Registered Nurse- Emergency Room/Urgent Care

Summary

Emergency Department Registered Nurse is responsible and accountable for all elements of the nursing process when providing and/or supervising direct patient care. Assesses - plans - implements - and evaluates care based on age specific components. Assumes responsibility for the coordination of care focused on patient education - self-management - and customer satisfaction throughout the continuum of care.

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
• 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 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)
• The approving official may authorize a waiver of the requirement for ACEN or CCNE accreditation of any degree in nursing provided the college or university has regional accreditation from an accrediting body recognized by the Department of Education at the time of the candidate's graduation and the composite qualifications of the applicant warrant such consideration
• 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
• Grade Determinations: The following criteria must be met in determining the grade assignment of candidates - and if appropriate - the level within a grade: Nurse I Level I - An Associate Degree (ADN) or Diploma in Nursing - with no additional nursing practice/experience required
• Nurse I Level II - An ADN or Diploma in Nursing and approximately 1 year of nursing practice/experience
• OR an ADN or Diploma in Nursing and a bachelor's degree in a related field with no additional nursing practice/experience
• OR a Bachelor's of Science in Nursing (BSN) with no additional nursing practice/experience
• Nurse I Level III - An ADN or Diploma in Nursing and approximately 2-3 years of nursing practice/experience
• OR an ADN or Diploma in Nursing and a Bachelor's degree in a related field and approximately 1-2 years of nursing practice/experience
• OR a BSN with approximately 1-2 years of nursing practice/experience
• OR a Master's degree in nursing (MSN) or related field with a BSN and no additional nursing practice/experience
• Nurse II - A BSN with approximately 2-3 years of nursing practice/experience
• OR ADN or Diploma in Nursing and a Bachelor's degree in a related field and approximately 2-3 years of nursing practice/experience
• OR a Master's degree in nursing or related field with a BSN and approximately 1-2 years of nursing practice/experience
• OR a Doctoral degree in nursing or meets basic requirements for appointment and has doctoral degree in a related field with no additional nursing practice/experience required
• Nurse III - Master's degree in nursing or related field with BSN and approximately 2-3 years of nursing practice/experience
• OR a Doctoral degree and approximately 2-3 years of nursing practice/experience
• Note regarding MSN degrees: If your MSN was obtained via a Bridge Program that qualifies for professional nursing registration - a BSN is not required
• Physical Requirements: This position requires visual acuity - keen hearing - clear distinctive speech - and manual dexterity
• This position requires potentially long periods of continued walking - standing - stooping - sitting - bending - pulling - and pushing
• Transferring patients and objects may be required
• 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
• Must complete annual Employee Health requirements - such as annual TB screening or testing - as a condition of employment.

Duties

• Emergency Department (ED) Registered Nurse (RN) executes position responsibilities that demonstrate leadership - experience - and creative approaches to management of complex patient care
• Collaborates in the development - implementation - evaluation - and revision of policies - procedures - and/or guidelines
• Provides urgent and emergent care to patients with acute and/or chronic medical - surgical - and psychiatric conditions
• Nursing care ranges from basic nursing care to stabilization - resuscitation - and life-support measures
• Emergency nursing practice is independent and collaborative
• The ED RN practice includes the roles of direct care provider - educator - administrator - researcher - consultant - leader - and advocate
• Provides peers with formal or informal constructive feedback for improvement
• Supports colleagues and other nurses through knowledge sharing to provide safe - quality nursing care
• Fosters a safe and supportive environment conducive to the professional development of health care professionals
• Evaluates outcomes of evidence-based decisions and practice changes for individuals - groups - and populations
• Responsible for the documented outcomes at the program or service level
• Program or service level outcomes must be broad and complex and can be demonstrated at any organizational level within a facility
• The ED RN is responsible and accountable for all elements of the nursing process when providing care
• They assess the patient by collecting pertinent data or information - including the triage of patients based on the five-level triage system to prioritize patients that require more immediate care
• They use the assessment data to determine diagnoses - problems - or other concerns
• They will identify expected outcomes to develop a collaborative and individualized plan for each patient
• The ED RN will implement that plan - including care Functional Statement: Nurse III Page 2 coordination - health teaching - and health promotion
• They evaluate the progress toward achieving the expected goal and outcomes and adjusts the plan as necessary
• The responsibilities of the Registered Nurse assigned to the Triage/Emergency Room area include but are not limited to: Maintains current/active Advanced Cardiac Life Support (ACLS)/Basic Cardiac Life Support (BCLS) provider status
• Monitors patient conditions when held over in the life support room
• Triages all unscheduled patients in accordance with Emergency Severity Index
• Responds to Outside Emergencies and implements appropriate interventions
• Provides immediate nursing intervention in emergency situations
• Implements patient safety practices with regard to medication administration - patient identification - fall risk assessment and prevention - hand-off reports using the SBAR (situation - background - assessment and recommendations) format
• Is responsible for ordering/maintaining supplies for the clinical area
• Provides appropriate hand-off report communication using the SBAR format
• Demonstrates/maintains competencies in accordance with the Core Competencies of the High Performance Development Model (HPDM)
• Provides assistance to other nursing units such as ICU/Telemetry
• Has knowledge and expertise in the following: Transvenous and external pacemakers Automated External Defibrillator (AED)/Cardioversion/Defibrillation Treatment of acute MI/ACS - CHF - acute seizure activity - and Respiratory Distress Syndrome Chest tubes Foley catheters/CBI - IV thrombolytics IV pain management Expanders Vasoactive Is able to assess and implement care of patients with Dx of overdose - acute psychotic episodes including but not limited to suicide - violence - and hallucinations
• Is capable of providing care to patients with fractures - altered mental state and acute stroke
• Work Schedule:8a-8p or 12p-12a (6 twelve hour tours and 1 eight hour tour) Telework: Not Available Bargaining Unit: Yes Virtual: This is not a virtual position
• Permanent Change of Station (PCS): Not authorized Financial Disclosure Report: Not required

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The Veterans Health Administration (VHA) is the largest integrated health care system in the United States, providing care at 1,321 health care facilities, including 172 VA Medical Centers and 1,138 outpatient sites of care of varying complexity (VHA outpatient clinics) to over 9 million Veterans enrolled in the VA health care program. VHA Medical Centers provide a wide range of services including traditional hospital-based services such as surgery, critical care, mental health, orthopedics, pharmacy, radiology and physical therapy. In addition, most of our medical centers offer additional medical and surgical specialty services including audiology & speech pathology, dermatology, dental, geriatrics, neurology, oncology, podiatry, prosthetics, urology, and vision care. Some medical centers also offer advanced services such as organ transplants and plastic surgery.

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