The LPN is assigned to the Tennessee Valley Healthcare System . The LPN, Primary Care Clinic GS-7 is under the supervision of the Nurse Manager at the Alvin C. York VA campus in Murfreesboro, TN., yet demonstrates independent technical judgment without the need for readily available supervision. The LPN is technically proficient and self-directed in initiating, performing and completing complex practical nursing care. 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. Education - Graduate of a school of practical or vocational nursing approved by the appropriate State agency accredited by the Accreditation Commission For Education in Nursing Inc. (ACEN) at the time the program was completed by the applicant. Licensure - Condition of employment. Active, full, current and unrestricted licensure as a Graduate Licensed Practical or Vocational Nurse in a State, Territory, or Commonwealth (i.e. Puerto Rico), of the United States or the District of Columbia. An LPN who has or has ever had, any license(s) revoked, suspended, denied, restricted, limited, or issued/placed in a probation status may be appointed only in accordance with regulations issued by the Under Secretary for Health or designee. Proficient in spoken and written English - as required by 38 U.S.C. 7402(d) and 7407 Preferred Experience: Primary Care GRADE DETERMINATIONS: The GS-7 grade level is for select, complex LPN/LVN positions, as established by each health care facility. To be advanced, employees must meet all of the following standards, provided the standard is part of their assignment NOTE: Determinations concerning placement of positions at this grade level shall take into consideration the skill mix and the availability of supervision in the work unit. Although these positions are under the supervision of an RN and/or MD/DO, employees in such settings successfully and consistently demonstrate the exercise of independent technical judgment (without the need for readily available supervision), as well as a comprehensive and thorough working knowledge of the most complex or difficult practices and procedures. Such individuals may also serve as leaders or co-leaders in a nursing unit or for a specifically identified group of patients.(a) Completion of (minimum of 3 years of LPN experience) at least one (1) year of additional qualifying experience at the GS-6 level or equivalent, fully meeting all of the performance requirements for the GS-6 LPN/LVN.(b) Knowledge and skills necessary to carry out more specialized patient care duties, including assignments in selected, more complex inpatient and/or outpatient care settings. Knowledge base promotes the incorporation of current patient care data in actively contributing to the development of the patient's overall health plan and in carrying out assigned nursing interventions. Positions at this grade level require broader knowledge and skills because supervision is more general and employees are expected to be involved to a greater degree in the development and modification of treatment plans.(c) Ability to assist RN and/or MD/DO to appropriately prioritize overall patient care needs and adjust plans for care delivery. Makes astute observations of subtle, less obvious changes, both physical and emotional, in patient's condition, and accurately and thoroughly documents care delivered and patient's response to care that could require immediate modification of the patient's care plan. Appropriately seeks assistance and guidance by informing RN or MD/DO of changes in patient's condition requiring higher-level intervention. At this grade level, the LPN/LVN is expected to participate to a greater degree in prioritizing, and, as appropriate, modifying patient care treatment. They must also possess the ability to observe more subtle physical and emotional changes in patients and demonstrate taking appropriate action based on those observations.(d) Ability to proactively assist the RN or MD/DO in addressing patient's needs for medication/treatments, accurately administering prescribed medications/treatments according to medications/treatments received. (This may include restricted medication locally authorized for administration by employees at this grade level.) Demonstrates the knowledge and ability to readily recognize the more subtle signs and symptoms of potential or actual drug reactions, promptly inform the RN or MD/DO of observed changes in patient's condition and initiate appropriate, prescribed interventions. Employees at this grade level demonstrate broader knowledge and skill with respect to these responsibilities than employees at lower grade levels.(e) Knowledge and skill to promptly recognize potential urgent or emergent patient care situations, seek assistance of the RN and/or MD/DO for appropriate team intervention and effectively intervene, as directed, to assure the continuation of optimal, safe and therapeutic patient care delivery. At this grade level, the LPN/LVN must have a broader knowledge of the patient treatment process and exercise judgment that demonstrates the ability to effectively intervene when appropriate.(f) Assists individuals or groups of patients and their families to take an active role in promoting healthy lifestyles for more positive patient outcomes. Exercises skill in influencing and communicating with unusually difficult to care for or communicate with patients and/or family members who may exhibit problems with lack of self-control, resistant or abusive behaviors, or impediments in their ability to understand or follow instructions. This includes the ability to effectively deal with the above types of patients under very general supervision.