Registered Respiratory Therapist
This candidate will have heavy emphasis on out-patient services to veterans but will also be crossed trained to provide in-patient coverage as written on the Functional Statement. The Respiratory Therapist will provide Full PFT/Spirometry, perform home oxygen evaluations and perform CPAP/ BiPap initiations and follow-ups. I. EMERGENCY PROCEDURES The incumbent:
Must successfully complete the didactic and skills assessment of the Out of Operating Room Airway Management Program in order to certify and perform tracheal intubation. Is responsible for airway management during a cardiac / respiratory arrest and may assist with other aspects of Cardiopulmonary Resuscitation. Responds to all STAT pages regarding a patient's respiratory status, making an assessment and providing emergency ventilatory and/or oxygenation support. II. MECHANICAL VENTILATION (MV) - INVASIVE VS NON-INVASIVE The incumbent, in corroboration with the physician:
Initiates Invasive and Non-invasive Ventilation, selection and implementation of settings relative to the patient's needs. This may also involve such modalities as PEEP, CPAP, Pressure Support, Control, PRVC, Auto-Mode, Bi-Level Ventilation, BiPAP and HFNO. Monitors mechanical ventilation via arterial blood gas results, chest auscultation, chest X -rays, bedside pulmonary function values, clinical observation, and adjusts parameters to match the degree of intervention with the patient's condition. Maintains the patient on mechanical ventilation with periodic checks of ventilator settings and performs troubleshooting and equipment maintenance. Removes the patient from MV after utilizing appropriate monitoring and other weaning techniques to determine the patient's ability for prolonged spontaneous ventilation. Measures the static compliance, critical lung volumes, flows and pressures for trend information on the critically ill patient. Calculates additional complex formulas (i.e., A-a gradients, shunts) related to the patient's critical status. Provides airway management assistance / transport of ventilated patient to all areas of the Medical Center. III. AIRWAY MANAGEMENT Airway management modalities are shared with nursing service personnel and other medical personnel. The RCP often provides the consultation and education associated with these therapies. The incumbent will perform or instruct others to perform:
Suctioning (endotracheal or nasotracheal). Administration of aerosolized medications. Assists with the selection and placement of endotracheal and / or tracheostomy tubes and the continued monitoring of these devices. Perform monthly tracheostomy tube changes. IV. OXYGENATION The incumbent selects equipment, administers, monitors, and maintains all concentrations of oxygen including critical concentrations of FIO2 (greater than 50%). V. HYPERINFLATION TECHNIQUES Upon receipt of an order for hyperinflation:
The incumbent checks the patient's chart for the appropriateness of the therapy and:
Recommends to the physician the most appropriate mode of administration. Discusses, directs and reviews the patient's progress with physicians, nurses and other medical personnel daily. VI. DIAGNOSTIC Upon certification of competency, the incumbent:
Performs radial and brachial punctures in order to secure arterial blood gas specimens. Places indwelling arterial lines in order to secure blood specimens or provide hemodynamic monitoring. Analyzes the specimens and calculates pertinent data (e.g., A-a ratios, shunt calculations, etc.) from the results. Alerts the physician regarding abnormal / critical values and the need for associated action relative to the patient's ventilatory and oxygenation status. Performs maintenance and quality control procedures of blood gas analyzers. Completes all record keeping activities associated with blood gas analysis. Performs a full range of non-critical pulmonary function testing in accordance with standards set forth by the American Thoracic Society. Evaluates the patient to determine need for supplemental oxygen upon discharge. VII. HEMODYNAMIC MONITORING The incumbent is responsible for the collection and analysis of mixed venous samples. VIII. EQUIPMENT AND SUPPLY MANAGEMENT The incumbent will ensure that:
Equipment is assembled in the manner recommended by the manufacturer. Ensures that all respiratory equipment is functioning properly and is being used in the appropriate manner. Work Schedule:
Monday - Friday 7:
30am - 4pm Financial Disclosure Report:
Not required 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. Registered Respiratory Therapist. Has a certificate as an RRT from the NBRC (National Board for Respiratory Care) and a registry number, or a certificate from another body which the NBRC recognizes as its credentialing equivalent. This includes registration based on either:
(1) Having fulfilled the requirements and passed the registry examination administered the NBRC since 1983, or (2) Having fulfilled the requirements and passed the registry examination for a registered inhalation or respiratory therapist administered by the (1) National Board for Respiratory Therapy from July 1974 through 1982 or (2) American Registry of Inhalation Therapists from 1961 through June 1974. Grade Determinations:
