Applicants pending the completion of educational or certification/licensure requirements may be referred and tentatively selected but may not be hired until all requirements are met. 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. Education: The Qualification Standard authorizes waiver of the requirement that licensed practical or licensed vocational nurses graduate from an approved school. Exceptions include: Health care education in the military service or training in the military service which is accepted by the licensing body in the jurisdiction in which the individual is licensed as qualifying for full LPN/L VN licensure will be accepted as meeting the education requirements for VHA employment. VHA employees who were converted to appointments under 38 U.S.C. 7401(3) in implementation of Public Law 98-160, enacted November 21, 1983, and for VHA employees converted to appointments under 38 U.S.C. 7405 in implementation of Public Law 99-576, enacted October 28, 1986; and for their future personnel actions under this authority. The waiver will not apply to persons appointed under 38 U.S.C. 7401(3) or 7405 after these conversions. Individuals granted a license by a jurisdiction that does not require graduation from an approved school. See paragraph 4, section C. Licensure: Full, active, current and unrestricted licensure as a licensed practical or vocational nurse in a State, Territory or Commonwealth (i.e., Puerto Rico) of the United States, or District of Columbia. An LPN/LVN who has or has ever had, any license(s) revoked, suspended, denied, restricted, limited, or issued/placed in a probationary status may be appointed only in accordance with the provisions in chapter 3, section B, paragraph 16 of this part. Qualifications: The GS-7 grade level is for select, complex LPN/L VN positions, as established by each health care facility. To be advanced, employees must meet all of the following standards, provided the standard is part of their assignment. ( a ) Completion of at least one (1) year of additional qualifying experience at the GS-6 level or equivalent, fully meeting all of the performance requirements for the GS-6 LPN/L VN. ( b ) Knowledge and skills necessary to carry out more specialized patient care duties, including assignments in selected, more complex inpatient and/or outpatient care settings. Knowledge base promotes the incorporation of current patient care data in actively contributing to the development of the patient's overall health plan and in carrying out assigned nursing interventions. Positions at this grade level require broader knowledge and skills because supervision is more general and employees are expected to be involved to a greater degree in the development and modification of treatment plans. ( c ) Ability to assist RN and/or MD/DO to appropriately prioritize overall patient care needs and adjust plans for care delivery. Makes astute observations of subtle, less obvious changes, both physical and emotional, in patient's condition, and accurately and thoroughly documents care delivered and patient's response to care that could require immediate modification of the patient's care plan. Appropriately seeks assistance and guidance by informing RN or MD/DO of changes in patient's condition requiring higher-level intervention. At this grade level, the LPN/L VN is expected to participate to a greater degree in prioritizing, and, as appropriate, modifying patient care treatment. They must also possess the ability to observe more subtle physical and emotional changes in patients and demonstrate taking appropriate action based on those observations. ( d ) Ability to proactively assist the RN or MD/DO in addressing patient's needs for medication/treatments, accurately administering prescribed medications/treatments according to established policies/procedures and appropriately recording administration and patient's response to medications/treatments received. (This may include restricted medication locally authorized for administration by employees at this grade level.) Demonstrates the knowledge and ability to readily recognize the more subtle signs and symptoms of potential or actual drug reactions, promptly inform the RN or MD/DO of observed changes in patient's condition and initiate appropriate, prescribed interventions. Employees at this grade level demonstrate broader knowledge and skill with respect to these responsibilities than employees at lower grade levels. ( e ) Knowledge and skill to promptly recognize potential urgent or emergent patient care situations, seek assistance of the RN and/or MD/DO for appropriate team intervention and effectively intervene, as directed, to assure the continuation of optimal, safe and therapeutic patient care delivery. At this grade level, the LPN/L VN must have a broader knowledge of the patient treatment process and exercise judgment that demonstrates the ability to effectively intervene when appropriate. ( f ) Assists individuals or groups of patients and their families to take an active role in promoting healthy lifestyles for more positive patient outcomes. Exercises skill in influencing and communicating with unusually difficult to care for or communicate with patients and/or family members who may exhibit problems with lack of self-control, resistant or abusive behaviors, or impediments in their ability to understand or follow instructions. This includes the ability to effectively deal with the above types of patients under very general supervision. ( g ) Exhibits skill, creativity and initiative in contributing to the improvement of overall care delivery and patient and/or family satisfaction levels through active participation in committees/task forces, research projects or in developing educational materials/media. Actively promotes and effectively incorporates established customer service standards in all aspects of their practice. ( h ) Possesses comprehensive practical nursing knowledge and skills in specialized procedures and practices to serve as a resource person for other staff in organizing and implementing more complex/specialized patient care. Serves as a role model and mentor to other nursing staff in the application of more complex technology, effectively guiding and directing their continuing practice in these areas. May qualify based on being covered by the Grandfathering Provision as described in the VA Qualification Standard for this occupation (only applicable to current VHA employees who are in this occupation and meet the criteria). The full performance level of this vacancy is GS7. Reference: For more information on this qualification standard, please visit https://www.va.gov/ohrm/QualificationStandards/. Physical Requirements: To perform in a fully successful manner, the individual must have the physical ability to perform job-related duties which require lifting, standing, bending, transferring, stooping, stretching, walking, pushing, or pulling without assistance from another patient care provider or significant other. Utilizes Safe Patient handling equipment. The incumbent will be exposed to fluoroscopy and must be able to wear lead protective equipment for extended periods of time. A health examination must be successfully completed prior to this assignment and periodically thereafter as required by the Employee Health Clinic policy. There will be intermittent exposure to blood and body fluids.