(g) Exhibits skill, creativity and initiative in contributing to the improvement of overall care delivery and patient and/or family satisfaction levels through active participation in committees/task forces, research projects or in developing educational materials/media. Actively promotes and effectively incorporates established customer service standards in all aspects of their practice. References: VA Handbook 5005, Part II, Appendix G13, Licensed Practical or Vocational Nurse Qualification Standard. Physical Requirements: See VA Handbook 5005, Part III, Chapter 2, paragraph 7, and VA Handbook 5019, Occupational Health Services. All applicants must be physically and mentally able to perform efficiently the duties of the position. Must be able to lift (30 lbs or more); twisting and/or bending, standing and/or walking almost constantly during the course of the day 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). ["VA Specialty Pay Scale VA 25 The LPN GS-7 must demonstrate an exceptional degree of practical nursing knowledge and skills necessary for concentrated effort and self-direction in carrying out the most complex practical nursing care assignments within the Primary Care Clinics for a Veteran population with a variety of health care needs. The LPN GS-7 exhibits independent technical judgment, critical thinking skills, and the use of independent judgment to carry out complex practices and procedures. Employees at the GS-7 grade level demonstrate broader skill with respect to these responsibilities. The LPN demonstrates knowledge, experience, skill and self-motivation to carry out complex patient assignments, which include prioritization and coordination of clinical activities with minimal supervision. The LPN collaborates with a Specialty team to provide complex/specialized patient-centered care to patients' ages, cultural backgrounds, education level, and any other special needs .Performs direct patient care activities, as appropriate to assignment, (includes, but is not limited to): Assesses, records, and reports vital signs, neurological signs, weight, and blood glucose levels. Appropriately triages and prioritizes patient needs as routine, urgent, or emergent in the clinic setting and modifies patient care/treatment as needed. Serves as a resource for complex/specialized procedures (i.e. suture removal, staple removal, wound care, blood draws, and clinic specific procedures, such as ear irrigation, performing EKGs, nebulizer treatments or assisting for set up of joint injections). Collaborates with the PACT team and other interdisciplinary services in the development, implementation, and evaluation of patient care. Exercises independent technical judgement and possesses a comprehensive working knowledge of the principles and science of practical nursing. Duties include following up on abnormal results with the provider and educating patients/families on disease management and anticipated plan of care. Serves in a leadership role within the PACT team to promote holistic care and optimize clinic efficiency. Assists other staff to improve and advance their practical nursing practice as appropriate. Serves as a resource person and Super User for frequently used equipment in the clinic setting ( i.e. PYXIS, EKG and Car Lift) and utilizes appropriate protocol for equipment repair and maintenance. Functions as a role model for co-workers in guiding clinical practice. Coordinates clinical work assignments with the RN to ensure patient care needs are met. Assist in completing staff competencies on frequently used equipment. Active participant in quality improvement projects/hospital committees/Unit Based Council to promote evidence-based practice and performance improvement in the clinic setting. Demonstrates engagement by regular attendance at committee meetings and providing committee updates during monthly staff meetings. Assists Nurse Manager with planning and organizing specialized unit projects e.g. Mobile flu clinic , injection clinic, and walk-in clinic. Leads PACT huddles effectively and serves as a resource for new clinical and administrative staff members re: PACT principles. Reviews and revises PACT schedule in advance of scheduled appointments and in conjunction with Data Warehouse/VSSC reports to optimize use of face-to-face, telephone, Nurse Health Maintenance, and other treatment modalities to improve patient outcomes. Demonstrates advanced knowledge and skill in preparation, administration, and documentation of commonly prescribed oral, topical, subcutaneous, and intramuscular medications permitted by facility policies and procedures and within the LPN Expanded Scope of Practice. Examples include administering immunizations, testosterone, influenza vaccinations, herpes zoster, pneumococcal, and Vitamin B12 injections. Performs a learning needs assessment and provides individual teaching for self-administration of specific medications. Recognizes subtle signs and symptoms of drug interactions and promptly notifies provider. Other Duties as assigned Work Schedule: Monday-Friday (days)\nTelework: Not Available\nVirtual: This is not a virtual position.\nPosition Title/Functional Statement #:Licensed Practical Nurse/000000\nRelocation/Recruitment Incentives: Not Authorized\nPermanent Change of Station (PCS): Not Authorized VA Careers - Pharmacy: https://youtube.com/embed/Fn_ickNBEws\nVA Careers - Physical Therapy: https://youtube.com/embed/Gi2hoFqIoqY\nVA Careers - Prosthetics: https://youtube.com/embed/3NUvF5jjErQ\nVA Careers - Social Work: https://youtube.com/embed/enRhz_ua_UU"]
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.