Registered Nurse (Intensive Care Unit)

Summary

The ICU Registered Nurse is responsible for delivering comprehensive care to the most critically ill patients in the hospital. As a mixed Intensive Care Unit - the ICU manages a diverse patient population including medical - surgical - and cardiac patients - with a significant number of individuals experiencing complex cardiac and heart failure conditions. Due to their unique skills and experience with unstable and high-acuity patients - ICU staff nurses are considered a hospital-wide resource

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/13094226 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

Experience

• ICU (at least two years in SICU - MICU - CVICU)
• Familiarity with devices (LVADs - Impellas - IABPs) - CRRT - Vents
• Additional

Certification

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

Requirements

The Registered Nurse (RN) must be able to perform all activities of the position without restriction This position involves considerable standing - walking - stooping - bending - reaching - lifting and turning It requires repositioning patients and assisting with transferring patients to wheelchairs/stretchers Mechanical devices when available are required to be used for heavy or difficult to lift patients The work may involve pushing or lifting in excess of 50 pounds and going up and down flights of stairs The position requires visual and auditory acuity at a level to provide safe and effective nursing care The position requires the nurse to work for periods of time with arms above shoulder level or with the neck in a fully flexed or extended position and the ability to physically control or protect him/herself from physically abusive patients The RN may be exposed to infected patients and contaminated materials and may be required to don protective clothing in isolation situations - operative/invasive procedures The RN may occasionally be exposed to patients who are combative secondary to delirium - dementia - or psychiatric disorders The RN must be mature - flexible - sensible individual capable of working effectively in stressful situations - able to shift priorities - based on patient needs.

Duties https://youtu.be/LM35k1p_3Tc?si=6wdZw0Lag331XBMR Major

Duties

Duties and responsibilities include - but are not limited to - the following: Complete admission assessment on assigned patients within 24 hours of admission Conduct reassessments on patients every four hours and as needed to determine rapidly changing conditions Transcribe provider orders using CPRS - check orders in CPRS at minimum of every two hours Take verbal and telephone orders per policy Complete patient care plans according to policy Document vital signs and assessments according to SOP using CPRS and/or Essentris Document medications using BCMA (Bar Code Medication Administration) Plan for discharge/transfer of patients including completion of discharge/transfer notes in Essentris/CPRS Function independently when performing care for complex patients in the ICU Initiate referrals and/or consultations as appropriate to achieve interdisciplinary care of patients Identify crucial assessment changes in patient status and appropriately communicate these changes to providers and the care team Respond appropriately to emergent situations following ACLS guidelines Safely perform moderate sedation - and out of OR recoveries per policy Provide individual - complex patient care consistent with managing critically ill medical and surgical patients consistent with identified diagnosis and standards and scope of practice - which may include but is not limited to: Cardiac monitoring Hemodynamic monitoring Administration and titration of high risk cardiac and/or vasoactive medications Ventilators - CPAP - BIPAP - and HF nasal cannula Advanced cardiac devices (IABP - Impella - BIVAD - and LVADs) Advanced renal replacement therapy (CRRT) Advanced neurologic devices (lumbar drain - EVD - bolts) Post-op management for cardiac - vascular - neuro - urology - general surgery - ortho - and ENT patients (not an all-inclusive list) Cardiogenic - hypovolemic - neurogenic - and/or septic shock Demonstrate ability to manage daily routine operations related to patient care (delegate - supervise - trouble shoot - and evaluate) Participate in clinical supervision of nursing students and new hire through role modeling and communicate objectives and expected competencies of orientees and students 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: Rotating Schedule (Days - Nights - Weekends - and Holidays) Compressed/Flexible: Authorized Telework: Not Available Virtual: This is not a virtual position Relocation/Recruitment Incentives: Not Authorized Permanent Change of Station (PCS): Not Authorized