Summary The LTC Charles S. Kettles VA Medical Center is seeking a Full-Time, Licensed Practical Nurse - Telehealth at the Toledo (OH) VA Community Based Outpatient Clinic (CBOC) within the Ambulatory Care Service. Responsibilities Duties include, but are not limited to: Demonstrates nursing practice with remote supervision of a registered nurse or licensed independent practitioner (LIP). Administers medication accurately and promptly under the general supervision of a registered nurse or LIP. Demonstrates understanding of the effects and/or reactions caused by medications, treatments, and procedures. Records and reports these observations. Demonstrates the ability to plan and organize assignments independently. Reports discrepancies to management. Initiates, performs, and completes assigned duties in providing telehealth patient care activities and phlebotomy responsibilities for adult and geriatric patients. Appropriately carries out assigned patient care based on the patients' conditions; uses judgment in selecting the appropriate order and sequence of procedures and treatments; and to accurately recognize, report and record relevant patient information. Assists the RN or LIP with urgent or emergent patient care situations, seek assistance of the RN and/or MD/DO, and initiate appropriate emergency interventions as directed. Accurately documents events. Adheres to standards and criteria identified in VAMC manuals and policies and current practice guidelines. Demonstrates the ability to assist RN and/or LIP to appropriately prioritize overall patient care needs and adjust plans for care delivery with some supervisory assistance. Makes 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. 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. Performs Telehealth imaging, including teleretinal screening, teledermatology, telewound care and other Telehealth programming as technology becomes available. Responsible for the patient site facilitation of the clinical, business, scheduling, and technical aspects for real-time Telehealth applications, including, but not limited to, Telemental health, telehealth primary care and specialty care, and telehealth patient education clinics or group visits. Installs, maintains, inventories and trains staff on all video-conferencing technologies, telehealth peripherals including stethoscopes, cameras, otoscopes, hearing aid fit testing, and Doppler technology and new technology as it becomes available. Provides advanced clinical technology information to patients, staff, and providers regarding Telehealth, education, and training processes. Uses video-conferencing technologies, Telehealth technology and scheduling software to coordinate and connect staff, resources, patients, and providers in the manner effective to delivery of services, patient care, education and training. Assists in patient care under the direct supervision of an independent licensed healthcare provider. Maintains daily telehealth schedule to assist in scheduling rooms, patients, technology and telepresenters. Reads, analyzes, and interprets directives, policies and regulations pertaining to telehealth services making recommendation of actions needed to ensure compliance with requirements. Independently reviews data for telehealth program and will design studies and training programs to improve patient telehealth services. Conducts quality control procedures on equipment and products and maintains proper records for quality control reports and workload reporting. Performs personal care, diagnostic support duties and treatments according to procedure under the direction of the professional nurse in a timely manner. Responds to patient's nursing needs, including physical comfort, and emotional needs and recognizing deviations from the normal. Instructs patients and family members on principles of health, self-care, and protocols for treatments and/or medications. Completes required patient care documentation and records significant observations and actions utilizing the nursing process in a clear and concise manner. Work Schedule: Monday - Friday - 8:00 AM - 4:30 PM Compressed/Flexible: Authorized based on needs of the service. Recruitment Incentive (Sign-on Bonus): Not Authorized Telework: Not Available Virtual: This is not a virtual position. Permanent Change of Station (PCS): Not Authorized Requirements Conditions of Employment You must be a U.S. Citizen to apply for this job. All applicants tentatively selected for VA employment in a testing designated position are subject to urinalysis to screen for illegal drug use prior to appointment. Applicants who refuse to be tested will be denied employment with VA. Selective Service Registration is required for males born after 12/31/1959. Must be proficient in written and spoken English. You may be required to serve a probationary period. Subject to background/security investigation. Selected applicants will be required to complete an online onboarding process. Must pass pre-employment physical examination. Participation in the seasonal influenza vaccination program is a requirement for all Department of Veterans Affairs Health Care Personnel (HCP). Participation in the Coronavirus Disease 2019 (COVID-19) vaccination program is a requirement for all Veterans Health Administration