Certified Registered Nurse Anesthetist
This position is for Nurse Anesthetist and is located in the Anesthesia Department within the Surgical and Perioperative Careline at the Greater Los Angeles VA Healthcare System (VAGLAHS). The Nurse Anesthetist is responsible for providing anesthesia service in and out of the operating room suite and assists and is medically supervised under the guidance of anesthesia physicians.
Major duties and responsibilities include but are not limited to:
- Administers anesthesia-related services within the VAGLAHS under the medical supervision of the attending anesthesiologist (available on-site or by phone/pager) in four general categories: (1) Pre-anesthesia preparation and evaluation; (2) Intra-procedure patient care; (3) Post-anesthesia care; and (4) Peri-anesthetic and clinical support functions.
- Performing and documenting pre-anesthetic assessment and evaluation of the patient, to include obtaining an appropriate health history and conducting a physical screening assessment; recommending, ordering and evaluating pertinent diagnostic studies; recommending, ordering and evaluating pertinent diagnostic studies; writing preoperative orders such as NPO at a specified time and to hold or administer patient medications on the day of surgery; explaining the anesthetic options and risks vs. benefits of anesthesia to the patient, obtaining informed consent for anesthesia/anesthetic adjuncts and documenting the pre-anesthetic evaluation; and providing consultation to other departments/services pertaining to a patient's condition prior to surgery may be made by CRNAs, within departmental guidelines.
- Selecting, obtaining and administering pre-anesthetic medications which may include sedatives/hypnotics/anxiolytics, narcotics, medications that decrease gastric acidity, medications that enhance gastric emptying, steroids, antimuscarinics, antisialagogues, antihypertensies and preoperative intravenous fluids.
- Obtaining, preparing, and assembling necessary equipment, monitors, supplies and drugs to be used for the administration of anesthesia and performing/ordering safety checks as needed.
- Reporting any anesthetic complication to attending anesthesiologist and Department Quality Assurance Committee.
- Responding to emergency situations by providing airway management, administration of emergency fluids and drugs and using basic or advanced cardiac life support techniques.
- Other related duties as assigned.
Individuals who are currently enrolled in a CRNA program with an expected graduation date within the next 12 months may apply. However, placement will not occur until all basic requirements (as described below) are met.
- United States Citizenship: Non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy.
- Education - You must possess a degree in nursing from 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:
(a) The National League for Nursing Accrediting Commission (NLNAC), an accrediting arm of the National League for Nursing located at 61 Broadway, 33rd Floor, New York, New York 10006. Additional information may be obtained from the NLNAC Web site; or (b) The Commission on Collegiate Nursing Education (CCNE), an accrediting arm of the American Association of Colleges of Nursing (AACN). The CCNE accredits bachelor's and master's degree programs and is located at One Dupont Circle, N.W., Suite 530, Washington, DC 20036. Additional information may be obtained from the CCNE Web site.
(In cases of graduates of foreign schools of professional nursing, possession of a current, full, and unrestricted registration and the possession of a Certificate from the Commission on Graduates of Foreign Nursing Schools (CGFNS) will meet the requirement of graduation from an approved school of professional nursing.)
You must be a graduate of an accredited nurse anesthesia educational program approved by the American Association of Nurse Anesthetists (AANA) at the time the program was completed by the applicant.
- Registration - Condition of Employment. You must possess a 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. The nurse anesthetist must maintain a current, full, active and unrestricted registration to continue employment with VA. The appointing official may waive this requirement if the nurse anesthetist is to serve in a country other than the United States and has registration in that country (e.g. Philippines).
- Certification - On and after May 4, 1993, certification by the Council on Certification of Nurse Anesthetists is a requirement for employment. This requirement does not apply to non-certified nurse anesthetists employed by VA as a nurse anesthetist prior to May 4, 1993 and continuously thereafter. Any nurse anesthetist who leaves VA employment or vacates the nurse anesthetist occupation for another VA position, must meet the current requirement of certification for re-appointment as a nurse anesthetist. The CCNA and the Council on Recertification of Nurse Anesthetists have designated the AANA's web site as a display agent for their information. Nurse Anesthetists will maintain recertification by meeting the Council on Recertification of Nurse Anesthetist's requirements as a condition of employment.
