Registered Nurse - Home Base Primary Care (HBPC)

Summary

The Nurse - Home Based Primary Care (HBPC) Outpatient Staff Registered Nurse (RN) is responsible and accountable for individual nursing practice and determines the appropriate delegation of tasks consistent with the nurses obligation to provide optimal outpatient care.

Qualifications

Basic Requirements:

• English Language Proficiency
• In accordance with 38 U.S.C. 7403(f) - no person shall serve in direct patient care positions unless they are proficient in basic written and spoken English
• Graduate of a school of professional nursing approved by the appropriate accrediting agency and accredited by one of the following accrediting bodies at the time the program was completed by the applicant: The Accreditation Commission for Education in Nursing (ACEN) or The Commission on Collegiate Nursing Education (CCNE)
• OR Individuals attending a master's level bridge program in nursing who have completed coursework equivalent to a bachelor's level degree in Nursing may have opportunity to become registered as a nurse with a state licensing board prior to completion of the bridge program
• Upon achievement of a State license - the individual may be appointed on temporary basis and later converted to a permanent appointment upon successful completion and graduation from the bridge program
• (Reference VA Handbook 5005 - Appendix G6)
• OR In cases of graduates of foreign schools of professional nursing - possession of a current - full - active - and unrestricted registration will meet the requirement for graduation from an approved school of professional nursing to warrant an appointment as a Nurse who has completed an associated degree/entry level Nursing education program
• Credit for foreign nursing education higher that associate degree/entry level requires a formal degree equivalency validation from a recognized equivalency evaluation accepted by VA such as International Consultants of Delaware (ICD)
• Current - full - active - and unrestricted registration as a graduate professional nurse in a State - Territory or Commonwealth (i.e. - Puerto Rico) of the United States - or the District of Columbia
• Graduate Nurse Technician (GNT) Exception: Candidates who otherwise meet the basic education requirements - but do not possess the required licensure - may be appointed at the entry step of the grade and level applicable to the completed nursing education as a GNT on a 120-day temporary appointment while actively pursuing licensure (may be extended up to two years on a case-by-case-basis.) Preferred Experience: A minimum of 3-5 years of experience in outpatient home care - with a primary focus on providing care to geriatric patients in their homes
• NOTE: Grandfathering Provision - All persons currently employed in VHA in 0610 series and performing the duties as described in the qualification standard on the effective date of the standard (1/29/2024) are considered to have met all qualification requirements for the grade held including positive education and licensure/certification
• Grade Determinations: The following Scope - Education and Dimension criteria must be met in determining the grade assignment of candidates - and if appropriate - the level within a grade
• The Dimension requirements (Practice - Veteran/Patient Driven Care - Leadership - Professional Development and Evidence-Based Practice/Research) are detailed for each grade and level within the online assessment:
• Grade/Level Scope Education Nurse I - Level I Delivers fundamental - knowledge-based care to assigned clients while developing technical competencies
• An Associate Degree (ADN) or Diploma in Nursing - with no additional professional nursing required
• Nurse I - Level II Demonstrates integration of biopsychosocial concepts - cognitive skills and technically competent practice in providing care to clients with basic or complex
• An ADN or Diploma in Nursing AND 1 year of specialized nursing experience equivalent to Nurse I - Level 1 ;OR a Bachelor of Science in Nursing (BSN) with no additional professional nursing experience required
• Nurse I - Level III Demonstrates proficiency in practice based on conscious and deliberate planning
• Self-directed in goal setting for managing complex client situations
• An ADN or Diploma in Nursing AND 2 years of professional nursing experience in which one year is equivalent to Nurse I - Level 2
• OR a BSN and 1 year of professional nursing experience equivalent to the Nurse I - Level 2
• OR a Master's degree in nursing (MSN) and no additional professional nursing experience
• OR a Master's degree in a *related field with a BSN and no additional professional nursing experience
• Nurse II Demonstrates leadership in delivering and improving holistic care through collaborative strategies with others
• A BSN with 2 years of professional nursing equivalent to Nurse I - Level 3
• OR an MSN with one year of specialized nursing experience equivalent to Nurse I - Level 3
• OR a Master's degree in a *related field with a BSN and one year of specialized nursing experience equivalent to Nurse I - Level 3
• OR a Doctoral degree in Nursing with no professional nursing experience
• OR a Doctoral degree in a *related field with a BSN with no additional professional nursing experience
• Nurse III Executes position responsibilities that demonstrate leadership - experience and creative approaches to management of complex client care beyond the immediate practice setting
• MSN and 2 years of specialized nursing experience - one of which is equivalent to Nurse II and meets all dimension requirements for Nurse III
• OR a Master's degree in *related field with BSN and two years of specialized nursing experience - one of which is equivalent to Nurse II and meets all dimension requirements for Nurse III
• OR a Doctoral degree in Nursing with and one year of specialized nursing experience equivalent to Nurse II and meets all dimension requirements for Nurse III
• OR a Doctoral degree in a *related field with a BSN and one year of specialized nursing experience equivalent to Nurse II and meets all dimension requirements for Nurse III
• *Note: Foreign education programs/degrees are not creditable as related degrees
• Reference: For more information on this qualification standard - please visit
• Physical Requirements: The position requires bending - grasping - kneeling - performing moderation lifting - carrying tasks of up to 35 pounds per the Safe Patient Handling and Mobility (SPHM) guidelines and using an appropriate mechanical lift
• Candidate must possess the ability to pivot their waist and neck - push and pull items not greater than 35 pounds and reach within a five-foot distance or above shoulder height
• Requires sitting - squatting - standing - walking and twisting - alongside wrist flexion and extension
• Requires adequate vision to accurately perform the assigned duties - distinguish basic colors and assess patients and the environment safely
• Ability to hear at a level to perform the assigned duties - and the use of hearing aids permitted
• This position includes a level of physicality normally associated with duties performed by nurses such as direct patient care - and potentially long periods of walking - standing - sitting - moderate lifting - repeated bending or kneeling.

