The Lead Licensed Practical/Vocational Nurse assigned to the George E. Wahlen Primary Care Clinics and CBOC's functions as a team lead under the supervision of the Clinic Nurse Manager, who will work under the direction of a Registered Nurse (RN) that reports to the Clinic Manager. The lead LPN/LVN is responsible for having the knowledge and skills necessary to carry out more specialized patient care duties, including assignments in selected, more complex care settings. 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: Graduate of a school of practical or vocational nursing approved by the appropriate State-accrediting agency and/or the National League for Nursing Accrediting Commission (NLNAC) http://www.nlnac.org (copy of transcripts required) - OR - Health care education in the military service or training in the military service which is accepted by the licensing body in the jurisdiction in which the individual is licensed as qualifying for full LPN/LVN licensure will be accepted as meeting the education requirements for VHA employment. Licensure: Full, active, current and unrestricted licensure as a licensed practical or vocational nurse in a State, Territory or Commonwealth (i.e., Puerto Rico) of the United States, or District of Columbia. An LPN[/LVN] who has or has ever had, any license(s) revoked, suspended, denied, restricted, limited, or issued/placed in a probationary status may be appointed only in accordance with the provisions in chapter 3, section B, paragraph 16 of this part. Grade Determinations:GS-7: Experience: Completion of at least one (1) year of additional qualifying experience at the GS-6 level or equivalent, fully meeting all of the performance requirements for GS-6 LPN/LVN. Knowledge, Skills, Abilities, in addition to the above listed experience a GS-7 LPN/LVN must posses the following KSA's: Knowledge and skills necessary to carry out more specialized patient care duties, including assignments in selected, more complex inpatient and/or outpatient care settings. Knowledge base promotes the incorporation of current patient care data in actively contributing to the development of the patient's overall health plan and in carrying out assigned nursing interventions. Positions at this grade level require broader knowledge and skills because supervision is more general and employees are expected to be involved to a greater degree in the development and modification of treatment plans. Ability to assist RN and/or MD/DO to appropriately prioritize overall patient care needs and adjust plans for care delivery. Makes astute observations of subtle, less obvious changes, both physical and emotional, in patient's condition, and accurately and thoroughly documents care delivered and patient's response to care that could require immediate modification of the patient's care plan. Appropriately seeks assistance and guidance by informing RN or MD/DO of changes in patient's condition requiring higher-level intervention. At this grade level, the LPN/LVN is expected to participate to a greater degree in prioritizing, and, as appropriate, modifying patient care treatment. They must also possess the ability to observe more subtle physical and emotional changes in patients and demonstrate taking appropriate action based on those observations. Ability to proactively assist the RN or MD/DO in addressing patient's needs for medication/treatments, accurately administering prescribed medications/treatments according to established policies/procedures and appropriately recording administration and patient's response to medications/treatments received. (This may include restricted medication locally authorized for administration by employees at this grade level.) Demonstrates the knowledge and ability to readily recognize the more subtle signs and symptoms of potential or actual drug reactions, promptly inform the RN or MD/DO of observed changes in patient's condition and initiate appropriate, prescribed interventions. Employees at this grade level demonstrate broader knowledge and skill with respect to these responsibilities than employees at lower grade levels. Knowledge and skill to promptly recognize potential urgent or emergent patient care situations, seek assistance of the RN and/or MD/DO for appropriate team intervention and effectively intervene, as directed, to assure the continuation of optimal, safe and therapeutic patient care delivery. At this grade level, the LPN/LVN must have a broader knowledge of the patient treatment process and exercise judgment that demonstrates the ability to effectively intervene when appropriate. Assists individuals or groups of patients and their families to take an active role in promoting healthy lifestyles for more positive patient outcomes. Exercises skill in influencing and communicating with unusually difficult to care for or communicate with patients and/or family members who may exhibit problems with lack of self-control, resistant or abusive behaviors, or impediments in their ability to understand or follow instructions. This includes the ability to effectively deal with the above types of patients under very general supervision. Exhibits skill, creativity and initiative in contributing to the improvement of overall care delivery and patient and/or family satisfaction levels through active participation in committees/task forces, research projects or in developing educational materials/media. Actively promotes and effectively incorporates established customer service standards in all aspects of their practice. Possesses comprehensive practical nursing knowledge and skills in specialized procedures and practices to serve as a resource person for other staff in organizing and implementing more complex/specialized patient care. Serves as a role model and mentor to other nursing staff in the application of more complex technology, effectively guiding and directing their continuing practice in these areas. Supports the RN or MD/DO in monitoring the practice of unlicensed nursing or non-medical staff in patient care delivery. Promptly reports any deviations from normal practice patterns to the RN or MD/DO. In addition to responsibilities at the lower grade level, the LPN/LVN is responsible for monitoring the practice