Clarification from the agency

First area of consideration will be given to current, permanent employees of the John D. Dingell VA Medical Center. Second area of consideration will be given to current, permanent VA employees. All others will be considered thereafter.

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The NP is a licensed independent practitioner with advanced education and national certification who provides evidence-based care for a population of patients.

• Independently manages or in collaboration with attending physician(s), a panel of patients with acute and chronic health conditions with emphasis on health promotion and disease prevention using evidence-based practice.
• Develops and implements an individualized plan to achieve optimal population health and disease management.
• Demonstrates leadership and works collaboratively with the interdisciplinary team.
• Initiates referrals and consults to specialty services.
• Provide End-Of-Life care and symptom management to all patients in an inpatient and outpatient setting.
• Assesses and adjusts the plan of care as needed to achieve optimal patient outcomes.
• Provider is committed to delivering compassionate, timely and Veteran-centered care through multidisciplinary palliative care teams. These teams support Veterans in VA hospitals, community living centers (CLCs) and even remotely via telehealth services.
• Provides medical services to veterans on an Outpatient, Inpatient or assigned by the supervisor as needed at the John D Dingell VAMC under GEC service.

CLINICAL PRACTICE: Influences and models the delivery of evidence-based health care, demonstrating expertise in the ability to manage a patient panel, population, or program.
Expectations:
1. Independently practices as a NP providing a full range of care utilizing treatment guidelines in the delivery of high-quality care.
2. Collaborates with patients, families, and health care practitioners to develop, implement treatment plans, and evaluate health outcomes.
3. Demonstrates critical thinking in assessing and managing complex clinical situations.
4. Leads the delivery of care to assure continuity of care and peer accountability for practice, improving outcomes of panel/program.
5. Care is provided in outpatient clinics, inpatient CLC, impatient consult service or as assigned by the supervisor under Geriatric & Extended care service.

OUTCOME FOCUS: Leads and implements changes that enhance the quality and timeliness of Veteran/patient care applying research and evidence in the delivery of healthcare for patient populations.
Expectations:
1. Leads performance improvement initiatives that improves care or processes.
2. Engages in evidence-based practice and the application of clinical practice guidelines.
3. Implements quality improvement initiatives that lead to outcomes at the panel/program level.

LEADERSHIP: Initiates and leads interdisciplinary teams informed by structured approaches and processes to improve outcomes that positively impact care for a patient panel, population, or program.
Expectations:
1. Demonstrates positive effective communication skills and professionalism that promote cooperation and teamwork with internal and external customers.
2. Works effectively as a leader in planning and facilitating systematic change to improve outcomes.
3. Collaborates with stakeholders to improve patient care, staff development, and performance measures.
4. Participates as a member or leader in formal/informal workgroups or interdisciplinary teams.
5. Leads within a High Reliability Organization framework.

PROFESSIONAL DEVELOPMENT: Acquires knowledge and skills, then disseminates acquired information within and/or outside the medical facility.
Expectations:
1. Acquires and disseminates knowledge that impacts patient outcomes.
2. Educates and/or mentors' colleagues and/or students.
3. Assumes responsibility and accountability for evaluating progress toward professional career goals.

PROFESSIONALISM/COLLEGIALITY: Initiates and leads interdisciplinary teams developing systems that positively impact outcomes at the panel, population, or program. Demonstrates effective communication skills and professional behavior, promoting cooperation and teamwork.
Expectations:
1. Utilizes cultural sensitivity, listening and communication skills in leading team(s).
2. Role models high standards of professional and ethical conduct.
3. Initiates and leads interdisciplinary teams.

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: Monday-Friday, 8:00a-4:30p
Virtual: This is not a virtual position
Relocation/Recruitment Incentives: Not Authorized
Permanent Change of Station (PCS): Not Authorized

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.
• 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.
• 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. Acceptable form(s) of identification will be required to complete pre-employment requirements (https://www.uscis.gov/i-9-central/form-i-9-acceptable-documents). Effective May 7, 2025, driver's licenses or state-issued dentification cards that are not REAL ID compliant cannot be utilized as an acceptable form of identification for employment.
• 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).

Qualifications

Preferred Experience: minimum 3-5 years Inpatient and Outpatient Hospice and Palliative Care experience.

Advanced Practice Nurse (Nurse Practitioner) Basic Requirements

• Education: A post-master's certificate or master's or doctoral degree as a Nurse Practitioner. (Applicants pending the completion of educational requirements may be referred and tentatively selected but may not be hired until the education requirements are met.) Must be a 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).
  • NOTE: Foreign Education. Graduates of foreign schools of professional nursing programs, the nurse practitioner degree equivalency must be validated through an Agency recognized degree equivalency evaluation agency, such as the International Consultants of Delaware (ICD). Candidates with equivalent nurse practitioner masters or doctorate level degrees who possess current, full, active, and unrestricted registration and certification will meet the requirement of graduation from an approved school of professional nursing to warrant appointment.
• License and Certification:
  • License. All APN (NPs) must possess and maintain an active, current, full, and unrestricted APN license to practice as an NP in a State, Territory or Commonwealth of the United States, or in the District of Columbia.
  • Basic Certification. All APN (NPs) must maintain full and current board certification in an area of clinical specialty from one of the following: the American Nurses Credentialing Center (ANCC), American Academy of Nurse Practitioners Certification Board (AANPCB), or other nationally recognized certifying body in the area in which the Nurse Practitioner is academically prepared.

