Registered Nurse Dialysis

Summary The Dialysis Nurse is a professional registered nurse (RN) with specialized knowledge and skills who demonstrates leadership when providing, directing, and improving care for patients with end-stage renal disease (ESRD), acute kidney injury (AKI), and late-stage chronic kidney disease (CKD). Collaborates with other disciplines/departments to achieve desired patient outcomes. Responsibilities The Dialysis Nurse is a professional registered nurse (RN) with specialized knowledge and skills who demonstrates proficiency when providing and directing care for patients with end-stage renal disease (ESRD), acute kidney injury (AKI), and latestage chronic kidney disease (CKD). Collaborates with other disciplines/departments to achieve desired patient outcomes. Adheres to Centers for Medicaid Services (CMS) Conditions for Coverage (CfC) for ESRD facilities; VHA Handbook 1042.01, VA Dialysis Programs Standards and Criteria under authority 38 U.S.C. 1703, 1710, and 7301(b); Centers for Disease Control (CDC) Guidelines for Infection Control in Dialysis Settings, Association for the Advancement of Medical Instrumentation (AAMI) Standards as they relate to dialysis solutions and water purification, the Joint Commission, and all other regulatory requirements. Team leads unlicensed assistive personnel such as hemodialysis medical instrument technicians (HDMITs). Participates in peer reviews and evaluation of other nurse colleagues and technicians. Functions as primary nurse for ESRD patient panel and serves as key resource assisting patients navigate VASDHS. Completes daily treatment encounters, annual clinical reminders, annual assessments, monthly and/or just-in-time patient education using TEACH-BACK methodology. Completes monthly ESRD patient care plans aligned with goals of care and coordinates advance care planning for end-of-life (EOL). Monitors, tracks/trends, and reports ongoing care continuity needs and outcomes to multi/interdisciplinary teams. Tracks/trends K-DOQI (kidney disease quality outcomes initiatives), VA Outpatient Dialysis Dashboard Metrics, and VA Outpatient Dialysis IPEC CLABSI outcomes. Orders and collects required specimens and submits to laboratory for processing. Completes documentation for all clinical and technical recordkeeping in the electronic health record and treatment flowsheets in accordance with established policies and procedures. Completes electronic encounters according to VA Directives for appropriate VERA allocation and managerial cost accounting (MCA). Uses a team approach to identify, analyze, and resolve patient care problems with measurable outcomes. Handles multiple projects and duties simultaneously, prioritizing as needed. Identifies potential and actual problems involving resources and/or safety. Takes action to avert or manage situation(s) in a manner which meets patient needs in a safe/therapeutic manner and promotes healthy workplace environments. Engages in daily Huddles using STEPS (safety, teams, equipment, process, supplies) and reports to leadership chain via Daily Management System (DMS). Participates in training for self and others for professional development activities aligned with VA mission, goals, and objectives. Engages in department/program performance improvement as measured against regulatory standards and takes action to correct deficits to ensure compliance as part of sustained clinical operations and continued readiness. .Demonstrates effective interpersonal communication skills and professional behaviors that promote cooperation and teamwork with internal and external customers. Treats all patients and employees with respect, regardless of their level, personality, culture, and/or background. Participates in shared governance, team meetings, and process improvement activities, monitors results, and advocates for self and staff compliance to regulatory requirements. Responds to changing priorities and resources with optimism, encouraging staff to respondpositively and proactively. Supports department strategic planning and assists unit-based educational program and activities. Performs dialysis on-call duties for inpatient urgent/emergent acute hemodialysis and peritoneal dialysis procedures. Performs all other duties as assigned. 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: Intermittent; As needed to cover patient care needs. Telework: N/A Virtual: This is not a virtual position. Relocation/Recruitment Incentives: N/A Requirements Conditions of Employment U.S. Citizenship; non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy. All applicants tentatively selected for VA employment in a testing designated position are subject to urinalysis to screen for illegal drug use prior to appointment. Applicants who refuse to be tested will be denied employment with VA. Selective Service Registration is required for males born after 12/31/1959. Subject to background/security investigation. Selected applicants will be required to complete an online onboarding process. Acceptable form(s) of identification will be required to complete pre-employment requirements ( Effective May 7, 2025, driver's licenses or state-issued identification cards that are not REAL ID compliant cannot be utilized as an acceptable form of identification for employment. Must pass pre-employment physical evaluation/examination. Participation in the seasonal influenza vaccination program is a requirement for all Department of Veterans Affairs Health Care Personnel (HCP). You may be required to serve a probationary period. Complete all application requirements detailed in the "Required Documents" section of this announcement. Qualifications Basic Requirements: English Language Proficiency. In accordance with 38 U.S.C. 7403(f), no person shall serve in direct patient care positions unless they are proficient in basic written and spoken English. Graduate of a school of professional nursing approved by the appropriate 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); OR Individuals attending a master's level bridge program in nursing who have completed coursework equivalent to a bachelor's level degree in Nursing may have opportunity to become registered as a nurse with a state licensing board prior to completion of the bridge program. Upon achievement of a State license, the individual may be appointed on temporary basis and later converted to a permanent appointment upon successful completion and graduation from the bridge program. (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 to warrant an appointment as a Nurse who has completed an associated degree/entry level Nursing education program. Credit for foreign nursing education higher that associate degree/entry level requires a formal degree equivalency validation from a recognized equivalency evaluation accepted by VA such as International Consultants of Delaware (ICD). 