Grade Determinations: In addition to the basic requirements stated above, the following qualification criteria must be met in determining the appropriate grade assignment of candidates.
Entry Level: (Nurse II) - Experience and Education. None beyond the basic requirements.
The following list of knowledge, skills and abilities present the minimum skill set expected of an Entry Level Nurse Anesthetist. Entry level into nurse anesthesia practice may include but are not limited to the following:
1. Ability to translate the principles of professional nursing practice in the care of assigned patients in order to provide appropriate care.
2. Ability to do a pre-anesthetic patient history and physical, which includes collecting pre-operative consults and data.
3. Ability to formulate an anesthetic plan and describe the anesthetic risks, benefits and options to the patient.
4. Ability to administer inhalation, regional, intravenous, local, and topical anesthetics and to detect unfavorable reactions in order to continuously evaluate the patient's physical status.
5. Ability to respond to emergency situations by providing airway management, administration of emergency fluids and drugs, and using appropriate resuscitation procedures for patient care.
6. Ability to provide patient care that is abreast of changing concepts and advancements in the profession.
7. Ability to work effectively in an interdisciplinary environment for improvement of services for patient care.
8. Ability to practice nurse anesthesia with colleagues and peers utilizing a collaborative team concept of anesthesia care.
Full Performance Level (Nurse III): In addition to meeting the requirements for Entry Level, the CRNA has had progressively responsible experience in the administration of anesthetics as indicated in the knowledge, skills and abilities listed below. These individuals must demonstrate the ability to participate in a program for nurse anesthesia care and demonstrate knowledge of anesthetizing locations, methods, equipment and procedures. At this level, the CRNA has experience in the administration of anesthetics that has demonstrated the nurse anesthetist's ability to participate in team programs that are technically challenging and/or complicated.
Demonstrated Knowledge, Skills, and Abilities. Full Performance Level practice in nurse anesthesia includes but is not limited to the following:
1. Skill in conducting and managing anesthesia for a broad range of complex surgical procedures. In addition, the CRNA must be able to adapt/modify anesthesia techniques in order to optimize patient care.
2. Ability to complete work assignments selected to add depth and breadth to their technical knowledge and skill competence. Work assignments will vary at each facility depending on the progressive acuity required for anesthesia care.
3. Ability to respond to emergency situations by providing airway management, administration of emergency fluids and drugs, and by the use of basic or advanced cardiac life support techniques in order to perform necessary resuscitation procedures.
4. Ability to effectively blend technology, skills, and competency for the advancement of anesthesia techniques, pharmacology, and equipment.
5. Ability to apply new developments and theories to develop and demonstrate the ability to recognize and solve various complex anesthesia situations.
6. Ability to practice nurse anesthesia with colleagues and peers in a team concept of anesthesia care and blend management skills with technical experience.
7. Ability to recognize clinical and technical aspects of anesthesia care and has in-depth knowledge of anesthesia methods and techniques for the practice of anesthesia.
8. Ability to perform as a mentor, preceptor, or nurse educator providing didactic and clinical instruction for graduate-level nurse anesthesia students and/or other anesthesia care providers.
9. Ability to participate in the development of anesthesia patient care audit processes involving in depth review and analysis of anesthesia records.
10. Ability to provide guidance and instruction in preparing others for positions of leadership and ethical practices which impact patient care.
References: VA HANDBOOK 5005/37, PART II, APPENDIX G7Physical Requirements: See VA Directive and Handbook 5019.
Selected applicants will be required to complete an online onboarding process.
To apply for this position, you must provide a complete Application Package which includes:
- 10-2850A Application for Nurses and Nurse Anesthetists
The following documents are accepted, and may be required if applicable to your eligibility and/or qualifications for this position. Please use this checklist to ensure you have included all documents required for your application, such as a copy of your transcript (if using education to qualify), etc.
- Cover Letter
- 10-2850A Application for Nurses and Nurse Anesthetists
- Other Veterans Document