The Nurse demonstrates the ability to identify an issue, analyze it, and develop and implement interventions. The Nurse practice affects unit, team, or work group. The proficient nurse considers fewer options and hones in on an accurate region of the problem' (Benner), identifying emerging issues on the unit that need to be addressed. The proficient nurse can now recognize when the expected normal picture does not materialize decision-making is less labored. The proficient nurse learns from experience what typical events to expect in each situation and how plans need to be modified in response to these events. The nurse is a PROFICIENT nurse, 'who understand a situation as a whole, because they perceive its meaning in terms of long-term goals. The Nurse demonstrates leadership in delivering and improving holistic care through collaborative strategies with others. The nurse's primary commitment is to the patient, whether an individual, family, group, or community. Core elements of performance include knowledge and active participation in unit/program level quality improvement processes and initiatives as well as customer service programs.

He/she possesses the knowledge related to VHA guidelines, utilization review criteria, current evidence-based standards of care, compliance guidelines and local policy related to Delegation of Authority as established by the facility Chief of Staff.

The Registered Nurse will serve as a liaison to both internal and external providers and will be responsible for managing the care of the Veteran and the seamless transition to and from the community. He/she is responsible for providing clinical leadership and expertise on consults, community care processes and regulations. The Registered Nurse is the lead of the integrated care team established by the VA Community Care Operating Model. The foundational elements will serve to support delivery of high quality, timely care to the Veteran receiving services in the community. The Nurse is responsible for the planning, integrating, implementing, modifying and evaluating the effectiveness of the Veteran's care.

The Nurse functions directly to support the activities of the Nursing service and assigned tasks related to care coordination and consults. The Registered Nurse Consult Specialist is assigned to the TVHS Nursing Services.

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