The applicant serves as a Surgical Certified Registered Nurse Anesthetist (CRNA) under the immediate supervision of the Chief, Anesthesiologists, and the Chief of Surgery within the Surgical Care Service Line. Applicant will maintain licensure and credentials sufficient to extend to the incumbent the authority to practice CRNA duties inclusive of all diagnostic and medical therapeutic modalities for the treatment of diseases, conditions and injuries related to the field of Anesthesia. Advanced Practice Nurse (Certified Nurse Anesthetist) Basic Requirements Education. A masters or doctoral degree in nurse anesthesia. (Applicants pending the completion of educational requirements may be referred and tentatively selected but may not be hired until the education requirements are met.) Nursing education must be from a school of professional nursing anesthesia accredited by Council on Accreditation of Nurse Anesthesia Education Programs (COA) at the time the program was completed by the applicant. Licensure and Certification. The following licensure and certification requirements are considered conditions of employment. License. All APN (CNAs) must maintain an active, current, full and unrestricted license to practice as a CNA or equivalent, in a State, Territory or Commonwealth of the United States or in the District of Columbia. Basic Certification. All APN (CNAs) must maintain full and current certification by the National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA) or an equivalent Nurse Anesthetist certification recognized by the COA. NOTE: Grandfathering Provision - All persons currently employed in VHA in 0610 series and an APN (CNA) 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 Education, Experience, and Knowledge, Skills and Abilities must be met for Advanced Practice Nurse (Certified Nurse Anesthetist) II: Exception to Licensure for Graduate Nurse Technicians. Candidates who otherwise meet the basic requirements, but do not possess the required APN (CNA) licensure and/or certification, may be appointed at the entry step of the Nurse II, as a Nurse Anesthetist on a temporary appointment up to any period not-to-exceed one year and a day under the authority of 38 U.S.C. § 7405(c)(2)(B). Education and Experience Requirement. Meets basic education requirement for an APN (CNA). Nurse II is considered the entry grade level for APN (CNAs); no experience is required. Demonstrated Knowledge, Skills, and Abilities. The following list of knowledge, skills and abilities present the minimum skill set expected of an Entry Level CNA. Entry level into practice may include but are not limited to the following: Ability to translate into anesthesia care the principles of professional nursing practice including the patients' rights to autonomy, dignity, privacy, and safety. Knowledge of current research and practice guidelines to frame anesthesia practice including up to date techniques, pharmacology, and equipment. Ability to obtain, document and verify informed anesthesia consent and perform a pre-anesthetic patient history and physical, which includes managing pre-operative consults and interpreting data. Ability to formulate a patient-specific anesthetic plan and describe salient anesthetic risks, benefits, and options to the patient. Ability to administer inhalational, regional, intravenous, local, and topical anesthetics. Skill in detecting and treating anesthesia or surgically related physiologic changes and ability to treat accordingly in order to maintain homeostasis. Skill in assessing patient status for appropriateness of transfer of care to another healthcare provider and communicating essential patient information to other providers effectively. Ability to participate in collaborative responsibility for proper patient positioning, physiologic monitoring, infection control and anesthesia documentation. Skill in responding to emergency situations by providing airway management, fluid and medication administration, invasive line insertion and management and the use of advanced cardiac life support techniques. Ability to provide patient care that is abreast of changing concepts and advancements in the profession, (e.g., ultrasound techniques.) Ability to practice anesthesia in an interdisciplinary environment utilizing a collaborative concept of anesthesia care. Knowledge of quality improvement processes to maintain ongoing review and evaluation of anesthesia care to improve outcomes. Ability to demonstrate a practice emphasis on safety, current established guidelines and protocols while recognizing the duty to report unsafe conditions or errors. The following Education, Experience, and Knowledge, Skills and Abilities must be met for Advanced Practice Nurse (Certified Nurse Anesthetist) III: Education and Experience Requirement: Meets basic education requirement for an APN (CNA) AND One year of specialized APN (CNA) experience equivalent to the APN (CNA) II grade level. Demonstrated Knowledge, Skills, and Abilities: Progressively responsible experience in the administration of anesthetics as indicated in the knowledge, skills and abilities listed below. Ability to plan, administer and manage anesthesia for a broad range of complex surgical procedures skillfully employing continuous assessment and anesthetic adaptation based