Registered Nurse -Home Based Primary Care
The incumbent will be assigned to the Home Based Primary Care (HBPC) program and be administratively responsible to the Home Based Primary Care Program Director. HPBC provides comprehensive, physician supervised interdisciplinary primary care administered to veterans in their homes. The incumbent will be the primary coordinator of services, managing patients with multiple complex medical or mental health problems requiring prolonged intervention to maintain or improve status and retard decline. In addition, the incumbent may also consult in clinical areas in which they are considered experts or specialists.
The incumbent has responsibility for a panel of primary care patients in collaboration with a Patient Aligned Care Team (PACT). Responsible and accountable for all elements of the nursing process when providing direct or virtual care. The nurse assesses, plans, implements, and evaluates care based on age- and culture-specific components. The nurse provides care and counseling of persons or in the promotion and maintenance of health and prevention of illness and injury based upon the nursing process, which includes systematic data gathering, assessment, appropriate nursing judgment, and evaluation of human responses to actual or potential health problems through such services as case finding, health teaching, health counseling; provision of care supportive to or restorative of life and well-being; and executing medical regimens including administering medications and treatments prescribed by a licensed or otherwise legally authorized provider.
The incumbent provides and/or directs the coordination of care, telephone triage and planning of multiple health care services; acts on behalf of the veteran to assure that necessary clinical services are received and that progress is being made. The incumbent is responsible to facilitate communication and collaboration between all members of the healthcare team (PACT) involving the patient and family in the decision-making process; to minimize fragmentation of healthcare delivery; to optimize quality of patient and family outcomes in a cost-effective manner. He/she provides professional assessment, coordination and planning of multiple health care services; acts on behalf of the veteran to assure that necessary clinical services are received and that progress is being made. Provides on-going case management services. Care will be provided in the least restrictive, most cost-effective manner through use of the clinical practice guidelines and clinical pathways. Evidence of health promotion and chronic disease will be monitored through the clinical practice guidelines and performance measures. Uses equipment correctly and accurately interprets data, particularly HBPC Telehealth video teleconferencing (v-tel), and secure messaging. Collaborates with patients, families, health care practitioners, and health care leaders in policy and program development, implementation, and evaluation, and in the delivery of care (Patient and Family Centered Care).
Work Schedule: Typically Administrative Hours, Monday - Friday (8:00am - 4:30pm)
Note: This position will require provider visits to HBPC patients in their homes so individual selected must have and maintain a valid driver's license. Incumbent will also be required to travel long distances during potential inclement weather and unknown road conditions.
Financial Disclosure Report: Not Required
- United States Citizenship: Non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy.
- 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.
- 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.
2-3 years of Nursing Experience
Case Management Experience
2-3 years of Home Care Experience
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's 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 year's of nursing practice/experience; OR a Master's degree in nursing or related field with a BSN and approximately 1-2 year's 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 year's of nursing practice/experience; OR a Doctoral degree.
Registered Nurse Functional Requirements: Heavy Lifting 50 lbs and over (intermittently); Carrying up to 45 lbs (intermittently); Repeated bending; Straight Pulling up to 45 lbs (intermittently); Straight Pushing up to 45 lbs (intermittently); Stooping (intermittently); Squatting (intermittently); Kneeling (occasionally); Use of both arms; Use of both hands; Use of fingers; Overhead work, both arms (intermittently); Prolonged walking (up to 4 hours/day); Prolonged standing (up to 4 hours/day); Sitting (up to 2 hours/day); Far Vision - correctable in one eye to 20/20 and 20/40 in the other; Near Vision - correctable to read newsprint at 13-16 inches; Ability to distinguish shades of colors; Hearing - ability to hear and understand the spoken voice from a distance of 8 feet. Emotional and mental stability - ability to effectively perform the essential functions of the position and respond appropriately in emergency situations.
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:
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), SF-50's, etc.
- Cover Letter