The Patient Aligned Care Team (PACT) LPN in ACOS/Primary Care Services provides outpatient primary and specialty care in the clinic setting. Patient populations are served in and include but are not limited to general medical and surgical clinics as well as medical/surgical subspecialty clinics, preventive medicine, geriatrics, GYN, and primary care clinics. Applicants pending the completion of educational or certification/licensure requirements may be referred and tentatively selected but may not be hired until all requirements are met. 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. 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. Education: Graduate of a school of practical or vocational nursing approved by the appropriate State-accrediting agency and/or the National League for Nursing Accrediting Commission (NLNAC) http://www.nlnac.org (copy of transcripts required OR Health care education in the military service or training in the military service which is accepted by the licensing body in the jurisdiction in which the individual is licensed as qualifying for full LPN/LVN licensure will be accepted as meeting the education requirements for VHA employment. 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). Grade Determinations: GS-3: None beyond the basic requirements. LPNs at this grade level are expected to perform all duties within the scope of their license (e.g., medication administration); however, completed work may require routine or detailed higher level review depending upon the complexity of the duties involved. GS-4: Employees may be appointed at or advanced to GS-4 if they meet any of the criteria below: Six months of qualifying experience as an LPN or LVN; or Graduation from an approved school and one year of experience that involved nursing care work in a hospital, outpatient clinic, nursing home, or other supervised medical, nursing, or patient care facility that provided a practical knowledge of human body structure and sterile techniques and procedures; or Graduation from an approved school of at least 24 months duration. GS-5: Completion of at least 1 year of qualifying experience at the GS-4 level or equivalent. Demonstrated knowledge and ability to provide a full range of practical nursing care to patients with a variety of physical and/or behavioral problems. Works with the RN and/or MD/DO to appropriately orient/train less experienced LPNs/LVNs and/or NAs/HTs in relation to acceptable standards of practice in promoting optimal patient care delivery. Provides effective education to patients and/or family members in relation to common disease processes, medication, and /or prescribed treatment regimes. Demonstrated ability to serve as a responsible member of the nursing team and interact in an appropriate manner with patients, family members, professional and other supportive personnel involved in the delivery of patient care, incorporating acceptable, established customer service standards into practice. Knowledge and skill sufficient to prepare, administer, and appropriately document actions taken specific to commonly prescribed oral, topical, subcutaneous, intramuscular, and/or intravenous medications as permitted by approved local facility policies and procedures. Observation and documentation will include patient's response to medication administered and the reporting of any noted change in patient's condition to RN or MD/DO. Knowledge and ability to recognize the need for and to institute emergency measures when indicated, promptly seek the assistance of the RN or MD/DO and assist in resuscitation procedures in cardiac and/or pulmonary arrest. Recognizes and appropriately responds to breakage/malfunction or loss of equipment, safety hazards, and supply deficiencies, promptly reporting to appropriate personnel for corrective action. Completed work is under the general supervision of an RN or MD/DO. Individuals at this grade level are expected to have a broad working knowledge of practical nursing procedures. However, completion of more complex practices or procedures may be subject to closer higher-level review. GS-6: Completion of at least 1 year of qualifying experience at the GS-5 level or equivalent, fully meeting all performance requirements for the GS-6 LPN/LVN: Technically proficient in initiating, performing and completing assigned duties in providing care to variable patient populations. Knowledge and ability to appropriately carry out assigned patient care based on the patients' conditions; to use judgment in selecting the appropriate order and sequence of procedures and treatments; and to accurately recognize, report and record relevant patient information. Completed work should need only a general review by a registered nurse (RN) or physician (MD/DO) for appropriateness and conformity with established policies/procedures. Ability to observe, identify and respond to the patient's needs for care, including medication, equipment-assisted care and patient/family education. In organizing and delivering care, the LPN/LVN recognizes and considers emotional, cultural, spiritual, socio-economic, and age-related factors. Prepares and administers prescribed medications (oral, topical, subcutaneous, intramuscular and/or intravenous) and performs treatments according to established policies/procedures. Observes for physical and/or emotional changes in patient's condition from prescribed medications/treatments, promptly and accurately documenting noted changes, and reporting any deviations from normal to RN or MD/DO. Knowledge and ability to recognize urgent or emergent patient care situations, seek assistance of the RN and/or MD/DO, and initiate appropriate emergency interventions as directed. Knowledge and understanding of human behavior, patient motivations and reactions to situations, and ability to appropriately utilize this knowledge in working effectively with patients, family members, and other staff. Establishes constructive relationships with individual patients and their families to elicit feelings and attitudes, and to promote positive relationships, communication and socialization skills. Fosters an environment of respect for individual patient and family rights to privacy and dignity in all aspects of care delivery. Effectively incorporates knowledge and understanding of established customer service standards in all interactions with