Summary The Licensed Vocational Nurse (LVN) GS-6 in the Primary Care/CBOC is a direct care provider whose scope of practice includes providing direct nursing care to patients in the ambulatory care setting at the VA Central California Health Care System, Fresno or Tulare, Merced or Oakhurst Community Based Outpatient Clinic (CBOC) of Primary Care Service. Incumbent practices in the outpatient care setting under the direction and supervision of the Clinical Nurse Manager. Responsibilities The LVN is a member of the Patient Aligned Care Team (PACT) consisting of (Veteran, Provider, RN Care Manager, Clinical Associate and Clerical Associate) and Expanded Team (Family/Caregiver, Social Worker, Pharmacist, Dietician, Internal and Community-Based Services) involved in providing care to the patient and in developing the PACT plan. The LVN is expected to demonstrate knowledge and ability to vary the order and sequence of assigned procedures based on patient's condition; to use judgment in selecting the most appropriate application of procedures and guidelines; and to accurately report and record significant patient information. Completed work needs only a general review by a registered nurse for technical soundness; appropriateness and conformity with policy and nursing assignments. Demonstrate ability to observe, identify and respond to the patient's needs for nursing, medication, and equipment- assisted care and to recognize deviations from normal. In modifying patient care plans, the employee considers physical, emotional and social factors. Knowledge and skill sufficient to competently & confidently prepare, administer and appropriately document actions taken specific to commonly prescribed oral, topical, intradermal, subcutaneous, and/or intramuscular mediations, immunizations or skin tests as permitted by approved local facility policies and procedures. Ability to astutely observe and document a patient's response to medications administered and report any change in patients' condition to RN or MD/DO, as appropriate. 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. Demonstrated knowledge, skill and ability to recognize and respond appropriately to emergency situations. Completed work is under the general supervision of an RN or MD/DO. Duties may also include, but not limited to: Adheres to standards of practice and safe technique in preparation and administration of medications. Demonstrating competency in completing health nurse procedures including EKGs, wound care, taking of vital signs, ear lavage, etc. Demonstrates understanding of age- and population-specific characteristics that affect the health care needs of the Veteran. Participates in PACT team huddles and meetings. Promptly recognizes urgent or emergent patient care situations, seeks assistance and effectively intervenes as directed and when appropriate. Based on the patient's goals, provides patient, family and caregiver health education, to include self- management, prevention, and wellness. Interacts and communicates appropriately with patients and family members. Participates within the PACT team secure messaging framework, typically as triage team member. Demonstrates professional behavior (e.g. respect, civility, ability to accept constructive criticism), effective communication and interpersonal skills. Adheres to principles of infection control, safety, and universal precautions. Maintains a clean clinic environment and stocking assigned exam rooms daily Incumbent possesses knowledge of proper handling and pre-cleaning of reusable medical equipment. Demonstrates competence utilizing special equipment needed to perform job duties Follows policy and procedures related to fire and disaster drills, safety and security measures. Performance Improvement (Non-Critical) Elements consist of: Recognizing that all employees are responsible for performance improvement with the health care system. Understanding the concept of national and VISN performance measures. Understanding special review process to the workplace in which are assigned (e.g. VORP, The Joint Commission, Environment of Care Rounds) Promotes the spirit of performance improvement between members of the PACT team. Participates in performance improvement activities at the unit level as assigned. This may include, but is not limited to project development, data gathering and/or data reporting. Uses performance improvement information to effect positive change at the unit level. Work Schedule: Monday - Friday 8:00 am - 4:00pm Telework: Available on an adhoc basis, as determined by agency policy. Virtual: This is not a virtual position. Functional Statement #: 2394A Relocation/Recruitment Incentives: 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. 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 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. Education or Training: Graduate of a school of practical or vocational nursing approved by the appropriate State Agency and/or accredited by the Accreditation Commission for Education in Nursing (ACEN); OR Received health care education/training in the military service which is accepted by the licensing body in the jurisdiction in which the individual is licensed as qualified for full LPN/LVN licensure 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. Physical Standards: As required per VA Directive and Handbook 5019. 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), 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). Grade Determinations: GS-6 Experience: One (1) year of progressively responsible assignments and experience equivalent to the GS-5 level which demonstrates knowledge, skills, and abilities that are directly related to the specific assignment and fully meets all of the performance requirements for the GS-5 LVN. In addition to meeting the basic requirements and grade determinations, applicant must demonstrate the following: 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. 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 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. Observes for physical and/or emotional changes in patient's condition from prescribed medications/treatments, promptly and accurately documenting noted changes, and reporting any deviations from normal to RN or MD/DO. 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. Fosters an environment of respect for individual patient and family rights to privacy and dignity in all aspects of care delivery. 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 specialized instruments or other specialized equipment, and monitoring the patient's condition before, during, and following the procedure. 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-06. Physical Requirements: This position requires possible long periods of continued walking, standing, stooping, sitting, bending, pulling, and pushing. Transferring patients and objects may be required. May be exposed to infected patients and contaminated materials, may be required to don protective clothing in isolation situations or operative/invasive procedures. Heavy Lifting (45 lbs and over); Heavy Carrying (45 lbs and over); Straight Pulling (7 to 8 hours); Pushing (7 to 8 hours); Reaching above shoulder; Use of fingers; Both hands required; Walking (7 to 8 hours); Standing/Kneeling (1 hour); Repeated bending (7 to 8 hours); both legs required; Ability for rapid mental and muscular coordination simultaneously; Near vision correctable at 13" to 16"; far vision correctable in one eye to 20/20 and to 20/40 in the other; Hearing (aid permitted); emotional/ mental stability. 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 Receiving Service Credit or Earning Annual (Vacation) Leave: Federal Employees earn annual leave at a rate (4, 6 or 8 hours per pay period) which is based on the number of years they have served as a Federal employee. Selected applicants may qualify for credit toward annual leave accrual, based on prior work experience or military service experience. This credited service can be used in determining the rate at which they earn annual leave. Such credit must be requested and approved prior to the appointment date and is not guaranteed. During the application process you may have an option to opt-in to make your resume available to hiring managers in the agency who have similar positions. Opting in does not impact your application for this announcement, nor does it guarantee further consideration for additional positions. 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.