The Certified Registered Nurse Anesthetist (CRNA) provides anesthetic care to patients under the scope of practice found in VA Handbook 1123 under provisions of anesthesia care. Care includes pre-anesthesia evaluation, peri-operative anesthetic administration and post-operative management. Specific practice settings are in Acute Medical & Surgical inpatient and outpatient setting. The practice of each CRNA is based on knowledge, experience and research has a direct impact on patient outcome. 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. 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 proficient in spoken and written English. Nurse Anesthetists must be proficient in spoken and written English in accordance with VA Handbook, Part II, Chapter 2, Section D, and Paragraph 5a. Must have a degree in nursing from a school of professional nursing approved by the appropriate accrediting agency and accredited by the National League for Nursing Accreditation Commission (NLNAC) or Commission on Collegiate Nursing Education (CCNE). In cases of graduates of foreign schools of professional nursing, possession of current, full, active and unrestricted registration and the possession of a Certificate from the Commission on Graduates of Foreign Nursing Schools (CGFNS) will meet the requirement of graduation from an approved school of professional nursing. Must be a graduate of an accredited nurse anesthesia educational program approved by the American Association of Nurse Anesthetists (AANA) at the time the program was completed. Must possess a current, full, active and unrestricted license as a graduate professional nurse in a State, Territory or Commonwealth (i.e., Puerto Rico) of the United States or the District of Columbia. The nurse anesthetist must maintain a current, full and unrestricted registration to continue employment with VA. Must be certified by the Council on Certification of Nurse Anesthetists and must maintain recertification by meeting the Council on Recertification of Nurse Anesthetist's requirements as a condition of employment. ACLS certification. May qualify based on being covered by the Grandfathering Provision as described in the VA Qualification Standard for this occupation (only applicable to current VHA employees who are in this occupation and meet the criteria). Preferred Experience: 2 Years Experience Entry Level: (Nurse II): Experience and Education. None beyond the basic requirements. Demonstrated Knowledge, Skills and Abilities. The following list of knowledge, skills and abilities present the minimum skill set expected of an Entry Level Nurse Anesthetist. Entry level into nurse anesthesia practice may include but are not limited to the following: Ability to translate the principles of professional nursing practice in the care of assigned patients in order to provide appropriate care. Ability to do a pre-anesthetic patient history and physical, which includes collecting pre-operative consults and data. Ability to formulate an anesthetic plan and describe the anesthetic risks, benefits and options to the patient. Ability to administer inhalation, regional, intravenous, local, and topical anesthetics and to detect unfavorable reactions in order to continuously evaluate the patient's physical status. Ability to respond to emergency situations by providing airway management, administration of emergency fluids and drugs, and using appropriate resuscitation procedures for patient care. Ability to provide patient care that is abreast of changing concepts and advancements in the profession. Ability to work effectively in an interdisciplinary environment for improvement of services for patient care. Ability to practice nurse anesthesia with colleagues and peers utilizing a collaborative team concept of anesthesia care. Full Performance Level: (Nurse III) Experience and Education. In addition to meeting the requirements for Entry Level, the CRNA has had progressively responsible experience in the administration of anesthetics as indicated in the knowledge, skills and abilities listed below. These individuals must demonstrate the ability to participate in a program for nurse anesthesia care and demonstrate knowledge of anesthetizing locations, methods, equipment and procedures. At this level, the CRNA has experience in the administration of anesthetics that has demonstrated the nurse anesthetist's ability to participate in team programs that are technically challenging and/or complicated. Typically candidates can demonstrate the knowledge, skills and abilities of Full Performance Level within 2 years from entering the occupation. Demonstrated Knowledge, Skills, and Abilities. Full Performance Level practice in nurse anesthesia includes but is not limited to the following: Skill in conducting and managing anesthesia for a broad range of complex surgical procedures. In addition, the CRNA must be able to adapt/modify anesthesia techniques in order to optimize patient care. Ability to complete work assignments selected to add depth and breadth to their technical knowledge and skill competence. Work assignments will vary at each facility depending on the progressive acuity required for anesthesia care. Ability to respond to emergency situations by providing airway management, administration of emergency fluids and drugs, and by the use of basic or advanced cardiac life support techniques in order to perform necessary resuscitation procedures. Ability to effectively blend technology, skills, and competency for the advancement of anesthesia techniques, pharmacology, and equipment. Ability to apply new developments and theories to develop and demonstrate the ability to recognize and solve various complex anesthesia situations. Ability to practice nurse anesthesia with colleagues and peers in a team concept of anesthesia care and blend management skills with technical experience. Ability to recognize clinical and technical aspects of anesthesia care and has in-depth knowledge of anesthesia methods and techniques for the practice of anesthesia. Ability to perform as a mentor, preceptor, or nurse educator providing didactic and clinical instruction for graduate-level nurse anesthesia students and/or other anesthesia care providers. Ability to participate in the development of anesthesia patient care audit processes involving in depth review and analysis of anesthesia records. Ability to provide guidance and instruction in preparing others for positions of leadership and ethical practices which impact patient care. Reference: VA Handbook 5005/37, Part II, Appendix G7 NURSE ANESTHETIST QUALIFICATION STANDARD. This can be found in the local Human Resources Office. Physical Requirements: This position requires Heavy Lifting, 45 pounds heavy carrying, 45 pounds straight pulling (4 hours); pushing (4 hours); use of fingers; both hands required; walking & standing 8-12 hours; repeated bending 8 hours; both legs required. Transferring patients and objects may be required. 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 CRNA is directly responsible and accountable to the supervising anesthesiologist or surgeon. The CRNA is responsible for the provision of direct care, assessing monitors, providing IV sedation, conduction anesthesia or general anesthesia for patients. Performs pre-operative evaluation for surgical patients. Participates in a team approach to ensure appropriate patient assessments, anticipate patient care needs, prevent avoidable complications and achieve optimal patient conditions and outcomes. The CRNA acts in adherence of nursing care in accordance with ethical principles and functions within the scope of practice. The CRNA is responsible and accountable for maintaining BLS and ACLS training to performing activities that reflect the educational, experiential and competency requirements outlined in the nine dimensions: Nursing Practice: 1.Quality of Care, 2.) Performance, 3.)Educational/Career Development, 4.) Collegiality, 5.) Ethics, 6.) Collaboration 7.) Research, 8.) Resource Utilization Communication and interact appropriately and courteously with internal and external customers. Maintain confidentially of electronic, written and/or verbal patient/employee information. Demonstrate working practices that include adherence to infection control standards and the safe use and operation of equipment and adherence to safety practices. Conform with all medical center and service/service line safety policies, procedures and protocols to avoid injury and/or illnesses to self or others. Employee prepares all reports and documentation pertaining to injuries within established time frames utilizing the ASISTS Program. Employee identifies and reports all unsafe conditions to appropriate personnel to ensure a safe environment for all patients, medical center personnel and visitors. Work Schedule:7:30am to 4:00pm (Monday to Friday)\nCompressed/Flexible\nTelework: Not Available\nVirtual: This is not a virtual position.\nRelocation/Recruitment Incentives: Not Authorized\nPermanent Change of Station (PCS): Not Authorized\nPCS Appraised Value Offer (AVO): Not Authorized\nFinancial Disclosure Report: Not required"]
Providing Health Care for Veterans: The Veterans Health Administration is America’s largest integrated health care system, providing care at 1,255 health care facilities, including 170 medical centers and 1,074 outpatient sites of care of varying complexity (VHA outpatient clinics), serving 9 million enrolled Veterans each year.