Advanced Practice Nurse (NP) - Vascular Surgery

Veterans Health Administration • San Antonio, TX

3d • Onsite

About The Position

The Advanced Practice Nurse (Nurse Practitioner) in Vascular Surgery is based at the Audie L. Murphy Memorial Veterans' Hospital in San Antonio, Texas, and reports to Surgical Care. This licensed independent practitioner provides a full range of services using treatment guidelines and evidence-based practice, making decisions autonomously and in consultation with physicians and other health care professionals. The role focuses on high-quality care for Veterans with vascular surgery needs, including assessment, treatment, coordination, follow-up, health promotion, and disease prevention.

The Nurse Practitioner manages a panel of patients with acute and chronic conditions; orders, facilitates, and interprets laboratory tests and diagnostic studies; prescribes pharmacologic and non-pharmacologic interventions; and assesses changes in patients’ conditions. The position includes routine staffing of the Vascular Surgery and Pre-Admission Surgical Screening clinics, inpatient rounding, postoperative care, discharge planning, postoperative clinic evaluation, and patient communications about surgical matters. The practitioner also coordinates with surgeons, physicians, nursing, MAS, radiology, pharmacy, and other services, and contributes to performance improvement and care-delivery initiatives.

The position has a Monday–Friday schedule from 7:30 a.m. to 4:00 p.m. CST. Telework and virtual work are not available. Relocation or recruitment incentives and permanent change-of-station authorization are not offered.

Requirements

• Graduate of a school of professional nursing approved by the appropriate accrediting agency and accredited by ACEN or CCNE when the applicant completed the program.
• A post-master’s certificate, master’s degree, or doctoral degree as a Nurse Practitioner.
• An active, current, full, and unrestricted APN license to practice as a Nurse Practitioner in a U.S. state, territory, commonwealth, or the District of Columbia.
• Maintain current, full basic board certification in the Nurse Practitioner area in which academically prepared from ANCC, AANPCB, or another nationally recognized certifying body.
• For Nurse Practitioner II: meet the basic education requirement; no experience is required. Demonstrate leadership in collaborative care, evidence-based clinical practice, outcome focus, professional development, and professionalism/collegiality.
• For Nurse Practitioner III: meet the basic education requirement and have one year of specialized APN (NP) experience equivalent to Nurse II; demonstrate leadership and experience managing complex care, outcome-focused practice, interdisciplinary leadership, professional development, and professionalism/collegiality.
• English proficiency in basic written and spoken English for direct patient care.
• U.S. citizenship is required unless qualified citizens cannot be recruited in accordance with VA policy.
• Male applicants born after December 31, 1959, must meet Selective Service registration requirements.
• Selected applicants are subject to background/security investigation and, for testing-designated positions, pre-employment drug testing; refusal to be tested results in denial of VA employment.
• Participation in the seasonal influenza vaccination program is required for VA Health Care Personnel.
• A transcript must be submitted if education is used to establish qualifications. Foreign nursing education must have nurse-practitioner degree equivalency validated through a recognized evaluation agency.
• Physical capabilities include moderate lifting and carrying (15–44 pounds), reaching above shoulder level, use of fingers and both hands, walking and standing for eight hours, repeated bending for 4–6 hours, rapid mental and muscular coordination, specified near and far vision, depth and color perception, hearing (hearing aid permitted), mental/emotional and cognitive stability, and ability to perform privileges and independently conduct physical examinations.

Nice To Haves

• Preferred experience includes autonomous practice decisions in consultation with physicians and other health professionals; ordering, facilitating, and interpreting laboratory and diagnostic studies for Vascular Surgery patients; writing daily General Surgery progress notes; independently reviewing or completing daily discharge summaries; following up on imaging, laboratory, and diagnostic results; and detecting significant changes in patients’ conditions and providing indicated treatment.

Responsibilities

• Make practice decisions autonomously and in consultation with physicians and other health care professionals, maintaining a collegial relationship for consultation and referral.
• Order, facilitate, and interpret laboratory tests and diagnostic studies for Vascular Surgery patients and ensure their timely completion.
• Write daily progress notes for General Surgery patients and assist teams with other progress notes as needed.
• Review or complete discharge summaries independently on a daily basis.
• Follow up on and evaluate results of X-rays, laboratory tests, and diagnostic procedures.
• Detect and evaluate significant changes in patients’ conditions and provide treatment as indicated.
• Independently manage a panel of patients with acute and chronic health conditions, emphasizing health promotion and disease prevention using evidence-based practice.
• Provide assessments, evaluations, and care coordination for Veterans.
• Prescribe pharmacologic and non-pharmacologic interventions.
• Develop and implement individualized plans to achieve optimal population health and disease management.
• Communicate with patients by phone, secure messaging, and other means regarding preoperative and postoperative surgical issues.
• Provide health promotion, disease prevention, and health education.
• Initiate referrals and consults, and serve as a VA and community liaison.
• Lead care delivery to ensure continuity of care and peer accountability, improving outcomes for the patient panel or program.
• Communicate with attending surgeons and physicians regarding Vascular Surgery patient follow-up and management of urologic procedures.
• Staff the Vascular Surgery and Pre-Admission Surgical Screening (PASS) clinics routinely.
• Work with the Vascular Surgeon to provide postoperative care, including inpatient rounding, hospital discharge instructions, and postoperative clinic evaluation and care.
• Educate patients about procedures to reduce postoperative wound infections, known surgical risks, preoperative and postoperative expectations, and expected hospital stays as needed.
• Maintain written scopes of practice for medical aspects of patient care, reviewed every two years by the APN and collaborating physician.
• Identify systems issues affecting patient care and take appropriate action to resolve them.
• Collaborate with nursing, MAS, radiology, pharmacy, and other interdisciplinary services as indicated.
• Review Vascular Surgery consults and assign them to appropriate clinics for scheduling by MAS.
• Collaborate with clients and families to identify physical, mental, cultural, and environmental factors that facilitate or impede surgical goals and postoperative discharge.
• Contribute to performance-improvement initiatives by identifying, analyzing, developing, and implementing processes that improve care at the panel, program, or population level.
• Collaborate with stakeholders to improve patient care, staff development, and performance measures.

Benefits

• Competitive salary with regular salary increases and potential performance awards.
• 50 days of paid time off per year: 26 days of annual leave, 13 days of sick leave, and 11 paid Federal holidays.
• Traditional federal pension with five-year vesting and a federal 401(k) with up to 5% in VA contributions.
• Federal health, vision, dental, term life, and long-term care insurance; many federal insurance programs may be carried into retirement.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level