Health Care Personnel (HCP) - See "Additional Information" below for details. Qualifications Basic Requirements: Citizenship: Citizen of the United States Education: Graduate of a school of practical or vocational nursing approved by the appropriate State agency and/or accredited by the National League for Nursing [Accrediting Commission (NLNAC) at the time the program was completed by the applicant. Verification can be obtained from the State approving agency [or] the National League for Nursing Accrediting Commission, 61 Broadway, 33rd Floor, New York, NY 10006. Additional information may also be obtained from the NLNAC Website. Exceptions include: Health care education in the military service or training in the military service which is accepted by the licensing body in the jurisdiction in which the individual is licensed as qualifying for full LPN/LVN licensure will be accepted as meeting the education requirements for VHA employment. Individuals granted a license by a jurisdiction that does not require graduation from an approved school. See paragraph 4, section C. Licensure. Full, active, current and unrestricted licensure as a licensed practical or vocational nurse in a State, Territory or Commonwealth (i.e., Puerto Rico) of the United States, or District of Columbia. An LPN/LVN who has or has ever had, any license(s) revoked, suspended, denied, restricted, limited, or issued/placed in a probationary status may be appointed only in accordance with the provisions in chapter 3, section B, paragraph 16 of this part. English Language Proficiency. Licensed practical or vocational nurses appointed to direct patient care positions must be proficient in [both] spoken and written English as required by 38 U.S.C. 7402(d), and 7407(d). Grade Determinations: In addition to the basic requirements, the following criteria must be met when determining the grade of candidates: GS-3:None beyond the basic requirements listed above. LPNs at this grade level are expected to perform all duties within the scope of their license (e.g., medication administration); however, completed work may require routine or detailed higher level review depending upon the complexity of the duties involved. GS-4:Employees may be appointed at or advanced to GS-4 if they meet any of the criteria below: Six months of qualifying experience as an LPN or LVN; OR Graduation from an approved school (which may be waived as provided in paragraph 4 of Section C) and one year of experience that involved nursing care work in a hospital, outpatient clinic, nursing home, OR Other supervised medical, nursing, or patient care facility that provided a practical knowledge of human body structure and sterile techniques and procedures; or graduation from an approved school of at least 24 months duration. LPNs at the GS-4 grade level perform all duties expected of employees at the GS-3 grade level; however, they are expected to exercise greater judgment, require less supervision, and to operate in accordance with all established policies, procedure, and techniques. GS-5:Completion of at least 1 year of qualifying experience at the GS-4 level or equivalent. Demonstrated knowledge and ability to provide a full range of practical nursing care to patients with a variety of physical and/or behavioral problems. Works with the RN and/or MD/DO to appropriately orient/train less experienced LPNs//LVNs and/or Nursing Assistants (NAs)/Health Technicians (HTs) in relation to acceptable standards of practice in promoting optimal patient care delivery. Provides effective education to patients and/or family members in relation to common disease processes, medication, and /or prescribed treatment regimes. Demonstrated ability to serve as a responsible member of the nursing team and interact in an appropriate manner with patients, family members, professional and other supportive personnel involved in the delivery of patient care, incorporating acceptable, established customer service standards into practice. Knowledge and skill sufficient to prepare, administer, and appropriately document actions taken specific to commonly prescribed oral, topical, subcutaneous, intramuscular, and/or intravenous medications as permitted by approved local facility policies and procedures. Observation and documentation will include patient's response to medication administered and the reporting of any noted change in patient's condition to RN or MD/DO. Knowledge and ability to recognize the need for and to institute emergency measures when indicated, promptly seek the assistance of the RN or MD/DO, and assist in resuscitation procedures in cardiac and/or pulmonary arrest. Recognizes and appropriately responds to breakage/malfunction or loss of equipment, safety hazards, and supply deficiencies, promptly reporting to appropriate personnel for corrective action. Completed work is under the general supervision of an RN or MD/DO. Individuals at this grade level are expected to have a broad working knowledge of practical nursing procedures. However, completion of more complex practices or procedures may be subject to closer higher-level review. GS-6:Completion of at least one (1) year of additional qualifying experience at the GS-5 level or equivalent fully meeting all performance requirements for the GS-5 