Registered Nurse - Electrophysiology

The EP RN provides comprehensive care coordination for the Electrophysiology program, including Veterans with cardiac arrhythmias and Cardiac Implantable Electronic Devices (CIEDs), including pacemakers, implantable cardioverter-defibrillators (ICDs), and implantable loop recorders. They are responsible for managing complex patient situations, acting as a patient advocate, and coordinating care for Veterans receiving evaluation and treatment for cardiovascular and electrophysiology conditions.

Major duties

Duties include, but are not limited to: Conduct comprehensive nursing assessment and clinical triage of Veterans with known or suspected arrhythmias and/or CIEDs, obtaining and reviewing pertinent medical history, symptoms, medications, diagnostic results, and outside records to support the plan of care. Independently manage and coordinate longitudinal care for the EP patient population, including arrhythmia and cardiac device patients, in collaboration with Electrophysiology providers and the interdisciplinary healthcare team. Manage telephone calls, secure messages, clinical reminders, view alerts, and other patient communications; assess clinical urgency, provide nursing guidance within established protocols, and escalate significant findings to the appropriate provider. Provide patient and caregiver education and coaching regarding arrhythmias, prescribed therapies, medications, diagnostic testing, CIEDs, remote monitoring, symptom recognition, and when to seek routine, urgent, or emergency care. Monitor adherence to established treatment plans and coordinate follow-up testing, appointments, referrals, and other care needs to promote continuity, timely access, and safe transitions of care. Coordinate pre- and post-procedure care needs for patients undergoing electrophysiology-related procedures, including patient education, review of required testing and treatment plans, communication of instructions, and follow-up after procedures. Independently perform CIED interrogation in outpatient settings, including ZVAMC clinics and remote clinics, and in inpatient or ancillary settings when clinically indicated, including MRI, Radiation Therapy, Emergency Department, and inpatient units. Collect, investigate, analyze, and interpret CIED data and communicate findings and recommendations to Electrophysiology providers. Troubleshoot device function, settings, arrhythmia episodes, alerts, and therapies in collaboration with the EP team. Actively manage remote monitoring of CIEDs, review and interpret transmissions and alerts, identify clinically significant findings, communicate with Veterans as appropriate, and promptly notify Electrophysiology providers when provider review or intervention is indicated. Monitor and evaluate multiple makes and models of pacemakers, implantable cardioverter-defibrillators, and implantable loop recorders and maintain knowledge of evolving device technology and management recommendations. Analyze clinical data and compose accurate, timely documentation of nursing assessments, triage encounters, care coordination activities, CIED management summaries, remote transmission reviews, and clinic visits in the electronic health record. Communicate and problem solve with the multidisciplinary team to address complex patient care issues, arrhythmia management needs, CIED function, access barriers, and continuity-of-care concerns. Proactively review patient schedules, referrals, and follow-up needs to support efficient EP clinical workflows, identify potential gaps or conflicts, and facilitate timely access to care. Participate in quality improvement, evidence-based practice, and clinical research activities related to electrophysiology and cardiac device care as assigned and consistent with the scope of the position. Maintain current knowledge and competency regarding electrophysiology, arrhythmia care, CIED technology, remote monitoring, applicable clinical protocols, and changes in practice relevant to the EP patient population. Provide cross-coverage within the integrated EP/Device RN model according to operational needs and demonstrated competency.

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: M-F Day shift with variable start times
• Telework: Not Available
• Virtual: This is not a virtual position.
• Relocation/Recruitment Incentives: Not Authorized
• Permanent Change of Station (PCS): Not Authorized

Qualifications

Basic Requirements: English Language Proficiency. In accordance with 38 U.S.C. 7403(f), no person shall serve in direct patient care positions unless they are proficient in basic written and spoken English. 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); OR Individuals attending a master's level bridge program in nursing who have completed coursework equivalent to a bachelor's level degree in Nursing may have opportunity to become registered as a nurse with a state licensing board prior to completion of the bridge program. Upon achievement of a State license, the individual may be appointed on temporary basis and later converted to a permanent appointment upon successful completion and graduation from the bridge program. (Reference VA Handbook 5005, Appendix G6); OR In cases of graduates of foreign schools of professional nursing, possession of a current, full, active, and unrestricted registration will meet the requirement for graduation from an approved school of professional nursing to warrant an appointment as a Nurse who has completed an associated degree/entry level Nursing education program. Credit for foreign nursing education higher that associate degree/entry level requires a formal degree equivalency validation from a recognized equivalency evaluation accepted by VA such as International Consultants of Delaware (ICD). 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.