of non-licensed nursing and medical staff. Work of considerable difficulty and responsibility is performed under general supervision. Individuals in these positions are, to a considerable extent, expected to exercise independent technical judgments and to possess and apply a comprehensive working knowledge of the principles, art and science of practical nursing. The staff mix is such that employees at this grade level are expected to perform practical nursing duties of considerable difficulty and responsibility under very general supervision. Actively seeks out educational opportunities to enhance nursing knowledge and skills, and providing leadership in assisting other staff improve and advance their nursing practice. References: VA Handbook 5005/3, Part II, Appendix G13. Physical Requirements: This position requires visual acuity, keen hearing, clear distinctive speech, and manual dexterity. This position requires potentially long periods of continued walking, standing, stooping, sitting, bending, pulling, and pushing a weight of 35 pounds in accordance with the Safe Patient Handling Program Directive 2010-032. 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. The incumbent may occasionally be exposed to patients who are combative secondary to delirium, dementia, or psychiatric disorders. The incumbent must be a mature, flexible, sensible individual capable of working effectively in stressful situations, able to shift priorities based on patient and clinic needs. ["Complete a system of nursing tasks that are age/era appropriate for the Veteran and orders. Complete a system of tasks that are specific to Primary Care Services. Makes observations and thoroughly documents care and the patient's response. Appropriately seeks assistance and guidance by informing RN or medical provider of changes in the patient's condition requiring higher-level intervention. Demonstrates understanding of age and population-specific characteristics that affect the health care needs of the Veteran. Interacts and communicates in a Veteran-centered manner with patients and family members. Demonstrates professional behavior (i.e., respect, civility, ability to accept constructive criticism), effective communication and interpersonal skills. Follows policy and procedures related to fire and disaster drills, safety and security measures. Assists in the orientation and competency validation of students, peers and clerical staff. Serves as an advocate in the protection of patient and family rights. Completes mandatory reviews, including motivational interviewing, in order to promote patient self management toward individualized life plan of care. Supports patient-driven care in a safe, efficient and cost-effective manner, using evidence-based principles. Demonstrates knowledge and ability to appropriately carry out assigned patient care based on the patients' conditions; to use judgment in selecting the appropriate order and sequence of procedures and treatments; and to accurately recognize, report, and record relevant patient information. Recognizes and appropriately responds to breakage, malfunction, or loss of equipment, safety hazards, and supply deficiencies. Appropriately utilizes the computer and various computer packages to enter and retrieve electronic data, i.e., CPRS, VISTA, mailman, leave requests, and patient information (progress notes, patient education, etc.). Supports the mission of increasing and supporting virtual appointments (VVC). Identifies and participates in process improvement initiatives. Participates in unit level quality improvement activities. Maintains Joint Commission standards related to patient care. Completes annual nursing mandatory reviews as well as competencies and continuous learning requirements. Utilizes correct body mechanics and assistive devices and equipment appropriately when providing patient care (i.e., lifting, moving, position, or transferring), to avoid patient or employee injuries. Demonstrates compliance with infection control practices, such as hand washing and wearing of appropriate personal protective equipment. Demonstrates safe work practices. Complies with safety rules and regulations for safe job performance and fire protection. Demonstrates practical knowledge of human behavior, motivations, and reactions to situations and uses this knowledge in working effectively with patients, family and other staff members. Ensures that working conditions and work practices within the worksite are such that the possibility of an on-the-job injury is minimized. Reports any work-related injuries or illnesses at the time of occurrence, and completes appropriate documentation. Displays an attitude of caring and courtesy toward all Veterans and their families by treating them as customers, greeting them with a smile, referring to them by name, responding quickly to their needs, maintaining confidentiality, and treating them at all times with dignity and respect. Demonstrates appropriate telephone courtesy by identifying self and service or work section when answering the phone, responding to the caller in a polite and courteous manner. Initiates patient calls and patient care follow-up in accordance with facility policy. Monitors and restocks exam room medical/clerical supplies. Performs other tasks as requested by providers or supervising nursing personnel within the scope of training and abilities. Ensures all actions and interactions are within the guidelines of VHA and Center directives and policies regarding cultural diversity, prevention of sexual harassment, EEO, etc. by executing assigned duties and responsibilities in a professional, appropriate manner. Adheres to Center policies and procedures as well as the provisions of the VA-AFGE Master Agreement and local agreements. The incumbent must recognize the need for and ensure an environment free of hostilities. Work Schedule: Monday-Friday, 8:00 AM to 4:30 PM Telework: Not Available Compressed/Flexible: Available Virtual: This is not a virtual position. Functional Statement #: 51120-O Relocation/Recruitment Incentives: Not Authorized Permanent Change of Station (PCS): Not Authorized Financial Disclosure Report: Not required"]

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