on patient response and comorbidities. Work assignments will vary by facility. Ability to participate in assignments that are technically challenging, encompass a variety of anesthetizing locations and utilize advanced equipment and procedures while adapting techniques to solve various complex anesthesia problems including the development of individualized programs of post-op anesthesia care. Skill in responsibility and accountability to perform to the extent of the CNA standards of practice as a licensed healthcare professional in any model of anesthesia practice. Ability to contribute to the educational mission as a mentor or preceptor providing didactic and clinical instruction in anesthesia to student nurse anesthetists, medical and dental residents, and other health care trainees. Knowledge to participate in the development, implementation and maintenance of auditing processes that ensure and improve the quality and consistency of anesthesia and associated documentation. Ability to contribute to departmental administrative processes through quality assurance, shared governance, or committee representation as applicable. Ability to serve as a representative on interdisciplinary teams to establish and maintain guidelines and communication. Skill demonstrated in the ability to embrace the safety culture emphasis by continuously assessing for safety risks, actively reporting safety concerns, and maintaining a just culture by identifying faults in systems rather than individuals. Physical Requirements: Must be able to pass a physical. ["Functions or Scope of Assigned Duties 1. The CRNA is responsible for the provision of direct patient care throughout all phases of the perioperative process including: a. Reviewing relevant information and completing a preoperative assessment, including ordering labs or other tests as indicated by chart review findings. b. Performing a thorough preoperative physical assessment and documenting findings as an addendum to the preoperative anesthesia assessment. c. Determining the anesthetic plan of care that best meets the needs of the patient and surgeon prior to entering the operating suite. d. Placing appropriate monitors and vascular access (both invasive and non-invasive) as indicated by the surgical procedure being performed and patient co-morbidities. e. Performing a broad scope of anesthesia techniques and procedures including: i. regional anesthetics ii. General anesthetics (induction, maintenance, emergence) iii. Monitored anesthesia care. iv. A-lines, central lines, PICC lines and other vascular access. f. Providing anesthesia services both in the operating suite and out of department in various locations throughout the facility. g. Supervising and managing the PACU care area and giving orders and assistance as needed. h. Recovering postoperative patients in circumstances that prevent a transfer of care postoperatively (PACU staff not on station, no available ICU beds or staff to recover patient postoperatively). 2. The CRNA is also responsible for maintaining all relevant licensures and certifications. 3. Responsibilities and accountabilities include demonstration of knowledge and skills necessary to provide care appropriate to the age-related needs of the patient served in the assigned areas of practice. The knowledge included undertaking changes associated with aging and principals of growth and development relevant to the Adult and Geriatric population. 4. The CRNA is also responsible and accountable for maintaining BLS and ACLS training and performing activities that reflect the educational, experiential and competency requirements outlined in the 9 dimensions. a. Nursing Practice b. Quality of Care c. Performance d. Educational/Career Development e. Collegiality f. Ethics g. Collaboration h. Research i. Resource Utilization 5. In addition, the CRNA is accountable and responsible for possessing the knowledge and skills to a. Communicate and interact appropriately and courteously with all internal and external customers. b. Maintain confidentiality of electronic, written and/or verbal patient/employee information. c. Demonstrate working practices that include adherence to Infection Control standards and the safe use of operation of equipment and adherence to safety practices. d. Conform with all medical center and service/service lines safety policies, procedures and protocols to avoid injury and or illness to self or others. Employee prepares all reports and documentation pertaining to employee injuries within established time frames utilizing the ASIST Program. Employee identified and reports all unsafe conditions to appropriate personnel to ensure a safe environment for all patients, medical center personnel and visitors. Employee practices safe working habits to avoid damage to government equipment, building structure and motor vehicles. Will participate in call rotation (nights and weekends) 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: 10:00am to 6:30pm Monday - Friday Will participate in call rotation (nights and weekends) Telework: Not Available Virtual: This is not a virtual position. Relocation/Recruitment Incentives: Not Authorized EDRP Authorized: Not Authorized Permanent Change of Station (PCS): Not Authorized"]

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