Nurse Practitioner - Primary Care

This position is eligible for the Education Debt Reduction Program (EDRP), a student loan payment reimbursement program. You must meet specific eligibility requirements per VHA policy and submit your EDRP application within four months of appointment. Program Approval, award amount (up to $200,000) & eligibility period (one to five years) are determined by the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible to apply.

VA offers a comprehensive total rewards package: VA Nurse Total Rewards FUNCTIONS OF ASSIGNED

Duties

The NP is a licensed independent practitioner with advanced education and national certification who provides evidence-based care for a population of patients . Major duties and responsibilities of the position: Primary focus of practice is the independent clinical evaluation of Veterans through their panel of patients including prevention and patient self -management. Comprehensive primary care will be provided to male and female Veterans.

Comprehensive primary care includes but is not limited to evaluating patients in an outpatient clinical setting to diagnose and treat acute and or chronic diseases, educating on health promotion and disease prevention and ensuring that health maintenance is up to date. Completes physical examinations, which may be comprehensive, or focused to formulate treatment plans. Treatment plans are evidence based and engages in shared medical decision making of treatment plans.

Care may be provided in many modalities, from direct face to face care, virtual care (including telephonic, video, secured messaging and others) Develops and implements an individualized plan to achieve optimal population health and disease management Orders and interprets labs, tests, and diagnostic studies Prescribes pharmacologic and non-pharmacologic interventions Initiates referrals and consults to specialty services Provides education to patients and their families Assesses and adjusts the plan of care as needed to achieve optimal patient outcomes Functions as a member of a Patient Aligned Care Team, collaborating with clinical and administrative support to provide timely, quality, coordinated care for Veterans Participates in continuous medical education as per requirements with topics included but not limited to opioid prescribing and trainings to fulfill and maintain designated women's health primary care provider May provide coverage for other providers in clinic or other primary care clinics if needed or assigned Participation in clinical education as appropriate License and DEA

requirements

The NP practices to the full extent of their education, training, and certification. However, per the Controlled Substances Act, 21 U. S. C. 801 et seq., which is enforced by the Drug Enforcement Administration (DEA), NPs prescribing controlled substances will need to meet North Carolina (NC) rules regarding prescribing. The NP will be required to have a collaborative practice agreement with a physician ONLY as it pertains to prescribing controlled substances.

Such agreement is embedded in the NP's privileging forms. It is a preferred qualification of the DVAHCS for all NPs to obtain a DEA (even if he/she is not prescribing controlled substances). The DVAHCS cannot mandate that an NP obtain a North Carolina NP approval to practice (aka NP license).

However; if an NP requests to maintain an NP license in a Non-FPA state, and that state's regulation requires that all NPs must collaborate with a physician who also holds a license in that same non FPA state, then the NP must abide by that state's practice act/ state's regulation. If there is NOT a physician collaborator at the DVAHCS who holds a matching state license in the Non-FPA state, and if it is a condition of the NP's employment to order/ prescribe controlled substances in primary care, then the NP will need to consider applying for a North Carolina NP approval to practice in order to fulfill his/her commitment to the assigned job duties. NPs maintaining a license in a Full Practice Authority (FPA) State while working at the DVAHCS must be aware of and must abide by that state board's regulation and practice act.

It is the NP's responsibility to provide information regarding his/her state's practice act/state's regulation to members of the Durham VA Health Care System when requested. 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-Friday 8:00 AM - 4:30 PM Compressed/Flexible: Not Authorized Telework: Ad hoc - as determined by the agency policy. Requires supervisory approval. Virtual: This is not a virtual position. Relocation/Recruitment Incentives: Not Authorized. EDRP Authorized: Former EDRP participants ineligible to apply for incentive. Contact, the EDRP Coordinator for questions/assistance. Learn more

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: Family Nurse Practitioner (FNP), Adult Nurse Practitioner (ANP), Adult-Gerontology Primary Care Nurse Practitioner (AGPCNP), or Gerontology Nurse Practitioner (GNP) 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 The full performance level of this vacancy is NP3. The actual grade at which an applicant may be selected for this vacancy is in the range of NP2 to NP3. Physical

Requirements

This position requires visual acuity, keen hearing, clear distinctive speech, and manual dexterity. This position requires mostly periods of continued walking, standing, stooping, sitting, bending, pulling, and pushing. Transferring patients and objects may be required. The incumbent may be exposed to infected patients and contaminated materials and may be required to don protective clothing in isolation situations. The incumbent may occasionally be exposed to patients/residents who are combative secondary to delirium, dementia, or psychiatric disorders. The incumbent must be a mature, flexible, sensible individual capable of working…