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The LPN is assigned to the Tennessee Valley Healthcare System. The LPN, Ambulatory Care/Surgical Specialty Clinics GS-7 is under the supervision of the Nurse Manager Outpatient Medical Specialty Clinics at the Nashville Campus, Nashville, TN., yet demonstrates independent technical judgment without the need for readily available supervision. 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. Your college transcripts are not proof of this documentation. 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(d). 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. (h) Possesses comprehensive practical nursing knowledge and skills in specialized procedures and practices to serve as a resource person for other staff in organizing and implementing more complex/specialized patient care. Serves as a role model and mentor to other nursing staff in the application of more complex technology, effectively guiding and directing their continuing practice in these areas. (i) Supports the RN or MD/DO in monitoring the practice of unlicensed nursing or non-medical staff in patient care delivery. Promptly reports any deviations from normal practice patterns to the RN or MD/DO. In addition to responsibilities at the lower grade level, the LPN/LVN is responsible for monitoring the practice of non-licensed nursing and medical staff. (j) Work of considerable difficulty and responsibility is performed under general supervision. Individuals in these positions are, to a considerable extent, expected to exercise independent technical judgments and to possess and apply a comprehensive working knowledge of the principles, art and science of practical nursing. The staff mix is such that employees at this grade level are expected to perform practical nursing duties of considerable difficulty and responsibility under very general supervision. (k) Actively seeks out educational opportunities to enhance nursing knowledge and skills, and providing leadership in assisting other staff improve and advance their nursing practice.] References: VA Handbook 5005/3, Part II, Appendix G-13 Licensed Practical or Vocational Nurse Qualification Standard. This can be found in the local Human Resources Office. Preferred Experience: Outpatient Medical Specialty Experience Physical Requirements: This position requires potentially long periods of continued walking, standing, stooping, sitting, bending, pulling, and pushing. Transferring patients and objects may be required. The incumbent may be exposed to infected patients and contaminated materials and may be required to don protective clothing in isolation situations or operative/invasive procedures. ["The LPN is technically proficient and self-directed in initiating, performing and completing complex practical nursing care to patients within Surgical Specialty Clinics. 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 Surgical Specialty 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 and 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. Specialty Clinic team members have independent duties within team to ensure that the patients are receiving high quality care and have timely access to care. 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. The panel population is multi-faceted, including geriatric patients, patients from all war-time eras, female patients, and patient with complex psychiatric needs. Performs direct patient care activities, as appropriate to assignment, (includes, but is not limited to): Manages patient care problems and deviations using self-direction in accordance with VA Nursing Practice and LPN licensure standards. 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. Educates and documents patient and caregiver in the home management of wounds. Checks patient into the clinic, interviews patient and documents intake data as per policy. Serves as a resource for complex/specialized procedures Performs other duties as assigned Preferred Experience: Outpatient Medical Specialty Experience Work Schedule: Monday -Friday Daytime hours Financial Disclosure Report: Not required"]

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