Advanced Practice Nurse (NP) - Vascular Surgery

The position is located at the Audie L. Murphy Memorial Veterans' Hospital in San Antonio, TX and reports to Surgical Care. The APN in Vascular Surgery provides a full range of services and practices decisions autonomously and in consultation with physician and health care professionals, in a collegial relationship for mutual consultation and referral. Orders, facilitates, and interprets laboratory tests, diagnostic studies, and for Vascular Surgery patients to ensure timely completion.

The Vascular Surgery APN/NP is a licensed independent practitioner with advanced education and national certification who provides a full range of care utilizing treatment guidelines in the delivery of high-quality care. Major duties and responsibilities of the position include, but are not limited to: Make practice decisions autonomously and in consultation with physician and health care professionals, in a collegial relationship for mutual consultation and referral. Order, facilitate, and interpret laboratory tests, diagnostic studies, and for Vascular Surgery patients to ensure timely completion. Write progress notes daily for General surgery patients and assist teams as necessary with other progress notes. Independently review or complete discharge summaries on all patients on a daily basis. Provide follow-up for evaluation of outcomes of x-rays, laboratory tests and diagnostic procedures. Detect and evaluate any significant change in patient's condition and provide treatment as indicated.

• Independently managing a panel of patients with acute and chronic health conditions with an emphasis on health promotion and disease prevention using evidence-based practice
• Providing assessments, evaluations, and care coordination of Veterans
• Prescribes pharmacologic and non-pharmacologic interventions.
• Developing and implementing an individualized plan to achieve optimal population health and disease management
• Ordering and interpreting labs, tests, and diagnostic studies. Demonstrates critical thinking in assessing and managing complex clinical situations.
• Communicates with patients via phone inquiries, secure messaging, etc. regarding surgical issues pre and post surgery.
• Aiding in health promotion, disease prevention, and health education
• Initiating referrals/consults for services, serving as a VA and community liaison
• Leads the delivery of care to assure continuity of care and peer accountability for practice, improving outcomes of panel/program.
• Communicates to attending surgeons and physicians regarding Vascular Surgery patients follow up and management of urologic procedures.
• Routinely staff the Vascular Surgery and Pre-Admission Surgical Screening Clinic (PASS) clinics
• In conjunction with Vascular Surgeon responsible for postoperative care of patients including inpatient rounding, discharge instructions from hospital, postoperative clinic evaluation and care.
• Educate patients on procedures to decrease post-operative wound infections, discuss some of the known risks of the surgery they are about to undergo, the pre-operative and post-operative expectations and expected hospital stay as needed.
• Maintaining written scopes of practice to medical aspects of patient care that are agreed upon and reviewed every 2 years by the APN and collaborating physician
• Identify systems issues affecting patient care and take appropriate actions to resolve the situation. Collaborate with nursing, MAS, radiology, pharmacy and other interdisciplinary services as indicated.
• Reviewing consults for Vascular Surgery and assigns to appropriate clinics for scheduling by MAS.
• Collaborate with the client/family to establish physical, mental, cultural and environmental factors that facilitate or impede expected goals of surgery and post operative discharge.
• Contributes to performance improvement initiatives by identifying, analyzing, developing, and implementing processes that improve care at the panel, program, or population level.
• Collaborates with stake holders to improve patient care, staff development, and performance measure.

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: Monday - Friday, 7:30-4pm CST
Telework: Not Available
Virtual: This is not a virtual position.
Relocation/Recruitment Incentives: Not Authorized
Permanent Change of Station (PCS): Not Authorized
EDRP: Not Authorized

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 as a Psychiatric-Mental Health Nurse Practitioner (PMHNP) 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.

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

Preferred Experience:

1. Make practice decisions autonomously and in consultation with physician and health care professionals, in a collegial relationship for mutual consultation and referral.
2. Order, facilitate, and interpret laboratory tests, diagnostic studies, and for Vascular Surgery patients to ensure timely completion. Write progress notes daily for General surgery patients and assist teams as necessary with other progress notes. Independently review or complete discharge summaries on all patients on a daily basis.
3. Provide follow-up for evaluation of outcomes of x-rays, laboratory tests and diagnostic procedures. Detect and evaluate any significant change in patient's condition and provide treatment as indicated.

Physical Requirements: moderate lifting, 15-44 pounds; moderate carrying, 15-44 pounds; reaching above shoulder; use of fingers; both hands required; walking, 8 hours; standing, 8 hours; repeated bending, 4-6 hours; ability for rapid mental and muscular coordination simultaneously; near vision correctable at 13 to 16 inches to Jaeger 1 to 4; specific visual requirement of far vision, 20/30; both eyes required; depth perception; ability to distinguish basic colors; ability to distinguish shades of colors; hearing, with an aid permitted; mental/emotional stability; ability to perform privileges; independently performs physical exam; and cognitive stability.

IMPORTANT: A transcript must be submitted with your application if you are basing all or part of your qualifications on education.

Master of Science degree in Nursing (MSN) must be fully accredited by the Accreditation Commission for Education in Nursing (ACEN) or the Commission on Collegiate Nursing Education (CCNE). Verification of accreditation may be obtained from

• http://www.acenursing.us/accreditedprograms/programsearch.htm or
• https://directory.ccnecommunity.org/reports/accprog.asp

Note: If your school has changed names, or is no longer in existence, you must provide this information in your application.

Note: If your school was accredited by ACEN or CCNE at the time of graduation, but is no longer listed on the websites, you must provide documentation of accreditation with your application packet.