The Registered Respiratory Therapist (RRT) is a member of the healthcare team in the Clinical Support Care Line at the Wilmington, DE Veterans Affairs (VA) Medical Center, performing quality therapeutic and diagnostic respiratory care under the order of a healthcare provider with recognized prescribing authority. Under the supervision of the Chief of Respiratory Care Services, the incumbent displays proficiency and performs at a level of excellence in Respiratory Care. Basic Requirements: United States Citizenship: Non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy. Education. Individuals must have successfully completed a respiratory care program accredited by the CoARC or its successor. Licensure. Persons appointed or reassigned to RRT positions in the GS-0601 series must possess and maintain for the duration of employment a full, current and unrestricted license from a state to practice as an RRT. Credential. Persons appointed or reassigned to RRT positions in the GS-0601 series must possess and maintain for the duration of employment a valid, current, unrestricted credential of RRT. Grade Determinations: In addition to the basic requirements for employment, all individuals referred and assigned to this occupation must meet all the qualification requirements and KSAs defined in the specific assignment as follows: Registered Respiratory Therapist, GS-09.Experience or Education, Licensure and Credential. Candidates must have: One year of creditable experience equivalent to the GS-07 grade level demonstrating the clinical competencies described at that level; OR A Master of Science degree in respiratory care AND a license AND an RRT credential. Demonstrated Knowledge, Skills and Abilities. In addition to the requirements above, candidates must demonstrate all the following KSAs: Skill in performing therapeutic modalities related to respiratory care. Ability to collaboratively consult with physicians and other healthcare professionals to help provide favorable patient outcomes. Skill in assessing oxygenation and ventilation. Ability to perform airway management to include artificial airways and mechanical ventilation. Assignments. This is a developmental position. RRTs at this grade level are responsible for the following under general guidance in both inpatient and/or outpatient settings. RRTs obtain, interpret and analyze physiological specimens and data. They consult with physicians and other healthcare professionals to ensure quality of patient care within area of specialty. They manage and maintain the airway and ventilation of the patient through the use of appropriate mechanical means. RRTs assess and evaluate patients to determine and recommend intervention to develop and implement a plan of care, such as, implementing protocols, intubation, monitoring critical systems and uses advanced modes of ventilation. They provide outpatient services such as home ventilators, PAP therapy, oxygen therapy and COPD care. Registered Respiratory Therapist, GS-11.Experience, Licensure and Credential. Candidates must have: One year of creditable experience equivalent to the GS-09 grade level demonstrating the clinical competencies described at that level. Hold an active license and RRT credential. Demonstrated Knowledge, Skills and Abilities. In addition to the requirements above, candidates must demonstrate all the following KSAs: Ability to collaboratively consult with physicians and other healthcare professionals for complex respiratory care to develop care plans to provide favorable patient outcomes. Skill in evaluating the efficacies of therapeutic modalities. Skill in performing advanced airway and ventilation management. Assignments. This assignment is the full performance level. RRTs at this grade level work independently providing respiratory care in both inpatient and/or outpatient settings. The specific assignments are dependent on facility structure and complexity levels. They use data and patient assessment to establish appropriate plan of care and determine if outcomes are being met. They consult with physicians and other healthcare professionals to ensure quality of patient care within area of specialty. They manage and maintain the airway and ventilation of the patient using appropriate mechanical means. RRTs determine and implement complex respiratory care such as protocols, respiratory modalities, bronchoscopy medications or supplemental oxygen and intubation. They monitor critical systems. They use advanced modes of ventilation and outpatient services, such as home ventilators and COPD case management. RRTs suggest alternate modes of treatment where indicated based on assessment and analysis of patient response to treatment. RRTs at this grade level may perform invasive procedures such as arterial line placement. They serve as a preceptor to lower graded staff. They may lead projects developing new policies, procedures or protocols. Preferred Experience: minimum of 1 year ICU experience The actual grade at which an applicant may be selected for this vacancy is GS-11. They manage and maintain the airway and ventilation of the patient using appropriate mechanical means. RRTs determine and implement complex respiratory care such as protocols, respiratory modalities, assist bronchoscopy, medications or supplemental oxygen and intubation. They monitor critical systems and use advanced modes of ventilation. RRTs suggest alternative modes of treatment where indicated based on assessment and analysis of patient response to treatment. At this level, the supervisor places considerable reliance on the Registered Respiratory Therapists knowledge of complex procedures, and completed work is evaluated for technical soundness, appropriateness, and conformity to policy. The RRT will extensively use a variety