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The Nurse Practitioner - Emergency Department is responsible in demonstrating creative approaches to management of complex client care. The Nurse Practitioner - Emergency Department provides leadership in the application of nursing process to Veteran 'patients, organizational processes and/or systems, improving outcomes at the program or service level. 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. Education: Graduate of a school of professional nursing approved by the appropriate State-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). In cases of graduates of foreign schools of professional nursing, possession of current, full, active and unrestricted registration will meet the requirement of graduation from an approved school of professional nursing. OR The completion of coursework equivalent to a nursing degree in a MSN Bridge Program that qualifies for professional nursing registration constitutes the completion of an approved course of study of professional nursing. Students should submit the certificate of professional nursing to sit for the NCLEX to the VA along with a copy of the MSN transcript. (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. RN Licensure: 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. AND must meet Nurse Practitioner Requirements: APRN/NP Licensure: Current, full, active, and unrestricted registration as a graduate professional Nurse Practitioner in a State, Territory or Commonwealth (i.e., Puerto Rico) of the United States, or the District of Columbia. Nurse Practitioners Education and Certification: Must possess a master's or doctoral degree from a program accredited by the NLNAC or CCNE and maintain full and current certification as a nurse practitioner from the American Nurses Association or another nationally recognized certifying body. The certification must be in the specialty to which the individual is being appointed or selected. Preferred Experience: Current Basic Life Support (BLS) provider card issued by the American Heart Association (AHA) or Military Training Network (MTN). Current Advanced Cardiac Life Support (ACLS) provider care by American Heart Association (AHA) or Military Training Network (MTN). Prescriptive privilege (Nurse Practitioner Furnishing Number) with a Drug Enforcement administration (DEA) number from the United States Drug Enforcement administration for Schedule II-V controlled substances with demonstration of meeting California State Board of Nursing requirements to prescribe controlled substances. Grade Determinations: The following criteria must be met in determining the grade assignment of candidates, and if appropriate, the level within a grade: Nurse I Level I - An Associate Degree (ADN) or Diploma in Nursing, with no additional nursing practice/experience required. Nurse I Level II - An ADN or Diploma in Nursing and approximately 1 year of nursing practice/experience; OR an ADN or Diploma in Nursing and a bachelor's degree in a related field with no additional nursing practice/experience; OR a Bachelor of Science in Nursing (BSN) with no additional nursing practice/experience. Nurse I Level III - An ADN or Diploma in Nursing and approximately 2-3 years of nursing practice/experience; OR an ADN or Diploma in Nursing and a bachelor's degree in a related field and approximately 1-2 years of nursing practice/experience; OR a BSN with approximately 1-2 years of nursing practice/experience; OR a master's degree in nursing (MSN) or related field with a BSN and no additional nursing practice/experience. Nurse II - A BSN with approximately 2-3 years of nursing practice/experience; OR ADN or Diploma in Nursing and a Bachelor's degree in a related field and approximately 2-3 years of nursing practice/experience; OR a Master's degree in nursing or related field with a BSN and approximately 1-2 years of nursing practice/experience; OR a Doctoral degree in nursing or meets basic requirements for appointment and has doctoral degree in a related field with no additional nursing practice/experience required. Nurse III - Master's degree in nursing or related field with BSN and approximately 2-3 years of nursing practice/experience; OR a Doctoral degree and approximately 2-3 years of nursing practice/experience. Reference: VA Regulations, specifically VA Handbook 5005, Part II, Appendix G-6 Nurse Qualification Standard. This can be found in the local Human Resources Office. 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 NP 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 NP may occasionally be exposed to patients who are combative secondary to delirium, dementia, or psychiatric disorders. The nurse must be a mature, flexible, sensible individual capable of working effectively in stressful situations, and be able to shift priorities based on patient needs. Heavy lifting & Carrying (45 lbs. and over); Straight Pulling & Pushing (7-8 hours); Reaching above shoulder; Use of fingers; Both hands required; Walking (up to 8 hours); Standing & Kneeling (up to 1 hour): Repeated bending (7-8 hours); Both legs required; Ability for rapid mental and muscular coordination simultaneously; Near vision correctable at 13" to 16"; Far vision correctable in one eye to 20/20 and 20/40 in the other; Hearing (aid permitted); Emotional and Mental Stability. ["***This is an OPEN CONTINOUS ANNOUNCMENT and will remain open until September 29, 2023, or when the position is filled. The initial cut-off date for referral of eligible applications will be December 1, 2022. Eligible applications received after that date will be accepted on an ongoing basis and qualified candidates will be considered as vacancies become available. ******Applicant Expiration: Applicants will remain active for 6 months after their initial application is received and/or updated. After that time, you must update your application through your USA Jobs account if you would like to be made active again for possible consideration during the open period. *** The Nurse Practitioner - Emergency Department will be for VA Central California Health Care System within our Primary Care Service located at 2615 East Clinton Avenue, Fresno, CA 93703. The Nurse Practitioner - Emergency Department may be assigned a panel of patients to manage their health care in Primary Care Clinic or Community Based Outpatient Clinic (CBOC) location, assigned to urgent/acute care duties in Primary Care Clinic, or assigned to the Emergency Department depending on their appointment. As a Title 38 nurse, position is accountable to the Chief of Primary Care Service or designee. Activities of the NP assigned to the Primary Care Service shall be in an administrative and clinical relationship with the attending physicians, medical center staff, and other health care professionals and members of the interdisciplinary health care team. VA offers a comprehensive total rewards package: VA Nurse Total Rewards Major duties and responsibilities include, but are not limited to: Analyzes patient complaints and signs and symptoms of illness or injury, and implement preventive patient care measures, promote positive health care, and provide educational support for patients with complex problems. Involves in outpatient care activities within various VA and standard medical practice guidelines, policies and directives. Participates in the multidisciplinary activities of the medical center. Responsible for internal medicine care, diagnosis, treatment, and plan for follow-up. Provides appropriate urgent or emergent care as needed and may practice in the CBOC, the Primary Care Clinics and Emergency Department. Coordinates with Registered Nurses providing health care in the rural community through the CCHT program. Orders appropriate laboratory tests, EKG, X-ray, and other tests. Initiates, renews, or refills medications as appropriate. Records findings and setting follow-ups. Counsel patients and family on health problems and treatment regimen. Provides preventive medicine and health promotion. Refers patients for consultation to specialty care areas as appropriate. Interacts with residents/interns in providing care as appropriate. Attends meetings and participates in task forces/projects when requested and participates in educational/training activities. 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: Variable Shifts, ED work schedule is 12 hour shifts - Service determines Tour of Duty to meet the needs of the unit/patients. Compressed/Flexible: 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."]

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