as key resource assisting patients navigate VASDHS.
• Completes daily treatment encounters, annual clinical reminders, annual assessments, monthly and/or just-in-time patient education using TEACH-BACK methodology. Completes monthly ESRD patient care plans aligned with goals of care and coordinates advance care planning for end-of-life (EOL).
• Monitors, tracks/trends, and reports ongoing care continuity needs and outcomes to multi/interdisciplinary teams. Tracks/trends K-DOQI (kidney disease quality outcomes initiatives), VA Outpatient Dialysis Dashboard Metrics, and VA Outpatient Dialysis IPEC CLABSI outcomes. Orders and collects required specimens and submits to laboratory for processing.
• Completes documentation for all clinical and technical recordkeeping in the electronic health record and treatment flowsheets in accordance with established policies and procedures. Completes electronic encounters according to VA Directives for appropriate VERA allocation and managerial cost accounting (MCA).
• Uses a team approach to identify, analyze, and resolve patient care problems with measurable outcomes. Handles multiple projects and duties simultaneously, prioritizing as needed. Identifies potential and actual problems involving resources and/or safety. Takes action to avert or manage situation(s) in a manner which meets patient needs in a safe/therapeutic manner and promotes healthy workplace environments.
• Engages in daily Huddles using STEPS (safety, teams, equipment, process, supplies) and reports to leadership chain via Daily Management System (DMS).
• Participates in training for self and others for professional development activities aligned with VA mission, goals, and objectives. Engages in department/program performance improvement as measured against regulatory standards and takes action to correct deficits to ensure compliance as part of sustained clinical operations and continued readiness.
• .Demonstrates effective interpersonal communication skills and professional behaviors that promote cooperation and teamwork with internal and external customers. Treats all patients and employees with respect, regardless of their level, personality, culture, and/or background.
• Participates in shared governance, team meetings, and process improvement activities, monitors results, and advocates for self and staff compliance to regulatory requirements. Responds to changing priorities and resources with optimism, encouraging staff to respondpositively and proactively. Supports department strategic planning and assists unit-based educational program and activities.
• Performs dialysis on-call duties for inpatient urgent/emergent acute hemodialysis and peritoneal dialysis procedures.
• Performs all other duties as assigned.

VA offers a comprehensive total rewards package: VA Nurse Total Rewards

Pay: Competitive salary, regular salary increases, potential for performance awards
Paid Time Off: 50 days of paid time off per year (26 days of annual leave, 13 days of sick leave, 11 paid Federal holidays per year)
Retirement: Traditional federal pension (5 years vesting) and federal 401K with up to 5% in contributions by VA
Insurance: Federal health/vision/dental/term life/long-term care (many federal insurance programs can be carried into retirement)
Licensure: 1 full and unrestricted license from any US State or territory

Work Schedule: Full Time, 0500-2300 Mon-Sat
Compressed/Flexible: N/A
Telework: N/A
Virtual: This is not a virtual position.
Relocation/Recruitment Incentives: N/A

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.
• Selective Service Registration is required for males born after 12/31/1959.
• 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 identification 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).
• You may be required to serve a probationary period.
• Complete all application requirements detailed in the "Required Documents" section of this announcement.

As a condition of employment for accepting this position, you will be required to serve a 2-year trial period during which we will evaluate your fitness and whether your continued employment advances the public interest. In determining if your employment advances the public interest, we may consider:

• your performance and conduct;
• the needs and interests of the agency;
• whether your continued employment would advance organizational goals of the agency or the Government; and
• whether your continued employment would advance the efficiency of the Federal service.

Upon completion of your trial period, your employment will be terminated unless you receive certification, in writing, that your continued employment advances the public interest.

Qualifications

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.

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/12829362.

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.


Preferred Experiences:

• Basic Qualifications Criteria for Hemodialysis Registered Nurse (RN) To qualify for the position of Hemodialysis Registered Nurse (RN),
• Minimum of 3 years of experience in a clinical setting.
• BLS certification is mandatory.
• Certification as a Certified Nephrology Nurse (CNN) is preferred.
• Candidates should possess at least 3 years of acute nursing experience, providing care specifically for patients with End-Stage Renal Disease (ESRD), Acute Kidney Injury (AKI), and late-stage chronic kidney disease (CKD).
• ICU experience is recommended to effectively care for dialysis patients with complex medical conditions requiring critical care. Additionally, knowledge of both acute and chronic peritoneal dialysis is essential.
• Applicants must demonstrate leadership in providing, directing, and improving patient care, and possess excellent skills in cannulation and care of dialysis vascular access, including central line catheter management.

Reference: For more information on this qualification standard, please visit https://www.va.gov/ohrm/QualificationStandards/.

Physical Requirements: This position requires potentially long periods of continued sitting, walking to and from meetings and some traveling to and from community providers/hospitals and community-based outpatient clinics (CBOCs). The incumbent must be able to climb stairs as well as mature, flexible, sensible individual capable of working effectively in stressful situations, able to shift priorities based on patient needs and workload.

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.

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 as an RN will be evaluated to determine if the experience is of an acceptable level of quality with regard to the following five dimensions of nursing: Practice, Veteran/Patient Driven Care, Leadership, Professional Development, and Evidence/Based Practice/Research. Each dimension of practice has criteria that demonstrate essential core competencies for VHA Nursing Personnel.

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.