The Advanced LVN GS-7 functions as a member of the health care team by demonstrating an exceptional degree of practical nursing knowledge and skills necessary for self-direction in carrying out complex practical nursing care assignments within their setting for a Veteran population with a variety of health care needs. The Advanced LVN will perform assignments at the CBOC Palm Desert ,CA location and will report to the Nurse Manager. 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. Must be a graduate of practical or vocational nursing approved by the appropriate State accrediting agency and/or the National League for Nursing at the time the program was completed by the applicant. Must be proficient in spoken and written English as required by 38 U.S.C. 7402(d) and 7407(d). Must have a full, current, active and unrestricted license as a graduate licensed practical or vocational nurse in a State, Territory, or Commonwealth (i.e., Puerto Rico) of the United States or District of Columbia. Grade Determinations: The GS-7 grade level is for select, complex LPN/LVN positions, as established by each health care facility. To be advanced, employees must meet all of the following standards, provided the standard is part of their assignment NOTE: Determinations concerning placement of positions at this grade level shall take into consideration the skill mix and the availability of supervision in the work unit. Although these positions are under the supervision of an RN and/or MD/DO, employees in such settings successfully and consistently demonstrate the exercise of independent technical judgment (without the need for readily available supervision), as well as a comprehensive and thorough working knowledge of the most complex or difficult practices and procedures. Such individuals may also serve as leaders or co-leaders in a nursing unit or for a specifically identified group of patients. (a) Completion of at least one (1) year of additional qualifying experience at the GS-6 level or equivalent, fully meeting all of the performance requirements for the GS-6 LPN/LVN. (b) Knowledge and skills necessary to carry out more specialized patient care duties, including assignments in selected, more complex inpatient and/or outpatient care settings. Knowledge base promotes the incorporation of current patient care data in actively contributing to the development of the patient's overall health plan and in carrying out assigned nursing interventions. Positions at this grade level require broader knowledge and skills because supervision is more general and employees are expected to be involved to a greater degree in the development and modification of treatment plans. (c) Ability to assist RN and/or MD/DO to appropriately prioritize overall patient care needs and adjust plans for care delivery. Makes astute observations of subtle, less obvious changes, both physical and emotional, in patient's condition, and accurately and thoroughly documents care delivered and patient's response to care that could require immediate modification of the patient's care plan. Appropriately seeks assistance and guidance by informing RN or MD/DO of changes in patient's condition requiring higher-level intervention. At this grade level, the LPN/LVN is expected to participate to a greater degree in prioritizing, and, as appropriate, modifying patient care treatment. They must also possess the ability to observe more subtle physical and emotional changes in patients and demonstrate taking appropriate action based on those observations. (d) Ability to proactively assist the RN or MD/DO in addressing patient's needs for medication/treatments, accurately administering prescribed medications/treatments according to established policies/procedures and appropriately recording administration and patient's response to medications/treatments received. (This may include restricted medication locally authorized for administration by employees at this grade level.) Demonstrates the knowledge and ability to readily recognize the more subtle signs and symptoms of potential or actual drug reactions, promptly inform the RN or MD/DO of observed changes in patient's condition and initiate appropriate, prescribed interventions. Employees at this grade level demonstrate broader knowledge and skill with respect to these responsibilities than employees at lower grade levels. (e) Knowledge and skill to promptly recognize potential urgent or emergent patient care situations, seek assistance of the RN and/or MD/DO for appropriate team intervention and effectively intervene, as directed, to assure the continuation of optimal, safe and therapeutic patient care delivery. At this grade level, the LPN/LVN must have a broader knowledge of the patient treatment process and exercise judgment that demonstrates the ability to effectively intervene when appropriate. (f) Assists individuals or groups of patients and their families to take an active role in promoting healthy lifestyles for more positive patient outcomes. Exercises skill in influencing and communicating with unusually difficult to care for or communicate with patients and/or family members who may exhibit problems with lack of self-control, resistant or abusive behaviors, or impediments in their ability Reference: VA HANDBOOK 5005/3 PART II APPENDIX G13 The full performance level of this vacancy is GS-7 . Physical Requirements: Heavy Lifting (45 lbs and over); Moderate Carrying (15-44 lbs); Pushing; Straight pulling; Pulling hand over hand; Reaching above shoulder; Use of fingers; Both hands required; Walking (up to 6 hours); Standing (up to 6 hours); Kneeling (Intermittent);Repeated bending (up to 6 hours); Both legs required; Ability for rapid mental and muscular coordination simultaneously; Near vision correctable at 13" to 16"; Far vision correctable in one eye to 20/20 an to 20/40 in the other; Ability to distinguish shades of colors; Hearing (aid permitted); Emotional and Mental Stability ["This is not a Remote Position. The LVN successfully and consistently demonstrates independent technical judgment as well as comprehensive and thorough working knowledge of complex practices and procedures. Incumbent demonstrates knowledge, experience, skill, and self-motivation to carry out complex patient assignments, which include prioritization and coordination of clinical activities with minimal supervision. The LVN provides a full range of duties and is responsible for day-to-day operation of telehealth services at the assigned location and between the assigned location and remote sites of care as needed. The incumbent will provide a wide range of clinical and technical services to the patient that demonstrates complex technical judgment under remote supervision of a Registered Nurse, Nurse Practitioner, Physician, Physician Assistant, or other LIP or specialty telehealth provider. The incumbent will provide established competency-based training, guidance and information on the use of advanced telehealth technologies to patients, staff, and providers, and standardized competency-based training for telehealth technology, facilitating interactive simulations for clinical staff participating in telehealth programs. The LVN assists in patient care under the direct supervision of an independent licensed health care provider. The LVN can be cross-trained to perform a range of direct duties that may include: collecting vital signs, EKGs, and other clinical components for a specialty care/primary care visit as directed by policy or clinic standard. The LVN conducts quality control procedures on equipment and products and maintains proper records for quality control reports and workload reporting. The LVN is responsible for the day-to-day operation of the clinical video telehealth clinics, training, and Store and Forward Telehealth clinics. Performs diagnostic support duties, treatments, and personal care according to procedure under the remote supervision of the register nurse in a timely manner. Responds to patient's nursing needs, including physical comfort and emotional needs and recognizing deviations from the normal. Assists maintaining inventories, tracking equipment issues, and documents accordingly. Ensures telehealth exam rooms and equipment are ready for clinical sessions. Coordinates information between facilities to expedite patient telehealth modality to access, promote, and ensure maximum continuity of care. The LVN is the point of contact for both outpatient and inpatient referrals requiring telehealth services. Coordinates telehealth modalities with medical staff, patients, facilities, telehealth services, and emergency services. Reviews each planned telehealth encounter for needed resources (e.g. video conferencing, clinical peripherals, tele presenters, scheduling, medical equipment, telehealth environment) to ensure resources are appropriate and meet safety requirements for the patient telehealth encounter. Ensures all appropriate clinical communication is done, including results communication. Participates in quality and safety audits when needed. Preferred Experience: Previous Telehealth/Virtual Care Experience. Experience with installing, configuring, activating, and testing equipment, related peripherals, applications and software particularly those related to telehealth. VHA Connected Care core competencies for Telehealth. Experience with Store and Forward technology, i.e. Teledermatology and TeleEye. Experience with scheduling, consult tool manager, VSE. Work Schedule: Monday thru Friday 0800-1630 Location: CBOC Palm Desert ,CA Financial Disclosure Report: Not required"]

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