Advanced Practice Nurse (Certified Nurse Anesthetist)-Intermittent

Summary

The Advanced Practice Nurse (Certified Nurse Anesthetist (CRNA)) provides comprehensive, specialized anesthesia care to Veterans. The CRNA performs pre-anesthesia assessments, develops and implements individualized anesthesia care plans, administers and manages anesthesia, continuously monitors patients, and provides post-anesthesia and acute pain management. The CRNA provides anesthesia services for surgical and diagnostic procedures, including procedures at the San Francisco VA Medical Center.

Duties

• **This is an OPEN CONTINUOUS ANNOUNCEMENT and will remain open until November 10, 2026. The initial cut-off date for referral of eligible applications will be September 25, 2026 with subsequent cut-off dates every 2 weeks. Eligible applications received after that date will be accepted on an ongoing basis and qualified candidates will be considered as vacancies become available.** The CRNA collaborates with anesthesiologists, surgeons, proceduralists, nurses, and other members of the interdisciplinary healthcare team to ensure safe, effective, evidence-based, and Veteran-centered care. The position requires sound clinical judgment in managing patients with varying levels of medical complexity and responding appropriately to changes in patient condition and perioperative emergencies. Duties include: Performs comprehensive pre-anesthesia assessments, including review of the Veteran's medical history, medications, allergies, laboratory and diagnostic results, physical status, and surgical/procedural needs. Develops individualized anesthesia plans of care based on the patient's condition, procedure, risk factors, and clinical needs. Provides anesthesia services for inpatient and outpatient surgical and procedural patients. Administers and manages general, regional, local, intravenous, and monitored anesthesia care/sedation, within the provider's approved scope of practice and clinical privileges. Performs anesthesia induction, maintenance, emergence, and recovery while continuously assessing the patient's physiologic response. Selects and administers appropriate anesthetic agents, analgesics, adjunct medications, intravenous fluids, and other medications necessary for safe anesthesia care. Establishes and maintains appropriate non-invasive and invasive monitoring to continuously evaluate cardiovascular, respiratory, neurologic, and other physiologic parameters. Performs and manages airway assessment and management, including intubation, ventilation, extubation, and emergency airway interventions as clinically indicated. Recognizes and promptly manages changes in the patient's condition, anesthesia-related complications, and other perioperative emergencies. Provides emergency response, including airway management, resuscitation, and BLS/ACLS interventions when required. Provides post-anesthesia care, including assessment of recovery from anesthesia, pain management, nausea and vomiting management, hemodynamic stability, and appropriate disposition. Performs post-anesthesia follow-up and evaluates patients for complications or additional anesthesia-related needs. Provides anesthesia services both inside and outside the operating room, as appropriate to the facility's services and the CRNA's clinical privileges. Collaborates with anesthesiologists, surgeons, proceduralists, nurses, and other interdisciplinary healthcare professionals to promote safe, coordinated, Veteran-centered care. Functions as a member of the anesthesia care team and contributes to perioperative decision-making based on education, experience, competency, and scope of practice. Prescribes or orders appropriate preoperative, intraoperative, and postoperative medications and treatments when authorized by applicable VA policy, state licensure, and clinical privileges. Maintains accurate and timely documentation of anesthesia assessments, care plans, medications, procedures, monitoring, interventions, and patient outcomes. Pay: Competitive salary, regular salary increases, potential for performance awards Licensure: 1 full and unrestricted license from any US State or territory Work Schedule: Not to Exceed one-year; intermittent schedule. Telework: Not Available. Virtual: This is not a virtual position. Relocation/Recruitment Incentives: Not Authorized. EDRP: Not Authorized. Permanent Change of Station (PCS): Not Authorized.

