Registered Nurse-Emergency Department

01Basic Requirements

English Language Proficiency. In accordance with 38 U.S.C. 7403(f), no person shall serve in direct patient care positions unless they are proficient in basic written and spoken English.

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); OR Individuals attending a master's level bridge program in nursing who have completed coursework equivalent to a bachelor's level degree in Nursing may have opportunity to become registered as a nurse with a state licensing board prior to completion of the bridge program.

Upon achievement of a State license, the individual may be appointed on temporary basis and later converted to a permanent appointment upon successful completion and graduation from the bridge program. (Reference VA Handbook 5005, Appendix G6); OR In cases of graduates of foreign schools of professional nursing, possession of a current, full, active, and unrestricted registration will meet the requirement for graduation from an approved school of professional nursing to warrant an appointment as a Nurse who has completed an associated degree/entry level Nursing education program.

Credit for foreign nursing education higher that associate degree/entry level requires a formal degree equivalency validation from a recognized equivalency evaluation accepted by VA such as International Consultants of Delaware (ICD). Current, full, active, and unrestricted registration as a graduate professional nurse in a State, Territory or Commonwealth (i.e., Puerto Rico) of the United States, or the District of Columbia.

Graduate Nurse Technician (GNT) Exception: Candidates who otherwise meet the basic education requirements, but do not possess the required licensure, may be appointed at the entry step of the grade and level applicable to the completed nursing education as a GNT on a 120-day temporary appointment while actively pursuing licensure (may be extended up to two years on a case-by-case-basis.) NOTE: Grandfathering Provision - All persons currently employed in VHA in 0610 series and 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.

02Grade Determinations

The following Scope, Education and Dimension criteria must be met in determining the grade assignment of candidates, and if appropriate, the level within a grade. The Dimension requirements (Practice, Veteran/Patient Driven Care, Leadership, Professional Development and Evidence-Based Practice/Research) are detailed for each grade and level within the online assessment: https://apply.usastaffing.gov/ViewQuestionnaire/13113266.

Grade/Level Scope Education Nurse I, Level I Delivers fundamental, knowledge-based care to assigned clients while developing technical competencies. An Associate Degree (ADN) or Diploma in Nursing, with no additional professional nursing required. Nurse I, Level II Demonstrates integration of biopsychosocial concepts, cognitive skills and technically competent practice in providing care to clients with basic or complex.

An ADN or Diploma in Nursing AND 1 year of specialized nursing experience equivalent to Nurse I, Level 1 ;OR a Bachelor of Science in Nursing (BSN) with no additional professional nursing experience required. Nurse I, Level III Demonstrates proficiency in practice based on conscious and deliberate planning. Self-directed in goal setting for managing complex client situations.

An ADN or Diploma in Nursing AND 2 years of professional nursing experience in which one year is equivalent to Nurse I, Level 2; OR a BSN and 1 year of professional nursing experience equivalent to the Nurse I, Level 2; OR a Master's degree in nursing (MSN) and no additional professional nursing experience; OR a Master's degree in a *related field with a BSN and no additional professional nursing experience.

Nurse II Demonstrates leadership in delivering and improving holistic care through collaborative strategies with others.

A BSN with 2 years of professional nursing equivalent to Nurse I, Level 3; OR an MSN with one year of specialized nursing experience equivalent to Nurse I, Level 3; OR a Master's degree in a related field with a BSN and one year of specialized nursing experience equivalent to Nurse I, Level 3; OR a Doctoral degree in Nursing with no professional nursing experience; OR a Doctoral degree in a related field with a BSN with no additional professional nursing experience.

Nurse III Executes position responsibilities that demonstrate leadership, experience and creative approaches to management of complex client care beyond the immediate practice setting.

MSN and 2 years of specialized nursing experience, one of which is equivalent to Nurse II and meets all dimension requirements for Nurse III; OR a Master's degree in related field with BSN and two years of specialized nursing experience, one of which is equivalent to Nurse II and meets all dimension requirements for Nurse III; OR a Doctoral degree in Nursing with and one year of specialized nursing experience equivalent to Nurse II and meets all dimension requirements for Nurse III; OR a Doctoral degree in a related field with a BSN and one year of specialized nursing experience equivalent to Nurse II and meets all dimension requirements for Nurse III. *Note: Foreign education programs/degrees are not creditable as related degrees.

03Preferred Experience

Previous experience in Acute Care, Emergency Department, or Acute Care setting BSN preferred Reference: For more information on this qualification standard, please visit https://www.va.gov/ohrm/QualificationStandards/.

04Physical Requirements

It is VA policy to ensure that all selected applicants and employed personnel are physically, mentally and emotionally fit to perform the duties of the position to which assigned. A pre-placement physical examination is required for all fulltime, part-time and intermittent employees identified by VA Directive and Handbook 5019. The pre-placement physical examination shall be completed prior to appointment to determine the physical and mental fitness for candidates for appointment in VA.

The examination will be concerned with the mental and physical ability of the applicant to satisfactorily perform the duties of the proposed assignment and will include requisite laboratory and other screening as required by Federal regulatory agencies. 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.

This position requires that you are able to lift at least 50 lbs. 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 a mature, flexible, sensible individual capable of working effectively in stressful situations, able to shift priorities based on organizational needs. Must complete annual Employee Health requirements, such as annual Influenza vaccination, TB screening or testing, as a condition of employment.

The Registered Nurse utilizes the nursing process to: Provide a safe and supportive environment for patients, staff and others; Use and direct others to use equipment safely and appropriately; Incorporate the age, gender, cultural and learning needs of patients and family requiring complex planning and evaluation of care; Apply and direct others to apply infection control measures appropriately in delivering care; Identify and analyze problems which effect/impede patient care and initiate their resolution; Participate in coordinating patient care and collaborating with other disciplines/departments to achieve patient care outcomes; Adhere to ethical principles and nursing standards in delivering care; Serve as a resource and guide to patients, families and other staff in providing patient care; Use effective communication skills with individuals and groups to achieve desired patient outcomes.

RN's are required to be competent in the standards of practice for the care of all patients in the ED. Duties include, but not limited to the following: Proficient with obtaining initial assessment of patient condition and response to treatment and initiates follow-up as needed. Triages patients using the Emergency Severity Index (ESI).

Demonstrates clinical expertise in the care of emergent and non-emergent patients including the incorporation of head-to-toe assessments with knowledge of normal versus abnormal findings and ability to report findings to Charge Nurse, MD, NP and/or PA as warranted. Provides leadership in the application of the nursing process to patient care, organizational processes and/or systems, improving outcomes at the program or service level Administers medication safely and accurately.

Responsible for assesses, developing and implementing a plan to meet learning needs, instructing patients and families in basic health teaching and discharge planning. Proficient in providing nursing care for patients placed on cardiac monitors and proficient in the identification of cardiac dysrhythmias including but not limited to: symptomatic bradycardia, frequent or paired or multifocal PVC's, ventricular tachycardia, ventricular fibrillation, pulseless electrical activity, and asystole.

Pay: Competitive salary, regular salary increases, potential for performance awards Licensure: 1 full and unrestricted license from any US State or territory. Work Schedule: Intermittent-as needed based on the needs of the service. Telework: Not available. Virtual: This is not a virtual position. Relocation/Recruitment Incentives: Not authorized. Permanent Change of Station (PCS): Not Authorized. Pay Schedule: N00T