Advanced Practice Nurse (Nurse Practitioner) - Medicine Service

Veterans Health Administration • Little Rock, AR

3d • Onsite

About The Position

This Advanced Practice Registered Nurse (Nurse Practitioner) Nocturnist provides independent overnight medical management for admitted and residential patients at the North Little Rock and/or Little Rock campuses. The role covers services including acute and subacute rehabilitation, dementia and geriatric psychiatry units, acute psychiatry, residential rehabilitation, domiciliary, Community Living Center, and inpatient services at JLM.

The nurse practitioner provides facility-wide medical oversight after hours, serving as the primary medical decision maker for urgent and emergent issues across inpatient, residential, and designated outpatient areas. The role includes independent clinical management, assessment and treatment, coordination with nursing staff and the Nurse of the Day (NOD), response to code events, arrangements for emergency transfers, and coverage of other after-hours duties required by VHA policy.

This position is eligible for the Education Debt Reduction Program (EDRP), subject to program eligibility requirements and approval. The program may provide up to $200,000 in student loan reimbursement over an eligibility period of one to five years. Former EDRP participants are not eligible to apply. The work schedule is seven days on and seven days off: Wednesday through Monday, 7:00 p.m. to 7:00 a.m., and Tuesday, 11:00 p.m. to 7:00 a.m. The schedule may change based on service needs. Compressed/flexible scheduling is available; telework and virtual work are not available. Relocation and recruitment incentives, and permanent change of station, are not authorized.

Requirements

• Graduate from a school of professional nursing approved by an appropriate accrediting agency and accredited by ACEN or CCNE when the program was completed.
• Hold a post-master's certificate, master's degree, or doctoral degree as a Nurse Practitioner.
• Foreign nursing education must have nurse practitioner degree equivalency validated through an agency-recognized degree equivalency evaluation agency.
• Possess and maintain an active, current, full, unrestricted nurse practitioner license in a U.S. state, territory, commonwealth, or the District of Columbia.
• Maintain current, full basic board certification in an eligible specialty: FNP, ANP, AGPCNP, ACNP, AGACNP, or GNP, from ANCC, AANPCB, or another nationally recognized certifying body in the area of academic preparation.
• For Nurse Practitioner III qualification, meet the basic education requirements and have one year of specialized APN experience equivalent to Nurse II.
• Demonstrate the applicable grade-level competencies in clinical practice, outcome focus, leadership, professional development, and professionalism/collegiality.
• Be a U.S. citizen, except that non-citizens may be appointed when qualified U.S. citizens cannot be recruited under VA policy.
• Demonstrate basic written and spoken English proficiency.
• Pass required pre-employment screening and requirements, including applicable drug testing, background/security investigation, physical evaluation, and onboarding requirements.
• Participate in the seasonal influenza vaccination program and meet any required TB screening or testing conditions.
• Be registered with Selective Service if a male born after December 31, 1959.
• Complete all application requirements in the announcement's Required Documents section.

Nice To Haves

• At least two years of Advanced Practice Registered Nurse experience.
• At least one year of inpatient hospital medicine experience.

Responsibilities

• Independently manage a panel of patients with acute and chronic health conditions, emphasizing health promotion and disease prevention using evidence-based practice.
• Develop and implement individualized plans to support optimal population health and disease management.
• Order and interpret laboratory tests, other tests, and diagnostic studies.
• Prescribe pharmacologic and non-pharmacologic interventions.
• Initiate referrals and consultations to specialty services.
• Educate patients and their families.
• Assess and adjust plans of care to achieve optimal patient outcomes.
• Provide facility-wide medical oversight after hours and serve as primary medical decision maker for urgent and emergent issues across inpatient, residential, and designated outpatient areas at North Little Rock.
• Respond promptly to nursing staff requests for evaluation and treatment, including electronic record review, in-person assessments, appropriate orders and documentation, and closed-loop communication with nursing staff.
• Respond promptly to all code blue events; at North Little Rock, lead the code team, coordinate resuscitative care, direct team roles, and collaborate with the NOD regarding EMS activation and transfers.
• Collaborate with the NOD to resolve escalated nursing or patient-care issues and arrange ED transportation when evaluation or stabilization needs exceed facility capabilities.
• Recognize after-hours evaluation and management limitations at North Little Rock and arrange timely transport to the ED when appropriate.
• Provide warm handoffs to providers for patients transferring to the ED or MICU.
• Cover VHA policy-mandated after-hours duties, including follow-up on critical laboratory values for clinic and inpatient Veterans.
• Evaluate patients requesting discharge for the safety of their discharge plan and facilitate discharge for patients with capacity, including medication fills and a discharge summary with notification to the primary team.
• For patients lacking capacity, facilitate surrogate-authorized or VHA-policy 72-hour holds when applicable.
• Perform histories and physicals and write admission orders when needed for services that permit after-hours admissions.
• Rapidly evaluate reported falls and document them according to VHA fall policy.
• Provide admission-related orders when orders have been lost due to user error or system limitations.
• Participate meaningfully in Joint Patient Safety Review reporting, Peer Review reporting, and Root Cause Analysis as appropriate.
• Participate in the facility peer review process, OPPE review process, and other assigned chart review processes.

Benefits

• Eligible for the Education Debt Reduction Program, with potential student loan reimbursement up to $200,000, subject to eligibility and approval.
• Competitive salary, 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.
• Federal 401(k) with up to 5% in contributions by VA.
• Federal health, vision, dental, term life, and long-term care insurance; many federal insurance programs can be carried into retirement.
• Compressed/flexible scheduling is available.

What This Job Offers

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