Graduate Nurse Technician (GNT) Exception: Candidates who otherwise meet the basic education requirements, but do not possess the required licensure, may be appointed at the entry step of the grade and level applicable to the completed nursing education as a GNT on a 120-day temporary appointment while actively pursuing licensure (may be extended up to two years on a case-by-case-basis.)

NOTE: Grandfathering Provision - All persons currently employed in VHA in 0610 series and 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.

Grade Determinations: The following Scope, Education and Dimension criteria must be met in determining the grade assignment of candidates, and if appropriate, the level within a grade. The Dimension requirements (Practice, Veteran/Patient Driven Care, Leadership, Professional Development and Evidence-Based Practice/Research) are detailed for each grade and level within the online assessment: https://apply.usastaffing.gov/ViewQuestionnaire/13090096.

Grade/Level Scope Education

• Nurse I, Level I Delivers fundamental, knowledge-based care to assigned clients while developing technical competencies. An Associate Degree (ADN) or Diploma in Nursing, with no additional professional nursing required.
• Nurse I, Level II Demonstrates integration of biopsychosocial concepts, cognitive skills and technically competent practice in providing care to clients with basic or complex. An ADN or Diploma in Nursing AND 1 year of specialized nursing experience equivalent to Nurse I, Level 1 ;OR a Bachelor of Science in Nursing (BSN) with no additional professional nursing experience required.
• Nurse I, Level III Demonstrates proficiency in practice based on conscious and deliberate planning. Self-directed in goal setting for managing complex client situations. An ADN or Diploma in Nursing AND 2 years of professional nursing experience in which one year is equivalent to Nurse I, Level 2; OR a BSN and 1 year of professional nursing experience equivalent to the Nurse I, Level 2; OR a Master's degree in nursing (MSN) and no additional professional nursing experience; OR a Master's degree in a *related field with a BSN and no additional professional nursing experience.
• Nurse II Demonstrates leadership in delivering and improving holistic care through collaborative strategies with others. A BSN with 2 years of professional nursing equivalent to Nurse I, Level 3; OR an MSN with one year of specialized nursing experience equivalent to Nurse I, Level 3; OR a Master's degree in a *related field with a BSN and one year of specialized nursing experience equivalent to Nurse I, Level 3; OR a Doctoral degree in Nursing with no professional nursing experience; OR a Doctoral degree in a *related field with a BSN with no additional professional nursing experience.
• Nurse III Executes position responsibilities that demonstrate leadership, experience and creative approaches to management of complex client care beyond the immediate practice setting. MSN and 2 years of specialized nursing experience, one of which is equivalent to Nurse II and meets all dimension requirements for Nurse III; OR a Master's degree in *related field with BSN and two years of specialized nursing experience, one of which is equivalent to Nurse II and meets all dimension requirements for Nurse III; OR a Doctoral degree in Nursing with and one year of specialized nursing experience equivalent to Nurse II and meets all dimension requirements for Nurse III; OR a Doctoral degree in a *related field with a BSN and one year of specialized nursing experience equivalent to Nurse II and meets all dimension requirements for Nurse III.

*Note: Foreign education programs/degrees are not creditable as related degrees.

Preferred qualifications include:

• Experience evaluating and managing patients with cardiac arrhythmias, including atrial fibrillation/flutter, supraventricular tachycardia, symptomatic bradycardia, frequent PVCs, and ventricular arrhythmias.
• Competent in recognition of common and complex arrhythmias, conduction defects, and paced rhythms.
• Prior experience supporting arrhythmia triage, including symptom assessment, secure message triage, guideline based recommendations, and urgent escalation for high risk arrhythmias.
• Experience caring for Veterans undergoing arrhythmia related diagnostics such as Holter/vent monitors, stress tests, device interrogations, and cardioversion coordination.
• Knowledge and experience managing patients with implantable cardiac rhythm devices, including pacemakers, ICDs, CRT devices, and loop recorders; ability to interpret device data, review arrhythmia episodes, and support remote monitoring workflows.
• Experience performing or assisting with device related peri procedural care (MRI/OR reprogramming, post radiation therapy checks, ED/inpatient interrogations).
• Strong clinical assessment and critical thinking skills in evaluating arrhythmia related symptoms and device related concerns in both clinic and remote settings.
• Additional arrhythmia or EP related training highly desirable.

Reference: For more information on this qualification standard, please visit https://www.va.gov/ohrm/QualificationStandards/.

Physical Requirements: This position includes a level of physicality normally associated with duties performed by nurses such as direct patient care, and potentially long periods of walking, standing, sitting, moderate lifting, repeated bending, or kneeling. Examples may include but are not limited to:

• Significant amounts of time standing assisting assigned patients
• Utilization of safe patient handling and mobility protocols

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. 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. Must pass pre-employment physical evaluation. 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.