of sources for guidance and make clinical decisions. The incumbent uses judgment in interpreting and adapting guidelines such as agency policies, regulations, precedents, and work directions for application to specific cases or problems. Physical Requirements: The work requires regular and recurring physical exertion such as standing or walking for prolonged periods of time; frequent bending, reaching, stooping, and stretching to set up and take apart respiratory equipment and apparatus; lifting , repositioning, safely moving patients medium lifting 35 lbs. and under and with assistance as needed; and pushing or pulling heavy objects (over 50 lbs.) such as oxygen tanks and/or ventilator equipment, routinely lifting and carrying small equipment items (less than 50lbs). The work may require specific physical characteristics and abilities such as above-average dexterity to perform intricate respiratory therapy procedures. References: VA Handbook 5005/141 PART II APPENDIX G11 ["This assignment is the full performance level. Registered Respiratory Therapists (RRTs) at this grade level are seasoned clinicians with advanced clinical skills and knowledge who can work independently providing respiratory care in both inpatient and/or outpatient settings. They use data and patient assessment to establish appropriate plan of care and determine if outcomes are being met. They consult with physicians and other health care professionals to ensure quality of patient care within the area of specialty. The services performed by RRTs at the Wilmington VAMC include, but are not limited to, the following activities performed in accordance with valid orders or under established protocols in both the inpatient and outpatient settings: Duties and responsibilities include, but are not limited to: 1. Clinical a. Administer a variety of complex respiratory treatments to patients on hospital wards and intensive care units. b. Supply, inspect, and test all respiratory therapy equipment to insure proper operating condition d. Set up and monitor respiratory equipment such as volume and pressure ventilators, respiratory monitor, re-breather, and oxygen monitor. They will make frequent adjustments in mechanical ventilator techniques such as Assist Control, Pressure Control, Airway Pressure Release Ventilation c. Ability to obtain, interpret and analyze physiological specimens and data. (APRV), Pressure Support ventilation, positive end expiratory pressure (PEEP), intermittent mandatory ventilation (IMV), and continuous positive airway pressure (CPAP), etc. e. Initiates airway management on patients, including endotracheal intubation, tracheobronchial and naso-tracheal suctioning, obtaining sputum/tracheal aspirates for cultures, endotracheal and tracheostomy tube cuff pressure monitoring, chest physical therapy involving postural drainage and percussion, and chest examinations for the presence of secretions and proper placement of the endotracheal tube. f. Ability to collaboratively consult with physicians and other health care professionals for complex respiratory care to develop care plans to provide favorable patient outcomes. g. Develop plans for weaning patients from ventilators and discuss with physician providers h. Perform bedside diagnostic tests, including sputum induction, measurement of pulmonary compliance, inspiratory force, tidal volume, and dead space of tidal volume ratios. Perform basic spirometry, including forced vital capacity, forced expired volume, forced expiratory flow and peak flow. i. Is an integral member of a team responsible for the endotracheal intubation by gathering materials and tools and positioning patients as required in order to perform the procedure. j. Respond to cardiac arrests (Code Blue) or Rapid Response as a part of the medical Emergency Response Team. Will initiate artificial ventilation using manual ventilation bag to ventilate. During the transport of patients will maintain clearance of airway, monitor vital signs, and perform cardiopulmonary resuscitation (CPR) and/or endotracheal intubation when necessary. k. In-house, will transport ventilator patients to and from Radiology, Nuclear medicine, or other diagnostic and operative procedures etc. I. Takes verbal orders in an emergency from provider for emergency respiratory treatments. Initiates and carries out these orders and document once the emergency passes. m. Calibrate complex respiratory equipment such as ventilators, carbon dioxide analyzers, and oximeters to assure accurate performance. n. Record treatments, findings and progress pertinent to patient care. o. Draws ABG's and initiates appropriate respiratory therapy as ordered. p. Performs pulmonary function testing as appropriate. Calibrate Pulmonary Function testing equipment as appropriate. q. A Respiratory Therapist will order specific supplies or equipment originally ordered by the Specialty Provider for which there are no additional refills, or when condition or loss necessitates. i. Items to be refilled include but are not limited to: 1. CPAP masks 2. Filters 3. Hoses ii. CPAP evaluations will be performed if the machine is malfunctioning. iii. Any equipment or supplies not specifically ordered as a refill or replacement will be accompanied by documentation of assessed need and the documentation placed for provider signature. Work Schedule: Rotating, evenings, nights, weekends, holidays Six 12-hour shifts and one 8-hour shift per pay period Tour of duty can be a combination of 0700-1900, 1500-2300, 1900-0700, 2300-0700 Telework: Not Available Virtual: This is not a virtual position. Relocation/Recruitment Incentives: Not Authorized Permanent Change of Station (PCS): Not Authorized Financial Disclosure Report: Not required"]

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