This position is for a Licensed Practical Nurse, located in the Primary Care Service at the VA Bedford Healthcare System in Gloucester, MA. This position is full-time at 40 hours per week. This position serves as a Licensed Practical Nurse for primary care. The incumbent may serve in a medical center, community-based outpatient clinic (CBOC), mobile medical unit or may have virtual/remote assignments, floating to other clinics as needed. 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. English Language Proficiency. Licensed practical or vocational nurses appointed to direct patient care positions must be proficient in spoken and written English as required by 38 U.S.C. 7402(d), and 7407(d). 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/accredited by the National League for Nursing Accrediting Commission (NLNAC) at the time the program was completed by the applicant. GRADE DETERMINATIONS: In addition to the basic requirements for employment, the following criteria must be met when determining the grade of candidates. GS-3 Grade Level: None beyond the basic requirements. GS-4 Grade Level: Experience. Six months of experience as an Licensed Practical Nurse OR, One year 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, Education. Graduation from approved school of at least 24 months duration. GS-5 Grade Level: Experience. At least 1 year of qualifying experience at the GS-4 level or equivalent, AND, In addition to the experience above, the candidate must demonstrate all of the following Knowledge, Skills and Abilities (KSAs): Demonstrated knowledge and ability to provide a full range of practical nursing care to patients with a variety of physical and/or behavioral problems. Demonstrated ability to serve as a responsible member of the nursing team and interact with patients, family members, professional and 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. GS-6 Grade Level: Experience. At least 1 year of qualifying experience at the GS-5 level or equivalent, AND, In addition to the experience above, the candidate must demonstrate all of the following Knowledge, Skills and Abilities (KSAs): 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. Ability to observe, identify and respond to the patient's needs for care, including medication, equipment-assisted care and patient/family education. 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 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. The full performance level of this vacancy is GS-6. The actual grade at which an applicant may be selected for this vacancy is in the range of GS-3 to GS-6. PHYSICAL REQUIREMENTS: This position requires visual acuity, keen hearing, clear distinctive speech, and manual dexterity. This position requires potentially long 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 or operative/invasive procedures. The incumbent may occasionally be exposed to patients who are combative secondary to delirium, dementia, or psychiatric disorders. The incumbent must be flexible and sensible individual capable of working effectively in stressful situations, able to shift priorities based on patient needs. Must complete Employee Health requirements. 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). Reference: For more information on this qualification standard, please visit https://www.va.gov/ohrm/QualificationStandards/. ["This position is eligible for the Education Debt Reduction Program (EDRP), a student loan payment reimbursement program. You must meet specific individual eligibility requirements in accordance with VHA policy and submit your EDRP application within four months of appointment. Program Approval, award amount (up to $200,000) and eligibility period (one to five years) are determined by the VHA Education Loan Repayment Services program office after complete review of the EDRP application. Former EDRP participants ineligible to apply. Major Duties in addition to basic LPN duties include, but are not limited to: Performs observation-based screening and collects patient information in collaboration with licensed personnel. Completes clinical reminders, obtains patient health history, chief complaints, medication history, and identification of health-related conditions that may impact the patient's health status. Completes approved templates and tools, such as the outpatient intake form, normal result notes, and follow up treatment. Assists licensed personnel with crisis intervention, management of aggressive or suicidal psychiatric patients, by providing one-to-one observations and applying prevention and management of disruptive behavior techniques (PMDB). Maintains a safe and therapeutic environment for the patient while promoting a sense of worth and dignity under the supervision of the licensed personnel. Assists licensed staff with preparing patients for medical evaluation, setting up equipment, passing instruments and providing treatment during in-person or virtual visits. Operates specialized medical equipment to obtain diagnostic and therapeutic outcomes. Collects a wide range of specimens and preparing them for transfer to processing. Observes patient status and Clinical responsibilities include but are not limited to: Vital signs. Examples: vital signs, 12-lead electrocardiogram (EKG). Point-of-care. Examples: Abbott hand-held blood analyzer (I-STAT), glucometer. Equipment and surgical instrumentation set up. Examples: skin biopsies (excisional, shave, punch). Treatments and interventions. Examples: Cryotherapy, incision and drainage, ambulation, and Foley coude' catheter insertion. Wound care. Examples: bandaging, application of dressings and wound measurements. Specimen collection and Preparation. Examples: collecting and labeling venous blood samples and mucous specimens. Assisting with patient exams and screening. Examples: gynecology exams. Mental health care. Examples: Crisis intervention, performs behavioral/mental health screens, conducts interviews, and observes behavioral patients. Preparation of lab specimens and transfer to the lab for processing. Examples: Labeling, placing in the proper bin or tube system. Utilizing technology such as telehealth peripherals. Examples: primary care physical exams (heart, eye, ear, nose, throat (EENT); gait exams, and skin exams. Patient education within scope of care or while providing an intervention. Examples: postprocedural care, splint care and wound care. Follow-up care: Examples: Suture removal. Electronic Health Record (EHR): Thoroughly and appropriately documents actions, interventions and procedures in the medical record. Examples: Procedural notes, progress notes, screenings, photo-documentation and secure messaging. Administration methods may include intramuscular, oral, topical, eye drops, ear drops, intranasal, rectal suppositories, local anesthetics, nebulized medications, subcutaneous, and intradermal. Follows national and local pharmacy and facility guidelines for disposal of medications. Work Schedule: Full-time. Monday-Friday, 7:30am-4:00pm Telework: Ad-Hoc Virtual: This is not a virtual position. Functional Statement #: 518-F2054/F2055/F2056/F2057 Relocation/Recruitment Incentives: Not Authorized. EDRP Authorized: Contact Karen Chapman, karen.chapman@va.gov, the EDRP Coordinator for questions/assistance. Former EDRP participants ineligible to apply. Learn more Permanent Change of Station (PCS): Not Authorized. Financial Disclosure Report: Not required. This position is in the Excepted Service. Due to a critical staffing shortage, 38 U.S.C. § 7412 waives the requirement to apply Veterans' preference for this job announcement. This position is a NAGE Bargaining Unit position. This position is covered by a special rate. Narrative responses to the knowledge, skills and abilities (KSAs) may be required from the selectee in order to proceed with the appointment. Veterans' preference does not apply for internal or other current permanent Federal agency employees. Current and former Federal employees must submit copies of their most recent SF-50, (Notice of Personnel Action). The SF-50 must identify the position title, series, grade, step, tenure and type of service (Competitive or Excepted). In some cases, more than one SF-50 may be required to show a higher grade previously held."]

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