LPN/LVN. Technically proficient in initiating, performing and completing assigned duties in providing care to variable patient populations. Knowledge and ability to appropriately carry out assigned patient care based on the patients' conditions; to use judgment in selecting the appropriate order and sequence of procedures and treatments; and to accurately recognize, report and record relevant] patient information. Completed work should need only a general review by a registered nurse (RN) or physician (MD/DO) for appropriateness and conformity with established policies/procedures. Ability to observe, identify and respond to the patient's needs for care, including medication, equipment-assisted care and patient/family education. In organizing and delivering care the LPN/LVN recognizes and considers emotional, cultural, spiritual, socio-economic, and age-related factors. Prepares and administers prescribed medications (oral, topical, subcutaneous, intramuscular and/or intravenous) and performs treatments according to established policies/procedures. Knowledge and ability to recognize urgent or emergent patient care situations, seek assistance of the RN and/or MD/DO, and initiate appropriate emergency interventions as directed. Knowledge and understanding of human behavior, patient motivations and reactions to situations, and ability to appropriately utilize this knowledge in working effectively with patients, family members, and other staff. Establishes constructive relationships with individual patients and their families to elicit feelings and attitudes, and to promote positive relationships, communication and socialization skills. Knowledge and skill in performing support duties for complex diagnostic tests and/or specialized practices or procedures, which include preparing the patient, assisting in the diagnostic examination, preparing and handling instruments. Actively seeks out educational opportunities to enhance nursing knowledge and skills. Reference: For more information on this qualification standard, please visit https://www.va.gov/ohrm/QualificationStandards/. The full performance level of this vacancy is GS-6. The actual grade at which an applicant may be selected for this vacancy is in the range of GS-3 to GS-6. Physical Requirements: The position may require prolonged standing and/or sitting for greater than 4 hours. This position may require lifting at least 45 pounds; the individual should not lift more and should arrange for assistance from the correct service line and/or point of contact. The position may require repetitive stooping, bending, kneeling, squatting, carrying items from one area to another, and/or transferring of patients to or from elevated surfaces. Education IMPORTANT: A transcript must be submitted with your application if you are basing all or part of your qualifications on education. Note: Only education or degrees recognized by the U.S. Department of Education from accredited colleges, universities, schools, or institutions may be used to qualify for Federal employment. You can verify your education here: http://ope.ed.gov/accreditation/. If you are using foreign education to meet qualification requirements, you must send a Certificate of Foreign Equivalency with your transcript in order to receive credit for that education. For further information, visit: https://sites.ed.gov/international/recognition-of-foreign-qualifications/. Additional Information Note: Must have Basic Life Support (BLS) certification prior to assuming clinical duties. The BLS requirement is satisfied by successfully completing an American Heart Association (AHA) BLS Healthcare Provider Course or Military Training Network (MTN). BLS courses are normally offered within 1-5 days of entry on duty. No online certifications will be accepted. This job opportunity announcement may be used to fill additional vacancies. This position is in the Excepted Service and does not confer competitive status. VA encourages persons with disabilities to apply. The health-related positions in VA are covered by Title 38, and are not covered by the Schedule A excepted appointment authority. Pursuant to VHA Directive 1193.01, VHA health care personnel (HCP) are required to be fully vaccinated against COVID-19 subject to such accommodations as required by law (i.e., medical, religious or pregnancy). VHA HCPs do not include remote workers who only infrequently enter VHA locations. If selected, you will be required to be fully vaccinated against COVID-19 and submit documentation of proof of vaccination before your start date. The agency will provide additional information regarding what information or documentation will be needed and how you can request a legally required accommodation from this requirement using the reasonable accommodation process. If you are unable to apply online or need an alternate method to submit documents, please reach out to the Agency Contact listed in this Job Opportunity Announcement. Under the Fair Chance to Compete Act, the Department of Veterans Affairs prohibits requesting an applicant's criminal history prior to accepting a tentative job offer. For more information about the Act and the complaint process, visit Human Resources and Administration/Operations, Security, and Preparedness (HRA/OSP) at The Fair Chance Act.