The Advanced Practice Nurse (APN) Certified Nurse Anesthetist (CNA) is a Certified Registered Nurse Anesthetist (CRNA). The CRNA provides a full range of services emphasizing quality, timeliness, and the advancement of the Veterans Affairs (VA) mission. The CRNA practices to the full extent of their education, training, and certification. Advanced Practice Nurse (Certified Nurse Anesthetist) Basic Requirements Education. A masters or doctoral degree in nurse anesthesia. (Applicants pending the completion of educational requirements may be referred and tentatively selected but may not be hired until the education requirements are met.) Nursing education must be from a school of professional nursing anesthesia accredited by Council on Accreditation of Nurse Anesthesia Education Programs (COA) at the time the program was completed by the applicant. Licensure and Certification. The following licensure and certification requirements are considered conditions of employment. License. All APN (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 APN (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. NOTE: Grandfathering Provision - All persons currently employed in VHA in 0610 series and an APN (CNA) assignment that are also 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. The following Education, Experience, and Knowledge, Skills and Abilities must be met for Advanced Practice Nurse (Certified Nurse Anesthetist) II: Exception to Licensure for Graduate Nurse Technicians. Candidates who otherwise meet the basic requirements, but do not possess the required APN (CNA) licensure and/or certification, may be appointed at the entry step of the Nurse II, as a Nurse Anesthetist on a temporary appointment up to any period not-to-exceed one year and a day under the authority of 38 U.S.C. § 7405(c)(2)(B). Education and Experience Requirement. Meets basic education requirement for an APN (CNA). Nurse II is considered the entry grade level for APN (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. The following Education, Experience, and Knowledge, Skills and Abilities must be met for Advanced Practice Nurse (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. Physical Requirements: This position requires visual acuity, keen hearing, clear distinctive speech, and manual dexterity. This position requires potentially long periods of continued walking, standing, stooping, sitting, bending, pulling, and pushing. Transferring patients and objects may be required. Mechanical lifts are provided. The incumbent may be exposed to infected patients and contaminated materials and may be required to don protective clothing in isolation situations, operative/invasive procedures. The incumbent may occasionally be exposed to patients who are combative secondary to delirium, dementia, or psychiatric disorders. Must complete annual Employee Health requirements as a condition of employment. The incumbent who provides care in home settings or other off-site locations may be required to drive and/or ride in GSA-vehicles. ["The aspects of practice include direct patient care, administration, education, and research activities. Core functions are outlined in the clinical privileges or scope of practice that correspond with this position and determined locally within the limits of the individual's state license and the local VA Medical Center (VAMC) bylaws. The CRNA provides advanced clinical practice, consultation, and management. As specified in the scope of practice and in accordance with skill, proficiency, and state licensure, the CRNA may provide the appropriate preoperative and postoperative anesthesia orders. CRNAs with Drug Enforcement Administration (DEA) numbers and/or facility DEA numbers may independently prescribe controlled substances in the preoperative, intraoperative, or postoperative settings. Major duties and responsibilities of the position include, but are not limited to the following: Collaborate with a variety of health care professionals to achieve common goals for care, safety, and welfare of patients. Foster high levels of confidence and satisfaction among patients and staff, as well as meet and exceed compliance standards. Provide anesthetic services within five general categories to include: pre-anesthesia evaluation and preparation; anesthesia induction, maintenance, and emergence; post anesthesia care; peri-anesthetic and clinical support functions; and emergency response techniques. Develops and implements a comprehensive anesthesia plan of care for patients requiring local, regional, general, and monitored anesthesia both inside and outside the Operating Room (OR) suite. Ensures anesthetic services delivered throughout the facility are of the highest quality to promote patient safety, satisfaction, and improve outcomes and efficiencies. Functions as resource for staff education and is willing to be a preceptor and adjunct clinical faculty for health care trainees rotating through the facility. Develops and implements evidence-based practices that are essential to the delivery of the highest quality anesthesia care. Prescribe appropriate preoperative, intra-operative and postoperative orders and medications. Exemplifies the ICARE core values of-Integrity, Commitment, Advocacy, Respect, and Excellence. All other duties as assigned to meet the needs of the Agency, Department, Facility, and/or Service. 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: A Standard tour of duty consist of four (4) days a week within Monday - Friday, 6:30am - 5:00pm; however the tour of duty is flexible and may include 8, 10, 12, 16 and 24 hour shifts. On call, Holidays, and Weekends may be required. Compressed/Flexible: Available Telework: AD-HOC, as determined by Facility/Agency policies. Virtual: This is not a virtual position. Relocation/Recruitment Incentives: Not Authorized Permanent Change of Station (PCS): Not Authorized"]

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