Qualifications

Advanced Practice Nurse (Certified Nurse Anesthetist) Basic Requirements Education. A masters or doctoral degree in nurse anesthesia. (Applicants pending the completion of educational requirements may be referred and tentatively selected but may not be hired until the education requirements are met.) Nursing education must be from a school of professional nursing anesthesia accredited by Council on Accreditation of Nurse Anesthesia Education Programs (COA) at the time the program was completed by the applicant. Licensure and Certification. The following licensure and certification requirements are considered conditions of employment. License. All APN (CNAs) must maintain an active, current, full and unrestricted license to practice as a CNA or equivalent, in a State, Territory or Commonwealth of the United States or in the District of Columbia. Basic Certification. All APN (CNAs) must maintain full and current certification by the National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA) or an equivalent Nurse Anesthetist certification recognized by the COA. NOTE: Grandfathering Provision - All persons currently employed in VHA in 0610 series and an APN (CNA) 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 Education, Experience, and Knowledge, Skills and Abilities must be met for Advanced Practice Nurse (Certified Nurse Anesthetist) II: Exception to Licensure for Graduate Nurse Technicians. Candidates who otherwise meet the basic requirements, but do not possess the required APN (CNA) licensure and/or certification, may be appointed at the entry step of the Nurse II, as a Nurse Anesthetist on a temporary appointment up to any period not-to-exceed one year and a day under the authority of 38 U.S.C. § 7405(c)(2)(B). Education and Experience Requirement. Meets basic education requirement for an APN (CNA). Nurse II is considered the entry grade level for APN (CNAs); no experience is required. Demonstrated Knowledge, Skills, and Abilities. The following list of knowledge, skills and abilities present the minimum skill set expected of an Entry Level CNA. Entry level into practice may include but are not limited to the following: Ability to translate into anesthesia care the principles of professional nursing practice including the patients' rights to autonomy, dignity, privacy, and safety. Knowledge of current research and practice guidelines to frame anesthesia practice including up to date techniques, pharmacology, and equipment. Ability to obtain, document and verify informed anesthesia consent and perform a pre-anesthetic patient history and physical, which includes managing pre-operative consults and interpreting data. Ability to formulate a patient-specific anesthetic plan and describe salient anesthetic risks, benefits, and options to the patient. Ability to administer inhalational, regional, intravenous, local, and topical anesthetics. Skill in detecting and treating anesthesia or surgically related physiologic changes and ability to treat accordingly in order to maintain homeostasis. Skill in assessing patient status for appropriateness of transfer of care to another healthcare provider and communicating essential patient information to other providers effectively. Ability to participate in collaborative responsibility for proper patient positioning, physiologic monitoring, infection control and anesthesia documentation. Skill in responding to emergency situations by providing airway management, fluid and medication administration, invasive line insertion and management and the use of advanced cardiac life support techniques. Ability to provide patient care that is abreast of changing concepts and advancements in the profession, (e.g., ultrasound techniques.) Ability to practice anesthesia in an interdisciplinary environment utilizing a collaborative concept of anesthesia care. Knowledge of quality improvement processes to maintain ongoing review and evaluation of anesthesia care to improve outcomes. Ability to demonstrate a practice emphasis on safety, current established guidelines and protocols while recognizing the duty to report unsafe conditions or errors. The following Education, Experience, and Knowledge, Skills and Abilities must be met for Advanced Practice Nurse (Certified Nurse Anesthetist) III: Education and Experience Requirement: Meets basic education requirement for an APN (CNA) AND One year of specialized APN (CNA) experience equivalent to the APN (CNA) II grade level. Demonstrated Knowledge, Skills, and Abilities: Progressively responsible experience in the administration of anesthetics as indicated in the knowledge, skills and abilities listed below. Ability to plan, administer and manage anesthesia for a broad range of complex surgical procedures skillfully employing continuous assessment and anesthetic adaptation based on patient response and comorbidities. Work assignments will vary by facility. Ability to participate in assignments that are technically challenging, encompass a variety of anesthetizing locations and utilize advanced equipment and procedures while adapting techniques to solve various complex anesthesia problems including the development of individualized programs of post-op anesthesia care. Skill in responsibility and accountability to perform to the extent of the CNA standards of practice as a licensed healthcare professional in any model of anesthesia practice. Ability to contribute to the educational mission as a mentor or preceptor providing didactic and clinical instruction in anesthesia to student nurse anesthetists, medical and dental residents, and other health care trainees. Knowledge to participate in the development, implementation and maintenance of auditing processes that ensure and improve the quality and consistency of anesthesia and associated documentation. Ability to contribute to departmental administrative processes through quality assurance, shared governance, or committee representation as applicable. Ability to serve as a representative on interdisciplinary teams to establish and maintain guidelines and communication. Skill demonstrated in the ability to embrace the safety culture emphasis by continuously assessing for safety risks, actively reporting safety concerns, and maintaining a just culture by identifying faults in systems rather than individuals. Salary for this position ranges dependent upon applicant qualifications (salary based on Full-time schedule) Grade 2: $194,127-$258,180 annually Grade 3: $211,598-$281,415 annually Reference: For more information on this qualification standard, please visit https://www.va.gov/ohrm/QualificationStandards/. Physical Requirements: This position requires visual acuity, keen hearing, clear distinctive speech, and manual dexterity. The position requires potentially, long periods of combined walking, standing, stooping, sitting, bending, pulling, and pushing. The incumbent must be a mature, flexible, sensible individual capable or working effectively in stressful situation, able to shift priorities based on needs of the organization. The incumbent may be required to travel occasionally. This position potentially requires flexibility in schedule and assignments. Telework is position dependent and appropriate approvals are required; telework is not guaranteed and incumbent must comply with all regulations relevant to telework agreements, policies, and processes. If a position requires driving, incumbent is required to maintain compliance with all relevant policies and processes.

