The Domiciliary Residential Rehabilitation Unit (DOM) is residential rehabilitation program focusing on physical, mental, social, rehabilitative, & vocational services. It is a 194 bed unit; staffing mix consists of Registered Nurses and Licensed Vocational Nurses. The LVN performs within this functional statement under close supervision of the Nurse Manager or designee. Assigned tasks require basic technical competence and skill. Citizenship. Citizen of the United States. (Noncitizens may be appointed when it is not possible to recruit qualified citizens in accordance with Chapter 3, Section A, paragraph 3g, this part.) 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 [Accrediting Commission (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. Additional information may also be obtained from the NLNAC Website. Exceptions include: 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. VHA employees who were converted to appointments under 38 U.S.C. 7401(3) in implementation of Public Law 98-160, enacted November 21, 1983, and for VHA employees converted to appointments under 38 U.S.C. 7405 in implementation of Public Law 99-576, enacted October 28, 1986; and for their future personnel actions under this authority. The waiver will not apply to persons appointed under 38 U.S.C. 7401(3) or 7405 after these conversions. Individuals granted a license by a jurisdiction that does not require graduation from an approved school. See paragraph 4, section C. 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. Physical Standards. See VA Directive and Handbook 5019. 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: In addition to the basic requirements stated above, the following qualification criteria must be met for each grade. The candidate's qualifications must clearly demonstrate the level of competence required for the grade. 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 in paragraphs below: (a) Six months of qualifying experience as an LPN or LVN; or (b) Graduation from an approved school (which may be waived as provided in paragraph 4 of Section C) 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 (c) Graduation from an approved school of at least 24 months duration. (d) LPNs at the GS-4 grade level perform all duties expected of employees at the GS-3 grade level; however, they are expected to exercise greater judgment, require less supervision, and to operate in accordance with all established policies, procedure, and techniques. GS-5. (a) Completion of at least 1 year of qualifying experience at the GS-4 level or equivalent. (b) 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 Nursing Assistants (NAs)/Health Technicians (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. (c) 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. (d) 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. (e) 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. (f) Recognizes and appropriately responds to breakage/malfunction or loss of equipment, safety hazards, and supply deficiencies, promptly reporting to appropriate personnel for corrective action. (g) 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 (a) Completion of at least one (1) year of additional qualifying experience at the GS-5 level or equivalent, fully meeting all performance requirements for the GS-5 LPN/LVN. (b) Technically proficient in initiating, performing and completing assigned duties in providing care to variable patient populations. (c) 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. (d) 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. (e) 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. QUALIFICATIONS CONDITINUED UNDER THE "ADDITIONAL INFORMATION' TAB ["CTVHCS is in the process of making a cultural change, shifting from a disease-focused approach to a health and wellbeing approach, in order to implement the Whole Health System of Care. This is a VA-wide initiative to provide a comprehensive and systematic approach to improve healthcare delivery at all stages of Veteran care. This entails moving from an episodic, \"siloed\" approach to an interdisciplinary, holistic approach, emphasizing self-care in the larger context of well-being. All staff in this facility will be part of this process, shifting the focus from the question, \"What's the matter with you?\" to the question, \"What matters to you, and how can we help you live your best life?\" This strategy also involves integrating a full range of conventional approaches with Complementary and Integrative Health (CIH) approaches in order to optimize lifelong health and well-being, as defined by the Veteran, rather than narrowly focusing on disease management. Major Duties as Assigned, but not limited to: CLINICAL PRACTICE Performs and documents focused assessment and reports abnormal findings to the Charge Nurse, Nurse Manager and/or RN Team Leader. As the Charge Nurse, the LVN within their scope of practice, effectively assigns, manages and directs other LVNs and Nurses' Aides in the delivery of patient/resident care. The LVN demonstrates the ability to assign patients/residents care needs and the capability of the staff to meet those needs. Demonstrates a basic 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. The LVN demonstrates technique in performing, reporting, and recording assigned nursing care, including, but not limited to: Administers oxygen therapy Medication administration to include IV medication if certified Completes clinical reminders with appropriate consults and alerts as indicated COMMUNICATION Demonstrates basic skill in identifying the individual's level of understanding and teaching the client and/or significant other about the basic concepts to his/her disease process, utilizing the standards of care and documenting client's response. Provides verbal and/or written information in a timely manner that is accurate, using clear and precise communication methods to ensure that customers understand. Makes observations and documents care and the patient's response. Appropriately seeks assistance and guidance by informing RN or medical provider of changes in the patient's condition requiring higher-level intervention. Basic knowledge in the use of various computer packages to enter and retrieve electronic data, i.e., CPRS, VISTA, mailman, leave requests, and patient information (progress notes, patient education, etc.). Demonstrates knowledge of human behavior, motivations, and reactions to situations and uses this knowledge in working effectively with patients, family and other staff members. Demonstrates courteous, compassionate, caring, and respectful behavior when interacting with all others. COLLABORATION/COLLEGIALITY Demonstrates a variety of basic communication skills and professional behaviors that promote cooperation and teamwork with internal and external customers. Practices good customer service in all work activities. Displays courtesy, empathy, tact, and respect for patients, families/significant others, and hospital staff. Remains calm in stressful situations Completes orientation and accepts responsibility for maintaining clinical competence and knowledge of current nursing practice. Seeks out educational opportunities to enhance nursing knowledge and skills. PROGRAM/ORGANIZATIONAL GOALS Supports the mission, vision, and values of the Healthcare system. Completes annual nursing mandatory reviews and continuous learning requirements. Demonstrates understanding for age- and population-specific characteristics that affect the health care needs of the Veteran. Complies with infection control practices, such as hand washing and wearing of appropriate personal protective equipment. Demonstrates safe work practices. Complies with safety rules and regulations for safe job performance and fire protection. Follows policy and procedures related to fire and disaster drills, safety and security measures. Work Schedule: 7:30am - 4:30pm, 3:30pm - 12:00pm, 11:30pm - 8:00am, rotating weekends/holidays; 3:30p.m-12mn; 11:30p.m.-8:00a.m..; The position requires flexibility in schedule and assignments. 24 hours operational to include weekends/holidays. Telework: Not Available Virtual: This is not a virtual position. Permanent Change of Station (PCS): Not Authorized Financial Disclosure Report: Not required"]
The Veterans Health Administration is America’s largest integrated health care system, providing care at 1,298 health care facilities, including 171 medical centers and 1,113 outpatient sites of care of varying complexity (VHA outpatient clinics), serving 9 million enrolled Veterans each year.