The CRNA provides direct patient care under the Anesthesiologist and/or the Chief, Surgery Service. The Nurse Anesthetist is a licensed independent practitioner responsible for the anesthetic management of patients to be rendered unconscious or insensitive to pain and emotional stress during surgical, dental, and certain medical procedures, including perioperative, intraoperative, and postoperative monitoring, evaluation, and treatment. 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. English Language Proficiency. In accordance with 38 U.S.C. 7402(d), 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 State-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). In cases of graduates of foreign schools of professional nursing, possession of current, full, active and unrestricted registration will meet the requirement of graduation from an approved school of professional nursing. OR The completion of coursework equivalent to a nursing degree in a MSN Bridge Program that qualifies for professional nursing registration constitutes the completion of an approved course of study of professional nursing. Students should submit the certificate of professional nursing to sit for the NCLEX to the VA along with a copy of the MSN transcript. (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. 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 of an accredited nurse anesthesia educational program approved by the American Association of Nurse Anesthetists (AANA) at the time the program was completed by the applicant. The AANA has compiled current listings of approved training institutions, which are published annually in the December issue of the American Association of Nurse Anesthetists Journal. The American Hospital Association in their "Guide to the Health Care Field" also publishes listings of approved training institutions annually in August. Certification: On and after May 4, 1993, certification by the Council on Certification of Nurse Anesthetists is a requirement for employment. This requirement does not apply to non-certified nurse anesthetists employed by VA as a nurse anesthetist prior to May 4, 1993 and continuously thereafter. Preferred Experience: 4 years experience as a CRNA Grade Determinations: The following criteria must be met in determining the grade assignment of candidates, and if appropriate, the level within a grade. The level that nurse anesthesia practice may be performed is based on a combination of education and experience. Beyond the minimum education requirements, grade determination upon appointment and advancement is dependent more on acquired knowledge, skills, and abilities than baseline education. As the nurse anesthetist acquires the knowledge and judgment that accrues with experience, the privilege of increased authority for patient care is expanded. 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 Nurse II, 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 Regulations, specifically VA Handbook 5005, Part II, Appendix G-7 Nurse Anesthetist Qualification Standard. This can be found in the local Human Resources Office. ["VA offers a comprehensive total rewards package: VA Nurse Total Rewards GCVHCS-Pensacola JACC is a small-scale facility that provides basic ambulatory surgical services for Veterans in our region and functions much like a surgical center. Case mix consists of providing general anesthesia or monitored anesthesia care for basic procedures within general surgery, urology, podiatry, and endoscopy. Duties include but are not limited to: Local and regional anesthesia with and without sedation, including topical and infiltration, minor and major nerve blocks, intravenous blocks, spinal, and epidural General anesthesia, including invasive and non-invasive monitoring, respiratory therapy, and airway management to include emergency cricothyroidotomy with direct supervision of surgeon or anesthesiologist Completes pre-anesthesia assessment of the preoperative (pre-procedure) patient Administers all types of anesthetics and places necessary invasive monitoring lines with supervision by an attending anesthesiologist Post-anesthesia management of patient Patient Controlled Analgesia (PCA) and other acute postoperative pain management (e.g. epidural infusion) Able to respond to situations of life threatening nature during normal tour of duty hours and in a timely fashion when assigned on-call duties Must act promptly, recognizing the need for supervisory assistance and support, and summoning the staff anesthesiologist promptly Participate in the instruction of medical students, residents, and other learners in the manual skills for which they have pertinent experience Participates in performance improvement monitoring and review activities Attends and participates in mandatory staff and committee meetings Undertakes any other procedures, tasks, or responsibility deemed appropriate by the Anesthesiologist with the approval of the Chief, Specialty Care Service, by the Professional Standards Board, Executive Committee of the Medical Staff, and by the Director Work Schedule: Monday - Friday, 7:30am - 4:00pm\nTelework: Not Available\nRelocation/Recruitment Incentives: Not Authorized\nPermanent Change of Station (PCS): 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.