Requirements

U.S. Citizenship; non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy. All applicants tentatively selected for VA employment in a testing designated position are subject to urinalysis to screen for illegal drug use prior to appointment. Applicants who refuse to be tested will be denied employment with VA. English Language Proficiency. In accordance with 38 U.S.C. 7402(f), no person shall serve in direct patient care positions unless they are proficient in basic written and spoken English. Selective Service Registration is required for males born after 12/31/1959. Subject to background/security investigation. Selected applicants will be required to complete an online onboarding process. Acceptable form(s) of identification will be required to complete pre-employment requirements (https://www.uscis.gov/i-9-central/form-i-9-acceptable-documents). Effective May 7, 2025, driver's licenses or state-issued identification cards that are not REAL ID compliant cannot be utilized as an acceptable form of identification for employment. Participation in the seasonal influenza vaccination program is a requirement for all Department of Veterans Affairs Health Care Personnel (HCP). You may be required to serve a probationary period. Complete all application requirements detailed in the "Required Documents" section of this announcement.

Education

IMPORTANT: A transcript must be submitted with your application if you are basing all or part of your qualifications on education. Note: Only education or degrees recognized by the U.S. Department of Education from accredited colleges, universities, schools, or institutions may be used to qualify for Federal employment. You can verify your education here: http://ope.ed.gov/accreditation/. If you are using foreign education to meet qualification requirements, you must send a Certificate of Foreign Equivalency with your transcript in order to receive credit for that education. For further information, visit: https://sites.ed.gov/international/recognition-of-foreign-qualifications/.

How to apply

All applicants are encouraged to apply online. To apply for this position, you must complete the full questionnaire and submit the documentation specified in the Required Documents section below. The complete application package must be submitted by 11:59 PM (ET) on 11/10/2026 to receive consideration. To preview the questionnaire click https://apply.usastaffing.gov/ViewQuestionnaire/13058797. To begin, click Apply Online to create a USAJOBS account or log in to your existing account. Follow the prompts to select your USA JOBS resume and/or other supporting documents and complete the occupational questionnaire. Click Submit My Answers to submit your application package. NOTE: It is your responsibility to ensure your responses and appropriate documentation is submitted prior to the closing date.