The Registered Respiratory Therapist (RRT) is a member of the healthcare team in the Clinical Support Care Line at Lebanon VAMC 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. The GS-5, GS-7, GS-9, GS-11 levels are available for this posting. 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. (You must submit a copy with your application) 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. (You must submit a copy with your application) 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: Respiratory Therapist (GS-05) Experience. None beyond the basic requirements Assignment. This is the entry level developmental position. RTs at this grade level perform basic therapeutic modalities in all areas of respiratory care environment under close clinical supervision by an RRT at the full performance level or higher. RTs are responsible for such assignments as medication delivery related to respiratory care, initiating and monitoring oxygen therapy, assisting with cardiopulmonary resuscitation suctioning of artificial airway, evaluating and performing aerosol humidification therapy and participating in care team rounds. Registered Respiratory Therapist (GS-07) Experience, Education, Licensure and Registration. In addition to the basic requirements, candidates must possess their RRT credential. Demonstrated Knowledge, Skills and Abilities. In addition to the requirements above, candidates must demonstrate all the following KSAs: Ability to perform therapeutic modalities related to respiratory care. Skill in analyzing physiological specimens obtained to include arterial blood gases, pulse oximetry, End tidal Co2 (ETCo2) monitoring, basic spirometry and other basic diagnostic procedures. Ability to collaboratively consult with physicians and other healthcare professionals for respiratory care to help provide favorable patient outcomes. Skill in assessing oxygenation and ventilation. Ability to perform basic airway management to include artificial airways and mechanical ventilation. Assignment. This is a developmental position. RRTs at this grade level will be responsible for the following assignments with minimal clinical supervision from an RRT at the full performance level in both inpatient and/or outpatient settings. RRTs complete patient assessment through direct contact, chart review and other means as appropriate and share the information with health care team members. They use accepted measuring/monitoring tools for determining plan of care. They place nasal and oropharyngeal airway and perform nasal and tracheal suctioning. RRTs obtain, analyze and report arterial and venous blood gas samples. They perform duties in the critical area with close supervision to include in- line suctioning, re-positioning and securing Endo Tracheal tube, bag valve mask ventilation, assisting in patient transport and performing patient ventilator assessment. RRTs provide outpatient services, such as positive airway pressure (PAP) therapy, oxygen therapy and COPD care. 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. RRT (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. The grade at which an applicant may be selected for this vacancy is in the range of GS-05 to GS-11. 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 ["The services performed by RRTs at the Lebanon 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: GS-5 (Entry Level): Respiratory Therapists at this grade level perform: Basic therapeutic modalities in all areas of respiratory care environment under close clinical supervision by an RRT at the full performance level or higher. Medication delivery related to respiratory care Initiating and monitoring oxygen therapy Assisting with cardiopulmonary resuscitation Suctioning of artificial airway Evaluating and performing aerosol humidification therapy Participating in care team rounds. GS-7: This is a developmental position. Registered Respiratory Therapists at this grade level will be responsible for the following assignments with minimal clinical supervision from an RRT at the full performance level in both inpatient and/or outpatient settings. Complete patient assessment through direct contact, chart review and other means as appropriate and share the information with health care team members. Use accepted measuring/monitoring tools for determining plan of care. Place nasal and oropharyngeal airway and perform nasal and tracheal suctioning. Obtain, analyze and report arterial and venous blood gas samples. Perform duties in the critical area with close supervision to include in- line suctioning, re­positioning and securing Endo Tracheal tube, bag valve mask ventilation, assisting in patient transport and performing patient ventilator assessment. Provide outpatient services, such as positive airway pressure (PAP) therapy, oxygen therapy and COPD care. GS9: Registered Respiratory Therapists at this grade level are responsible for the following under general guidance in both inpatient and/or outpatient settings. Obtain, interpret, and analyze physiological specimens and data. Consult with physicians and other healthcare professionals to ensure quality of patient care within area of specialty. Manage and maintain the airway and ventilation of the patient through the use of appropriate mechanical means. 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. Provide outpatient services such as home ventilators, PAP therapy, oxygen therapy and COPD care. GS11: Registered Respiratory Therapists at this grade level 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: - Equipment selection and setup to appropriately provide care ordered by physician or protocol. Therapeutic and diagnostic procedures with the use of medical gases and administration devices, humidification and aerosols. Administration of medication to the cardiopulmonary system. Transport of patients to and from areas for special procedures on oxygen, BiPAP, or transport ventilators. Verification of all orders before implementation. Discontinuation or exchange of all equipment, and reprocessing of Reusable Medical Equipment (RME) in accordance with VHA Directives and facility and department policies. Maintenance of natural and artificial airways as necessary, including endotracheal suctioning, oropharyngeal or nasopharyngeal suctioning, sputum induction, tracheal lavage, and securing of nasal or oral endotracheal tubes or tracheostomies. Ventilatory support, including initiation, maintenance, and management of life support systems, and the patient/ventilator interface. Bedside training of physicians-in-training and medical residents through patient contacts, discussions, consultations. Monitoring patient status as appropriate via arterial blood gases, chest auscultation, review of x-ray studies, clinical observation. Various other duties as assigned. The RRT practices professionally; must be reliable, able to work independently, and be self-motivated. The RRT is responsible for performing job duties in accordance with mission, vision, and values of Lebanon VAMC. Work Schedule: Rotating Hours, Rotating Days 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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