NOTE: Grandfathering Provision - All persons currently employed in VHA in 0610 series and an APN (NP) 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 Scope, Education and Experience, and Dimension criteria must be met to qualify for Advanced Practice Nurse (Nurse Practitioner) II:
Exception to Licensure for Graduate Nurse Technicians. Candidates who otherwise meet the basic requirements, but do not possess the required licensure and/or certification, may be appointed at the entry step of the Nurse II, as a Graduate Nurse Technician - Nurse Practitioner on a temporary appointment up to any period not-to-exceed one year and a day under the authority of 38 U.S.C. § 405(c)(2)(B).

• Scope: Demonstrates leadership in delivering and improving holistic care through collaborative strategies with others
• Education and Experience Requirement: Meets basic education requirement for APN (NP). Nurse II is considered the entry grade level for APN (NPs); no experience is required.
• Dimension Requirement: APNs (NPs) at level II are expected to meet the following dimension requirements:
  • Clinical Practice. Delivers evidence-based health care, demonstrating proficiency in the ability to manage a patient panel, population, or program.
  • Outcome Focus. Utilizes research and evidence-based practice to evaluate the patient care delivery system within a patient panel or program, presents findings and contributes to changes that enhance the quality and timeliness of veteran/patient care.
  • Leadership. Works effectively as a leader within a team/unit/group and seeks interdisciplinary collaboration as appropriate to enhance patient care.
  • Professional Development. Acquires knowledge and skills to develop expertise in area of practice.
  • Professionalism/Collegiality. Demonstrates effective communication skills and professional behavior, promoting cooperation and teamwork. Participates in interdisciplinary teams and processes that positively impact patient outcomes.

The following Scope, Education and Experience, and Dimension criteria must be met to qualify for Advanced Practice Nurse (Nurse Practitioner) III:

• Scope: Executes position responsibilities that demonstrate leadership, experience, and creative approaches to management of complex client care.
• Education and Experience Requirement: Meets basic education requirement for an APN (NP) AND one year of specialized APN (NP) experience equivalent to the Nurse II grade level.
• Dimension Requirement: APN (Nurse Practitioners) at grade III are expected to meet the following dimension requirements:
  • Clinical Practice. Influences and models the delivery of evidence- based health care, demonstrating expertise in the ability to manage a patient panel, population, or program.
  • Outcome Focus. Leads and implements changes that enhance the quality and timeliness of Veteran/patient care applying research and evidence in the delivery of healthcare for patient populations.
  • Leadership. Initiates and leads interdisciplinary teams informed by structured approaches and processes to improve outcomes that positively impact care for a patient panel, population, or program.
  • Professional Development. Acquires knowledge and skills, then disseminates acquired information within and/or outside the medical facility.
  • Professionalism/Collegiality. Initiates and leads interdisciplinary teams developing systems that positively impact outcomes at the panel, population, or program level. Demonstrates effective communication skills and professional behavior, promoting cooperation and teamwork.

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, simply grasp and fine manipulation. 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 incumbent must complete annual Employee Health requirements, such as annual TB screening or testing, as a condition of employment.

How you will be evaluated

You will be evaluated for this job based on how well you meet the qualifications above.

IN DESCRIBING YOUR EXPERIENCE, PLEASE BE CLEAR AND SPECIFIC. WE MAY NOT MAKE ASSUMPTIONS REGARDING YOUR EXPERIENCE. Your application, resume, C.V., and/or supporting documentation will be verified. Please follow all instructions carefully. Errors or omissions may affect consideration for employment.

NOTE: Candidate's education, scope, and length of nursing practice (experience) will be considered in determining the grade and salary of the applicant selected. The recommended salary may be at any point in the range listed for this vacancy.

Experience refers to paid and unpaid experience, including volunteer work done through National Service programs (e.g., Peace Corps, AmeriCorps) and other organizations (e.g., professional; philanthropic; religions; spiritual; community; student; social). Volunteer work helps build critical competencies, knowledge, and skills and can provide valuable training and experience that translates directly to paid employment. You will receive credit for all qualifying experience, including volunteer experience.

The Department of Veterans Affairs performs pre-employment reference checks as an assessment method used in the hiring process to verify information provided by a candidate (e.g., on resume or during interview or hiring process); gain additional knowledge regarding a candidate's abilities; and assist a hiring manager with making a final selection for a position.

It is the policy of the VA to not deny employment to those that have faced financial hardships or periods of unemployment.

Veterans and Transitioning Service Members: Please visit the VA for Vets site for career-search tools for Veterans seeking employment at VA, career development services for our existing Veterans, and coaching and reintegration support for military service members.