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. Education: (1) A degree in nursing from a school of professional nursing approved by the appropriate state accrediting agency and accredited by one of the following accrediting bodies at the time the program was completed by the applicant:(a) The National League for Nursing Accrediting Commission (NLNAC), an accrediting arm of the National League for Nursing. Additional information may be obtained from the NLNAC Web site; or (b) The Commission on Collegiate Nursing Education (CCNE), an accrediting arm of the American Association of Colleges of Nursing (AACN). Additional information may be obtained from the CCNE Web site. (c) In cases of graduates of foreign schools of professional nursing, possession of a current, full, and unrestricted registration and the possession of a Certificate from the Commission on Graduates of Foreign Nursing Schools (CGFNS) will meet the requirement of graduation from an approved school of professional nursing.(2) Graduate of an accredited nurse anesthesia educational program approved by the American Association of Nurse Anesthetists (AANA) at the time the program was completed by the applicant. Registration: (1) Condition of Employment. 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. The nurse anesthetist must maintain a current, full, active and unrestricted registration to continue employment with VA. Certification: (1) On and after May 4, 1993, certification by the Council on Certification of Nurse Anesthetists is a requirement for employment. This requirement does not apply to non-certified nurse anesthetists employed by VA as a nurse anesthetist prior to May 4, 1993 and continuously thereafter. Any nurse anesthetist who leaves VA employment or vacates the nurse anesthetist occupation for another VA position, must meet the current requirement of certification for re-appointment as a nurse anesthetist. (2) Nurse Anesthetists will maintain recertification by meeting the Council on Recertification of Nurse Anesthetist's requirements as a condition of employment. Grandfathering Provision. All nurse anesthetists employed in VHA on the effective date of this qualification standard are considered to have met all qualification requirements for the title, series and grade held, including positive education and licensure/certification/registration that are part of the basic requirements of the occupation. Recent Graduates. (1) A graduate nurse anesthetist who has applied to take the national Certification Examination (NCE) and has been declared Certification Eligible may be given a temporary appointment for a period not to exceed one year as a graduate nurse anesthetist. The graduate nurse anesthetist must take the NCE at the earliest schedulable date following the date of their temporary appointment. (2) Failure to become certified within the one-year period will result in removal as a nurse anesthetist and may result in termination from employment. English Language Proficiency. Proficient in spoken and written English. Grade Determinations: Entry Level: (Nurse II) (a) Experience and Education. None beyond the basic requirements. (b) Demonstrated Knowledge, Skills and Abilities. The following list of knowledge, skills and abilities present the minimum skill set expected of an Entry Level Nurse Anesthetist. Entry level into nurse anesthesia practice may include but are not limited to the following: 1. Ability to translate the principles of professional nursing practice in the care of assigned patients in order to provide appropriate care. 2. Ability to do a pre-anesthetic patient history and physical, which includes collecting pre-operative consults and data. 3. Ability to formulate an anesthetic plan and describe the anesthetic risks, benefits and options to the patient. 4. Ability to administer inhalation, regional, intravenous, local, and topical anesthetics and to detect unfavorable reactions in order to continuously evaluate the patient's physical status. 5. Ability to respond to emergency situations by providing airway management, administration of emergency fluids and drugs, and using appropriate resuscitation procedures for patient care. 6. Ability to provide patient care that is abreast of changing concepts and advancements in the profession. 7. Ability to work effectively in an interdisciplinary environment for improvement of services for patient care. 8. Ability to practice nurse anesthesia with colleagues and peers utilizing a collaborative team concept of anesthesia care. Full Performance Level: (Nurse III) Experience and Education. Basic requirements plus progressively responsible experience in the administration of anesthetics as indicated in the knowledge, skills and abilities listed below. These individuals must demonstrate the ability to participate in a program for nurse anesthesia care and demonstrate knowledge of anesthetizing locations, methods, equipment and procedures. At this level, the CRNA has experience in the administration of anesthetics that has demonstrated the nurse anesthetist's ability to participate in team programs that are technically challenging and/or complicated. Typically, candidates can demonstrate the knowledge, skills and abilities of Full Performance Level within 2 years from entering the occupation. Demonstrated Knowledge, Skills, and Abilities 1. Skill in conducting and managing anesthesia for a broad range of complex surgical procedures. In addition, the CRNA must be able to adapt/modify anesthesia techniques in order to optimize patient care. 2. Ability to complete work assignments selected to add depth and breadth to their technical knowledge and skill competence. Work assignments will vary at each facility depending on the progressive acuity required for anesthesia care. 3. Ability to respond to emergency situations by providing airway management, administration of emergency fluids and drugs, and by the use of basic or advanced cardiac life support techniques in order to perform necessary resuscitation procedures. 