Vocational Nurse (Wound Care)

The Wound Care LVN/LPN at the VA Palo Alto Health Care System reports directly to the Wound Care Nurse Manager, Nursing Ambulatory Care. The incumbent is in a complex assignment with minimal supervision and demonstrates the ability to coordinate competing demands and set priorities effectively, while supporting multiple providers to ensure effective operations of the wound care and telehealth clinic. The incumbent supports the Inpatient Nursing Service and Community-Based Outpatient Clinics.

Total Rewards of an Allied Health Professional The role includes orientation and mentoring of peers and other interdisciplinary team members in maintaining compliance with standards. The incumbent serves as a clinical expert through training and mentoring of nursing staff (RN, LVN/LPN, and NA) in the knowledge and skills of the wound care program. In addition, the LVN/LPN is a clinic leader involved in keeping the clinic workflow operating efficiently and appropriately.

Functions or Scope of Assigned Duties Includes but is not limited to: Direct Patient Care: Manages the daily operations of the Wound Care and Tele-wound Clinics. Independently works in collaboration with the Wound Care provider (MD, NP, or RN) to manage the continuation of care for Veterans with ongoing wound care problems such as pain, healing concerns, dressings, and comfort. Makes appropriate referrals as needed.

Tele-wound Clinics: Store and Forward Telehealth (SFT) LVN/LPN Incumbent performs telehealth imaging and test administration for Tele-wound care, as identified and referred by the VA provider. Guided by local policy/standing orders and protocols, the imager can generate consultations for patients based on guidance or protocol on behalf of the provider, who retains the overall responsibility for patient care. These consultations encompass follow-up service as a result of events that unfold during the telehealth visit.

Examples may include changes in the health status, a finding during or immediately after the visit, or from the initial or ongoing interview performed by the LVN/LPN Imager before, during, and after the telehealth visit. The imager will provide specific/individualized patient education regarding the imaging/testing process, including expectations, follow-up, and how to address equipment failure or other environment of care concerns. Obtains abbreviated patient medical histories relevant to the examination being performed.

Wound care clinic/Telehealth Tele-presenter/Clinical Facilitator: Incumbent serves as patient site clinical coordinator and is essential for the clinical aspects as described below of the appointment. The incumbent serves as a member of the clinic team, available for all tele-wound visits, and carries out the following

duties

Patient site facilitation of the clinical, business, and technical aspects for real-time telehealth applications for wound clinics. Observation, Reporting and Documentation: Identifies subtle changes in patient condition, both physical and emotional. Possesses a high degree of specialized skill in the evaluation and documentation of wounds.

Demonstrates practical knowledge of human behavior, motivation, and reactions to situations. Reports these in a timely manner and initiates appropriate action within scope. Documents all interactions, observations, interventions, and outcomes in CPRS.

Through the initial interview pre-telehealth process, identifies potential triggers for negative patient response and takes definitive action to mitigate or eliminate these triggers. For example, a patient who self-reports claustrophobia will be educated on ways to ensure privacy while offering alternatives to the closed room feeling for the Veteran. Maintaining a Safe and Therapeutic Environment: Maintains a safe, clean, therapeutic environment and ensures adherence to infection control guidelines.

Nursing Practice/Technical Competence: Current and active in licensure requirements, basic life support, and TMS education, which provides an opportunity for the LVN/LPN to demonstrate core LVN/LPN competencies. Other Duties as assigned. This position potentially requires flexibility in schedule and assignments.

Work Schedule: M-F, 7:00 am - 3:30 pm, or as determined by the supervisor. Compressed/Flexible: This may be authorized at the supervisor's discretion. Paid Time Off: 37-50 days of annual paid time off per year (13-26 days of annual leave, 13 days of sick leave, 11 paid Federal holidays per year) Selected applicants may qualify for credit toward annual leave accrual, based on prior [work experience] or military service experience.

Parental Leave: After 12 months of employment, up to 12 weeks of paid parental leave for the birth, adoption, or foster care placement of a child. Child Care Subsidy: After 60 days of employment, full-time employees with a total family income below $144,000 may be eligible for a childcare subsidy up to 25% of total eligible childcare costs for eligible children up to the monthly maximum of $416.66. Retirement: Traditional federal pension (5-year 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) Telework: Not Available Virtual: This is not a virtual position. Functional Statement #: 11071-F

Basic

Requirements

United States Citizenship: Non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy.

Education

Graduate of a school of practical or vocational nursing approved by the appropriate State agency and/or accredited by the National League for Nursing (NLNAC) at the time the program was completed by the applicant. Verification can be obtained from the State approving agency or the National League for Nursing Accrediting Commission, 61 Broadway, 33rd Floor, New York, NY 10006.

