Registered Nurse First Assist | Veterans Affairs, Veterans Health Administration

Saint Louis, Missouri, Summary The First Assist Registered Nurse (RN) is a proficient nurse who demonstrates proficiency in decision-making and using the nursing process for complex situations that affect performance outcomes at the point of care. Practice is enhanced through the development of collegial relationships. Demonstrates collaboration by using the group process to solve problems. 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/13082734 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 Preferred Experience : 2-3 years of experience as a Registered Nurse First Assist in hospital setting Demonstrates proficiency and accountability in all aspects of assigned patient care under direct supervision – progressing with skill development and independent practice as appropriate to experience Participates in and complies with Employee Health requirements – including PMDB (Prevention and Management of Disruptive Behavior) training Must be able to meet the physical demands of the position – including prolonged standing – walking – lifting – bending – and wearing PPE when required May be assigned to different assignments – tours – or roles as operational and patient care needs dictate Protects patient privacy and PHI in accordance with federal regulations and facility policy – including electronic/computer security standards Supports the culture of safety and reports potential and actual safety events – near-misses – and system issues Reference: For more information on this qualification standard – please visit https://www.va.gov/ohrm/QualificationStandards/ Physical Requirements: This position requires potentially long periods of continued walking – standing – and sitting The incumbent may be exposed to infected patients and contaminated materials and may be required to don protective clothing 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 comply with any Employee Health requirements as a condition of employment This includes but is not limited to carrying/lifting 45 pounds and over walking and/or standing for eight hours at a time and kneeling and repeated bending throughout shift Significant amounts of time standing assisting assigned patients Utilization of safe patient handling and mobility protocols In the performance of duties – the incumbent may be required to drive and/or ride in GSA-vehicles Duties The First Assist Registered Nurse (RN) is a proficient nurse who demonstrates proficiency in decision-making and using the nursing process for complex situations that affect performance outcomes at the point of care Practice is enhanced through the development of collegial relationships Demonstrates collaboration by using the group process to solve problems The focus is on leadership in strategically planning long-term goals for the microsystem (unit – team – or workgroup) that impacts operations or resources They demonstrate critical thinking with efficiency and accuracy in assessing and managing situations First Assist RN’s – function in an expanded perioperative nursing role When performing delegated medical functions – First Assist RNs are practitioners who are agents of the supervising physician(s)/independent licensed practitioner(s) who are responsible for the First Assist RN’s actions within the agreed upon scope of practice The supervising physician/independent licensed provider is to direct and review the work and practice on a continuous basis to ensure that appropriate directions are given and understood – and appropriate care is rendered The First Assist RN must have acquired the necessary knowledge – judgment – and skills specific to the expanded role of First Assist RN clinical practice Duties include – but are not limited to: Delivers fundamental – knowledge-based perioperative nursing care to assigned patients – developing technical skills based on age-specific components and patient needs Assesses – plans – implements – and evaluates nursing care for patients in the perioperative setting – with a focus on education – safety – satisfaction – and self-management throughout the surgical continuum Applies professional nursing practice as an RNFA – including all validated competencies and functions delegated by the supervising surgeon RNFA duties include: Assisting in patient positioning and prepping/draping of the surgical site Providing exposure through tissue manipulation – using surgical instruments – suctioning – and retraction Controlling bleeding and providing hemostasis using standard and advanced technologies (e.g. – electrosurgical units – ligatures – suture – topical agents – argon beam – bipolar/ultrasonic devices) Suturing and stapling of tissue – and closure of surgical wounds and application of dressings including wound vac therapy Making skin incisions – creating laparoscopic access (stab wounds/trocars) as allowed by the State Board of Nursing Placing and securing drains – inserting and removing surgical instrumentation (including robotics) Application and removal of casts and splints Harvesting veins and arteries for bypass conduit as delegated Administration of local anesthetic under surgeon direction Cleansing surgical site (superficial – subcutaneous – muscle/fascia – bone – abdominal/pelvic cavities) Removal of surgical drains (chest tubes – orthopedic/joint drains) Other intraoperative – preoperative – and postoperative RNFA tasks as permitted by certification and defined by hospital policy Note: This functional statement serves as a summary of major duties – responsibilities – and qualification requirements for the RNFA Additional duties may be assigned at the discretion of the supervisor or owing to patient care needs Validation of RNFA competency is required before assignment of RNFA-specific responsibilities 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 Location: VA St Louis Health Care System – John Cochran Campus Work Schedule: Monday – Friday 6:30 AM to 3:00 PM with required on-call rotation Telework: Ad-Hoc – as determined by agency policy Virtual: This is not a virtual position Relocation/Recruitment Incentives: Not Authorized Permanent Change of Station (PCS): Not Authorized