Registered Nurse (Perioperative)

Veterans Health Administration, Department of Veterans Affairs; Salisbury (NC); On-site; USD 90,000 - 120,000; Full time

Job summary

Veterans Health Administration (VA) is seeking a Post Anesthesia Care Unit Registered Nurse (PACU RN) to oversee and deliver peri-anesthesia care from Pre- to Phase II recovery. The role emphasizes education, self-management, and patient satisfaction across the care continuum.

The ideal candidate will have ADN/ Diploma in Nursing with active RN licensure, strong airway and hemodynamic skills, and PACU or critical care experience.

Qualifications

• Must be a graduate of an approved nursing program and eligible for licensure in the United States.
• Current, full, active, and unrestricted RN registration in a US state or territory.
• Experience in PACU, critical care, or post-anesthesia recovery is preferred.

Responsibilities

• Provide and coordinate peri-anesthesia care including Pre, Phase I, and Phase II recovery.
• Assess and monitor cardiovascular and respiratory status; manage airway as needed.
• Document care comprehensively in the EHR and participate in evidence-based practice.

Skills

English proficiency

Registered Nurse license

Airway management

Hemodynamic monitoring

Post-anesthesia care

Critical thinking

Education

ADN or Diploma in Nursing

BSN preferred or 1 year experience

State nursing license

Job description

Summary

The Post Anesthesia Care Unit Registered Nurse (PACU) is responsible and accountable for all elements of the nursing process when providing and/or supervising direct patient care. Assumes responsibility for the coordination of care focused on patient education - self-management - and customer satisfaction throughout the continuum of care. Administers medications and procedures per established policies and guidelines.

Qualifications

Basic Requirements:

• English Language Proficiency
• In accordance with 38 U.S.C. 7403(f) - no person shall serve in direct patient care positions unless they are proficient in basic written and spoken English
• 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)
• OR Individuals attending a master's level bridge program in nursing who have completed coursework equivalent to a bachelor's level degree in Nursing may have opportunity to become registered as a nurse with a state licensing board prior to completion of the bridge program
• Upon achievement of a State license - the individual may be appointed on temporary basis and later converted to a permanent appointment upon successful completion and graduation from the bridge program
• (Reference VA Handbook 5005 - Appendix G6)
• OR In cases of graduates of foreign schools of professional nursing - possession of a current - full - active - and unrestricted registration will meet the requirement for graduation from an approved school of professional nursing to warrant an appointment as a Nurse who has completed an associated degree/entry level Nursing education program
• Credit for foreign nursing education higher that associate degree/entry level requires a formal degree equivalency validation from a recognized equivalency evaluation accepted by VA such as International Consultants of Delaware (ICD)
• Current - full - active - and unrestricted registration as a graduate professional nurse in a State - Territory or Commonwealth (i.e. - Puerto Rico) of the United States - or the District of Columbia
• Graduate Nurse Technician (GNT) Exception: Candidates who otherwise meet the basic education requirements - but do not possess the required licensure - may be appointed at the entry step of the grade and level applicable to the completed nursing education as a GNT on a 120-day temporary appointment while actively pursuing licensure (may be extended up to two years on a case-by-case-basis.) NOTE: Grandfathering Provision - All persons currently employed in VHA in 0610 series and 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
• Preferred Experience: Minimum of 1-2 years of recent experience in an acute or high acuity setting (ICU - Emergency Department - Step Down - or Telemetry)
• Prior PACU - critical care - or post operative recovery experience strongly preferred
• Demonstrated competency in airway management - hemodynamic monitoring - and rapid assessment of post anesthesia patients
• Experience identifying and managing post anesthesia complications such as respiratory instability - laryngospasm - and emergence delirium
• Moderate sedation experience with documented competency in monitoring - recovery assessment - and recognition of sedation related complications
• Proficiency in evidence based pain and nausea management during Phase I and Phase II recovery
• Ability to prioritize and safely manage multiple patients in different stages of surgical recovery
• Familiarity with Aldrete or Modified Aldrete scoring criteria for progression through recovery phases
• CPAN/CAPA certification preferred
• Grade Determinations: The following Scope - Education and Dimension criteria must be met in determining the grade assignment of candidates - and if appropriate - the level within a grade
• The Dimension requirements (Practice - Veteran/Patient Driven Care - Leadership - Professional Development and Evidence-Based Practice/Research) are detailed for each grade and level within the online assessment: https://apply.usastaffing.gov/ViewQuestionnaire/13098715
• Grade/Level Scope Education Nurse I - Level I Delivers fundamental - knowledge-based care to assigned clients while developing technical competencies
• An Associate Degree (ADN) or Diploma in Nursing - with no additional professional nursing required
• Nurse I - Level II Demonstrates integration of biopsychosocial concepts - cognitive skills and technically competent practice in providing care to clients with basic or complex
• An ADN or Diploma in Nursing AND 1 year of specialized nursing experience equivalent to Nurse I - Level 1 ;OR a Bachelor of Science in Nursing (BSN) with no additional professional nursing experience required
• Nurse I - Level III Demonstrates proficiency in practice based on conscious and deliberate planning
• Self-directed in goal setting for managing complex client situations
• An ADN or Diploma in Nursing AND 2 years of professional nursing experience in which one year is equivalent to Nurse I - Level 2
• OR a BSN and 1 year of professional nursing experience equivalent to the Nurse I - Level 2
• OR a Master's degree in nursing (MSN) and no additional professional nursing experience
• OR a Master's degree in a *related field with a BSN and no additional professional nursing experience
• Nurse II Demonstrates leadership in delivering and improving holistic care through collaborative strategies with others
• A BSN with 2 years of professional nursing equivalent to Nurse I - Level 3
• OR an MSN with one year of specialized nursing experience equivalent to Nurse I - Level 3
• OR a Master's degree in a *related field with a BSN and one year of specialized nursing experience equivalent to Nurse I - Level 3
• OR a Doctoral degree in Nursing with no professional nursing experience
• OR a Doctoral degree in a *related field with a BSN with no professional nursing experience
• Nurse III Executes position responsibilities that demonstrate leadership - experience and creative approaches to management of complex client care beyond the immediate practice setting
• MSN and 2 years of specialized nursing experience - one of which is equivalent to Nurse II and meets all dimension requirements for Nurse III
• OR a Master's degree in *related field with BSN and two years of specialized nursing experience - one of which is equivalent to Nurse II and meets all dimension requirements for Nurse III
• OR a Doctoral degree in Nursing with and one year of specialized nursing experience equivalent to Nurse II and meets all dimension requirements for Nurse III
• OR a Doctoral degree in a *related field with BSN and one year of specialized nursing experience equivalent to Nurse II and meets all dimension requirements for Nurse III
• *Note: Foreign education programs/degrees are not creditable as related degrees
• Reference: For more information on this qualification standard - please visit https://www.va.gov/ohrm/QualificationStandards/
• Physical Requirements: This position includes a level of physicality normally associated with duties performed by nurses such as direct patient care - and potentially long periods of walking - standing - sitting - moderate lifting - repeated bending - or kneeling
• Examples may include but are not limited to: (1) Significant amounts of time standing assisting assigned patients
• (2) Utilization of safe patient handling and mobility protocols
• This position potentially requires flexibility in schedule and assignments
• The incumbent may occasionally be exposed to patients who"" are combative secondary to delirium - dementia - or psychiatric disorders
• The incumbent must be a mature - flexible - sensible individual capable of working effectively in stressful situations - able to shift priorities based on patient needs
• Must complete- annual Employee Health requirements - such as annual TB screening or testing - as a condition of employment.

