Advanced Practice Nurse (Nurse Practitioner) - Primary Care (Float)

This position is eligible for the Education Debt Reduction Program (EDRP), a student loan payment reimbursement program. You must meet specific eligibility requirements per VHA policy and submit your EDRP application within four months of appointment. Program Approval, award amount (up to $200,000) & eligibility period (one to five years) are determined by the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible to apply.

DUTIES:

• Provide short or long-term coverage for a panel of patients in the primary care service.
• Require intermittent and often frequent travel to various locations.
• Provide walk-in coverage, assist with performance improvement activities to improve quality metrics, conduct virtual care visits to other locations, or assist with other clinical duties as assigned.
• Performs independently or in collaboration with the provider to carry out the plan of care for the Veteran.
• Delegates to other Patient Aligned Care Team (PACT) members, but is responsible for diagnosing and treating medical problems, care coordination to higher level of care, and making complex clinical decisions.
• Serve as the leader of the PACT teamlet, that consists of an RN, LPN/Clinical Associate, and Advanced Medical Support Assistant (AMSA).
• Optimizes care delivery and provides care to patients with acute problems, patients undergoing transitions of care, and patients with chronic conditions who would benefit in developing and performing self-management skills for chronic conditions especially diabetes, hypertension, CHF, hyperlipidemia, pain, and depression.
• Utilizes motivational interviewing techniques to facilitate patient development of patient driven goals for health optimization and will be required to attend a formal Motivational Interviewing course.
• Demonstrate leadership in delivering and improving holistic care by utilizing health promotion and disease prevention and whole health strategies.
• Uses face to face, telephone, and video virtual care visits, and secure messaging, to provide care to patients.
• Develops the appropriate plan of care and tracks patient outcomes to determine if interventions are effective.
• Document timely, appropriately, and effectively in the medical record; ensure the patient's care plan contains medical recommendations for clinically indicated care; and communicate test results and plans of care to patients or ensure this is accomplished by clinical support staff in a timely and effective manner.
• Performs clinical assessments; triages face to face or virtually; in collaboration with the patient to identify goals for optimizing health; provides patient/family education to improve outcomes, evaluates patient's progress or lack of progress toward achieving goals; and performs case management activities and care coordination activities for those patients assigned to the team who require those services.
• Participate in team performance improvement and sustainment activities to optimize team efficiency and care delivery; provide leadership to the PACT including shared delegation of appropriate care and care processes to appropriate team members.
• Report directly to the Primary Care Director and/or Associate Chief of Staff of Primary Care.
• Other duties assigned

VA offers a comprehensive total rewards package: VA Nurse Total Rewards

Pay: Competitive salary, regular salary increases, potential for performance awards
Paid Time Off: 50 days of paid time off per year (26 days of annual leave, 13 days of sick leave, 11 paid Federal holidays per year)
Retirement: Traditional federal pension (5 years vesting) and federal 401K with up to 5% in contributions by VA
Insurance: Federal health/vision/dental/term life/long-term care (many federal insurance programs can be carried into retirement)
Licensure: 1 full and unrestricted license from any US State or territory

Work Schedule: 7:30am-4:00pm or 8:00am- 4:30pm Monday- Friday, some weekends and evenings based on the needs of service.
Telework: Ad-hoc
Virtual: This is not a virtual position.
Relocation/Recruitment Incentives: Not Authorized
EDRP Authorized: Former EDRP participants ineligible to apply for incentive. Contact vhaedrpprogramsupport@va.gov, the EDRP Coordinator for questions/assistance. Learn more
Permanent Change of Station (PCS): Not Authorized
Financial Disclosure Report: Not required

