Nurse Practitioner (Home Based Primary Care)

The Certified Nurse Practitioner (NP) practices in Home-Based Primary Care (HBPC) provides a full range of services emphasizing quality, timeliness, and the advancement of the Veterans Affairs (VA) mission. The NP provides advanced clinical practice, consultation, and management. The NP practices to the full extent of their education, training, and certification. The NP has prescriptive authority for a panel of patients or program as indicated by their position.

Bend is a city in Central Oregon and the county seat of Deschutes County, Oregon, United States. It is located to the east of the Cascade Range, on the Deschutes River. The site became known by pioneers as a fordable crossing point of the river, where it was ran through a bend. An 1870s ranch popularized the name "Farewell Bend", with the post office later distinguishing the area as Bend. It was incorporated as a city in 1905, starting off as a logging town. In 1910, Mirror Pond was created as a dammed river reservoir to provide energy. In 1950, the two major logging companies were consolidated due to depleted timber, causing an economic drop. In later decades, it experienced rapid growth as a center of recreation.

The Home Based Primary Care Nurse Practitioner is a licensed independent practitioner with advanced education and national certification who provides evidence-based care for a population of patients.

Duties include, but not limited to:

• Independently manages a panel of patients with acute and chronic health conditions, with an emphasis on health promotion and disease prevention, using evidence-based practice and in-home clinical visits augmented by other modalities.
• Develops and implements an individualized plan to achieve optimal population health and disease management.
• Demonstrates leadership and works collaboratively with the interdisciplinary team.
• Orders and interprets labs, tests, and diagnostic studies.
• Prescribes pharmacologic and non-pharmacologic interventions.
• Initiates referrals and consults to specialty services.
• Provides education to patients and their families.
• Assesses and adjusts the plan of care as needed to achieve optimal patient outcomes.
• Exemplifies the ICARE core values of-Integrity, Commitment, Advocacy, Respect, and Excellence.

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, 0730-1600 or 0800-1630
Telework: Ad-hoc
Virtual: This is not a virtual position.
Relocation/Recruitment Incentives: Not authorized
Permanent Change of Station (PCS): Not authorized

Advanced Practice Nurse (Nurse Practitioner) Basic Requirements

• Education: A post-master's certificate or master's or doctoral degree as a Nurse Practitioner. (Applicants pending the completion of educational requirements may be referred and tentatively selected but may not be hired until the education requirements are met.) Must be a 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).
  • NOTE: Foreign Education. Graduates of foreign schools of professional nursing programs, the nurse practitioner degree equivalency must be validated through an Agency recognized degree equivalency evaluation agency, such as the International Consultants of Delaware (ICD). Candidates with equivalent nurse practitioner masters or doctorate level degrees who possess current, full, active, and unrestricted registration and certification will meet the requirement of graduation from an approved school of professional nursing to warrant appointment.
• License - All APN (NPs) must possess and maintain an active, current, full, and unrestricted APN license to practice as an NP in a State, Territory or Commonwealth of the United States, or in the District of Columbia.
• Basic Board Certification - All APN (NPs) must maintain full and current basic board certification in one of the following: Family Nurse Practitioner (FNP), Adult Nurse Practitioner (ANP), Adult-Gerontology Primary Care Nurse Practitioner (AGPCNP), or Gerontology Nurse Practitioner (GNP) from one of the following: the American Nurses Credentialing Center (ANCC), American Academy of Nurse Practitioners Certification Board (AANPCB), or other nationally recognized certifying body in the area in which the Nurse Practitioner is academically prepared.

Preferred Experience: Home care experience preferred; 5 or more years clinical experience; interdisciplinary team experience preferred; AHA BLS certification required; valid drivers license and proof of insurability required.

NOTE: Grandfathering Provision - All persons currently employed in VHA in 0610 series and an APN (NP) assignment that are also 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.

The following Scope, Education and Experience, and Dimension criteria must be met to qualify for Advanced Practice Nurse (Nurse Practitioner) II:
Exception to Licensure for Graduate Nurse Technicians. Candidates who otherwise meet the basic requirements, but do not possess the required licensure and/or certification, may be appointed at the entry step of the Nurse II, as a Graduate Nurse Technician - Nurse Practitioner on a temporary appointment up to any period not-to-exceed one year and a day under the authority of 38 U.S.C. § 405(c)(2)(B).

• Scope: Demonstrates leadership in delivering and improving holistic care through collaborative strategies with others
• Education and Experience Requirement: Meets basic education requirement for APN (NP). Nurse II is considered the entry grade level for APN (NPs); no experience is required.
• Dimension Requirement: APNs (NPs) at level II are expected to meet the following dimension requirements:
  • Clinical Practice. Delivers evidence-based health care, demonstrating proficiency in the ability to manage a patient panel, population, or program.
  • Outcome Focus. Utilizes research and evidence-based practice to evaluate the patient care delivery system within a patient panel or program, presents findings and contributes to changes that enhance the quality and timeliness of veteran/patient care.
  • Leadership. Works effectively as a leader within a team/unit/group and seeks interdisciplinary collaboration as appropriate to enhance patient care.
  • Professional Development. Acquires knowledge and skills to develop expertise in area of practice.
  • Professionalism/Collegiality. Demonstrates effective communication skills and professional behavior, promoting cooperation and teamwork. Participates in interdisciplinary teams and processes that positively impact patient outcomes.

The following Scope, Education and Experience, and Dimension criteria must be met to qualify for Advanced Practice Nurse (Nurse Practitioner) III:

• Scope: Executes position responsibilities that demonstrate leadership, experience, and creative approaches to management of complex client care.
• Education and Experience Requirement: Meets basic education requirement for an APN (NP) AND one year of specialized APN (NP) experience equivalent to the Nurse II grade level.
• Dimension Requirement: APN (Nurse Practitioners) at grade III are expected to meet the following dimension requirements:
  • Clinical Practice. Influences and models the delivery of evidence- based health care, demonstrating expertise in the ability to manage a patient panel, population, or program.
  • Outcome Focus. Leads and implements changes that enhance the quality and timeliness of Veteran/patient care applying research and evidence in the delivery of healthcare for patient populations.
  • Leadership. Initiates and leads interdisciplinary teams informed by structured approaches and processes to improve outcomes that positively impact care for a patient panel, population, or program.
  • Professional Development. Acquires knowledge and skills, then disseminates acquired information within and/or outside the medical facility.
  • Professionalism/Collegiality. Initiates and leads interdisciplinary teams developing systems that positively impact outcomes at the panel, population, or program level. Demonstrates effective communication skills and professional behavior, promoting cooperation and teamwork

Physical Requirements: Moderate lifting (15-44 lbs); Moderate carrying (15-44 lbs); Straight pulling (0.5 hrs); Pushing (0.5 hrs); Reaching above shoulder; Use of fingers; Both hands required; Walking (3 hrs); Standing (4-6 hrs); Kneeling (0.5hrs); Repeated bending (2.0 hrs); Climbing (legs only 1 hr); Both legs required; Operation of crane, truck, tractor, or motor vehicle; Specific visual requirement: at least 20/40 in each eye; Both eyes required; Depth perception; Ability to distinguish shades of colors; Hearing (aid may be permitted); Mental and emotional stability; At least 70' peripheral in horizontal meridian each eye.

Environmental Factors: Outside and inside; Excessive heat; Excessive cold; Dust; Fumes, smoke, or gases; Slippery or uneven walking surfaces; Working around moving objects or vehicles; Working closely with others; Working alone; Animal dander; Insects; Does not transport patients.