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Veterans Affairs, Veterans Health Administration NURSING ASSISTANT - Rehabilitation Nursing Service in Palo Alto, California

Summary

The Rehabilitation Nursing Service Assistant (NA) is a key member of the nursing and rehabilitation treatment team. In addition, the NA will also assist, as assigned, in observation of stable post-operative patients and complex medical patients requiring additional observation. Rehabilitation Nursing Service serves the following areas; Polytrauma, Comprehensive Rehabilitation, Spinal Cord Injury/ Disorder, and Western Blind Rehabilitation.

Responsibilities

The role of the NA is to provide basic patient care that supports patient's activities of daily living, hygiene, and nutrition as well as those task that support professional nursing. The incumbent is responsible to perform a variety of nursing care duties, ranging from routine to moderately specialized in nature within rehabilitation units. Duties include, but are not limited to: Obtaining and documenting vital signs, including temperature, pulse, respirations, and blood pressure and pain level (and notifying the professional nurse when these values are outside of established parameters) Bathing, grooming, toileting, dressing and undressing Feeding and assisting with fluid and nutritional intake, including following dietary and fluid guidelines and aspiration precautions Perform oral suctioning (with Yankauer only) Mobility assistance including ambulation, transfers, positioning, range of motion, and positioning precautions. Lifts, moves and transports clients, using proper body mechanics or lifting devices. Performs all job responsibilities in accordance with prescribed safety and infection control procedures including thorough hand washing, use of disposable gloves where indicated, and proper disposal of soiled materials. Observing urine color and smell and documenting input and output Observes and documents bowel movements, assist with bowel care (positioning in bed, commode, toilet, check rectal vault, perform digital stimulation or manual evacuation, assist as needed with perineal hygiene) Applying external catheters and maintaining and cleaning urinary drainage bags, perform bladder scans (and obtain/record post void residual-PVR) Provides orientation as indicated Displaying behavioral management skills, including positive reinforcement and adherence to behavior management program structure Applying prescribed orthotics, prosthetics, and other mobility devices and observing for skin breakdown Notifying professions of any changes in clinical or functional status as appropriate Observing patient behaviors and reporting observations to the registered nurse Assisting in socialization activities and reporting the level of patient participation to the registered nurse Provides care that maintains skin integrity to prevent pressure ulcers, skin tears and other damage by changing incontinent clients, turning, repositioning immobile clients, and applying moisturizers to fragile skin, etc. Observes for skin integrity for irritation, bruising, and redness and reporting observations to registered nurse Assists in maintaining a safe, neat and clean environment; reports environmental deficiencies to the registered nurse, such as lighting or equipment problems Work Schedule: 7:30 a.m. - 4:00 p.m. Monday- Friday

