The Clinical Nurse Leader (CNL) utilizes independent critical thinking skills and the nursing process to provide care through Primary Care Services which encompasses the practice area at Medical Practice and Primary Health Units (Women's Health, Infectious Disease, Travelling Veterans Coordination and Anticoagulation) at the San Francisco VA Health Care System. 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.) 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: https://apply.usastaffing.gov/ViewQuestionnaire/12461058. 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. Requirement: Board Certification as a Clinical Nurse Leader from the Commission on Nurse Certification (CNC), or American Association of Colleges of Nursing (AACN). Bachelor's Degree in Nursing Master's Degree in Nursing/Clinical Nurse Leader from an accredited CNL Education Program. Salary for this position ranges dependent upon applicant qualifications Grade I: $149,816-$199,250 annually Grade II: $172,288-$221,900 annually Grade III: $189,516-$221,900 annually 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: The physical requirements of this position include lifting, prolonged standing, frequent bending and stooping, walking, reaching, and repetitive motion. Heavy Lifting, Heavy Carrying, Straight Pulling, Pushing, Reaching above shoulder; Use of fingers; Both hands required; Walking, Standing, Repeated bending, Ability for rapid mental and muscular coordination simultaneously; Near vision correctable at 13" to 16"; Hearing (aid permitted). The mental/sensory requirements include recall, reasoning, problem-solving, hearing, speaking clearly, writing, keyboarding, reading, and logical thinking. There may be the need to use personal protective equipment to prevent exposure to disease, illness, and hazardous materials. Mechanical inpatient lifts are provided for lifting anything over 45lbs. The incumbent may be exposed to infected patients and contaminated materials and may be required to don protective clothing in isolation situations, operative/invasive procedures, or home settings. The incumbent may occasionally be exposed to patients who are combative secondary to delirium, dementia, or psychiatric disorders. The incumbent must be a mature, flexible, sensible individual capable of working effectively in stressful situations, and able to shift priorities based on patient needs. Must complete annual Employee Health requirements as a condition of employment. ["The Clinical Nurse Leader (CNL) applies the nursing process and care management principles within a collaborative and inter-disciplinary practice setting. Nursing staff are supported in the provision of complex patient care. The CNL participates in the education and procedural teaching of patients and their significant others, maintaining patient confidentiality and ensuring privacy. They communicate with the veterans and their families to assure understanding of their disease process and the goals of therapy. By being readily available to family members, the CNL provides emotional support and is a valuable link between them and the health care delivery system. A supportive role in staff education becomes important as needs are identified. By collaborating with other healthcare professionals and colleagues, team building activities become an important part of the CNL position. Using professional standards of care, the CNL guides and supports staff development from a leadership perspective, using scientific evidence and practice to evaluate programs and/or services and their effectiveness. The CNL will have demonstrated performance and leadership that is broad enough to facilitate those practices to wider applications when appropriate. The CNL ensures that unit staff competencies are met yearly. Compliance with current policies and procedures is an important role that ensures patient and staff safety. Acting as a resource to others and serving as a mentor for the staff provides a readily available resource for the primary care nurse. Participating in continuing education and achieving and maintaining certification sets a high standard for professional achievement. The CNL looks for \"learning opportunities\" to acquire and/or teach new skills and functions as a clinical expert. They become a resource to ancillary staff and facilitate their function as it affects the patients' outcome. Leading and organizing delivery of care assures continuity and peer accountability for practice. By possessing knowledge of programmatic and organizational level monitors and improvement findings, the CNL contributes to program and organizational success by developing and participating in performance improvement activities. The advanced clinical knowledge and judgment of the CNL promotes staff involvement in planning, decision-making and evaluating outcomes because it facilitates a supportive environment for all staff to best meet the patient's individual needs. By using the group process, the CNL can identify, analyze, and resolve care problems. By applying their leadership function and exercising creative approaches to management, the CNL better serves the patient as the individual staff members become an invested part of the health care team. The CNL is a part of the documentation process and ensures that patient data is updated and accurate to ensure continuity of care. Program or service level outcomes must be documented as well and may be broad and complex. Program outcomes may be defined as substantial coordinated groups of activities impacting patients and/or employees at any organizational level within a facility or VISN. The systematic evaluation of current practice and formulating desired plans of care for groups of patients makes the CNL an important part of the health care team. Using their advanced clinical knowledge/judgment to promote staff involvement in planning, decision-making and evaluating outcomes, contributes to organizational success as they improve patient care. The understanding of program and organization level goals helps them to implement practice at the bedside and can help to achieve those goals. 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: Full-time, 7:30-16:00pm-hours vary on patient and facility needs Telework: Not Available Virtual: This is not a virtual position. Relocation/Recruitment Incentives: Not Authorized Permanent Change of Station (PCS): Not Authorized Financial Disclosure Report: Not required"]

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