4. Ability to effectively blend technology, skills, and competency for the advancement of anesthesia techniques, pharmacology, and equipment. 5. Ability to apply new developments and theories to develop and demonstrate the ability to recognize and solve various complex anesthesia situations. 6. Ability to practice nurse anesthesia with colleagues and peers in a team concept of anesthesia care and blend management skills with technical experience. 7. Ability to recognize clinical and technical aspects of anesthesia care and has in-depth knowledge of anesthesia methods and techniques for the practice of anesthesia. 8. Ability to perform as a mentor, preceptor, or nurse educator providing didactic and clinical instruction for graduate-level nurse anesthesia students and/or other anesthesia care providers. 9. Ability to participate in the development of anesthesia patient care audit processes involving in depth review and analysis of anesthesia records. 10. Ability to provide guidance and instruction in preparing others for positions of leadership and ethical practices which impact patient care. References: VA Handbook 5005/27, Part II, Appendix G7. The full performance level of this vacancy is VN-3. The actual grade at which an applicant may be selected for this vacancy is in the range of VN-2 to VN-3. Physical Requirements: The position will require walking, standing or sitting for periods of up to or beyond 10 to 12 hours each day. ["The VA Midwest Health Care Network advocates for a Whole Health System of care in each of the Medical Centers. This is an approach to healthcare that empowers and equips people to take charge of their health and well-being and live their lives to the fullest. As an employee operating in a Whole Health System of care, you will operate in a model with three core elements, seeking to create a personalized health plan for each Veteran. This is done in the context of healing relationships and healing environments and a connection back to the Veteran's community. This aligns with the Veterans Health Administration (VHA) Mission Statement to Honor America's Veterans by providing exceptional health care that improves their health and well-being. Nebraska Western Iowa VA Health Care System is currently seeking a CRNA to join Surgical Care which includes general surgery, vascular surgery, ophthalmology, audiology, cardiology, dentistry, orthopedics, podiatry, and urology. Special procedure anesthesia care is also provided to other service lines. The incumbent ensures quality and timeliness of services provided, customer satisfaction, and compliance with standards of accrediting bodies such as Joint Commission and Inspector General's Combined Assessment Program. CRNA is authorized to perform routine duties on a regular, repetitive basis. These duties include, but are not restricted to: Provision of care in the most complex surgical procedures. Perform and document a preanesthetic evaluation of the patient before surgery including requesting consultations, additional diagnostic and/or laboratory studies within the scope of practice, consulting with the anesthesiologist for further preoperative work up when necessary. Initiation of the planned anesthetic technique that may include general, regional, MAC, or local anesthesia. Interventions include administration of fluids, medications, ventilator support, provision of homeostasis, provision of adequate pain relief and management of anesthesia and surgical side effects. Induction of general anesthesia and initial airway management. Endotracheal intubation for surgical or procedural cases. Placement of endobronchial tubes or blockers for procedures requiring one lung ventilation or lung isolation. Central line placement; Pulmonary artery (Swan-Ganz) catheter placement Peripheral nerve blocks. Central neuroaxial blocks. Epidural blood patches. Adjustment of anesthetic drugs and techniques utilized in the maintenance of anesthesia. Sedation for field blocks or MAC as discussed in the anesthetic care plan. Manages emergence from anesthesia and transition to the post anesthesia care unit. Provide anesthetic for: electroconvulsive therapy not requiring intubation; routine eye surgery not requiring general anesthesia; elective cardioversions; ICD checks. May participate on the Code Blue Team, primarily to manage the patient's airway, but also to perform other tasks which they are qualified to perform, as directed by the Code Team Leader. Emergency airway management throughout the facility, following the ASA Difficult Airway Algorithm and department protocols, as requested. Work Schedule: Monday-Friday, 0700-1530, Rotating On Call schedule/Weekend coverage. Additional information may be provided during the interview process.\nRecruitment/Relocation incentive: Authorized\nADHOC: May be authorize (Employee who Telework on an occasional, episodic, or short-term, and have completed required telework training and telework agreement). This is not a virtual position.\nFinancial 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.