patients, family members, and/or other internal/external customers. Knowledge and skill in performing support duties for complex diagnostic tests and/or specialized practices or procedures, which include preparing the patient, assisting in the diagnostic examination, preparing and handling specialized instruments or other specialized equipment, and monitoring the patient's condition before, during, and following the procedure. Serves as a preceptor in orienting, educating, and training less experienced LPNs/LVNs or NAs/HTs related to support duties for these more complex, specialized tests/procedures. Actively seeks out educational opportunities to enhance nursing knowledge and skills, sharing new knowledge gained with other staff to improve and advance nursing practice. References: VA Handbook 5005/3, Part II, Appendix G13 The full performance level of this vacancy is GS-06. The actual grade at which an applicant may be selected for this vacancy is in the range of GS-03 to GS-06 Physical Requirements: Requires potentially long periods of continues walking, standing, stooping, sitting, bending, pulling, and pushing. Transferring patient and objects may be required. ["Oversees a full range of nursing care to patients with complex care needs utilizing the nursing process based on the ANA Standards of Nursing Practice. Demonstrates ability to prioritize delivery of care which considers the patient's and unit needs. Administers treatment based on the plan of care with supervision. Uses a team approach to identify, analyze, and resolve patient care problems that result in improved patient outcomes. Participates in team meetings, conferences, and huddles. Recognizes emergencies and acts appropriately to get assistance. Reinforces education initiated by RN to patient/family/significant other. Participates appropriately in the staging of all clinic patients including: pre-visit phone calls, completion of new patient forms, initiates medication reconciliation, and provides discharge instructions per the After-Visit Summary (AVS). Accurately documents in the medical record patient findings, evaluations, and care provided. Practice follows the ANA Code of Ethics for Nurses. Treats all patients, families, and co-workers with dignity and respect and maintains professional boundaries with patients, families, and employees. Acts as a patient advocate when patient self-determination is questioned. Safeguards patient privacy and maintains confidentiality of all electronic and printed patient information. Identifies potential and actual problems involving resources and/or safety. Effectively plans patient care and nursing resources for maximum staff productivity, staff and time efficiency, and positive patient outcomes. Consults with other disciplines for post-discharge care reducing hospital readmission. Demonstrates leadership with compliance with infection control practices. Complies with safety rules and regulations for safe job performance and fire protection. Practices safe body mechanics and uses mechanical devices, and/or requests help when needed. Promptly reports all accidents to and notifies appropriate parties of unsafe or unhealthy environmental situations/conditions including broken equipment. Corrects safety hazards promptly. Conserves resources effectively by using supplies and equipment in a responsible manner. Updates patient problem list upon any new diagnosis for appropriate coding of medical issues. Appropriate utilization of LPN clinic visits with 75% documentation of productivity, Secure Messaging, and or VA Video Connect. Utilizes software program Patient Care Assessment Systems (PCAS) in coordination of timely accurate coordination of patient care. Provides timely and effective coordination and communication with other services. Accurately updates medical record, problem list, and codes nurse visits appropriately based on input from other medical departments, home health agencies, non-VA community partners. Self-directed in seeking opportunities to increase knowledge and staff development activities and has an identified educational plan the he/she can articulate. Evaluates unit performance as measured against TJC standards and acts to correct deficits to ensure compliance as part of continued readiness. Recognizes changes in the patient's condition, behavior and /or comfort. Reports observations and interventions to the RN or PCP and records observations and interventions in the electronic medical record. Takes and records vital signs (blood pressure, pulse, respirations, and pulse oximetry) including pain level. Reports abnormal vital signs and pain level immediately to RN or PCP. Demonstrates positive effective communication skills and professional behaviors that promote cooperation and teamwork with internal and external customers. Refers and consults with the multi-professional healthcare team and integrates recommendations for continuing patient care into the plan of care. Encourages and supports patients and families to participate in care and decision-making at the level they choose. Collaborates with patients, families, health care practitioners, and health care leaders in policy and program development, implementation, and evaluation, as well as in the delivery of care. Educates colleagues and/or students. Complies with established policies and procedures in the preparation of, administration of and documentation of medications. Recognizes side effects of medications; reports observations to the RN or PCP immediately. Demonstrates proficiency using the Omini-cell system and documents in the medical record. Complies with established policy and procedure for inventory and administration of narcotics. Assists the RN in checking emergency equipment. Work Schedule: Monday - Friday, Schedule varies based on needs of the Service. Telework: Not Available Virtual: This is not a virtual position. Functional Statement #: 50561-A, Relocation/Recruitment Incentives: Not Authorized Permanent Change of Station (PCS): Not Authorized Financial Disclosure Report: Not required"]
Providing Health Care for Veterans: The Veterans Health Administration is America’s largest integrated health care system, providing care at 1,255 health care facilities, including 170 medical centers and 1,074 outpatient sites of care of varying complexity (VHA outpatient clinics), serving 9 million enrolled Veterans each year.