Staff CRNA is a nurse anesthetist who reports to the Chief CRNA and the Chief of Anesthesiology and Perioperative Care Services. The incumbent provides anesthesia services for a diverse Veteran population and a broad range of situations throughout the medical center. 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. APN (Certified Nurse Anesthetist) II. Education and Experience Requirement. Meets basic education requirement for an APN (CNA). Nurse II is considered the entry grade level for APNs (CNAs); no experience is required. Demonstrated Knowledge, Skills and Abilities. The following list of knowledge, skills and abilities present the minimum skill set expected of an Entry Level CNA. Entry level into practice may include but are not limited to the following: Ability to translate into anesthesia care the principles of professional nursing practice including the patients' rights to autonomy, dignity, privacy and safety. Knowledge of current research and practice guidelines to frame anesthesia practice including up to date techniques, pharmacology and equipment. Ability to obtain, document and verify informed anesthesia consent and perform a pre-anesthetic patient history and physical, which includes managing pre-operative consults and interpreting data. Ability to formulate a patient-specific anesthetic plan and describe salient anesthetic risks, benefits and options to the patient. Ability to administer inhalational, regional, intravenous, local and topical anesthetics. Skill in detecting and treating anesthesia or surgically related physiologic changes and ability to treat accordingly in order to maintain homeostasis. Skill in assessing patient status for appropriateness of transfer of care to another healthcare provider and communicating essential patient information to other providers effectively. viii Ability to participate in collaborative responsibility for proper patient positioning, physiologic monitoring, infection control and anesthesia documentation. Skill in responding to emergency situations by providing airway management, fluid and medication administration, invasive line insertion and management and the use of advanced cardiac life support techniques. Ability to provide patient care that is abreast of changing concepts and advancements in the profession, (e.g., ultrasound techniques.) Ability to practice anesthesia in an interdisciplinary environment utilizing a collaborative concept of anesthesia care. Knowledge of quality improvement processes to maintain ongoing review and evaluation of anesthesia care to improve outcomes. Ability to demonstrate a practice emphasis on safety, current established guidelines and protocols while recognizing the duty to report unsafe conditions or errors. APN (Certified Nurse Anesthetist) III. Education and Experience Requirement. Meets basic education requirement for an APN (CNA) AND One year of specialized APN (CNA) experience equivalent to the APN (CNA) II grade level. Demonstrated Knowledge, Skills and Abilities. Progressively responsible experience in the administration of anesthetics as indicated in the knowledge, skills and abilities listed below. Ability to plan, administer and manage anesthesia for a broad range of complex surgical procedures skillfully employing continuous assessment and anesthetic adaptation based on patient response and comorbidities. Work assignments will vary by facility. Ability to participate in assignments that are technically challenging, encompass a variety of anesthetizing locations and utilize advanced equipment and procedures while adapting techniques to solve various complex anesthesia problems including the development of individualized programs of post-op anesthesia care. Skill in responsibility and accountability to perform to the extent of the CNA standards of practice as a licensed healthcare professional in any model of anesthesia practice. Ability to contribute to the educational mission as a mentor or preceptor providing didactic and clinical instruction in anesthesia to student nurse anesthetists, medical and dental residents and other health care trainees. Knowledge to participate in the development, implementation and maintenance of auditing processes that ensure and improve the quality and consistency of anesthesia and associated documentation. Ability to contribute to departmental administrative processes through quality assurance, shared governance or committee representation as applicable. Ability to serve as a representative on interdisciplinary teams to establish and maintain guidelines and communication. Skill demonstrated in the ability to embrace the safety culture emphasis by continuously assessing for safety risks, actively reporting safety concerns and maintaining a just culture by identifying faults in systems rather than individuals. Reference: VA Regulations, specifically VA Handbook 5005, Part II, Appendix G-7 Nurse Anesthetist Qualification Standard. This can be found in the local Human Resources Office. Physical Requirements: heavy lifting (45lbs & over); pushing; reaching above shoulder; use of fingers; both hands required; walking (1-4hrs); standing (1-4hrs); repeated bending (1-2 hrs); ability for rapid mental and muscular coordination simultaneously; near vision correctable at 13" to 