The Nurse Practitioner ICU role requires advanced knowledge about professional nursing practice, advanced pharmacology, as well as the physical, psychosocial and cultural aspects as it relates to health and illness behaviors. The Nurse Practitioner serves as the primary health care provider for a selected group of patients with acute and/or chronic conditions in a Critical Care setting at the VA Caribbean Healthcare System. Basic Requirements: United States Citizenship: Non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy. English Language Proficiency. In accordance with 38 U.S.C. 7402(d), 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 State-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). In cases of graduates of foreign schools of professional nursing, possession of current, full, active and unrestricted registration will meet the requirement of graduation from an approved school of professional nursing. OR The completion of coursework equivalent to a nursing degree in a MSN Bridge Program that qualifies for professional nursing registration constitutes the completion of an approved course of study of professional nursing. Students should submit the certificate of professional nursing to sit for the NCLEX to the VA along with a copy of the MSN transcript. (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. 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. Additional requirements for Nurse Practitioners Nurse Practitioners. A nurse practitioner must be licensed or otherwise recognized as a nurse practitioner in a State, possess a master's degree from a program accredited by the NLNAC or CCNE, and maintain full and current certification as a nurse practitioner from the American Nurses Association or another nationally recognized certifying body. Preferred Experience: Two years of experience as a Nurse Practitioner, preferred. ICU experience, preferred. Proficient in spoken and written Spanish, preferred. Grade Determinations: The following criteria must be met in determining the grade assignment of candidates, and if appropriate, the level within a grade: Nurse I Level I - An Associate Degree (ADN) or Diploma in Nursing, with no additional nursing practice/experience required. Nurse I Level II - An ADN or Diploma in Nursing and approximately 1 year of nursing practice/experience; OR an ADN or Diploma in Nursing and a bachelor's degree in a related field with no additional nursing practice/experience; OR a Bachelor's of Science in Nursing (BSN) with no additional nursing practice/experience. Nurse I Level III - An ADN or Diploma in Nursing and approximately 2-3 years of nursing practice/experience; OR an ADN or Diploma in Nursing and a Bachelor's degree in a related field and approximately 1-2 years of nursing practice/experience; OR a BSN with approximately 1-2 years of nursing practice/experience; OR a Master's degree in nursing (MSN) or related field with a BSN and no additional nursing practice/experience. Nurse II - A BSN with approximately 2-3 years of nursing practice/experience; OR ADN or Diploma in Nursing and a Bachelor's degree in a related field and approximately 2-3 year's of nursing practice/experience; OR a Master's degree in nursing or related field with a BSN and approximately 1-2 year's of nursing practice/experience; OR a Doctoral degree in nursing or meets basic requirements for appointment and has doctoral degree in a related field with no additional nursing practice/experience required. Nurse III - Master's degree in nursing or related field with BSN and approximately 2-3 year's of nursing practice/experience; OR a Doctoral degree and approximately 2-3 year's of nursing practice/experience. Reference: VA Regulations, specifically VA Handbook 5005, Part II, Appendix G-6 Nurse Qualification Standard. This can be found in the local Human Resources Office. Physical Requirements: Heavy Lifting (45 lbs. and over); Heavy Carrying (45 lbs.and over); Straight Pulling (up to 1 hour); Pushing (1 - 2 hours); Reaching above shoulder; Use of fingers; Both hands required; Walking (up to 3 hours); Standing (up to 3 hours); Repeated bending (up to 1 hour); Ability for rapid mental and muscular coordination simultaneously; Near vision correctable at 13" to 16"; Hearing (aid permitted). ["This practice includes independent and interdependent decision-making and direct accountability for clinical judgment. The primary setting will be the Medical Intensive Care units. This clinician is accountable for addressing a large majority of health care needs and practicing in the context of acute critical care setting. The core clinical duties under the supervision of a Pulmonary/Critical Care Medicine specialist will include, but not limited to: performing and documenting history and physical examinations; may order and evaluate diagnostic testing and therapeutic modalities, including, but not limited to laboratory tests, EKG, radiological studies, hemodynamic monitoring, treatments; ordering ancillary services (including, but not limited to pharmacy, physical, occupational and speech therapy, nutrition, and prosthetics); obtaining and documenting informed consent for treatments and procedures in which NP is privileged to perform; performing basic procedures including: venipuncture to obtain specimens, intradermal, intramuscular, and subcutaneous injections, Foley catheter insertion, cerumen removal, basic nail care, suture removal, and wound dressing changes; managing basic, acute, and chronic conditions; HIV pre-post counseling; requesting consultations from other healthcare providers; prescribing devices, supplies, and durable medical equipment; promoting health maintenance and disease prevention through patient counseling, education, and vaccine administration; conducting and documenting goals of care discussions, implementing palliative and end-of-life care including, but not limited to writing code status, state authorized portable orders, and entering life sustaining treatment orders. Conducting goals of care conversations and writing life sustaining treatment (LST) progress notes and LST orders, including DNAR/DNR orders as appropriate. Make rounds on hospitalized patients, Medication management, including management of anticoagulants, Management of arterial and central lines, Management of urinary catheters. Other duties as appropriate include: participating in clinical research or quality improvement projects, instruction of health care trainees, and non-advanced practice duties as needed. Work Schedule: Rotating Shift 24/7 Telework: Not available Virtual: This is not a virtual position. Permanent Change of Station (PCS): Not authorized. Financial Disclosure Report: Not required"]

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