Summary The Nurse Practitioner (NP) is a professional registered nurse with advanced education from a university-based Nurse Practitioner program and appropriate experience who provides evidence-based care for a specific population of patients in Medical Service (Cardiology), VA San San Diego Healthcare System. The NP is a licensed independent practitioner with advanced education and national certification who provides evidence-based care for General Cardiology patients. Responsibilities Major duties and responsibilities of the position: Perform comprehensive history & physical exams, bio-psycho-social assessments with a focus on the patient's functional abilities, family support, ability to manage self-care. Using approved standardized procedures, develop & implement an individualized care plan that incorporates multiple internal and external resources to meet the patient's needs. Participates in treatment and planning and uses specialized knowledge to assess the needs of hospitalized cardiology patients and their families. Coordinates plans for outpatient care, elective admissions, as well as external services when needed. Assists with non-invasive cardiac procedures as necessary. Coordinates care for cardiology patients prior to hospitalization by: 1. Acts as liaison between Medicine and Cardiology Services. Facilitates access/follow-up for cardiology patients. Participates in staff education/development in the care of patients. Evaluates patients preoperatively by: 1. Performing a pre-operative, risk stratification of the patient in collaboration with the attending cardiologist for high risk patients undergoing noncardiac surgery. Orders pertinent studies to evaluate patients preoperatively. Optimizes patients' clinical status perioperatively to improve surgical outcomes and enhance post-op recovery. Manages complex cardiology patients and monitors their status and treatment plans according to standardized procedures and in collaboration with attending cardiologist(s), including geriatric cardiology patients, post-myocardial infarction (Ml), post ACS and post-coronary artery bypass graft(CABG) patients. Develops inter-professional treatment plans, including reviewing medical records, reviewing lab/diagnostic tests, placing treatment and medication orders, and responding to telephone inquiries from patients, their DPOA, as well as providers and other members of the healthcare team. Collaborates with the attending cardiologist to assist in review all exercise stress test requests for appropriateness, indications, and evaluates what medications should be held prior to the study; stands by for treadmill testing to ensure safe administration of the exercise study based upon approved protocols. Acts as clinical expert for ETT lab staff and is available as a resource to ETT staff. Communicates preliminary results to the patient and ensures timely and appropriate follow up with respect to further testing or referral to pre-catheterization clinic. Works with staff from the exercise lab to optimize scheduling of patients referred from the emergency room and from the inpatient areas for exercise stress testing. Collaborates with Cardiology Care Coordinator to coordinate care and follow-up visits to assess efficacy of treatment plans. Evaluates cardiology patients via Computerized Video Telehealth (CVT) as appropriate. The NP may perform the following functions: general evaluation of health status, including, but not limited to, the ordering of diagnostic procedures, medical supplies and formulating plans of care; assessment and management of acute and chronic illness; and the furnishing of medications & devices according to standardized procedures. Standardized procedures are to be performed in areas that will allow for the collaborating physician to be available to the NP by telephone or in person, including, but not limited to, all VA facilities or the patient's home. Physician consultation will be obtained for non-emergent situations when the nurse practitioner is managing a medical condition that is not resolving as anticipated, adjustments in medications/therapy have not brought about the expected improvements, or any time the nurse practitioner seeks additional expertise on providing appropriate treatment for a specific condition. Electronic progress notes will be in a problem-oriented format and sufficiently detailed to obtain a clear picture of the patient's current health status. All patient contacts and visits with physician involvement must include the name of the physician in the progress notes. Maintains mandatory and clinical competencies of the position. 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: Full Time Compressed/Flexible: N/A Telework: N/A Virtual: This is not a virtual position. Relocation/Recruitment Incentives: not authorized. Requirements Conditions of Employment U.S. Citizenship; non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy. All applicants tentatively selected for VA employment in a testing designated position are subject to urinalysis to screen for illegal drug use prior to appointment. Applicants who refuse to be tested will be denied employment with VA. English Language Proficiency. In accordance with 38 U.S.C. 7402(f), no person shall serve in direct patient care positions unless they are proficient in basic written and spoken English. Selective Service Registration is required for males born after 12/31/1959. You may be required to serve a probationary period. Subject to background/security investigation. Selected applicants will be required to complete an online onboarding process. Acceptable form(s) of identification will be required to complete pre-employment requirements (https://www.uscis.gov/i-9-central/form-i-9-acceptable-documents). Effective May 7, 2025, driver's licenses or state-issued dentification cards that are not REAL ID compliant cannot be utilized as an acceptable form of identification for employment. Must pass pre-employment physical examination. Participation in the seasonal influenza vaccination program is a requirement for all Department of Veterans Affairs Health Care Personnel (HCP). Qualifications 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 and Certification: 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 Certification. All APN (NPs) must maintain full and current board certification in an area of clinical specialty 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: Lifting maximum of 35 pounds for patient care (animate); non patient care (inanimate objects) maximum lifting is 50 pounds. Pulling, pushing and reaching above shoulder may be required; use of fingers, both hands required, walking and standing for the duration of your tour; repeated bending; Ability for rapid mental and muscular coordination. Safe patient handling and management modalities are required at all times. VA Directive and Handbook 5019, Employee Occupational Health Service. Education Education. A post-master's certificate or master's or doctoral degree as a Nurse Practitioner. Education Accreditation Requirement. Nursing education must be from a school of professional nursing accredited by one of the following accrediting organizations at the time the program was completed by the applicant: (a) The Accreditation Commission for Education in Nursing (ACEN), 3343 Peachtree Road NE, Suite 850, Atlanta, GA 30326. The ACEN accredits all levels of nursing programs, including clinical doctorate, masters/post-master's certificate, baccalaureate, associate and diploma nursing education programs. (NOTE: The National League for Nursing Accrediting Commission/NLNAC changed its name to ACEN in May 2013 ACEN's website may be utilized to verify accredited programs using automated inquiry processes; however, for verification of any nursing program's accreditation prior to 1998, an automated inquiry cannot be used and ACEN must be contacted directly via their email contact information on the ACEN website to verify.); or The Commission on Collegiate Nursing Education (CCNE), 655 K Street, NW, Suite 7, Washington, DC 20001. The CCNE is an accrediting arm of the American Association of Colleges of Nursing (MCN) and accredits nursing education programs at the bachelor and master's level. Additional Information Reference: For more information on this qualification standard, please visit https://www.va.gov/ohrm/QualificationStandards/. During the application process you may have an option to opt-in to make your resume available to hiring managers in the agency who have similar positions. Opting in does not impact your application for this announcement, nor does it guarantee further consideration for additional positions. This job opportunity announcement may be used to fill additional vacancies. This position is in the Excepted Service and does not confer competitive status. VA encourages persons with disabilities to apply. The health-related positions in VA are covered by Title 38, and are not covered by the Schedule A excepted appointment authority. If you are unable to apply online or need an alternate method to submit documents, please reach out to the Agency Contact listed in this Job Opportunity Announcement. Under the Fair Chance to Compete Act, the Department of Veterans Affairs prohibits requesting an applicant's criminal history prior to accepting a tentative job offer. For more information about the Act and the complaint process, visit Human Resources and Administration/Operations, Security, and Preparedness (HRA/OSP) at The Fair Chance Act.