16" to Jaeger 1 to 4; specific visual requirement (see computer screen); depth perception; ability to distinguish colors; ability to distinguish shades of colors; hearing (aid may be permitted); mental & emotional stability. Environmental Factors: outside & inside; dust; constant noise; fumes, smoke or gases; working closely with others; working alone ["Performs pre-anesthetic evaluations, collaborates with the interdisciplinary team to prepare the anesthesia plan, delivers of all forms of anesthesia, and provides intra and post-operative care of patients. Provides emergency airway and resuscitation management throughout the facility and establishes effective working relationships with all levels of staff throughout the VAPSHCS. The Full Performance Level CRNA translates the principles of professional nurse anesthesia practice into appropriate patient care: Performs the pre-anesthetic patient history and physical, including the collection of preoperative consults and data, from which an appropriate anesthetic plan is formulated. The anesthetic risks, benefits, and options are described to the patient. Administers inhalation, regional, intravenous, local, and topical anesthetics and continuously evaluates the patient's physical status and response to anesthesia. Performs post-anesthetic management of patients in order to optimize the recovery from anesthesia and minimize pain. Provides patient care that is a abreast of changing concepts and advancements in the profession while working effectively in an interdisciplinary environment for improvement of services for patient care. Practices with colleagues and peers utilizing a collaborative team concept of anesthesia care while demonstrating effective communication skills and professional behaviors that promote cooperation and interdisciplinary teamwork. Demonstrates skill in conducting and managing anesthesia for a broad range of surgical procedures and the ability to adapt and modify anesthesia techniques in order to optimize patient care. Demonstrates the ability to perform the clinical and technical aspects of anesthesia care and has in-depth knowledge of anesthesia methods and techniques. Effectively blends technology, skills, and competency for the advancement of anesthesia techniques, pharmacology, and equipment. Applies new developments and theories to recognize and solve various complex anesthesia situations. Demonstrates the ability to share expertise within or beyond the facility through leadership or as an active participant in interdisciplinary groups (e.g. committees, task-forces, projects, formal teaching, publications or other professional activities). Participates in the development of the anesthesia patient care audit processes which involves the in depth review and analysis of anesthesia records. Emergency Duties: Responds to emergency situations by providing airway management, administration, of emergency fluids and medications and using appropriate resuscitation procedures for patient care. Additional Duties: Administration: Assists in the development of policies, procedures, and protocols related to anesthesia within the institution and contributes to other policies, procedures, and protocols as appropriate. Participates in ad hoc committees as needed. Education: Formal and informal teaching of clinical staff, patients, and families. Demonstrates leadership by sharing knowledge with colleagues and/or students to enhance professional growth, development and practice. Performs as a mentor, preceptor, or nurse educator providing didactic and clinical instruction for graduate-level nurse anesthesia students and/or anesthesia care providers. The individual is responsible for maintaining competencies by attending relevant continuing education programs and maintaining active professional involvement within the academic community. Applies current research data by contributing to Healthcare Care System policies, procedures, and protocols. Participation in clinical research as appropriate. VA offers a comprehensive total rewards package: VA Nurse Total Rewards Work Schedule: Monday - Friday; 6:30am - 3pm Telework: NOT available Virtual: This is not a virtual position. Relocation/Recruitment Incentives: NOT authorized EDRP Authorized: Contact V20CompensationTeam@va@gov, the EDRP Coordinator for questions/assistance. Learn more. Financial Disclosure Report: Not required. This position is eligible for the Education Debt Reduction Program (EDRP), a student loan payment reimbursement program. You must meet specific individual eligibility requirements in accordance with VHA policy and submit your EDRP application within four months of appointment. Approval, award amount (up to $200,000) and eligibility period (one to five years) are determined by the VHA Education Loan Repayment Services program office after complete review of the EDRP application."]
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. At VA Long Beach Healthcare System, our health care teams are deeply experienced and guided by the needs of Veterans, their families, and caregivers. Our medical center provides primary care and specialty health services, including cardiology, mental health care, treatment for spinal cord injuries and disorders, suicide prevention, women’s health services, and more.