Advanced Practice Nurse (Nurse Practitioner) Basic Requirements

• Education: A post-master's certificate or master's or doctoral degree as a Nurse Practitioner. (Applicants pending the completion of educational requirements may be referred and tentatively selected but may not be hired until the education requirements are met.) Must be a 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).
  • NOTE: Foreign Education. Graduates of foreign schools of professional nursing programs, the nurse practitioner degree equivalency must be validated through an Agency recognized degree equivalency evaluation agency, such as the International Consultants of Delaware (ICD). Candidates with equivalent nurse practitioner masters or doctorate level degrees who possess current, full, active, and unrestricted registration and certification will meet the requirement of graduation from an approved school of professional nursing to warrant appointment.
• License - All APN (NPs) must possess and maintain an active, current, full, and unrestricted APN license to practice as an NP in a State, Territory or Commonwealth of the United States, or in the District of Columbia.
• Basic Board Certification - All APN (NPs) must maintain full and current basic board certification in one of the following: Family Nurse Practitioner (FNP), Adult Nurse Practitioner (ANP), Adult-Gerontology Primary Care Nurse Practitioner (AGPCNP), Acute Care Nurse Practitioner (ACNP), Adult-Gerontology Acute Care Nurse Practitioner (AGACNP), or Gerontology Nurse Practitioner (GNP) from one of the following: the American Nurses Credentialing Center (ANCC), American Academy of Nurse Practitioners Certification Board (AANPCB), or other nationally recognized certifying body in the area in which the Nurse Practitioner is academically prepared.

NOTE: Grandfathering Provision - All persons currently employed in VHA in 0610 series and an APN (NP) assignment that are also 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.

The following Scope, Education and Experience, and Dimension criteria must be met to qualify for Advanced Practice Nurse (Nurse Practitioner) II:
Exception to Licensure for Graduate Nurse Technicians. Candidates who otherwise meet the basic requirements, but do not possess the required licensure and/or certification, may be appointed at the entry step of the Nurse II, as a Graduate Nurse Technician - Nurse Practitioner on a temporary appointment up to any period not-to-exceed one year and a day under the authority of 38 U.S.C. § 405(c)(2)(B).

• Scope: Demonstrates leadership in delivering and improving holistic care through collaborative strategies with others
• Education and Experience Requirement: Meets basic education requirement for APN (NP). Nurse II is considered the entry grade level for APN (NPs); no experience is required.
• Dimension Requirement: APNs (NPs) at level II are expected to meet the following dimension requirements:
  • Clinical Practice. Delivers evidence-based health care, demonstrating proficiency in the ability to manage a patient panel, population, or program.
  • Outcome Focus. Utilizes research and evidence-based practice to evaluate the patient care delivery system within a patient panel or program, presents findings and contributes to changes that enhance the quality and timeliness of veteran/patient care.
  • Leadership. Works effectively as a leader within a team/unit/group and seeks interdisciplinary collaboration as appropriate to enhance patient care.
  • Professional Development. Acquires knowledge and skills to develop expertise in area of practice.
  • Professionalism/Collegiality. Demonstrates effective communication skills and professional behavior, promoting cooperation and teamwork. Participates in interdisciplinary teams and processes that positively impact patient outcomes.

The following Scope, Education and Experience, and Dimension criteria must be met to qualify for Advanced Practice Nurse (Nurse Practitioner) III:

• Scope: Executes position responsibilities that demonstrate leadership, experience, and creative approaches to management of complex client care.
• Education and Experience Requirement: Meets basic education requirement for an APN (NP) AND one year of specialized APN (NP) experience equivalent to the Nurse II grade level.
• Dimension Requirement: APN (Nurse Practitioners) at grade III are expected to meet the following dimension requirements:
  • Clinical Practice. Influences and models the delivery of evidence- based health care, demonstrating expertise in the ability to manage a patient panel, population, or program.
  • Outcome Focus. Leads and implements changes that enhance the quality and timeliness of Veteran/patient care applying research and evidence in the delivery of healthcare for patient populations.
  • Leadership. Initiates and leads interdisciplinary teams informed by structured approaches and processes to improve outcomes that positively impact care for a patient panel, population, or program.
  • Professional Development. Acquires knowledge and skills, then disseminates acquired information within and/or outside the medical facility.
  • Professionalism/Collegiality. Initiates and leads interdisciplinary teams developing systems that positively impact outcomes at the panel, population, or program level. Demonstrates effective communication skills and professional behavior, promoting cooperation and teamwork

Physical Requirements:
Position requires the knowledge, skill set, and abilities to provide quality care promoting outcomes in a culture of safety to various patient groups under different modalities. The availability of qualified candidates is limited as area hospitals are offering recruitment and/or retention incentives to retain staff.