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 are encouraged to apply and may be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy.
• English Language Proficiency. In accordance with 38 U.S.C. 7402(d), no person shall serve in direct patient care positions unless they are proficient in basic written and spoken English.
• Education:
  • (1) A degree in nursing from a school of professional nursing approved by the appropriate state accrediting agency and accredited by one of the following accrediting bodies at the time the program was completed by the applicant:
    • (a) The National League for Nursing Accrediting Commission (NLNAC), an accrediting arm of the National League for Nursing located at 61 Broadway, 33rd Floor, New York, New York 10006. Additional information may be obtained from the NLNAC Web site; or
    • (b) The Commission on Collegiate Nursing Education (CCNE), an accrediting arm of the American Association of Colleges of Nursing (AACN). The CCNE accredits bachelor's and master's degree programs and is located at One Dupont Circle, N.W., Suite 530, Washington, DC 20036. Additional information may be obtained from the CCNE Web site.
    • (c) In cases of graduates of foreign schools of professional nursing, possession of a current, full, and unrestricted registration (see basic requirement in subparagraph c below) and the possession of a Certificate from the Commission on Graduates of Foreign Nursing Schools (CGFNS) will meet the requirement of graduation from an approved school of professional nursing.
  • (2) Graduate of an accredited nurse anesthesia educational program approved by the American Association of Nurse Anesthetists (AANA) at the time the program was completed by the applicant. The AANA has compiled current listings of approved training institutions, which are published annually in the December issue of the American Association of Nurse Anesthetists Journal. The American Hospital Association in their "Guide to the Health Care Field" also publishes listings of approved training institutions annually in August.
• Licensure/Registration: 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.
• Certification: Certification by the Council on Certification of Nurse Anesthetists is a requirement for employment. A graduate nurse anesthetist who has applied to take the national Certification Examination and has been declared Certification Eligible may be given a temporary appointment for a period not to exceed one year.

Grade Determinations: In addition to the basic requirements stated above, the following qualification criteria must be met in determining the appropriate grade assignment of candidates:

Entry Level: (Nurse II)(a) Experience and Education. None beyond the basic requirements.(b) Demonstrated Knowledge, Skills and Abilities. The following list of knowledge, skills and abilities present the minimum skill set expected of an Entry Level Nurse Anesthetist. Entry level into nurse anesthesia practice may include but are not limited to the following:

• Ability to translate the principles of professional nursing practice in the care of assigned patients in order to provide appropriate care.
• Ability to do a pre-anesthetic patient history and physical, which includes collecting pre-operative consults and data.
• Ability to formulate an anesthetic plan and describe the anesthetic risks, benefits and options to the patient.
• Ability to administer inhalation, regional, intravenous, local, and topical anesthetics and to detect unfavorable reactions in order to continuously evaluate the patient's physical status.
• Ability to respond to emergency situations by providing airway management, administration of emergency fluids and drugs, and using appropriate resuscitation procedures for patient care.
• Ability to provide patient care that is abreast of changing concepts and advancements in the profession.
• Ability to work effectively in an interdisciplinary environment for improvement of services for patient care.
• Ability to practice nurse anesthesia with colleagues and peers utilizing a collaborative team concept of anesthesia care.

Full Performance Level: (Nurse III)(a) Experience and Education. In addition to meeting the requirements for Entry Level, the CRNA has had progressively responsible experience in the administration of anesthetics as indicated in the knowledge, skills and abilities listed below. These individuals must demonstrate the ability to participate in a program for nurse anesthesia care and demonstrate knowledge of anesthetizing locations, methods, equipment and procedures. At this level, the CRNA has experience in the administration of anesthetics that has demonstrated the nurse anesthetist's ability to participate in team programs that are technically challenging and/or complicated. Typically candidates can demonstrate the knowledge, skills and abilities of Full Performance Level within 2 years from entering the occupation.(b) Demonstrated Knowledge, Skills, and Abilities. Full Performance Level practice in nurse anesthesia includes but is not limited to the following:

• Skill in conducting and managing anesthesia for a broad range of complex surgical procedures. In addition, the CRNA must be able to adapt/modify anesthesia techniques in order to optimize patient care.
• Ability to complete work assignments selected to add depth and breadth to their technical knowledge and skill competence. Work assignments will vary at each facility depending on the progressive acuity required for anesthesia care.
• Ability to respond to emergency situations by providing airway management, administration of emergency fluids and drugs, and by the use of basic or advanced cardiac life support techniques in order to perform necessary resuscitation procedures.
• Ability to effectively blend technology, skills, and competency for the advancement of anesthesia techniques, pharmacology, and equipment.
• Ability to apply new developments and theories to develop and demonstrate the ability to recognize and solve various complex anesthesia situations.
• Ability to practice nurse anesthesia with colleagues and peers in a team concept of anesthesia care and blend management skills with technical experience.
• Ability to recognize clinical and technical aspects of anesthesia care and has in-depth knowledge of anesthesia methods and techniques for the practice of anesthesia.
• Ability to perform as a mentor, preceptor, or nurse educator providing didactic and clinical instruction for graduate-level nurse anesthesia students and/or other anesthesia care providers.
• Ability to participate in the development of anesthesia patient care audit processes involving in depth review and analysis of anesthesia records.
• Ability to provide guidance and instruction in preparing others for positions of leadership and ethical practices which impact patient care.

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: See VA Directive & Handbook 5019