Summary The Registered Nurse in the Emergency Department meets the needs of customers while supporting VA missions. Consistently communicates and treats customers (Veterans, their representatives, visitors, and all VA staff) in a courteous, tactful, and respectful manner. Provides the customer with consistent information according to established policies and procedures. Handles conflict and problems in dealing with the customer constructively and appropriately. Responsibilities The ED RN assumes the following major duties and responsibilities: Leads and organizes delivery of care to assure continuity of care & peer accountability for practice, including access to care & discharge planning. Uses advance clinical knowledge/judgment to promote staff involvement in planning, decision-making, & evaluating outcomes. Functions as an expert in clinical practice and/or areas related to the assignment of roles & responsibilities. Systematically evaluates current practice and formulates outcomes for groups of patients and/or organizational processes within an area of expertise. Guides, develops, & supports staff from a leadership perspective. Uses professional standards of care, scientific evidence, & practice to evaluate programs and/or service activities. Participates in orientation, unit-based in-services, & mandatory education activities in a self-directed manner. Evaluates unit performance as measured against The Joint Commission standards and takes action to correct deficits to ensure compliance as part of continued readiness. Supports and encourages others to read and correctly interpret medical center & service-level policies and procedures. Assumes leadership role in identifying policies, procedures, standards, guidelines, & protocols requiring review or revision. Applies and directs others to apply infection control measures appropriately in delivering care. Identifies and analyzes systems problems which effect/impede patient care & initiates their resolution. Provides leadership in coordinating patient care & collaborating with other disciplines/departments to achieve patient care outcome. Performs procedures or seeks help when needed, such as phlebotomy, IV insertion, 12 lead ECG, blood transfusions, urinary catheter insertion & care. Administers medications as ordered by physicians. Performs Point of Care laboratory testing, including glucometer, ISTAT, & urine hCG. Safely and effectively uses equipment required for patient care. Reports equipment in need of repair. Takes and records vital signs. Recognizes subtle abnormal signs and symptoms and/or changes in patients' condition & responds appropriately. Makes assignments and directs activities of other unit staff, (RNs, LVNs/LPNs, students, MSAs, other team members). Formulates a plan of care based on nursing assessments based on the ANA Standards of Nursing Practice & seeks assistance as needed. Completes initial assessment of patient condition, screenings, & response to treatment and initiates follow-up as needed Triages patients using the Emergency Severity Index (ESI) & initiates established protocols. Provides leadership in establishing goals, evaluating the plan of care, & in discharge planning. Initiates referrals to other disciplines and/or services as appropriate Updates plan of care with assistance as needed. 25. Assesses patient's learning needs, learning preference, & readiness to learn. Develops and implements a plan to meet learning needs, instructing patients & families in basic health teaching & discharge planning. Documents the nursing process. Evaluates & documents patient response to interventions and progress towards attainment of goals and expected outcomes. Revises plan of care according to evaluations of patient responses. Uses the Computerized Patient Record System (CPRS) or currently used electronic medical record, Bar Code Medication Administration (BCMA), Bed Management System (BMS), and the Emergency Department Integrated Software (EDIS) per policy. Assigns patient care responsibilities based upon triage level, patient care needs, & competencies of staff. Functions as charge nurse/team leader in providing direction to staff in meeting patient care needs. Participates in hospital wide committees, workgroups, or councils to improve patient outcomes & organizational/departmental measures. Follows-up to ensure that assigned delegated tasks are completed by team member Responds to emergencies as a member of the Rapid Response Team (RRT) and Code Blue Team. Utilizes all available safe patient handling equipment. Transports patients via wheelchair, gurney, & electric emergency vehicle. Performs other Duties as assigned. 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: Full Time; 1900-0730 Compressed/Flexible: N/A Telework: N/A Virtual: This is not a virtual position. Relocation/Recruitment Incentives: N/A Requirements Conditions of Employment U.S. Citizenship; non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy. 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. 