Licensed Practical/Vocational Nurse (Float, Outpatient Primary Care)

About the role

Float LVN supporting San Antonio clinics as a multi-site resource. Provides foundational, patient-centered nursing care under RN/provider supervision. Performs health screenings, vital collection, patient rooming, and medication/immunization administration. Supports PACT team through pre-visit planning, clinic flow management, and health coaching. Requires nursing judgment proportionate to grade level. Physical demands include standing, walking, moderate lifting, and direct patient assistance.

Qualifications

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: Graduate of a school of practical or vocational nursing approved by the appropriate State agency and/or accredited by the National League for Nursing Accrediting Commission (NLNAC) at the time the program was completed by the applicant. 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/LVN licensure; VHA employees converted to appointments under 38 U.S.C. 7401(3) (Public Law 98-160, November 21, 1983) or 38 U.S.C. 7405 (Public Law 99-576, October 28, 1986); individuals granted a license by a jurisdiction that does not require graduation from an approved school.
• 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.

Grade Determinations

• GS-3: None beyond the basic requirements.
• GS-4: Six months of qualifying experience as an LPN or LVN; OR graduation from an approved school and one year of experience involving nursing care work in a hospital, outpatient clinic, nursing home, or other supervised medical, nursing, or patient care facility providing practical knowledge of human body structure and sterile techniques and procedures; OR graduation from an approved school of at least 24 months duration.
• GS-5: Completion of at least 1 year of qualifying experience at the GS-4 level or equivalent, plus demonstrated knowledge and ability to:
  • Provide a full range of practical nursing care to patients with a variety of physical and/or behavioral problems
  • Work with the RN and/or MD/DO to orient/train less experienced LPNs/LVNs and/or Nursing Assistants (NAs)/Health Technicians (HTs) in relation to acceptable standards of practice
  • Provide effective education to patients and/or family members regarding common disease processes, medication, and/or prescribed treatment regimes
  • Serve as a responsible member of the nursing team and interact appropriately with patients, family members, professional and other supportive personnel, incorporating established customer service standards
  • Prepare, administer, and appropriately document actions specific to commonly prescribed oral, topical, subcutaneous, intramuscular, and/or intravenous medications as permitted by approved local facility policies and procedures; observe and document patient's response and report changes to RN or MD/DO
  • Recognize the need for and institute emergency measures when indicated, promptly seek assistance of the RN or MD/DO, and assist in resuscitation procedures in cardiac and/or pulmonary arrest
  • Recognize and appropriately respond to breakage/malfunction or loss of equipment, safety hazards, and supply deficiencies, promptly reporting to appropriate personnel
  Completed work is under the general supervision of an RN or MD/DO. Individuals at this grade level are expected to have a broad working knowledge of practical nursing procedures; more complex practices or procedures may be subject to closer higher-level review.
• GS-6: Completion of at least 1 year of qualifying experience at the GS-5 level or equivalent, plus demonstrated knowledge and ability to:
  • Be technically proficient in initiating, performing, and completing assigned duties in providing care to variable patient populations
  • Appropriately carry out assigned patient care based on patients' conditions, use judgment in selecting the appropriate order and sequence of procedures and treatments, and accurately recognize, report, and record relevant patient information
  • Have completed work needing only a general review by an RN or MD/DO for appropriateness and conformity with established policies/procedures
  • Observe, identify, and respond to the patient's needs for care, including medication, equipment-assisted care, and patient/family education
  • In organizing and delivering care, recognize and consider emotional, cultural, spiritual, socio-economic, and age-related factors
  • Prepare and administer prescribed medications (oral, topical, subcutaneous, intramuscular and/or intravenous) and perform treatments according to established policies/procedures; observe for physical and/or emotional changes, document changes, and report deviations to RN or MD/DO
  • Recognize urgent or emergent patient care situations, seek assistance of the RN and/or MD/DO, and initiate appropriate emergency interventions as directed
  • Understand human behavior, patient motivations and reactions, and utilize this knowledge in working effectively with patients, family members, and other staff
  • Establish constructive relationships with individual patients and their families to elicit feelings and attitudes, and promote positive relationships, communication, and socialization skills
  • Foster an environment of respect for individual patient and family rights to privacy and dignity in all aspects of care delivery
  • Effectively incorporate established customer service standards in all interactions with patients, family members, and/or other internal/external customers
  • Perform support duties for complex diagnostic tests and/or specialized practices or procedures, including preparing the patient, assisting in the diagnostic examination, preparing and handling specialized instruments or equipment, and monitoring the patient's condition before, during, and following the procedure
  • Serve as a preceptor in orienting, educating, and training less experienced LPNs/LVNs or NAs/HTs related to support duties for complex, specialized tests/procedures
  • Actively seek educational opportunities to enhance nursing knowledge and skills, sharing new knowledge with other staff to improve and advance nursing practice

The full performance level of this vacancy is GS-06. The actual grade at which an applicant may be selected is in the range of GS-03 to GS-06. Reference: https://www.va.gov/ohrm/QualificationStandards/

Responsibilities

GS-03

• Perform routine structured/focused health screenings and basic nursing interventions under close supervision
• Room patients, collect vital data, complete assigned clinical reminders, and maintain clinic flow
• Administer medications and immunizations following established protocols
• Support clinical decision-making by reviewing medications/allergies and communicating findings to RN/provider
• Participate in PACT team operations including pre-visit planning, daily huddles, and team meetings

GS-04

• Perform structured/focused health screenings and basic nursing interventions with greater judgment and less supervision than GS-03
• Exercise judgment in clinical decision-making by identifying urgent needs, reviewing medications/allergies, and initiating nursing protocols
• Manage clinic flow by rooming patients, assisting providers with procedures, and maintaining exam room readiness
• Conduct pre-visit planning by reviewing records, obtaining missing documentation, and preparing clinical data
• Contribute to schedule management and panel review, identifying opportunities for alternate care modalities

GS-05

• Provide a full range of practical nursing care to patients with varied physical and/or behavioral problems
• Orient and train less experienced LPNs/LVNs and nursing assistants in relation to acceptable standards of practice
• Administer commonly prescribed medications (oral, topical, subcutaneous, intramuscular, intravenous) with appropriate observation and documentation
• Support clinical decision-making with broad working knowledge by identifying urgent/emergent situations and communicating key findings
• Manage clinic operations through pre-visit planning, patient rooming, procedure assistance, and PACT collaboration under general supervision

GS-06

• Demonstrate technical proficiency in initiating, performing, and completing complex diagnostic tests and specialized procedures with appropriate patient preparation and monitoring
• Serve as a preceptor, orienting and educating less experienced LPNs/LVNs and nursing assistants on complex, specialized procedures and support duties
• Use clinical judgment to select appropriate order and sequence of procedures/treatments; accurately recognize, report, and record patient information
• Actively seek educational opportunities to enhance nursing knowledge and skills, sharing new knowledge with staff