Summary
The Advanced Practice Nurse (APN)/Certified Nurse Practitioner (NP) practices in Cardiology Service to provide a full range of Licensed Independent Practitioner (LIP) services emphasizing quality, timeliness, and the advancement of the Veterans Affairs (VA) mission. The NP provides advanced clinical practice, consultation, and management.
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Duties
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The NP is a LIP with advanced education and national certification who provides evidencebased care for a population of patients.
Major duties and responsibilities of the position:
- Independently manage a panel of patients with acute and chronic health conditions with an emphasis on health promotion and disease prevention using evidence-based practice.
- Develop and implement an individualized plan to achieve optimal population health and disease management.
- Demonstrate leadership and work collaboratively with the interdisciplinary team.
- Order and interpret labs, tests, and diagnostic studies.
- Prescribe pharmacologic and non-pharmacologic interventions.
- Initiate referrals and consults to specialty services.
- Provide education to patients and their families.
- Assess and adjust the plan of care as needed to achieve optimal patient outcomes.
- Exemplify the ICARE core values of-Integrity, Commitment, Advocacy, Respect, and Excellence.
CARDIOLOGY ELECTROPHYSIOLOGY/PACEMAKER SPECIFIC DUTIES/RESPONSIBILITIES
Advanced Practice Provider (APP) in this role, functions independently and in collaboration with a multidisciplinary team, providing comprehensive guideline directed evidence based care to cardiology patients. This position is one of a group of Cardiology Advanced Practice Providers who respond to cardiology consult requests from within the hospital as well as from the VISN facilities.
The APP provides care to Veterans in the Electrophysiology/Pacemaker/Cardiology Clinic, delivering care in the outpatient setting, by face to face, telephone and telemedicine visits. Interacts with patients within acute care, emergency department, Cardiac Cath Lab/EP lab, and/or the community living centers (CLC). The population served includes male and female veterans across the adult lifespan, as well as active duty personnel. Patients managed in the Electrophysiology/Pacemaker clinic by the APP may have complex comorbidities such as arrhythmias including atrial fibrillation/flutter, ventricular tachycardia, heart block, or other diseases including hypertension, COPD, diabetes, valvular diseases, coronary artery disease, cerebral vascular disease, auto immune disorders and renal impairment.
Primary functions of this role include:
- Interrogate and evaluate device function and identify normal or abnormal function
- Sound knowledge of device function and ability to reprogram as necessary
- Identify rhythms and interpret all information
- Download device interrogation by remote transmission and interpreting results
- Complete cardiac procedural consults for pacemakers/defibrillators/lead extractions/ablations and other EP procedures for patients in the Pacemaker Clinic; make note with recommendations for peri-op device management for upcoming surgerical procedures
- Evaluate patients for appropriate use of Life Vests, orders the vest through prosthetics; educates patients and caregivers on the use and care of a life vest and alternative therapies and follow these patients monthly in clinic
- Evaluate and schedule patients for MRI, make sure device is MRI compatible, older than 6 weeks and that there are no additional or abandoned leads through an x-ray. iIterrogate and reprogramm devices prior to the MRI, and monitor the rhythm and pulse oximeter during the MRI
- Interrogate and test device again post MRI and return to normal settings
- Provide comprehensive guideline directed evidence based care to patients with pacemaker devices
- Implement assessment, diagnosis and management of patients with complex comorbidities
- Prescribe individualized pharmacological and non-pharmacological interventions for treatment of heart conditions and related medical problems
- Educate patient, significant others and affiliated medical center staff on health care issues (medications, diet, lifestyle changes, 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.
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: Monday thru Friday, 7:00 am to 3:30 pm
Telework: Not Available
Virtual: This is not a virtual position.
Relocation/Recruitment Incentives: Not Authorized
Permanent Change of Station (PCS): Not Authorized
Requirements
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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.
- 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.
Qualifications
Advanced Practice Nurse (Nurse Practitioner) Basic Requirements
- Education: A post-master's certificate or master's or doctoral degree as a Nurse Practitioner. (Applicants pending the completion of educational requirements may be referred and tentatively selected but may not be hired until the education requirements are met.) Must be a 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).
- NOTE: Foreign Education. Graduates of foreign schools of professional nursing programs, the nurse practitioner degree equivalency must be validated through an Agency recognized degree equivalency evaluation agency, such as the International Consultants of Delaware (ICD). Candidates with equivalent nurse practitioner masters or doctorate level degrees who possess current, full, active, and unrestricted registration and certification will meet the requirement of graduation from an approved school of professional nursing to warrant appointment.