Duties

• The Home-Based Registered Nurse provides care in the Veteran's home to promote health and prevention of illness and injury which includes appropriate nursing judgment through case finding - health teaching - health counseling
• provision of care supportive to or restorative of life and well-being
• and executing medical regimens including administering medications and treatments prescribed by a licensed or otherwise legally authorized provider
• The RN will be required to travel to other locations of care within JDDVAMC catchment area
• The RN is required to drive and/or travel using a government vehicle to other sites of care within JDDVAMC as well as - to community partners - as necessary to accomplish work assigned
• Duties include but are not limited to the following: Perform diverse nursing functions such as significant case management - coordination of patient care - physical assessment - creating care plans - completing primary care clinical reminders - teaching in-home patient care to Medical Foster Home (MFH) and family caregivers - and drawing lab studies
• Must have a Valid Driver's license
• Travel is expected to be up to 75% of work week Administers medications and procedures per established policies and guidelines
• Evaluate new consults to HBPC team - case management of HBPC patients and supporting the provision of care in the home to a complex population of chronically ill or severely disabled Veterans of JDDVAMC
• Support the provision of care by others to the HBPC population - Homemaker/Home Health Aide population - Home Hospice and Intermittent Skilled Services patient population - MFH - and Contract Nursing Home population
• Perform other duties as assigned by the Home Care Leadership team - Home Care Program Director - and the Associate Chief of Staff - Geriatrics and Extended Care
• Administers medications and procedures per established policies and guidelines
• Utilizes interventions - which maximize health capabilities and reduces unnecessary urgent care and emergency room visits - per Veteran's goals of care
• Makes home visits to Veterans in the program
• Focuses on individual growth and development in HBPC nursing practice with increased levels of self-direction
• Seeks guidance on how to improve care provided to patients and families
• Delegates elements of care to the appropriate individual based upon assessed needs - condition - and safety of the patient
• Brings HBPC principles and theory with limited application of critical thinking skills
• Manages consults and patient inquiries (electronic or telephone) expeditiously
• Use appropriate data sources (Clinical Reminders/dashboards) for proper patient management
• Schedules home visits according to patient needs and understanding
• schedules consults promptly
• Monitors patients at high risk for hospitalization and keeps the HBPC Provider and Primary Care Provider apprised of clinical issues needing provider intervention
• Provides individualized education and support to the patient and caregiver to optimize clinical outcomes and support quality of life decisions
• Develops and coordinates the patient's plan of care to include ongoing assessment and re-assessment - care planning - care coordination - monitoring - and evaluating clinical outcomes
• Identifies specific goals and develops a treatment plan within 30 days of admission - collaborating with other interdisciplinary team members
• Evaluate patient progress towards achieving goals as needed
• Effectively provides care and manages clinical issues of a panel/caseload of 25-30 Veteran patients VA offers a comprehensive total rewards package: VA Nurse Total Rewards Pay: Competitive salary - regular salary increases - potential for performance awards Paid Time Off: 50 days of paid time off per year (26 days of annual leave - 13 days of sick leave - 11 paid Federal holidays per year) Retirement: Traditional federal pension (5 years vesting) and federal 401K with up to 5% in contributions by VA Insurance: Federal health/vision/dental/term life/long-term care (many federal insurance programs can be carried into retirement) Licensure: 1 full and unrestricted license from any US State or territory Work Schedule: Monday - Friday - 7:30 AM to 4:00 PM
• Telework: Not Available Virtual: This is not a virtual position
• Relocation/Recruitment Incentives: Not Authorized Permanent Change of Station (PCS): Not Authorized

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The Veterans Health Administration (VHA) is the largest integrated health care system in the United States, providing care at 1,321 health care facilities, including 172 VA Medical Centers and 1,138 outpatient sites of care of varying complexity (VHA outpatient clinics) to over 9 million Veterans enrolled in the VA health care program. VHA Medical Centers provide a wide range of services including traditional hospital-based services such as surgery, critical care, mental health, orthopedics, pharmacy, radiology and physical therapy. In addition, most of our medical centers offer additional medical and surgical specialty services including audiology & speech pathology, dermatology, dental, geriatrics, neurology, oncology, podiatry, prosthetics, urology, and vision care. Some medical centers also offer advanced services such as organ transplants and plastic surgery.

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