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Summary
This position is eligible for the Education Debt Reduction Program (EDRP), a student loan payment reimbursement program. You must meet specific individual eligibility requirements in accordance with VHA policy and submit your EDRP application within four months of appointment. Approval, award amount (up to $200,000) and eligibility period (one to five years) are determined by the VHA Education Loan Repayment Services program office after complete review of the EDRP application.
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Duties
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The Advanced Practice Nurse (APN) Certified Nurse Anesthetist (CNA) is a Certified Registered Nurse Anesthetist (CRNA). The CRNA provides a full range of services emphasizing quality, timeliness, and the advancement of the Veterans Affairs (VA) mission. The CRNA practices to the full extent of their education, training, and certification.
Core functions are outlined in the clinical privileges or scope of practice that correspond with this position and determined locally within the limits of the individual's state license and the local VA Medical Center (VAMC) bylaws. The CRNA provides advanced clinical practice, consultation, and management.
The CRNA administers anesthesia in both inpatient and outpatient settings to patients of all health complexities. The aspects of practice include direct patient care, administration, education, and research activities.
Major duties and responsibilities of the position:

• Collaborate with a variety of health care professionals to achieve common goals for care, safety, and welfare of patients.
• Foster high levels of confidence and satisfaction among patients and staff, as well as meet and exceed compliance standards.
• Provide anesthetic services within five general categories to include: pre-anesthesia evaluation and preparation; anesthesia induction, maintenance, and emergence; post anesthesia care; pen -anesthetic and clinical support functions; and emergency response techniques.
• Develops and implements a comprehensive anesthesia plan of care for patients requiring local, regional, general, and monitored anesthesia both inside and outside the Operating Room (OR) suite.
• Ensures anesthetic services delivered throughout the facility are of the highest quality to promote patient safety, satisfaction, and improve outcomes and efficiencies.
• Functions as resource for staff education and is willing to be a preceptor and adjunct clinical faculty for healthcare trainees rotating through the facility.
• Develops and implements evidence-based practices that are essential to the delivery of the highest quality anesthesia care.
• Prescribe appropriate preoperative, intra-operative and postoperative orders and medications.
• Exemplifies the ICARE core values of-Integrity, Commitment, Advocacy, Respect, and Excellence.

As privileged or as specified in the scope of practice and in accordance with skill, proficiency, and state licensure, the CRNA may provide the appropriate preoperative and postoperative anesthesia orders. CNAs with Drug Enforcement Administration (DEA) numbers and/or facility DEA numbers may independently prescribe controlled substances in the preoperative, intraoperative, or postoperative settings.
Work Schedule: Monday-Friday, 07:00am-3:30pm
Telework: Not Authorized
EDRP Authorized: Contact James.Anderson5@va.gov, the EDRP Coordinator for questions/assistance. Learn more
Relocation/Recruitment Incentives: Not Authorized
Permanent Change of Station (PCS): Not Authorized
Financial Disclosure Report: Not required
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.
• 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
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 (CRNAs) must maintain an active, current, full and unrestricted license to practice as a CRNA or equivalent, in a State, Territory or Commonwealth of the United States or in the District of Columbia.
  • Basic Certification. All APN (CRNAs) 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.

NOTE: Grandfathering Provision - All persons currently employed in VHA in 0610 series and an APN (CRNA) 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 Education, Experience, and Knowledge, Skills and Abilities must be met for Advanced Practice Nurse (Certified Registered Nurse Anesthetist) II:
Exception to Licensure for Graduate Nurse Technicians. Candidates who otherwise meet the basic requirements, but do not possess the required APN (CRNA) licensure and/or certification, may be appointed at the entry step of the Nurse II, as a Nurse Anesthetist on a temporary appointment up to any period not-to-exceed one year and a day under the authority of 38 U.S.C. § 7405(c)(2)(B).

• Education and Experience Requirement. Meets basic education requirement for an APN (CRNA). Nurse II is considered the entry grade level for APN (CRNAs); 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 CRNA. 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.

The following Education, Experience, and Knowledge, Skills and Abilities must be met for Advanced Practice Nurse (Certified Registered Nurse Anesthetist) III:

• Education and Experience Requirement: Meets basic education requirement for an APN (CRNA) AND One year of specialized APN (CRNA) experience equivalent to the APN (CRNA) 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 CRNA 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.

Physical Requirements: Walking, bending, stooping, and some lifting in the direct care of patients. There may also be extended periods of sitting.
Education
IMPORTANT: A transcript must be submitted with your application if you are basing all or part of your qualifications on education.
Note: All Registered Nurses 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); 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; 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).
Additional information
Reference: For more information on this qualification standard, please visit https://www.va.gov/ohrm/QualificationStandards/.
During the application process you may have an option to opt-in to make your resume available to hiring managers in the agency who have similar positions. Opting in does not impact your application for this announcement, nor does it guarantee further consideration for additional positions.
This job opportunity announcement may be used to fill additional vacancies.
This position is in the Excepted Service and does not confer competitive status.
VA encourages persons with disabilities to apply. The health-related positions in VA are covered by Title 38, and are ...