Department: Department of Veterans Affairs
Location(s): Saint Louis, Missouri
Salary Range: $125634 - $187138 Per Year
Job Summary: The Cardiothoracic Surgery team at VA St. Louis Health Care System seeks an experienced NP with full practice authority to provide outpatient, inpatient, and ICU care. Duties include ordering and titrating cardiac medications, surgical first assist, hemodynamic surveillance, chest tube management, VAD implantation support, and transplant evaluation. Coordinate perioperative, intra-operative and post-operative care with cardiac surgeons and intensivists under VA APRN privileging guidelines.
Major Duties:
Qualifications: Advanced Practice Nurse (Nurse Practitioner) Basic Requirements Education: A post-master's certificate or master's or doctoral degree as a Nurse Practitioner. (Applicants pending the completion of educational requirements may be referred and tentatively selected but may not be hired until the education requirements are met.) Must be a 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). NOTE: Foreign Education. Graduates of foreign schools of professional nursing programs, the nurse practitioner degree equivalency must be validated through an Agency recognized degree equivalency evaluation agency, such as the International Consultants of Delaware (ICD). Candidates with equivalent nurse practitioner masters or doctorate level degrees who possess current, full, active, and unrestricted registration and certification will meet the requirement of graduation from an approved school of professional nursing to warrant appointment. License - All APN (NPs) must possess and maintain an active, current, full, and unrestricted APN license to practice as an NP in a State, Territory or Commonwealth of the United States, or in the District of Columbia. Basic Board Certification - All APN (NPs) must maintain full and current basic board certification in one of the following: Acute Care Nurse Practitioner (ACNP), Adult-Gerontology Acute Care Nurse Practitioner (AGACNP), from one of the following: the American Nurses Credentialing Center (ANCC), American Academy of Nurse Practitioners Certification Board (AANPCB), or other nationally recognized certifying body in the area in which the Nurse Practitioner is academically prepared. NOTE: Grandfathering Provision - All persons currently employed in VHA in 0610 series and an APN (NP) 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 Scope, Education and Experience, and Dimension criteria must be met to qualify for Advanced Practice Nurse (Nurse Practitioner) II: Exception to Licensure for Graduate Nurse Technicians. Candidates who otherwise meet the basic requirements, but do not possess the required licensure and/or certification, may be appointed at the entry step of the Nurse II, as a Graduate Nurse Technician - Nurse Practitioner on a temporary appointment up to any period not-to-exceed one year and a day under the authority of 38 U.S.C. § 405(c)(2)(B). Scope: Demonstrates leadership in delivering and improving holistic care through collaborative strategies with others Education and Experience Requirement: Meets basic education requirement for APN (NP). Nurse II is considered the entry grade level for APN (NPs); no experience is required. Dimension Requirement: APNs (NPs) at level II are expected to meet the following dimension requirements: Clinical Practice. Delivers evidence-based health care, demonstrating proficiency in the ability to manage a patient panel, population, or program. Outcome Focus. Utilizes research and evidence-based practice to evaluate the patient care delivery system within a patient panel or program, presents findings and contributes to changes that enhance the quality and timeliness of veteran/patient care. Leadership. Works effectively as a leader within a team/unit/group and seeks interdisciplinary collaboration as appropriate to enhance patient care. Professional Development. Acquires knowledge and skills to develop expertise in area of practice. Professionalism/Collegiality. Demonstrates effective communication skills and professional behavior, promoting cooperation and teamwork. Participates in interdisciplinary teams and processes that positively impact patient outcomes. The following Scope, Education and Experience, and Dimension criteria must be met to qualify for Advanced Practice Nurse (Nurse Practitioner) III: Scope: Executes position responsibilities that demonstrate leadership, experience, and creative approaches to management of complex client care. Education and Experience Requirement: Meets basic education requirement for an APN (NP) AND one year of specialized APN (NP) experience equivalent to the Nurse II grade level. Dimension Requirement: APN (Nurse Practitioners) at grade III are expected to meet the following dimension requirements: Clinical Practice. Influences and models the delivery of evidence- based health care, demonstrating expertise in the ability to manage a patient panel, population, or program. Outcome Focus. Leads and implements changes that enhance the quality and timeliness of Veteran/patient care applying research and evidence in the delivery of healthcare for patient populations. Leadership. Initiates and leads interdisciplinary teams informed by structured approaches and processes to improve outcomes that positively impact care for a patient panel, population, or program. Professional Development. Acquires knowledge and skills, then disseminates acquired information within and/or outside the medical facility. Professionalism/Collegiality. Initiates and leads interdisciplinary teams developing systems that positively impact outcomes at the panel, population, or program level. Demonstrates effective communication skills and professional behavior, promoting cooperation and teamwork Preferred Experience: Conduct detailed assessments (hemodynamics, volume status), assist in surgical interventions specific to HF (VAD implantation, transplant evaluation), and coordinate intra and post operative care in collaboration with cardiac surgeons and intensivists. Preoperative Care: Conduct comprehensive assessments, obtain medical histories, perform physical exams, and order/interpret diagnostic tests (EKGs, lab studies, imaging) to prepare patients for surgery. Intraoperative First Assist: Assist with surgical exposure, tissue handling, suturing, hemostasis, and closure; Perform vein or artery harvesting (saphenous, radial) during CABG, chest closure, cannulation, valve placement, decannulation, and Chest tube placement. Manage operative equipment and sterile field logistics (suction, retractors, endoscopic devices). Postoperative Care: Provides all orders, participate in ICU/PACU transfers, postoperative rounds, wound care, pacing wire removal, and discharge planning. Immediate ICU management: Oversee care for intubated and ventilated patients post-cardiac surgery, including ventilator weaning and arterial blood gas monitoring. Chest tube, hemodynamics surveillance: Monitor, manage, and document chest tube output; detect complications like hemorrhage, tamponade, or low cardiac output; adjust therapy accordingly Certified Nurse Practitioner: Acute Care Nurse Practitioner or adult-gerontology acute care focus RN First Assistant certification and/or RNFA course completion CRNFA and AORN member preferred Additional certifications: BLS, ACLS, CNOR (required), CCRN, and CRNFA preferred Minimum of 2 years recent cardiothoracic perioperative experience (OR and ICU) Rationale: The job requires independent titration of cardiac medications, ventilator weaning, chest tube/hemodynamics surveillance, and rapid recognition of life threatening complications. Prescriptive authority consistent with APRN scope (institutional privileging + formulary for inotropes, antiarrhythmics, anticoagulants, diuretics, and narcotics) Rationale: The role explicitly requires ordering/titrating cardiac medications; privileging aligns with VA/APRN practice authorities. Certified Perioperative Nurse in the Operating Room
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 11:59 PM (ET) on 03/17/2026 to receive consideration. To preview the questionnaire click https://apply.usastaffing.gov/ViewQuestionnaire/12898269. 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.
Application Deadline: 2026-03-17