Physician Assistant / Nurse Practioner

Veterans Affairs, Veterans Health Administration | Lebanon, PA

Posted Date 8/01/2019
Description The Nurse Practitioner or Physician Assistant works with a designated collaborating physician. The incumbent provides both routine scheduled appointments as well as urgent or same day care when indicated. Primary Care is comprehensive and continuous and covers preventative and psycho social aspects of patient management.

Duties include, but are not limited to, providing histories and physicals, (H and P's) pre-operative assessment under supervision and co-signature of collaborative physician, orders subspecialty consults, tests, prosthetic requests, completes forms on veterans behalf that are within the treatment purview of the incumbent, and performs other clinical duties as directed deemed by service chief and collaborative physician to be appropriate and in the interest of the Veteran. Incumbent works cooperatively with professionals throughout the medical center to make sure all aspects of care are coordinated.

Work Schedule: Monday through Friday, 8:00 am to 4:30 PM, unless otherwise approved by supervisor
Financial Discloser Report: Not required

Physical Requirements: Moderate lifting, 15-44 lbs; light lifting, under 15 lbs; moderate carrying, 15-44 lbs; reaching above shoulders; use of fingers; both hands required; walking 6-8 hours; standing 6-8 hours; both legs required; ability for rapid mental and muscular coordination simultaneously; near vision correctable at 13" to 16" to Jaeger 1 to 4; far vision correctable in one eye to 20/20 and 20/40 in the other; both eyes required; depth perception; ability to distinguish basic colors; hearing (aid permitted) min 15/20 one ear and mental and emotional stability required.Physician Assistant Specific Requirements
  • Graduate of a PA training program, or of a surgical assistant program which is accredited by the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA) or one of its predecessor organizations AND a bachelor's degree from an accredited PA training program or in another health sciences related field from an accredited college or university recognized by the U.S. Department of Education.
  • Current and continuous certification by the National Commission on Certification of Physician Assistants (NCCPA) is required for employment in VHA. PAs on VA rolls prior to March 12, 1993 who are not NCCPA certified remain exempt from the NCCPA certification requirement. However, a PA who subsequently became or becomes certified is no longer exempt and must maintain certification as a condition of employment.
Physician Assistant Grade Determination: Requirements for appointment or promotion to a specific grade are based on the candidate's ability to demonstrate the elements described.

Full Grade. There is no experience or educationbeyond the basic requirements in paragraph 2 of this standard.

