The Certified Registered Nurse Anesthetist is an advanced practice nurse who utilizes specialized clinical nursing skills and is prepared to administer anesthesia care. As independently licensed health professionals, CRNAs are responsible and accountable for their practice. The scope of practice includes direct patient care, administration, educational, and research activities. A recruitment or relocation incentive may be available for highly qualified applicants. Advanced Practice Nurse (Certified Nurse Anesthetist) Basic Requirements 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. 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. Reference: VA Regulations, specifically VA Handbook 5005, Part II, Appendix G-6 Nurse Qualification Standard. This can be found in the local Human Resources Office. Preferred Experience: Acute Care Experience Operating Room Experience Physical Requirements: Physical and mental stamina sufficient to diligently monitor the anesthetized patient for prolonged periods of time and have the ability to manage many stressful situations. ["Duties and responsibilities include, but are not limited to, the following: Performs a pre-anesthetic patient assessment based on patient interview, patient history, lab results, and type of surgical procedure to be performed. Patient assignments per Chief Nurse Anesthetist or another designed person. Selects and administers pre-anesthetic medication according to established protocol. Requests and evaluates pertinent laboratory studies, pulmonary function studies, including blood gases, respiratory therapy, and other appropriate studies under established protocol. Inserts intravenous catheters, according to established protocol, Swan-Ganz catheters and central venous pressure catheters under medical supervision, and arterial catheters; perform puncture for blood gases. Utilizes all current techniques in monitoring. Performs endotracheal intubation and extubation. Selects and administers anesthetic techniques (intravenous, regional, various field blocks, or inhalational), medications/ adjunct drugs appropriate to the individual patient's condition and procedure (surgical or non-surgical) within established protocols in the operating suite and any off-site location (i.e. Endoscopy, Radiology, Cardiology, MRI, etc.). Manages fluid, blood and electrolyte therapy within a medical care plan. Initiates and modifies therapies, (i.e. drug and pain therapy) within established protocols. Examines patients in post-anesthesia recovery/hospital units to assess patient's reaction to anesthetic management. Identifies any complications or abnormal patient responses to anesthesia or to adjunctive medication and implement appropriate management techniques. Assists in the treatment and management of emergency airway problems throughout the hospital. Participates in cardiopulmonary resuscitation by performing airway management including endotracheal intubations. Serves as code captain in the absence of a physician. Provides anesthetic consultation to physicians, nurses, and other hospital staff. Makes post-operative rounds and records to patient's permanent record the presence or absence of anesthesia-related-complications. Takes an active role in the departmental in-service program. Takes emergency calls assigned by Chief Nurse Anesthetist or another designated person Responsible for patient care activities for adult and geriatric patients, modifying treatment plans to accommodate the changes that occur with aging. Safeguards sensitive data per provisions of the Privacy Act of 1974 and other applicable laws, federal regulations. VA statutes and policies. Sets up, properly uses, reprocesses, and maintains all unit/department-specific equipment in accordance with equipment Standard Operating Procedure, with validation of ongoing competency at least annually. Demonstrates the knowledge and ability to implement The Joint Commission standards to improve patient care outcomes. Provides guidance and instruction in preparing others for positions of leadership and ethical practices which impact patient care. Participates in the development of anesthesia patient care audit processes involving in depth review and analysis of anesthesia records. Performs as a mentor, preceptor, or nurse educator providing didactic and clinical instruction for graduate-level nurse anesthesia students and/or other anesthesia care providers. Recognizes clinical and technical aspects of anesthesia care and has in-depth knowledge of anesthesia methods and techniques for the practice of anesthesia. Practices nurse anesthesia concepts within a team to deliver anesthesia care and blend management skills with technical experience. Applies new developments and theories to develop and demonstrate the ability to recognize and solve various complex anesthesia situations. Effectively blends technology, skills, and competency for the advancement of anesthesia techniques, pharmacology, and equipment. 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; 7:00AM-3:30PM Telework: Not Available Virtual: This is not a virtual position. Relocation/Recruitment Incentives: May Be Authorized Permanent Change of Station (PCS): Not Authorized Financial Disclosure Report: Not required"]

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