Registered Nurse (Perioperative)

Veterans Health Administration • Salisbury, NC

9d

About The Position

The Post Anesthesia Care Unit (PACU) Registered Nurse provides and/or supervises direct patient care and is accountable for all elements of the nursing process. The nurse coordinates care focused on patient education, self-management, and customer satisfaction across the continuum of care, and administers medications and procedures in accordance with established policies and guidelines.

The role provides specialized care throughout the peri-anesthesia continuum, including pre-anesthesia, Post-Anesthesia Phase I and Phase II, and extended care following sedation, analgesia, or anesthesia for surgical, diagnostic, and therapeutic procedures. The nurse assesses and prepares patients, recognizes contraindications to anesthesia or surgery, monitors postoperative status and physiological systems, and implements interventions to maintain or restore patients to baseline or better.

The nurse follows current ASPAN standards, VA directives, and service-level procedures; documents all phases of care accurately and promptly in the electronic health record; and contributes to collaborative, evidence-based nursing practice, professional development, and quality patient outcomes. On-call duties may be required. The schedule is described as a compressed schedule of 10-hour shifts, 7:45 a.m. to 6:15 p.m., subject to supervisory discretion.

Requirements

• Proficiency in basic written and spoken English.
• Graduation from an appropriately accredited school of professional nursing, or qualifying education under the stated VA provisions for bridge-program or foreign-school graduates.
• Current, full, active, and unrestricted registered-nurse licensure in a U.S. State, Territory, Commonwealth, or the District of Columbia; a temporary Graduate Nurse Technician exception may apply to eligible candidates pursuing licensure.
• Ability to meet applicable VA grade and level requirements for education, experience, and nursing practice dimensions.
• Ability to complete required pre-employment screening and onboarding, including a physical examination, background/security investigation, and drug testing for testing-designated positions.
• Participation in the seasonal influenza vaccination program and completion of annual Employee Health requirements, such as TB screening or testing.
• Ability to meet the physical demands of nursing duties, including prolonged standing, walking, sitting, moderate lifting, repeated bending, or kneeling, and use of safe patient handling and mobility protocols.
• Ability to work effectively in stressful situations, shift priorities based on patient needs, and occasionally work with patients who may be combative due to delirium, dementia, or psychiatric disorders.
• U.S. citizenship is required, except that non-citizens may be appointed when qualified citizens cannot be recruited under VA policy.

Nice To Haves

• At least 1–2 years of recent experience in an acute or high-acuity setting such as ICU, Emergency Department, Step Down, or Telemetry.
• Prior PACU, critical care, or postoperative recovery experience.
• Demonstrated competency in airway management, hemodynamic monitoring, and rapid assessment of post-anesthesia patients.
• Experience identifying and managing post-anesthesia complications, including respiratory instability, laryngospasm, and emergence delirium.
• Moderate sedation experience with documented competency in monitoring, recovery assessment, and recognition of sedation-related complications.
• Proficiency in evidence-based pain and nausea management during Phase I and Phase II recovery.
• Ability to prioritize and safely manage multiple patients in different stages of surgical recovery.
• Familiarity with Aldrete or Modified Aldrete scoring criteria.
• CPAN or CAPA certification.

Responsibilities

• Provide and supervise direct patient care, taking responsibility for all elements of the nursing process.
• Coordinate care focused on patient education, self-management, and customer satisfaction throughout the continuum of care.
• Administer medications and procedures according to established policies and guidelines.
• Assess, plan, implement, and evaluate care throughout the peri-anesthesia continuum, including pre-anesthesia, Phase I and Phase II recovery, and extended care after sedation, analgesia, or anesthesia.
• Assess and prepare patients for procedures and recognize contraindications to anesthesia or surgical intervention.
• Apply appropriate post-sedation scoring and assess postoperative cardiovascular and respiratory status, airway needs, neurological status, hemodynamic stability, pain, comfort, and mental status.
• Implement appropriate interventions to maintain or return physiological systems to baseline or above.
• Maintain knowledge of current ASPAN standards, VA directives, and service-level standard operating procedures.
• Document all phases of care accurately, completely, and promptly in the electronic health record.
• Collaborate with the interdisciplinary team and contribute a professional nursing perspective to discussions and care strategies.
• Evaluate practice on an ongoing basis using the best available evidence and question clinical practices to support evidence-based care.
• Provide peers with constructive feedback and support colleagues through knowledge sharing.
• Foster a safe, supportive environment conducive to healthcare professionals' development.
• Share educational findings, experiences, and ideas with peers and participate in activities that sustain an evidence-based-practice culture.
• May perform on-call duties.

Benefits

• Competitive salary, regular salary increases, and potential performance awards.
• 50 days of paid time off per year, consisting of 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 contributions by VA.
• Federal health, vision, dental, term life, and long-term care insurance; many federal insurance programs can be carried into retirement.

What This Job Offers

• Job Type: Full-time
• Education Level: Associate degree