Clinical Competencies
Clinical Proficiency:
  1. Provides effective care to patients characterized by the use of sound judgment in assessing, planning, implementing, documenting, and evaluating patient care for assigned patients. This includes possessing the skill and competency to obtain thorough medical histories, perform comprehensive physical examinations, order appropriate diagnostic studies, interpret and analyze medical data, establish
  2. diagnoses, formulate and implement treatment plans, and modify treatment plans when appropriate.
  3. Works effectively and makes appropriate requests for assistance from the assigned physician and recognizes complex patient care situations where referral is appropriate.
  4. References quality improvement information and organizes patient care needs to assure safe, efficient and cost-effective care.
  5. Initiates effective actions in emergencies
Professional Development:
  1. Obtains additional knowledge and skills appropriate to the practice setting to improve performance.
  2. Provides patient education in an effective manner.
Ethics Safeguards patient privacy and confidentiality. Provides care in a nonjudgmental, nondiscriminatory manner respecting the patient's values and beliefs.
Interpersonal Skills Works effectively with patients, families, caregivers, and other professional and support personnel.
Research:
  1. Demonstrates awareness of research application to practice.
  2. Researches medical literature and applies evidenced-based medicine to improve clinical practice.
Intermediate Grade. Individuals appointed or advanced to Intermediate Grade will have demonstrated the ability to analyze and solve more complex medical problems and meet the following requirements:
Experience / Education
  1. 1 year of professional practice as a PA; or
  2. Successful completion of a PA post-graduate residency program accredited by ARC-PA or by the U.S. Armed Forces; or
  3. A Master's degree from a PA training program certified by ARC-PA or in another health-related field from an accredited college or university recognized by the U.S. Department of Education.
Clinical Competencies
Clinical Proficiency
  1. Effectively treats patients with more complex medical problems requiring a higher degree of clinical skill and competency than that expected of the previous grade.
  2. Performs more complex diagnostic and therapeutic procedures requiring skills and competency, as applicable to the assignment, beyond that expected in the previous grade.
  3. Practices with a higher degree of autonomy and seeks guidance from the assigned physician less frequently than expected of the previous grade.
  4. Evaluates the delivery system of patient care within the area of assignment, presents findings and recommendations, and contributes to changes that enhance the quality and timeliness of care.
Professional Development
  1. Acquires knowledge and skills to maintain expertise in area of practice.
  2. Shares medical literature research findings with colleagues to enhance patient care delivery.
  3. Participates in educational activities to improve clinical knowledge and enhance role performance.
  4. Serves as a clinical preceptor to healthcare students.
  5. Serves on service level committees or subcommittees when assigned.
Ethics
  1. Identifies medical ethical issues and takes appropriate actions.
  2. Supports and enhances patient self-determination.
Interpersonal Skills Collaborates effectively with other occupations and services to identify, analyze, and resolve patient care problems.
Research
  1. Shares medical literature research findings with colleagues to enhance patient care delivery.
  2. Uses a body of research to validate or change group practice.
Senior Grade. Individuals appointed or advanced to Senior Grade will have demonstrated the behaviors or responsibilities listed in one or more of the following categories:
Experience / Education
  1. 3 years of professional practice as a PA; or
  2. 2 years of professional practice as a PA and successful completion of a PA post-graduate residency program accredited by ARC-PA or by the U.S. Armed Forces; or
  3. 2 years of professional practice as a PA and a degree from a PA training program certified by ARC-PA or in another health-related field from an accredited college or university recognized by the U.S. Department of Education; or
  4. A Doctoral degree in a health-related field from an accredited college or university recognized by the U. S. Department of Education.
Management/Administrative One of the following responsibilities must be demonstrated:
  1. Evaluates service level patient care delivery systems and validates or identifies barriers to safe, effective care. Presents findings and recommendations to appropriate management officials and participates in implementation of changes.
  2. Manages patient quality management data bases such as the National Surgical Quality Improvement Program (NSQIP) if assigned.
  3. Serves on service or facility committees/task forces if applicable to the assignment.
  4. Coordinates consult referrals within the service assigned.
  5. Coordinates and facilitates inter-service agreements.
Clinical Competencies
Clinical Proficiency
  1. Manages patients with complex or multi-system medical problems.
  2. Practices with a significant degree of autonomy and seeks guidance from assigned physicians with less frequency than expected at the previous grade.
  3. Performs more complex diagnostic and therapeutic procedures beyond what is expected at the previous grade.
  4. First or second assists in surgical procedures.
Professional Development
  1. Acts as a consultant/mentor to PAs in lower grades and other clinical and support staff.
  2. Serves as a clinical preceptor for students or organizes and participates in facility clinical educational programs.
  3. Makes sustained contribution to health care by sharing expertise within and/or outside the medical facility.
Ethics Identifies and addresses ethical issues that impact patients and staff including participation in ethics consultations if appropriate to the area of assignment.
Interpersonal Skills
  1. Communicates and collaborates effectively with other facility staff and outside institutions when applicable to the area of assignment.
  2. Effectively promotes the physician assistant profession to health care staff, patients and other stakeholders at the local level.
  3. Makes significant contributions which serve to enhance the distinctive role of PAs within the local institution and the health care system.
Research
  1. Collaborates with others in research activities to improve patient care, or;
  2. Authors, or collaborates with others, on a paper or study for publication.
Nurse Requirements listed below under Education.

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