Duties

• The Post Anesthesia Care Unit (PACU) Registered Nurse (RN) provides specialized care in the assessment - planning - implementing and evaluation of care throughout the peri anesthesia continuum to include the Pre anesthesia Phase - Post anesthesia Phase I - Post anesthesia Phase II - and extended care from sedation/analgesia and/or anesthesia for surgical - diagnostic - or therapeutic procedures
• Assigned Duties Possesses knowledge related to the physiology associated with various anesthesia techniques and surgical interventions
• Assesses and prepare patients for procedures appropriately
• Performs clinical assessment of the patient and readily recognizes contraindication for anesthesia and/or surgical intervention
• Applies the appropriate post sedation scoring and assesses the patient's postoperative status to include cardiovascular and respiratory systems and airway management needs - neurological system - hemodynamic stability - pain - and comfort needs and mental status - implementing appropriate interventions to maintain or return all physiological system to baseline or above
• Maintain knowledge of current American Society of Peri anesthesia Nurses (ASPAN) standards - Veterans Health Administration (VHA) Directives and service level standard operating procedures (SOPs)
• Responsible for ensuring comprehensive documenting of all phases of care and is timely - complete - and accurate in the electronic health record (EHR)
• Demonstrate leadership in delivering and improving holistic care through collaborative strategies with others
• Evaluates practice in an ongoing process - based on best evidence
• Provides peers with informal constructive feedback for improvement
• Fosters a safe and supportive environment conducive to the professional development of healthcare professionals
• Contributes professional nursing perspective in discussions with the interdisciplinary team
• Partners with others to effect change and produce optimal outcomes
• Supports colleagues through knowledge sharing to provide safe - quality nursing care
• Shares educational findings - experiences - and ideas with peers
• Questions clinical practices for the purpose of providing evidence-based care
• Participates in activities and strategies to sustain an evidence-based-practice culture
• May be required to perform on-call duties
• 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: Supervisory Discretion NOTE: Compressed schedule of 10 hour shifts 07:45am to 06:15pm Relocation/Recruitment Incentives: Not Authorized