Advanced Practice Nurse (Nurse Anesthetist)

The Advanced Practice Nurse (APN) II Certified Nurse Anesthetist (CNA) is a Certified Registered Nurse Anesthetist (CRNA). The CRNA provides a full range of services emphasizing quality, timeliness, and the advancement of the Veterans Affairs (VA) mission. The CRNA practices to the full extent of their education, training, and certification.

Advanced Practice Nurse (Certified Nurse Anesthetist) Basic Requirements

• Education. A masters or doctoral degree in nurse anesthesia. (Applicants pending the completion of educational requirements may be referred and tentatively selected but may not be hired until the education requirements are met.) Nursing education must be from a school of professional nursing anesthesia accredited by Council on Accreditation of Nurse Anesthesia Education Programs (COA) at the time the program was completed by the applicant.
• Licensure and Certification . The following licensure and certification requirements are considered conditions of employment.
  • License. All APN (CNAs) must maintain an active, current, full and unrestricted license to practice as a CNA or equivalent, in a State, Territory or Commonwealth of the United States or in the District of Columbia.
  • Basic Certification. All APN (CNAs) must maintain full and current certification by the National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA) or an equivalent Nurse Anesthetist certification recognized by the COA.

NOTE: Grandfathering Provision - All persons currently employed in VHA in 0610 series and an APN (CNA) assignment that are also 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.

The following Education, Experience, and Knowledge, Skills and Abilities must be met for Advanced Practice Nurse (Certified Nurse Anesthetist) II:

• Education and Experience Requirement. Meets basic education requirement for an APN (CNA). Nurse II is considered the entry grade level for APN (CNAs); no experience is required.
• Demonstrated Knowledge, Skills, and Abilities. The following list of knowledge, skills and abilities present the minimum skill set expected of an Entry Level CNA. Entry level into practice may include but are not limited to the following:
  • Ability to translate into anesthesia care the principles of professional nursing practice including the patients' rights to autonomy, dignity, privacy, and safety.
  • Knowledge of current research and practice guidelines to frame anesthesia practice including up to date techniques, pharmacology, and equipment.
  • Ability to obtain, document and verify informed anesthesia consent and perform a pre-anesthetic patient history and physical, which includes managing pre-operative consults and interpreting data.
  • Ability to formulate a patient-specific anesthetic plan and describe salient anesthetic risks, benefits, and options to the patient.
  • Ability to administer inhalational, regional, intravenous, local, and topical anesthetics.
  • Skill in detecting and treating anesthesia or surgically related physiologic changes and ability to treat accordingly in order to maintain homeostasis.
  • Skill in assessing patient status for appropriateness of transfer of care to another healthcare provider and communicating essential patient information to other providers effectively.
  • Ability to participate in collaborative responsibility for proper patient positioning, physiologic monitoring, infection control and anesthesia documentation.
  • Skill in responding to emergency situations by providing airway management, fluid and medication administration, invasive line insertion and management and the use of advanced cardiac life support techniques.
  • Ability to provide patient care that is abreast of changing concepts and advancements in the profession, (e.g., ultrasound techniques.)
  • Ability to practice anesthesia in an interdisciplinary environment utilizing a collaborative concept of anesthesia care.
  • Knowledge of quality improvement processes to maintain ongoing review and evaluation of anesthesia care to improve outcomes.
  • Ability to demonstrate a practice emphasis on safety, current established guidelines and protocols while recognizing the duty to report unsafe conditions or errors.

The following Education, Experience, and Knowledge, Skills and Abilities must be met for Advanced Practice Nurse (Certified Nurse Anesthetist) III:

• Education and Experience Requirement: Meets basic education requirement for an APN (CNA) AND One year of specialized APN (CNA) experience equivalent to the APN (CNA) II grade level.
• Demonstrated Knowledge, Skills, and Abilities: Progressively responsible experience in the administration of anesthetics as indicated in the knowledge, skills and abilities listed below
  • Ability to plan, administer and manage anesthesia for a broad range of complex surgical procedures skillfully employing continuous assessment and anesthetic adaptation based on patient response and comorbidities. Work assignments will vary by facility.
  • Ability to participate in assignments that are technically challenging, encompass a variety of anesthetizing locations and utilize advanced equipment and procedures while adapting techniques to solve various complex anesthesia problems including the development of individualized programs of post-op anesthesia care.
  • Skill in responsibility and accountability to perform to the extent of the CNA standards of practice as a licensed healthcare professional in any model of anesthesia practice.
  • Ability to contribute to the educational mission as a mentor or preceptor providing didactic and clinical instruction in anesthesia to student nurse anesthetists, medical and dental residents, and other health care trainees.
  • Knowledge to participate in the development, implementation and maintenance of auditing processes that ensure and improve the quality and consistency of anesthesia and associated documentation.
  • Ability to contribute to departmental administrative processes through quality assurance, shared governance, or committee representation as applicable.
  • Ability to serve as a representative on interdisciplinary teams to establish and maintain guidelines and communication.
  • Skill demonstrated in the ability to embrace the safety culture emphasis by continuously assessing for safety risks, actively reporting safety concerns, and maintaining a just culture by identifying faults in systems rather than individuals.

Physical Requirements:

This position includes a level of physicality normally associated with duties performed by certified nurse anesthetist such as direct patient care, and potentially long periods of walking, standing, sitting, moderate lifting, repeated bending, or kneeling. Examples may include but are not limited to: ? Significant amounts of time standing assisting patients ? Utilization of safe patient handling and mobility protocols This position potentially requires flexibility in schedule and assignments and may include other duties as assigned. Incumbent may be needed to take on-call status.