The Practical Nurse uses the Nursing process and evidence-based practice to care for adult and geriatric residents in the long-term care and palliative care environment. The LPN is responsible and accountable for all elements of the nursing process when providing and/or supervising direct resident care and is responsible for collaborating with the care team, family, and internal and external services to the VA, to provide resident centered care and meet residents' care delivery needs. 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. 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: (1) GS-3. None beyond the basic requirements. LPNs at this grade level are expected to perform all duties within the scope of their license (e.g., medication administration); however, completed work may require routine or detailed higher level review depending upon the complexity of the duties involved. (2) GS-4. Employees may be appointed at or advanced to GS-4 if they meet any of the criteria in paragraphs 3b(2)(a) through (c) below: (a) Six months of qualifying experience as an LPN or LVN; or (b) Graduation from an approved school (which may be waived as provided in paragraph 4 of Section C) and one year of experience that involved nursing care work in a hospital, outpatient clinic, nursing home, or other supervised medical, nursing, or patient care facility that provided a practical knowledge of human body structure and sterile techniques and procedures; or (c) Graduation from an approved school of at least 24 months duration. (d) LPNs at the GS-4 grade level perform all duties expected of employees at the GS-3 grade level; however, they are expected to exercise greater judgment, require less supervision, and to operate in accordance with all established policies, procedure, and techniques. (3) GS-5 (a) Completion of at least 1 year of qualifying experience at the GS-4 level or equivalent. (b) Demonstrated knowledge and ability to provide a full range of practical nursing care to patients with a variety of physical and/or behavioral problems. Works with the RN and/or MD/DO to appropriately orient/train less experienced LPNs/LVNs and/or Nursing Assistants (NAs)/Health Technicians (HTs) in relation to acceptable standards of practice in promoting optimal patient care delivery. Provides effective education to patients and/or family members in relation to common disease processes, medication, and /or prescribed treatment regimes. (c) Demonstrated ability to serve as a responsible member of the nursing team and interact [in an appropriate manner] with patients, family members, professional and [other] supportive personnel[involved in the delivery of] patient care, [incorporating acceptable, established customer service standards into practice. (d) Knowledge and skill sufficient to prepare, administer, and appropriately document actions taken specific to commonly prescribed oral, topical, subcutaneous, intramuscular, and/or intravenous medications as permitted by approved local facility policies and procedures. Observation and documentation will include patient's response to medication administered and the reporting of any noted change in patient's condition to RN or MD/DO.(e) 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. (f) Recognizes and appropriately responds to breakage/malfunction or loss of equipment, safety hazards, and supply deficiencies, promptly reporting to appropriate personnel for corrective action. (g) Completed work is under the general supervision of an RN or MD/DO. Individuals at this grade level are expected to have a broad working knowledge of practical nursing procedures. However ,completion of more complex practices or procedures may be subject to closer higher-level review. (4) GS-6 [(a) Completion of] at least [one (1)] year of [additional] qualifying experience at the GS-5 level or equivalent [, fully meeting all performance requirements for the GS-5 LPN/LVN. (b) Technically proficient in initiating, performing and completing assigned duties in providing care to variable patient populations. (c) 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. Completed work [should need]only a general review by a registered nurse [(RN) or physician (MD/DO)] for [ ] appropriateness and conformity with [established policies/procedures. (d) 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 [LPN/LVN recognizes and] considers [ ] emotional [, cultural, spiritual, socio-economic, and age-related] factors. [(e) 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. (f) 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. (g) 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. (h) 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. Effectively incorporates knowledge and understanding of established customer service standards in all interactions with patients, family members, and/or other internal/external customers. (i) 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. Serves as a preceptor in orienting, educating, and training less experienced LPNs/LVNs or NAs/HTs related to support duties for these more complex, specialized tests/procedures. (j) Actively seeks out educational opportunities to enhance nursing knowledge and skills, sharing new knowledge gained with other staff to improve and advance nursing practice. Reference: For more information on this qualification standard, please visit https://www.va.gov/ohrm/QualificationStandards/. The full performance level of this vacancy is 06. The actual grade at which an applicant may be selected for this vacancy is in the range of 03 to 06. Physical Requirements: This position requires visual acuity, keen hearing, manual dexterity, and clear distinctive speech. This position requires potentially long periods of continued walking, standing, stooping, sitting, and bending. Bending, lifting, and carrying light items may be required. The Incumbent must be able to demonstrate nursing procedures requiring technical skills. ["Responsibilities include, but are not limited to: 1) Manages patient care issues in accordance with VA practice and LPN licensure. Maintains knowledge and skills to care for a wide range of patients including those with acute and chronic illnesses. Demonstrated knowledge and ability to provide a full range of practical nursing care to patients with a variety of physical and/or behavioral problems. Demonstrates comprehensive understanding of disease condition, nursing principles/standards/practices to coordinate nursing care in the CLC setting. 2) Reviews records and reports Vital Signs, weight, blood glucose levels and/or abnormal findings to the Registered Nurse and/ or Provider. 3) Possesses comprehensive knowledge of VA protocols, VHA Directives, VA HVCS SOP/Policies related to patient management, documentation, and procedural requirements such as the reading and implementation of provider orders, vocational nursing care, and safe administration of medication. 4) Demonstrates knowledge, skill, and ability to promptly recognize and effectively intervene in potential or emergent situations; instituting emergency measures when indicated-Rapid Response, Code Blue/Green. Demonstrates the ability to independently adjust or modify care being delivered to meet the changing needs of the patient with notification to the RN or provider for concurrence. Responsibilities include prompt recognition and facilitation of treatment for urgent needs such as hypoglycemia, acute shortness of breath, acute chest pain, seizures, stroke symptoms and/or mental health issues LPNs at the GS-6 level demonstrate knowledge and skill with respect to these responsibilities demonstrating the ability to serve as a responsible member of the nursing team and interact with patients, family members, professional and support personnel. Performs other duties as assigned. Work Schedule: Nights with rotation Relocation/Recruitment Incentives: Not Authorized Permanent Change of Station (PCS): Not Authorized"]
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.