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: English Language Proficiency. In accordance with 38 U.S.C. 7403(f), no person shall serve in direct patient care positions unless they are proficient in basic written and spoken English. Graduate of a school of professional nursing approved by the appropriate accrediting agency and accredited by one of the following accrediting bodies at the time the program was completed by the applicant: The Accreditation Commission for Education in Nursing (ACEN) or The Commission on Collegiate Nursing Education (CCNE); OR Individuals attending a master's level bridge program in nursing who have completed coursework equivalent to a bachelor's level degree in Nursing may have opportunity to become registered as a nurse with a state licensing board prior to completion of the bridge program. Upon achievement of a State license, the individual may be appointed on temporary basis and later converted to a permanent appointment upon successful completion and graduation from the bridge program. (Reference VA Handbook 5005, Appendix G6); OR In cases of graduates of foreign schools of professional nursing, possession of a current, full, active, and unrestricted registration will meet the requirement for graduation from an approved school of professional nursing to warrant an appointment as a Nurse who has completed an associated degree/entry level Nursing education program. Credit for foreign nursing education higher that associate degree/entry level requires a formal degree equivalency validation from a recognized equivalency evaluation accepted by VA such as International Consultants of Delaware (ICD). Current, full, active, and unrestricted registration as a graduate professional nurse in a State, Territory or Commonwealth (i.e., Puerto Rico) of the United States, or the District of Columbia. Graduate Nurse Technician (GNT) Exception: Candidates who otherwise meet the basic education requirements, but do not possess the required licensure, may be appointed at the entry step of the grade and level applicable to the completed nursing education as a GNT on a 120-day temporary appointment while actively pursuing licensure (may be extended up to two years on a case-by-case-basis.) NOTE: Grandfathering Provision - All persons currently employed in VHA in 0610 series and 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. Grade Determinations: The following Scope, Education and Dimension criteria must be met in determining the grade assignment of candidates, and if appropriate, the level within a grade. The Dimension requirements (Practice, Veteran/Patient Driven Care, Leadership, Professional Development and Evidence-Based Practice/Research) are detailed for each grade and level within the online assessment: https://apply.usastaffing.gov/ViewQuestionnaire/12557600. Grade/Level Scope Education Nurse I, Level I Delivers fundamental, knowledge-based care to assigned clients while developing technical competencies. An Associate Degree (ADN) or Diploma in Nursing, with no additional professional nursing required. Nurse I, Level II Demonstrates integration of biopsychosocial concepts, cognitive skills and technically competent practice in providing care to clients with basic or complex. An ADN or Diploma in Nursing AND 1 year of specialized nursing experience equivalent to Nurse I, Level 1 ;OR a Bachelor of Science in Nursing (BSN) with no additional professional nursing experience required. Nurse I, Level III Demonstrates proficiency in practice based on conscious and deliberate planning. Self-directed in goal setting for managing complex client situations. An ADN or Diploma in Nursing AND 2 years of professional nursing experience in which one year is equivalent to Nurse I, Level 2; OR a BSN and 1 year of professional nursing experience equivalent to the Nurse I, Level 2; OR a Master's degree in nursing (MSN) and no additional professional nursing experience; OR a Master's degree in a *related field with a BSN and no additional professional nursing experience. Nurse II Demonstrates leadership in delivering and improving holistic care through collaborative strategies with others. A BSN with 2 years of professional nursing equivalent to Nurse I, Level 3; OR an MSN with one year of specialized nursing experience equivalent to Nurse I, Level 3; OR a Master's degree in a *related field with a BSN and one year of specialized nursing experience equivalent to Nurse I, Level 3; OR a Doctoral degree in Nursing with no professional nursing experience; OR a Doctoral degree in a *related field with a BSN with no additional professional nursing experience. Nurse III Executes position responsibilities that demonstrate leadership, experience and creative approaches to management of complex client care beyond the immediate practice setting. MSN and 2 years of specialized nursing experience, one of which is equivalent to Nurse II and meets all dimension requirements for Nurse III; OR a Master's degree in *related field with BSN and two years of specialized nursing experience, one of which is equivalent to Nurse II and meets all dimension requirements for Nurse III; OR a Doctoral degree in Nursing with and one year of specialized nursing experience equivalent to Nurse II and meets all dimension requirements for Nurse III; OR a Doctoral degree in a *related field with a BSN and one year of specialized nursing experience equivalent to Nurse II and meets all dimension requirements for Nurse III. *Note: Foreign education programs/degrees are not creditable as related degrees. Reference: For more information on this qualification standard, please visit https://www.va.gov/ohrm/QualificationStandards/. Preferred Experiences: 2 years of recent Emergency Department Experience. Charge nurse experience Physical Requirements: Lifting maximum of 35 pounds for patient care (animate); non patient care (inanimate objects) maximum lifting is 50 pounds. Pulling, pushing and reaching above shoulder may be required; use of fingers, both hands required, walking and standing for the duration of your tour; repeated bending; Ability for rapid mental and muscular coordination. Safe patient handling and management modalities are required at all times. VA Directive and Handbook 5019, Employee Occupational Health Service. Education Additional Information 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.