RN Staff - Home Based Primary Care (Littleton NH)

Veterans Health Administration • Littleton, NH

2d • Onsite

About The Position

The RN Staff position is in the Geriatrics and Extended Care Service at the VA White River Junction Healthcare System, based at the Littleton, New Hampshire location. It is a full-time position scheduled for 40 hours per week, Monday through Friday, 8:00 a.m. to 4:30 p.m. The role provides home-based primary care to veterans, including complex primary, geriatric, preventive, and palliative care. Routine home visits are part of care delivery. Ad-hoc telework may be available at the supervisor’s discretion; the position is not virtual. A compressed or flexible schedule is not available.

The nurse provides and supervises direct patient care and is accountable for all elements of the nursing process. The role coordinates care across settings, with emphasis on patient education, self-management, and satisfaction; manages cases through assessment, triage, education, and coordination of resources and medications; and develops individualized care plans. The nurse administers medications and performs clinical procedures in accordance with established policies and guidelines, delivers evidence-based care, and oversees licensed vocational nurses and nursing assistants. Care interventions aim to maximize health, reduce hospital and emergency department visits, and align with each veteran’s goals of care.

The position also supports nursing staff orientation, education, and competency development; provides constructive peer feedback; and contributes to quality improvement and outcome evaluation. The nurse collaborates with the interdisciplinary team to address issues affecting the veteran experience, incorporates the knowledge, values, and beliefs of patients and caregivers without discrimination, advocates for their needs, and serves as a resource for ethical concerns.

The role leads the integration of evidence-based practice and research, applies current findings to improve processes and outcomes, assesses clinical processes for efficient and cost-effective care, monitors and evaluates outcomes, and leads initiatives that integrate patient preferences and shared decision-making.

Applicants must meet the applicable education, licensure, and grade-level requirements. The position requires a current, full, active, unrestricted nursing registration in a U.S. state, territory, or commonwealth, or the District of Columbia, subject to the stated Graduate Nurse Technician exception. Applicants must be proficient in written and spoken English. A valid unrestricted driver’s license and a clean driving record for the prior five years are required. The selectee must pass a pre-employment physical evaluation and credentialing, and is subject to background/security investigation, drug screening where applicable, and the seasonal influenza vaccination requirement.

The position is in the Excepted Service and is covered by a special rate. VA describes the compensation as a competitive salary with regular increases and potential performance awards. Benefits listed include 50 days of paid time off per year (26 days annual leave, 13 days sick leave, and 11 paid federal holidays), a traditional federal pension with five-year vesting, a federal 401(k) with up to 5% in VA contributions, and federal health, vision, dental, term life, and long-term care insurance. Relocation and recruitment incentives are not authorized.

Requirements

• Proficiency in basic written and spoken English.
• Graduation from an appropriately accredited school of professional nursing, with education meeting the stated VA requirements. Applicable pathways include an ADN/diploma, BSN, MSN, or other qualifying degree and experience combinations for the grade sought.
• Current, full, active, and unrestricted registration as a graduate professional nurse in a U.S. state, territory, or commonwealth, or the District of Columbia; a stated Graduate Nurse Technician exception may apply to eligible candidates pursuing licensure.
• A valid unrestricted driver’s license.
• A clean driving record for the last five years.
• Ability to satisfactorily perform the position’s duties and pass a pre-placement physical examination.
• Satisfactory completion of credentialing and background/security investigation requirements.
• Compliance with applicable pre-employment drug screening and the VA seasonal influenza vaccination program.
• Compliance with applicable U.S. citizenship requirements; non-citizens may be appointed only when qualified citizens cannot be recruited in accordance with VA policy.
• Males born after December 31, 1959, must meet Selective Service registration requirements.
• Education used to qualify must be recognized by the U.S. Department of Education and meet applicable accreditation requirements. Foreign education requires the specified equivalency documentation.

Responsibilities

• Provide and supervise direct patient care and ensure accountability for all elements of the nursing process.
• Coordinate patient care across settings, emphasizing education, self-management, and patient satisfaction.
• Administer medications and perform clinical procedures according to established policies and guidelines.
• Participate in unit- and program-level quality improvement and customer service initiatives.
• Deliver evidence-based care to home-based primary care patients, including oversight of licensed vocational nurses and nursing assistants.
• Manage cases through assessment, triage, patient education, resource and medication coordination, and individualized care planning.
• Plan and deliver comprehensive, technically competent home-based care addressing complex primary, geriatric, preventive, and palliative needs.
• Implement interventions to maximize health, reduce hospital and emergency department visits, and align care with veterans’ goals.
• Conduct routine home visits to veterans.
• Support nursing staff orientation, education, and competency development; contribute to quality improvement and outcome evaluation.
• Provide constructive feedback to peers and foster a safe, supportive, and professional environment for staff development.
• Collaborate with the interdisciplinary team to resolve issues affecting the veteran experience, including care coordination, timeliness, satisfaction, and environment-of-care concerns.
• Incorporate the knowledge, values, and beliefs of patients, families, and caregivers into care delivery without judgment or discrimination.
• Advocate for patient, family, and caregiver needs and serve as a resource for resolving ethical concerns.
• Lead integration of evidence-based practice and research to improve care quality, resource use, and outcomes.
• Apply current evidence and research findings to daily practice to improve processes or outcomes.
• Assess clinical processes for opportunities to deliver care efficiently and cost-effectively.
• Monitor, analyze, and evaluate care outcomes to drive improvements.
• Lead initiatives that incorporate patient preferences and shared decision-making into care delivery.

Benefits

• 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.

What This Job Offers

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