Nurse Practitioner(Hospice/Palliative Care/RRTP)
What you'd do
Cheyenne Veterans Affairs Healthcare System (CVAHCS) is a Level 3 facility with service-lines serving medical, mental health, surgical, and neurological outpatients, with a Level 3 Emergency Department, and multiple Community-Based Outpatient Clinics (CBOCs). There is a large outpatient psychiatric population, with admissions for medical co-morbidities. Home-Based Primary Care is provided in the veteran's home.
Major duties
The Advanced Practice Nurse (APN) II Certified Nurse Practitioner (NP) practices in Geriatrics Extended Care Service and the Residential Rehabilitation Treatment Program to provide a full range of services emphasizing quality, timeliness, and the advancement of the Veterans Affairs (VA) mission. The NP provides advanced clinical practice, consultation, and management. The NP practices to the full extent of their education, training, and certification. Core functions are outlined in the clinical privileges that correspond with this position. The NP has prescriptive authority for a panel of patients or program as indicated by their position. Major Duties and responsibilities of the position: - Independently manages a panel of patients with acute and chronic health conditions with an 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. - Orders and interprets labs, tests, and diagnostic studies. - Prescribes pharmacologic and non-pharmacologic interventions. - Initiates referrals and consults to specialty services. - Provides education to patients and their families. - Assesses and adjusts the plan of care as needed to achieve optimal patient outcomes. - Exemplifies the ICARE core values of-Integrity, Commitment, Advocacy, Respect, and Excellence. The Nurse Practitioner provides direct patient care through various modalities, including in-person visits (at the Community Living Center, hospital, and outpatient settings), VVC/telehealth, and any other appropriate environments for care. The NP will collaborate with the interdisciplinary team across services, including but not limited to mental health, pain management, whole health, education, primary care, home oxygen, laboratory services, radiology services, innovation, Physical Medicine & Rehabilitation Services (PM&RS), complementary/integrative health, social work, pharmacy, physical therapy, occupational therapy, surgical services, telehealth, and nursing services. The hospice and palliative care nurse practitioner will conduct palliative care consultations in conjunction with palliative care team members, including engaging in goals of care conversations and addressing symptom management needs. They will communicate palliative care consultation findings with the referring medical provider, the veteran, and/or their medical decision-maker. The NP will provide consultations and follow-ups for veterans receiving hospice care in the Community Living Center, offering prognostic estimations, addressing symptom management, and meeting other palliative care needs in conjunction with other team members. The NP will collaborate with the veteran's attending medical provider at the Community Living Center. They will complete or update Life-Sustaining Treatment orders for veterans receiving palliative and/or hospice consultations after discussions with the veteran or their medical decision-maker. The NP will provide education to palliative care team members and medical staff on palliative care topics, contribute to policies, protocols, and strategic planning for palliative care at the CVAHCS, and generate reports on palliative care services for MEB and other requested meetings. The NP will also track and analyze palliative care surveys and data. The Nurse Practitioner will assess hospice eligibility and handle recertifications. Additional responsibilities, as assigned by the Chief of Geriatrics and Extended Care, may include providing coverage for the Community Living Center and/or Home-Based Primary Care as needed. Residential Rehabilitation Treatment Program: The incumbent works within the context of the interdisciplinary Residential Rehabilitation Treatment Program (RRTP) and primarily provides medical services for Veterans admitted to the RRTP or to the acute care ward for substance use disorder (SUD) and/or post-traumatic stress disorder (PSTD). Other duties include general medical care for the CVAMC depending on the needs of the facility. 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 8am to 4:30pm Telework: Ad-hoc Virtual: This is not a virtual position.
What you need to qualify
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 - 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 Board Certification - All APN (NPs) must maintain full and current basic board certification in one of the following: Family Nurse Practitioner (FNP), Adult Nurse Practitioner (ANP), Adult-Gerontology Primary Care Nurse Practitioner (AGPCNP), Acute Care Nurse Practitioner (ACNP), Adult-Gerontology Acute Care Nurse Practitioner (AGACNP), or Gerontology Nurse Practitioner (GNP) 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: Pre-placement evaluation Required, however incidental drivers shall undergo a standard Pre-Placement examination and periodic medical evaluation at least once every 4 years to ensure that employees who operate government owned or leased vehicles are medically able to do so without undo risk to themselves or others.
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