Nurse Anesthesia is an advanced clinical nursing specialty based upon a graduate level curriculum focused on development of clinical judgment and critical thinking. CRNAs are qualified to render patients insensible to pain and emotional stress during surgical, obstetrical, diagnostic and invasive procedures utilizing general and regional anesthesia and all levels of sedation techniques. Preferred Experience: 5 years experience working as a Certified Registered Nurse Anesthetist. APNP (Advanced Practice Nurse Prescriber) Credential. 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. Licensure and Certification. The following licensure and certification requirements are considered conditions of employment. License. All APNs (CNAs) must maintain an active, current, full and unrestricted license to practice as a CNA or equivalent, in a State, Territory or Commonwealth of the United States or in the District of Columbia. Basic Certification. All APNs (CNAs) must maintain full and current Certification by the National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA) or an equivalent Nurse Anesthetist certification recognized by the COA. Grade Requirements. Recency and Quality of Experience. Recency and quality of education, training and experience in the administration of a variety of anesthesia techniques for a diversity of surgical and non-operating room cases will be considered when determining the appropriate grade. To be creditable, experience must demonstrate possession of knowledge, skills and abilities related to the current practice of anesthesia. The importance of specific types of experience or training may vary according to the intended assignment. Experience. To be creditable, experience must demonstrate possession of requirements and specialized experience identified for each grade level. Research. At any grade, APNs (CNAs) may conduct, collaborate or assist with approved research or scholarly projects that enhance their knowledge and skills in the profession and advance the missions of VA. Grade Determination. In addition to the basic qualification requirements, the grade level of an APN (CNA) is based on a combination of education and experience. Beyond the minimum education requirements, grade determination for appointment, advancement and promotion will be based on the following specific requirement for the APN (CNA). The level of practice that an APN (CNA) may perform at is based upon a combination of many factors. Beyond the minimum educational requirements, grade determination, upon appointment and advancement, is dependent upon aspects such as continued professional development (formal and/or informal education,) clinical performance, judgment, outcomes (at the service level and beyond), leadership and interpersonal skills that influence, inspire and motivate others within their program/service or beyond. As the APN (CNA) acquires the knowledge, skills and judgment that accrues with experience, the privilege of increased authority for patient care and service in administrative roles is expanded as applicable. 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. 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) 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. vii 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-6d Advanced Practice Nurse (Certified Nurse Anesthetist) Standard. This can be found in the local Human Resources Office. ["The CRNA practices to the fullest extent of his/her training and experience to achieve common goals for care, safety and welfare of VA patients and provide anesthetic services, in collaboration with an anesthesiologist when feasible, within four general categories: 1. Pre-anesthesia preparation and evaluation 2. Anesthesia induction, maintenance and emergence in the operating room (OR) and out-of-OR environments 3. Post anesthesia care, including pain management 4. Peri-anesthetic and clinical support functions in the OR and out-of-OR environments The CRNA works with diverse age groups to include adult and geriatric patients and is able to meet age specific needs of the patient population served. The anesthetist demonstrates the knowledge and clinical skills necessary to perform his/her duties in providing anesthetic care appropriate to the VA patient. The anesthetist demonstrates knowledge of age-associated changes, illnesses and potential disabilities in order to work with geriatric patients. VA offers a comprehensive total rewards package: VA Nurse Total Rewards Work Schedule: Full Time 1.0 FTEE / 40 Hours Weekly Compressed/Flexible: Day Shift, Variable Starts, Compressed Schedules Available Telework: Not Available Virtual: This is not a virtual position. Relocation/Recruitment Incentives: Not Authorized Permanent Change of Station (PCS): Not Authorized Financial Disclosure Report: Not required. 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"]

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