Requirements

Conditions of Employment

Qualifications

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 or Training: One year above high school with courses related to the CNA occupation. Completion of an intensive, specialized, occupation-related course of study of less than one year which resulted in attaining certification as a nursing assistant may also meet in full the experience requirements for GS-3. Certification: as a CNA by a State is a basic requirement for all grade levels. Once certified, CNAs must maintain a full, active and unrestricted certification to remain qualified for employment. Loss of certification will result in removal from the GS-621 CNA series and may result in termination of employment. Physical Requirements. See VA Directive and Handbook 5019. English Language Proficiency. CNAs must be proficient in spoken and written English in accordance with VA Handbook 5005, part II, chapter 3, section A, paragraph 3j. May qualify based on being covered by the Grandfathering Provision as described in the VA Qualification Standard for this occupation (only applicable to current VHA employees who are in this occupation). May qualify based on being covered by the Grandfathering Provision as described in the VA Qualification Standard for this occupation (only applicable to current VHA employees who are in this occupation and meet the criteria). Preferred Experience: Current BLS provider card CNA Certification Grade Determinations: (1) GS-3 CNA (Entry Level) (a) Experience, Education and Certification. None beyond the basic requirements. (b) Assignments. Individuals assigned as GS-3 CNAs are considered to be at the entry level and are closely supervised. (2) GS-4 CNA (a) Experience. One year of specialized experience as a CNA or experience in another medical field (licensed practical nurse, health technician, hospital corpsman, etc.), performing technical and nursing skills requiring knowledge of the human physical and emotional states, therapeutic communication, and technical skills required for basic and intermediate treatments; OR, (b) Education. Successful completion of 2 years above high school in an accredited institution with courses related to nursing care, health care or in a field of study appropriate to the specialization of the position, such as education in a program for psychology, psychiatric, or operating room technicians; AND (c) Demonstrated Knowledge, Skills, and Abilities (KSAs). In addition, the candidate must demonstrate the following KSAs: 1. Ability to provide a range of patient/resident care and contribute to the completion of the nurse care plan and recovery of patients/residents. 2. Ability to observe patients/residents' or resident's physical or emotional status and refer deviations and/or problems to supervisor in a timely manner. 3. Ability to properly use equipment, materials and supplies in simple diagnostic and treatment procedures such as bladder scan, continuous passive motion device, blood glucose monitoring machine, specimen collection, etc. 4. Ability to communicate effectively with patients/residents, their families and other health professionals. (d) Assignment 1. Individuals assigned as GS-4 CNAs are considered to be at the intermediate or developmental level and are closely supervised. CNAs at this grade level function as a member of the nursing care team and assist higher graded CNAs, licensed nursing staff, and other members of the care team in the care of patients/residents receiving outpatient care, home or community living care or other patients/residents who are in acute, sub-acute, or chronic states of illness. The significant factor is that they provide care under close supervision and refer issues/questions to supervisors, higher graded CNAs or other healthcare professionals. 2. In this role, the Nursing Assistant functions as a member of the nursing care team and assists higher graded CNAs, licensed nursing staff, and other members of the care team in the care of patients/residents receiving outpatient care, home or community living care, or other patients who are in acute, sub-acute, or chronic states of illness. The Nursing Assistant in this role provides care under close supervision and refers issues/questions to supervisors, higher graded CNAs, or other healthcare professionals. (3) GS-5 CNA (Full Performance Level) (a) Experience. One year of progressively responsible assignments and experience equivalent to the GS-4 level which demonstrates knowledge, skills, and abilities that are directly related to the specific assignment. In addition, the candidate must demonstrate the professional KSAs in subparagraph (c) below; OR, (b) Education. Successful completion of a 4-year course of study above high school leading to a bachelor's degree that included 24 semester hours of courses related to health care or possession of a bachelor's degree; AND (c) Demonstrated KSAs 1. Ability to assist in the full range of nursing care to patients/residents with physical and/or behavioral problems in a hospital, long term care or outpatient setting under the direction of a Registered Nurse and/or Licensed Vocational Nurse/Licensed Practical Nurse. 2. Ability to communicate orally with patients/residents, families, interdisciplinary team and other personnel. This includes serving as a preceptor to new CNAs by assisting with the coordination of their orientation and overseeing/assessing their practical experience while in a clinical setting. 3. Ability to recognize and react to emergent patient/resident care situations and intervene while waiting for assistance. For example, recognizing need for basic life support, controlling bleeding and assisting with behavior crisis, etc. (d) Assignment. This is the full performance level for CNAs. CNAs at this grade level function as a member of the nursing care team and assist licensed nursing staff in the care of patients/residents receiving outpatient care, home or community living care or other patients/residents who are in acute, sub acute or chronic states of illness. The distinguishing factor is that patient/resident assignments typically involve more complex nursing needs which can vary within a range of predictable to unpredictable requirements. CNAs at this level also assume more of a peer education/mentorship role. References: VA Handbook 5005/71 Part II Appendix G46 The full performance level of this vacancy is GS-05. The actual grade at which an applicant may be selected for this vacancy is in the range of GS-3 to GS-5. Physical Requirements: This position requires potentially long periods of continued walking, standing, stooping, sitting, bending, pulling, and pushing. Transferring patients and objects may be required. The incumbent may be exposed to infected patients and contaminated materials and may be required to don protective clothing in isolation situations or operative/invasive procedures.

Education

IMPORTANT: A transcript must be submitted with your application if you are basing all or part of your qualifications on education. Note: Only education or degrees recognized by the U.S. Department of Education from accredited colleges, universities, schools, or institutions may be used to qualify for Federal employment. You can verify your education here: http://ope.ed.gov/accreditation/. If you are using foreign education to meet qualification requirements, you must send a Certificate of Foreign Equivalency with your transcript in order to receive credit for that education. For further information, visit: http://www.ed.gov/about/offices/list/ous/international/usnei/us/edlite-visitus-forrecog.html.

Additional Information

This job opportunity announcement may be used to fill additional vacancies. It is the policy of the VA to not deny employment to those that have faced financial hardships or periods of unemployment. This position is in the Excepted Service and does not confer competitive status. VA encourages persons with disabilities to apply. The health-related positions in VA are covered by Title 38, and are not covered by the Schedule A excepted appointment authority. Veterans and Transitioning Service Members: Please visit the VA for Vets site for career-search tools for Veterans seeking employment at VA, career development services for our existing Veterans, and coaching and reintegration support for military service members. If you are unable to apply online view the following link for information regarding an Alternate Application.

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