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. Graduate Nurse Technician (GNT) Exception: Candidates who otherwise meet the basic education requirements, but do not possess the required licensure, may be appointed at the entry step of the grade and level applicable to the completed nursing education as a GNT on a 120-day temporary appointment while actively pursuing licensure (may be extended up to two years on a case-by-case-basis.) NOTE: Grandfathering Provision - All persons currently employed in VHA in 0610 series and performing the duties as described in the qualification standard on the effective date of the standard (1/29/2024) are considered to have met all qualification requirements for the grade held including positive education and licensure/certification. Grade Determinations: The following Scope, Education and Dimension criteria must be met in determining the grade assignment of candidates, and if appropriate, the level within a grade. The Dimension requirements (Practice, Veteran/Patient Driven Care, Leadership, Professional Development and Evidence-Based Practice/Research) are detailed for each grade and level within the online assessment: Grade/Level Scope Education Nurse I, Level I Delivers fundamental, knowledge-based care to assigned clients while developing technical competencies. An Associate Degree (ADN) or Diploma in Nursing, with no additional professional nursing required. Nurse I, Level II Demonstrates integration of biopsychosocial concepts, cognitive skills and technically competent practice in providing care to clients with basic or complex. An ADN or Diploma in Nursing AND 1 year of specialized nursing experience equivalent to Nurse I, Level 1 ;OR a Bachelor of Science in Nursing (BSN) with no additional professional nursing experience required. Nurse I, Level III Demonstrates proficiency in practice based on conscious and deliberate planning. Self-directed in goal setting for managing complex client situations. An ADN or Diploma in Nursing AND 2 years of professional nursing experience in which one year is equivalent to Nurse I, Level 2; OR a BSN and 1 year of professional nursing experience equivalent to the Nurse I, Level 2; OR a Master's degree in nursing (MSN) and no additional professional nursing experience; OR a Master's degree in a *related field with a BSN and no additional professional nursing experience. Nurse II Demonstrates leadership in delivering and improving holistic care through collaborative strategies with others. A BSN with 2 years of professional nursing equivalent to Nurse I, Level 3; OR an MSN with one year of specialized nursing experience equivalent to Nurse I, Level 3; OR a Master's degree in a *related field with a BSN and one year of specialized nursing experience equivalent to Nurse I, Level 3; OR a Doctoral degree in Nursing with no professional nursing experience; OR a Doctoral degree in a *related field with a BSN with no additional professional nursing experience. Nurse III Executes position responsibilities that demonstrate leadership, experience and creative approaches to management of complex client care beyond the immediate practice setting. MSN and 2 years of specialized nursing experience, one of which is equivalent to Nurse II and meets all dimension requirements for Nurse III; OR a Master's degree in *related field with BSN and two years of specialized nursing experience, one of which is equivalent to Nurse II and meets all dimension requirements for Nurse III; OR a Doctoral degree in Nursing with and one year of specialized nursing experience equivalent to Nurse II and meets all dimension requirements for Nurse III; OR a Doctoral degree in a *related field with a BSN and one year of specialized nursing experience equivalent to Nurse II and meets all dimension requirements for Nurse III. *Note: Foreign education programs/degrees are not creditable as related degrees. Preferred Experiences: Minimum of 1-2 years active/current nursing experience (i.e., critical care, med-surgical, procedural/perioperative, ambulatory) in hospital setting. Experience in performing peritoneal dialysis procedures BLS certification Certification as a Certified Nephrology Nurse (CNN) is preferred. Candidates should possess at least 3 years of acute nursing experience, providing care specifically for patients with End-Stage Renal Disease (ESRD), Acute Kidney Injury (AKI), and late-stage chronic kidney disease (CKD). Applicants must demonstrate leadership in providing, directing, and improving patient care, and possess excellent skills in cannulation and care of dialysis vascular access, including central line catheter management. Reference: For more information on this qualification standard, please visit Physical Requirements: This position requires heavy lifting and carrying 45 pounds and over, straight pulling and pushing 1/2 hour, reaching above shoulder, use of fingers, both hands required, walking 2/4 hours, standing 2/6 hours, kneeling .5 hour, repeated bending 1/2 hours, both legs required, ability for rapid mental and muscular coordination simultaneously, near vision correctable at 13" to 16" to Jaeger 1 to 4, far vision correctable in one eye to 20/20 and to 20/40 in the other, Depth perception. External Factors: Outside and inside; Working closely with other; Working alone; Protracted or irregular hours of work. Education Additional Information This job opportunity announcement may be used to fill additional vacancies. 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. If you are unable to apply online or need an alternate method to submit documents, please reach out to the Agency Contact listed in this Job Opportunity Announcement. Under the Fair Chance to Compete Act, the Department of Veterans Affairs prohibits requesting an applicant's criminal history prior to accepting a tentative job offer. For more information about the Act and the complaint process, visit Human Resources and Administration/Operations, Security, and Preparedness (HRA/OSP) at The Fair Chance Act.