Licensure

Full, active, current, and unrestricted licensure as a licensed practical or vocational nurse in a State, Territory, or Commonwealth (i.e., Puerto Rico) of the United States, or District of Columbia. An LPN/LVN who has or has ever had any license(s) revoked, suspended, denied, restricted, limited, or issued/placed in a probationary status may be appointed only in accordance with the provisions in chapter 3, section B, paragraph 16 of this part. English Language Proficiency: Licensed practical or vocational nurses appointed to direct patient care positions must be proficient in both spoken and written English as required by 38 U. S. C. 7402(d), and 7407(d).

May qualify based on being covered by the Grandfathering Provision as described in the VA Qualification Standard for this occupation (only applicable to current VHA employees who are in this occupation and meet the criteria). Grade Determinations: GS-7: The GS-7 grade level is for select, complex LPN/LVN positions, as established by each health care facility. To be advanced, employees must meet all of the following standards, provided the standard is part of their assignment.

Completion of at least one (1) year of additional qualifying experience at the GS-6 level or equivalent, fully meeting all of the performance requirements for the GS-6 LPN/LVN. Knowledge and skills necessary to carry out more specialized patient care duties, including assignments in selected, more complex inpatient and/or outpatient care settings. Knowledge base promotes the incorporation of current patient care data in actively contributing to the development of the patient's overall health plan and in carrying out assigned nursing interventions.

Positions at this grade level require broader knowledge and skills because supervision is more general and employees are expected to be involved to a greater degree in the development and modification of treatment plans. Ability to assist RN and/or MD/DO to appropriately prioritize overall patient care needs and adjust plans for care delivery. Makes astute observations of subtle, less obvious changes, both physical and emotional, in the patient's condition, and accurately and thoroughly documents care delivered and the patient's response to care that could require immediate modification of the patient's care plan.

Appropriately seeks assistance and guidance by informing the RN or MD/DO of changes in the patient's condition requiring higher-level intervention. At this grade level, the LPN/LVN is expected to participate to a greater degree in prioritizing and, as appropriate, modifying patient care treatment. They must also possess the ability to observe more subtle physical and emotional changes in patients and demonstrate taking appropriate action based on those observations.

Ability to proactively assist the RN or MD/DO in addressing patients' needs for medication/treatments, accurately administering prescribed medications/treatments according to established policies/procedures and appropriately recording administration and patient's response to medications/treatments received. (This may include restricted medication locally authorized for administration by employees at this grade level.) Demonstrates the knowledge and ability to readily recognize the more subtle signs and symptoms of potential or actual drug reactions, promptly inform the RN or MD/DO of observed changes in patient's condition and initiate appropriate, prescribed interventions. Employees at this grade level demonstrate broader knowledge and skill with respect to these responsibilities than employees at lower grade levels.

Knowledge and skill to promptly recognize potential urgent or emergent patient care situations, seek assistance of the RN and/or MD/DO for appropriate team intervention and effectively intervene, as directed, to assure the continuation of optimal, safe, and therapeutic patient care delivery. At this grade level, the LPN/LVN must have a broader knowledge of the patient treatment process and exercise judgment that demonstrates the ability to effectively intervene when appropriate. Assists individuals or groups of patients and their families to take an active role in promoting healthy lifestyles for more positive patient outcomes.

Exercises skill in influencing and communicating with unusually difficult to care for or communicate with patients and/or family members who may exhibit problems with lack of self-control, resistant or abusive behaviors, or impediments in their ability to understand or follow instructions. This includes the ability to effectively deal with the above types of patients under very general supervision. Exhibits skill, creativity and initiative in contributing to the improvement of overall care delivery and patient and/or family satisfaction levels through active participation in committees/task forces, research projects or in developing educational materials/media.

Actively promotes and effectively incorporates established customer service standards in all aspects of their practice. Possesses comprehensive practical nursing knowledge and skills in specialized procedures and practices to serve as a resource person for other staff in organizing and implementing more complex/specialized patient care. Serves as a role model and mentor to other nursing staff in the application of more complex technology, effectively guiding and directing their continuing practice in these areas.

Supports the RN or MD/DO in monitoring the practice of unlicensed nursing or non-medical staff in patient care delivery. Promptly reports any deviations from normal practice patterns to the RN or MD/DO. In addition to responsibilities at the lower grade level, the LPN/LVN is responsible for monitoring the practice of non-licensed nursing and medical staff.

Work of considerable difficulty and responsibility is performed under general supervision. Individuals in these positions are, to a considerable extent, expected to exercise independent technical judgments and to possess and apply a comprehensive working…