- License - All APN (NPs) must possess and maintain an active, current, full, and unrestricted APN license to practice as an NP in a State, Territory or Commonwealth of the United States, or in the District of Columbia.
- Basic Board Certification - All APN (NPs) must maintain full and current basic board certification in one of the following: Acute Care Nurse Practitioner (ACNP) or Adult-Gerontology Acute Care Nurse Practitioner (AGACNP) from one of the following: the American Nurses Credentialing Center (ANCC), American Academy of Nurse Practitioners Certification Board (AANPCB), or other nationally recognized certifying body in the area in which the Nurse Practitioner is academically prepared.
NOTE: Grandfathering Provision - All persons currently employed in VHA in 0610 series and an APN (NP) assignment that are also 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.
The following Scope, Education and Experience, and Dimension criteria must be met to qualify for Advanced Practice Nurse (Nurse Practitioner) II:
Exception to Licensure for Graduate Nurse Technicians. Candidates who otherwise meet the basic requirements, but do not possess the required licensure and/or certification, may be appointed at the entry step of the Nurse II, as a Graduate Nurse Technician - Nurse Practitioner on a temporary appointment up to any period not-to-exceed one year and a day under the authority of 38 U.S.C. § 405(c)(2)(B).
- Scope: Demonstrates leadership in delivering and improving holistic care through collaborative strategies with others
- Education and Experience Requirement: Meets basic education requirement for APN (NP). Nurse II is considered the entry grade level for APN (NPs); no experience is required.
- Dimension Requirement: APNs (NPs) at level II are expected to meet the following dimension requirements:
- Clinical Practice. Delivers evidence-based health care, demonstrating proficiency in the ability to manage a patient panel, population, or program.
- Outcome Focus. Utilizes research and evidence-based practice to evaluate the patient care delivery system within a patient panel or program, presents findings and contributes to changes that enhance the quality and timeliness of veteran/patient care.
- Leadership. Works effectively as a leader within a team/unit/group and seeks interdisciplinary collaboration as appropriate to enhance patient care.
- Professional Development. Acquires knowledge and skills to develop expertise in area of practice.
- Professionalism/Collegiality. Demonstrates effective communication skills and professional behavior, promoting cooperation and teamwork. Participates in interdisciplinary teams and processes that positively impact patient outcomes.
The following Scope, Education and Experience, and Dimension criteria must be met to qualify for Advanced Practice Nurse (Nurse Practitioner) III:
- Scope: Executes position responsibilities that demonstrate leadership, experience, and creative approaches to management of complex client care.
- Education and Experience Requirement: Meets basic education requirement for an APN (NP) AND one year of specialized APN (NP) experience equivalent to the Nurse II grade level.
- Dimension Requirement: APN (Nurse Practitioners) at grade III are expected to meet the following dimension requirements:
- Clinical Practice. Influences and models the delivery of evidence- based health care, demonstrating expertise in the ability to manage a patient panel, population, or program.
- Outcome Focus. Leads and implements changes that enhance the quality and timeliness of Veteran/patient care applying research and evidence in the delivery of healthcare for patient populations.
- Leadership. Initiates and leads interdisciplinary teams informed by structured approaches and processes to improve outcomes that positively impact care for a patient panel, population, or program.
- Professional Development. Acquires knowledge and skills, then disseminates acquired information within and/or outside the medical facility.
- Professionalism/Collegiality. Initiates and leads interdisciplinary teams developing systems that positively impact outcomes at the panel, population, or program level. Demonstrates effective communication skills and professional behavior, promoting cooperation and teamwork
Preferred Experience:
- Master of Science in Nursing (MSN) or Doctor of Nursing Practice (DNP) Preferred
- Current/Recent Nursing Experience in Cardiology for more than 2 years
- Must maintain full and current basic board certification in one of the following: Acute Care Nurse Practitioner (ACNP) or Adult-Gerontology Acute Care Nurse Practitioner (AGACNP) - Required
Physical Requirements: To perform in a fully successful manner, the individual must have the physical ability to perform job-related duties which require lifting, standing, bending, transferring, stooping, stretching, walking, pushing, or pulling without assistance from another patient care provider or significant other. A health examination must be successfully completed prior to this assignment and periodically thereafter as required by the Employee Health Clinic policy. There may 
