The North Florida/South Georgia Veterans Health System consists of two medical centers, three large multi-specialty outpatient clinics and eight small community-based primary care outpatient clinics. The Malcom Randall VA Medical Center in Gainesville is a tertiary care facility, identified as the most complex VA health care system, that is also an active teaching hospital, with an extensive array of specialty services. The VA Medical Center combines a full range of patient care services. 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. Education: (1) 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. (c) In cases of graduates of foreign schools of professional nursing, possession of a current, full, and unrestricted registration (see basic requirement in subparagraph c below) 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. (2) 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. The AANA has compiled current listings of approved training institutions, which are published annually in the December issue of the American Association of Nurse Anesthetists Journal. The American Hospital Association in their "Guide to the Health Care Field" also publishes listings of approved training institutions annually in August. Registration: 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). (2) Impaired Registration. A nurse anesthetist who has, or has ever had, any registration(s) revoked, suspended, denied, restricted, limited, or issued/placed in a probationary status may be appointed only in accordance with the provisions of chapter 3, section B, paragraph 15 of this part Certification (1) 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. (2) Nurse Anesthetists will maintain recertification by meeting the Council on Recertification of Nurse Anesthetist's requirements as a condition of employment. Grandfathering Provision. All nurse anesthetists employed in VHA on the effective date of this qualification standard are considered to have met all qualification requirements for the title, series and grade held, including positive education and licensure/certification/registration that are part of the basic requirements of the occupation. (1) A graduate nurse anesthetist who has applied to take the national Certification Examination and has been declared Certification Eligible may be given a temporary appointment for a period not to exceed one year as a graduate nurse anesthetist under the authority of 38 U.S.C. § 7405(a)(1)(D). The graduate nurse anesthetist must take the national Certification Examination at the earliest schedulable date following the date of their temporary appointment. At the time of appointment as a graduate nurse anesthetist, the Chief, Anesthesia Section will provide the graduate nurse anesthetist a copy of this section of the qualification standard and make clear the consequences for not becoming certified during the 1-year temporary appointment. Upon certification by the CCNA, the graduate nurse anesthetist will be converted to an appointment under 38 U.S.C. § 7401(1). (2) Failure to become certified within the one year period will result in removal as a nurse anesthetist and may result in termination from employment. Preferred Experience: Candidates with at least 5 years of experience are preferred Grade Determinations: Full Performance Level: (Nurse III) (a) Experience and Education. 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. (b) 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 G7 Physical Requirements: Must be able to pass a physical ["Major duties include but are not limited to; Perform interim histories and pre- anesthesia physical exam for pre-operative patients requiring anesthesia care. Attending signature acquired prior to surgery. Order routine laboratory, radiologic and diagnostic tests on pre-anesthesia patients. Initiate and/or expedite requests for medical consultations. Order/initiate arterial punctures in order to obtain test specimens and/or initiate arterial catheter placement and monitoring procedures. Order/initiate peripheral intravenous punctures and supportive fluid therapy. Provide appropriate patient education. May order/initiate appropriate airway management techniques. Determine, in conjunction with managing physician, appropriate technique of anesthesia for patients. Provide General anesthesia (under the supervision of an available anesthesiologist) Initiate and manage intravenous sedation and various regional block anesthetic techniques that include: - brachial plexus blockade - axillary block - lumbar spinal anesthesia - lumbar epidural anesthesia - ankle block - IV (Bier) block With direct Physician Manager supervisor, initiate central venous puncture/cannulation and pulmonary artery catheter placement and monitoring procedures. The nature of the practice of nurse anesthesia requires that proficiency in emergency life saving skills be an integrated part of the overall scope of practice, including CPR, Advanced Cardiac Life Support (ACLS), and emergency airway management, expertise in both venous and arterial cannulation techniques, emergency diagnostic skills, and abilities at interpretation of various laboratory tests. Participate in the following miscellaneous duties not otherwise specified in their Scope of Practice and to perform usual anesthesia management and professional functions. 1. Initiate clinical research subject to existing regulations/approvals. 2. Coordinate, provide instruction/preceptorship to nursing students, nurses, and allied health care employees in airway management, difficult airway procedures, peripheral intravenous puncture and radial artery cannulation and other health care procedures and functions related to education of personnel in emergency care. 3. Administrative duties: serves on various committees or established training courses that may be requested from time to time by an authority outside of anesthesiology. 4. Continue providing clinical and management support to the anesthesiology section. Work Schedule: Variable\nCompressed/Flexible: Not Available\nTelework: Not Available\nVirtual: This is not a virtual position.\nRelocation/Recruitment Incentives: Not Available\nPermanent Change of Station (PCS): Not Available\nPCS Appraised Value Offer (AVO): Not Available\nFinancial Discloser Report: Not required"]