Department of Veterans Affairs
Demonstrate proficiency in practice based on conscious and deliberate planning. Self-directed in goal setting for managing complex client situations. Assesses, plans, implements, and evaluates care based on age-specific components. Assumes responsibility for the coordination of care focused on patient education, self-management, and customer satisfaction throughout the continuum of care.
- Duties include but are not limited to: The VISN 4 CRH GEM Specialty RN uses the nursing process and evidence-based practice to provide whole healthcare approach to the Veteran. This is done in collaboration with the Specialty Care provider as well as families/caregivers and internal and community-based services. The CRH Specialty RN provides patient and family health education with a focus on whole health management, based on the patient's goals. The CRH Specialty RN is a member of the Specialty Care Pain team. Coordinating scheduling of appropriate labs and appointments, performing screenings, visit triage, and care coordination. Supports the location to and from which care is delivered, including but not limited to VA clinical locations and provider alternate worksites. The incumbent in this position will support the VISN CRH which may provide Telehealth and face-to-face services not only to clinical areas within the VISN CRH but also other VISN CRHs throughout the nation. Provides direct care to one or multiple patients Collaborates with other members of the Specialty expanded health care team, facilitates pain management coordination and transition of care between services, and may involve the patient and family in the decision-making process. The incumbent works effectively with all levels of staff, to include collaborative efforts with other health professionals, providing ongoing care management/coordination services. Responsible and accountable for all elements of the nursing process when providing direct patient care. The CRH RN independently provides professional assessment, coordination, 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 CRH RN is expected to provide RN coverage to remaining sites when staff is out of office. Identify clinical issues impacting the patient/caregiver's ability to achieve optimal outcomes. Reinforcing and providing education to the Veterans and caregivers regarding findings and recommendations made in collaboration with the TeleGEM team members. Assist in the development of an individualized clinical plan of care in collaboration with the Veteran/family & IDT team during the TeleGEM team meeting for each Veteran. Coordinate the process of care with the other interdisciplinary and PACT team members, and other community resources and services. This will help maximize efficiency and improve clinical outcomes. Incumbent is responsible for maintaining their discipline & continuing education requirements for licensure and/or certification in addition to mandatory VHA education requirements. Participate in clinical leadership activities, including committee and workgroup participation, safety initiatives, research, and quality assurance. Participate in the development and implementation of TeleGEM's process for continuous performance improvement with measurable outcomes. This may require collecting and maintaining a data monitoring system. Provide crisis intervention services, seeking to address the cause as well as presenting complaints, coordinate family conferences and serve as liaison to family members. Provide education, coordination and referral about VA, other government and community resources and services. Independently perform comprehensive initial and follow-up nursing assessments of the medical and psychosocial needs and functioning of the patient, caregiver, and their support systems. This may include utilization and completion of different cognitive screens {MOCA, SLUMS, Blessed dementia scale (short version), etc.}, nutritional, medical (including ADL and IADL assessments, falls assessment, Hearing Handicap of the Elderly assessment), psychosocial evaluation scales (PHQ9; GAi), etc. during patient/caregiver interviews. 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: Mon-Fri 8:00am - 4:30pm Compressed/Flexible: Not Available Telework: This is a remote position Virtual: This is not a virtual position. Relocation/Recruitment Incentives: ???????Not Authorized EDRP Authorized: Former EDRP participants ineligible to apply for incentive. Contact , the EDRP Coordinator for questions/assistance. Learn more Permanent Change of Station (PCS): Not Authorized
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