Summary
VA NWIHCS is an integrated system that serves more than 148,000 Veterans in 101 counties in Nebraska, western Iowa, Kansas, and Missouri. It includes a tertiary medical center in Omaha, 2 larger clinics in Lincoln and Grand Island (which includes a Community Living Center), 5 community-based outpatient clinics, and one contract clinic.
Duties
The VA Midwest Health Care Network advocates for a Whole Health System of care in each of the Medical Centers. This is an approach to healthcare that empowers and equips people to take charge of their health and well-being and live their lives to the fullest. As an employee operating in a Whole Health System of care, you will operate in a model with three core elements, seeking to create a personalized health plan for each Veteran. This is done in the context of healing relationships and healing environments and a connection back to the Veteran's community. This aligns with the Veterans Health Administration (VHA) Mission Statement to Honor America's Veterans by providing exceptional health care that improves their health and well-being.
VA offers a comprehensive total rewards package: VA Nurse Total Rewards
Nebraska Western Iowa VA Health Care System is currently seeking a CRNA to join Surgical Care which includes general surgery, vascular surgery, ophthalmology, audiology, cardiology, dentistry, orthopedics, podiatry, and urology. Special procedure anesthesia care is also provided to other service lines. The incumbent ensures quality and timeliness of services provided, customer satisfaction, and compliance with standards of accrediting bodies such as Joint Commission and Inspector General's Combined Assessment Program. CRNA is authorized to perform routine duties on a regular, repetitive basis. These duties include, but are not restricted to:
- Provision of care in the most complex surgical procedures.
- Perform and document a preanesthetic evaluation of the patient before surgery including requesting consultations, additional diagnostic and/or laboratory studies within the scope of practice, consulting with the anesthesiologist for further preoperative work up when necessary.
- Initiation of the planned anesthetic technique that may include general, regional, MAC, or local anesthesia. Interventions include administration of fluids, medications, ventilator support, provision of homeostasis, provision of adequate pain relief and management of anesthesia and surgical side effects.
- Induction of general anesthesia and initial airway management.
- Endotracheal intubation for surgical or procedural cases.
- Placement of endobronchial tubes or blockers for procedures requiring one lung ventilation or lung isolation.
- Central line placement; Pulmonary artery (Swan-Ganz) catheter placement
- Peripheral nerve blocks. Central neuroaxial blocks.
- Epidural blood patches.
- Adjustment of anesthetic drugs and techniques utilized in the maintenance of anesthesia.
- Sedation for field blocks or MAC as discussed in the anesthetic care plan.
- Manages emergence from anesthesia and transition to the post anesthesia care unit.
- Provide anesthetic for: electroconvulsive therapy not requiring intubation; routine eye surgery not requiring general anesthesia; elective cardioversions; ICD checks.
- May participate on the Code Blue Team, primarily to manage the patient's airway, but also to perform other tasks which they are qualified to perform, as directed by the Code Team Leader.
- Emergency airway management throughout the facility, following the ASA Difficult Airway Algorithm and department protocols, as requested.
Work Schedule: Monday -Friday 0700-1530
Financial Disclosure Report: Not required
Requirements
Conditions of Employment
- 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.
- You may be required to serve a probationary period.
- 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 dentification cards that are not REAL ID compliant cannot be utilized as an acceptable form of identification for employment.
- Must pass pre-employment physical examination.
- Participation in the seasonal influenza vaccination program is a requirement for all Department of Veterans Affairs Health Care Personnel (HCP).
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.
Physical Requirements: You will be asked to participate in a pre-employment examination or evaluation as part of the pre-employment process for this position. Questions about physical demands or environmental factors may be addressed at the time of evaluation or examination.
Benefits
A career with the U.S. government provides employees with a comprehensive benefits package. As a federal employee, you and your family will have access to a range of benefits that are designed to make your federal career very rewarding. Opens in a new windowLearn more about federal benefits.
Review our benefits
Eligibility for benefits depends on the type of position you hold and whether your position is full-time, part-time or intermittent. Contact the hiring agency for more information on the specific benefits offered.
How You Will Be Evaluated
You will be evaluated for this job based on how well you meet the qualifications above.
IN DESCRIBING YOUR EXPERIENCE, PLEASE BE CLEAR AND SPECIFIC. WE MAY NOT MAKE ASSUMPTIONS REGARDING YOUR EXPERIENCE. Your application, resume, C.V., and/or supporting documentation will be verified. Please follow all instructions carefully. Errors or omissions may affect consideration for employment.
NOTE: Candidate's education, scope, and length of nursing practice (experience) will be considered in determining the grade and salary of the applicant selected. The recommended salary may be at any point in the range listed for this vacancy.
Experience refers to paid and unpaid experience, including volunteer work done through National Service programs (e.g., Peace Corps, AmeriCorps) and other organizations (e.g., professional; philanthropic; religions; spiritual; community; student; social). Volunteer work helps build critical competencies, knowledge, and skills and can provide valuable training and experience that translates directly to paid employment. You will receive credit for all qualifying experience, including volunteer experience.
The Department of Veterans Affairs performs pre-employment reference checks as an assessment method used in the hiring process to verify information provided by a candidate (e.g., on resume or during interview or hiring process); gain additional knowledge regarding a candidate's abilities; and assist a hiring manager with making a final selection for a position.
It is the policy of the VA to not deny employment to those that have faced financial hardships or periods of unemployment.
Veterans and Transitioning Service Members: Please visit the VA for Vets site for career-search tools for Veterans seeking employment at VA, career development services for our existing Veterans, and coaching and reintegration support for military service members.
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 10:59 PM (ET) on 08/11/2025 to receive consideration. To preview the questionnaire click https://apply.usastaffing.gov/ViewQuestionnaire/12774402.
- 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.
Next steps
Once your online application is submitted you will receive a confirmation notification by email. After we receive application packages (including all required documents) and the vacancy announcement closes, we will review applications to ensure qualification and eligibility requirements are met. After the review is complete, a referral certificate(s) is issued and applicants will be notified of their status by email. Referred applicants will be notified as such and may be contacted directly by the hiring office for an interview. All referred applicants receive a final notification once a selection decision has been made.
You may check the status of your application at any time by logging into your USA Jobs account and clicking on Applications. Information regarding your application status can be found in the USAJobs Help Center.
NOTE: Participation in the seasonal influenza program is a condition of employment and a requirement for all Department of Veterans Affairs Health Care Personnel (HCP). It is a requirement that all HCP to receive annual seasonal influenza vaccination or obtain an exemption for medical or religious reasons. Wearing a face mask is required when an exemption to the influenza vaccination has been granted. HCP in violation of this directive may face disciplinary action up to and including removal from federal service. HCP are individuals who, during the influenza season, work in VHA locations or who come into contact with VA patients or other HCP as part of their duties. VHA locations include, but are not limited to, VA hospitals and associated clinics, community living centers (CLCs), community-based outpatient clinics (CBOCs), domiciliary units, Vet centers and VA-leased medical facilities. HCP include all VA licensed and unlicensed, clinical and administrative, remote and onsite, paid and without compensation, full- and part-time employees, intermittent employees, fee basis employees, VA contractors, researchers, volunteers and health professions trainees (HPTs) who are expected to perform any or all of their work at these facilities. HPTs may be paid or unpaid and include residents, interns, fellows and students. HCP also includes VHA personnel providing home-based care to Veterans and drivers and other personnel whose duties put them in contact with patients outside VA medical facilities.