The NP practices in Palliative Care/Hospice & Community Living Center (CLC), to provide a full range of services in outpatient/inpatient settings emphasizing quality, timeliness & the advancement of the mission. The NP provides advanced clinical practice, consultation & management. The NP practices to the full extent of their education, training, & certification. The NP has prescriptive authority for a panel of patients or program as indicated by their position or assigned by their supervisor. Preferred Experience: 3-5 years in Hospice/Palliative Care and Geriatrics (Inpatient/Outpatient). 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 up to 35 pounds for 8-12 hours, intermittently; moderate carrying (15-35 pounds) for 8 to 12 hours, intermittently; lifting over 35 pounds with assistive devices in accordance with the Safe Patient Handling Policy except in emergent situations requiring prompt patient care; pulling for 8 to 12 hours, intermittently; pushing for 8-12 hours, intermittently; reaching above the shoulders for 8-12 hours, intermittently, both hands required; walking 8-12 hours, intermittently; standing 8-12 hours intermittently; kneeling 8 to 12 hours, intermittently; repeated bending for 8-12 hours, intermittently; climbing and use of both legs and arms for 8-12 hours, intermittently, both legs required; near vision at 13 to 16" Jaeger 1 to 4, far vision correctable in one eye to 20/20 and to 20/40 in the other eye; ability to distinguish basic colors; hearing aid permitted; twisting, simply grasp and fine manipulation. 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 patient needs. The incumbent must complete annual Employee Health requirements, such as annual TB screening or testing, as a condition of employment. ["NP practices to the full extent of their education, training, and certification. NP has prescriptive authority for a panel of patients or program as indicated by their position. FUNCTIONS OF ASSIGNED DUTIES: NP is a licensed independent practitioner with advanced education and national certification who provides evidence-based care for a population of patients. Major duties and responsibilities of the position: Independently manages or in collaboration with attending physician(s), a panel of patients with acute and chronic health conditions with emphasis on health promotion and disease prevention using evidence-based practice. Develops and implements an individualized plan to achieve optimal population health and disease management. Demonstrates leadership and works collaboratively with the interdisciplinary team. Orders and interprets labs, tests, and diagnostic studies. Prescribes pharmacologic and non-pharmacologic interventions. Initiates referrals and consults to specialty services. Provides education to patients and their families. Assesses and adjusts the plan of care as needed to achieve optimal patient outcomes. Provides medical services to veterans on an Outpatient, Inpatient or assigned by the supervisor as needed at the John D Dingell VAMC under GEC service. 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. Expectations: 1. Independently practices as a NP providing a full range of care utilizing treatment guidelines in the delivery of high-quality care. 2. Collaborates with patients, families, and health care practitioners to develop, implement treatment plans, and evaluate health outcomes. 3. Demonstrates critical thinking in assessing and managing complex clinical situations. 4. Leads the delivery of care to assure continuity of care and peer accountability for practice, improving outcomes of panel/program. 5. Care is provided in outpatient clinics, Inpatient CLC, impatient consult service or as assigned by the supervisor under GEC (Geriatric & Extended care service). 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. Expectations: 1. Leads performance improvement initiatives that improves care or processes. 2. Engages in evidence-based practice and the application of clinical practice guidelines. 3. Implements quality improvement initiatives that lead to outcomes at the panel/program level. 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. Expectations: 1. Demonstrates positive effective communication skills and professionalism that promote cooperation and teamwork with internal and external customers. 2. Works effectively as a leader in planning and facilitating systematic change to improve outcomes. 3. Collaborates with stakeholders to improve patient care, staff development, and performance measures. 4. Participates as a member or leader in formal/informal workgroups or interdisciplinary teams. 5. Leads within a High Reliability Organization (HRO) framework. PROFESSIONAL DEVELOPMENT: Acquires knowledge and skills, then disseminates acquired information within and/or outside the medical facility. Expectations: 1. Acquires and disseminates knowledge that impacts patient outcomes 2. Educates and/or mentors' colleagues and/or students. 3. Assumes responsibility and accountability for evaluating progress toward professional career goals. PROFESSIONALISM/COLLEGIALITY: Initiates and leads interdisciplinary teams developing systems that positively impact outcomes at the panel, population, or program. Demonstrates effective communication skills and professional behavior, promoting cooperation and teamwork. Expectations: 1. Utilizes cultural sensitivity, listening and communication skills in leading team(s). 2. Role models high standards of professional and ethical conduct. 3. Initiates and leads interdisciplinary teams. 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: full and unrestricted license from any US State or territory Work Schedule: Monday-Friday, 8:00am-4:30pm Virtual: This is not a virtual position. Relocation/Recruitment Incentives: Not Authorized"]

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