The Veteran Integrated Referral System/ Traveling Veteran Coordinator (VIRS/ TVC) Nurse is assigned to Patient Care Service of the Roseburg Veterans Affairs Healthcare System, Roseburg, OR. The VIRS/TVC Nurse provides professional nursing care to acute and chronically ill Veterans. The VIRS/ TVC is responsible for the coordination and collaboration of and direct patient care delivered by the TVC program as outlined by VHA Handbook 1101.11(3), Coordinated Care for Traveling Veterans. The coordinator is assigned to Veterans requiring complex care coordination or specialized case management services (e.g., Operation Enduring Freedom-Operation Iraqi Freedom- Operation New dawn (OEF-OIF-OND), Serious Mental Illness, SCI/D, and Blind and Vision Rehabilitation Continuum of Care, Etc.). The VIRS/ TVC serves as the primary point of contact these Veterans and their families or caregivers and communicates with the health care team while leading complex care coordination and case management efforts. The VIRS/ TVC RN duties are multifaceted and may be divided between RN functions of the TVC Program and the VIRS. The coordinator assists with significant collaboration with VISN healthcare personnel in the transition of Veterans through the VA Healthcare System. VIRS/ TVC RN received, coordinates, monitors, and trends interfacility consults to assist with delivery of patient care. The coordinator works with VISN 20 facilities and coordinators to facilitate the transition of patients for continued treatment or consultative care. The coordinator will work in conjunction with the Patient Centered Management Module Coordinator VISN 20 VA NORTHWEST HEALTH NETWORK ROSEBURG VETERANS AFFAIRS HEALTH CARE SYSTEM (RVAHCS) FUNCTIONAL STATEMENT CRITERIA BASED PERFORMANCE STANDARDS VIRS/TRAVELING VETERAN COORDINATOR /STAFF NURSE III ACNE Approved 7/2021 (PCMM) as outlined in VA Directive 1406. In addition, the nurse will function as the Roseburg VAMC resource for Interfacility Transfers (IFC) during the transition to Cerner electronic medical record throughout the VA. The nurse will work with Cerner staff and other VA IFC to ensure Veteran care is coordinated between facilities. This position potentially requires flexibility in schedule and assignments, as this is a 24/7 hospital. The incumbent must be poised and articulate in communicating with people of varied educational level as and varied ethnic backgrounds. The incumbent is willing to work collaboratively as a member of a team in all assignments. Makes caring for the Veteran his/her priority while in the work setting and demonstrates customer service principles in all aspects of work. Self-motivated in the pursuit of meeting professional work standards The Nurse functions as a primary nurse for a defined group of Veterans for her/his shift. Responsible and accountable for all elements of the nursing process when providing and/or supervising direct Veteran care. Assesses, plans, implements, and evaluates care based on age- and cultural-specific components. Assumes responsibility for the coordination of care focused on Veteran transition through the continuum of care, Veteran, and family education, Veteran self-management after discharge, and supporting factors that impact customer satisfaction. The Registered Nurse provides care and counseling of persons or in the promotion and maintenance of health and prevention of illness and injury based upon the nursing process that includes systematic data gathering, assessment, appropriate nursing judgment, and evaluation of human responses to actual or potential health problems through such services as case finding, health teaching, health counseling; provision of care supportive to or restorative of life and well-being; and executing medical regimens including administering medications and treatments prescribed by a licensed or otherwise legally authorized provider. Considers all characteristics of the individual, including age and life stages, state of health, race and culture, values, and previous experiences. Administers medications and procedures per established policies and guidelines. Provides cross coverage to other areas as assigned by management. Influences care outcomes by collaborating with members of the interdisciplinary team. Core elements of performance include knowledge and active participation in unit/program level quality improvement processes and initiatives and customer service programs Work Schedule: Monday - Friday, 0:800 am - 4:30 pm Telework: Not available .Financial Disclosure Report: Not required
Providing Health Care for Veterans: The Veterans Health Administration is America’s largest integrated health care system, providing care at 1,255 health care facilities, including 170 medical centers and 1,074 outpatient sites of care of varying complexity (VHA outpatient clinics), serving 9 million enrolled Veterans each year.