The CRNA is responsible for direct perioperative patient care, patient/family education, and participation in all appropriate peri-operative activities involving surgical patient care. A Recruitment/Relocation incentive may be authorized. 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. 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, simple grasp and fine manipulation. ["This is an OPEN CONTINUOUS ANNOUNCEMENT and will remain open until December 31, 2024. The initial cut-off date for referral of eligible applications will be June 18, 2024. Eligible applications received after that date will be referred at regular intervals or as additional vacancies occur on an as-needed basis until positions are filled. The CRNA requires appropriate time mapping and resources to ensure they are empowered to meet expected proficiencies in administration, clinical practice, education, and research. Administrative: Writes Medical Orders and prescriptions for non-controlled and controlled substances, as necessary, for the care of the patient in accordance with Federal and State law. Documents care provided in the Innovian Anesthesia Record Keeping software and Computerized Patient Record System (CPRS) in accordance with Valley Coastal Bend Health Care System requirements. Documents the detailed, targeted, initial history and physical examination required for evaluation in the electronic tool(s) required by VA. Obtains consent and documents procedures performed for which the CRNA is responsible. Provides education and counseling of patients and families in preventive care, medical conditions, and the use of prescribed treatments and drugs. Review and revise policies and scope of practice/standards of operation to meet the needs of the National VA and VA Texas Valley Coastal Bend Health Care System mandates. Review and guide protocols in anesthetic managements including coordinating efforts with various department to meet patient needs and maintain fiscal responsibility. Clinical: Responds to and completes consults received for the evaluation of anesthetic considerations, including: Performs a comprehensive, detailed, targeted, initial history and physical examination in compliance with national guidelines. Orders diagnostic studies such as laboratory tests, X-rays, electrocardiograms (EKGs) and other tests appropriate for perioperative care of patient. Consults other disciplines, as necessary, to complete the patient evaluation. Carries out health promotion and disease prevention activities including education and shared decision-making. Participate in all requested VISN and national level efforts in Anesthesia program as well as local committees. Non-routine duties: Teach students of various fields and specialties. VA offers a comprehensive total rewards package: VA Nurse Total Rewards Work Schedule: Mon - Fri 0800-1630 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. Preferred Experience: Minimum 5-7 years of experience as clinically practicing nurse anesthetist in all arenas of anesthesia to include general, regional, MAC Competence and comfort in performing procedures- intubation with direct laryngoscopy or videoscopes, epidural, spinal, regional blocks- w/ no or nominal supervision by anesthesiologist or surgeon Perioperative management ventilator, fluids, challenging IV access Experience in performing preoperative assessment, especially as to pertaining to cardiopulmonary and neurologic risk management and ability to interpret laboratory, radiologic, EKG data and manage post-operative complications w/ nominal supervision Excellent communication skills and ability to work w/ interdisciplinary staff including perioperative nursing, surgeons and anesthesiologists"]

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