In addition to meeting the basic requirements stated above, the following qualifications criteria must be met in determining the appropriate grade assignment of candidates. GS-8. Candidates must have all of the following:
At least 1 year of successful experience related to respiratory therapy at the GS-7 level or equivalent. Qualifying experience at this level is work which includes duties such as:
administering assisted and controlled ventilation to patients with tracheotomies and other complex medical problems requiring frequent adjustments in ventilator parameters; administering and monitoring advanced ventilator techniques such as positive end expiratory pressure and continuous positive airway pressure; developing plans for weaning patients from ventilators; assessing the respiratory status of patients using data acquired through physical observation and clinical analysis of blood gas data, chest x-rays, and electrocardiogram to determine the effectiveness of therapy being administered and to make recommendations to physicians regarding changes in treatment; performing the most difficult respiratory therapy procedures to maintain ventilation, including endotracheal intubation, tracheal lavage, and tracheotomy care; and providing in-service training to others in various specialized areas of respiratory care. Demonstrated knowledge and ability needed to perform complex respiratory procedures with minimal supervision. Is able to participate with physicians and nurses and other staff in planning respiratory treatment, with great reliance on the individual's knowledge of the equipment. Demonstrated knowledge and ability to provide emergency or critical respiratory care; service as a shift leader or supervisor or sole responsible respiratory therapist on a shift; and to plan and conduct training sessions with respiratory therapy students, hospital staff, patients, and family members. References:
VA HANDBOOK 5005 PART II APPENDIX G11 The full performance level of this vacancy is GS-8. Physical Requirements:
See VA Directive and Handbook 5019.
Estimated Salary: $20 to $28 per hour based on qualifications.
Must successfully complete the didactic and skills assessment of the Out of Operating Room Airway Management Program in order to certify and perform tracheal intubation. Is responsible for airway management during a cardiac / respiratory arrest and may assist with other aspects of Cardiopulmonary Resuscitation. Responds to all STAT pages regarding a patient's respiratory status, making an assessment and providing emergency ventilatory and/or oxygenation support. II. MECHANICAL VENTILATION (MV) - INVASIVE VS NON-INVASIVE The incumbent, in corroboration with the physician:
Initiates Invasive and Non-invasive Ventilation, selection and implementation of settings relative to the patient's needs. This may also involve such modalities as PEEP, CPAP, Pressure Support, Control, PRVC, Auto-Mode, Bi-Level Ventilation, BiPAP and HFNO. Monitors mechanical ventilation via arterial blood gas results, chest auscultation, chest X -rays, bedside pulmonary function values, clinical observation, and adjusts parameters to match the degree of intervention with the patient's condition. Maintains the patient on mechanical ventilation with periodic checks of ventilator settings and performs troubleshooting and equipment maintenance. Removes the patient from MV after utilizing appropriate monitoring and other weaning techniques to determine the patient's ability for prolonged spontaneous ventilation. Measures the static compliance, critical lung volumes, flows and pressures for trend information on the critically ill patient. Calculates additional complex formulas (i.e., A-a gradients, shunts) related to the patient's critical status. Provides airway management assistance / transport of ventilated patient to all areas of the Medical Center. III. AIRWAY MANAGEMENT Airway management modalities are shared with nursing service personnel and other medical personnel. The RCP often provides the consultation and education associated with these therapies. The incumbent will perform or instruct others to perform:
Suctioning (endotracheal or nasotracheal). Administration of aerosolized medications. Assists with the selection and placement of endotracheal and / or tracheostomy tubes and the continued monitoring of these devices. Perform monthly tracheostomy tube changes. IV. OXYGENATION The incumbent selects equipment, administers, monitors, and maintains all concentrations of oxygen including critical concentrations of FIO2 (greater than 50%). V. HYPERINFLATION TECHNIQUES Upon receipt of an order for hyperinflation:
The incumbent checks the patient's chart for the appropriateness of the therapy and:
Recommends to the physician the most appropriate mode of administration. Discusses, directs and reviews the patient's progress with physicians, nurses and other medical personnel daily. VI. DIAGNOSTIC Upon certification of competency, the incumbent:
Performs radial and brachial punctures in order to secure arterial blood gas specimens. Places indwelling arterial lines in order to secure blood specimens or provide hemodynamic monitoring. Analyzes the specimens and calculates pertinent data (e.g., A-a ratios, shunt calculations, etc.) from the results. Alerts the physician regarding abnormal / critical values and the need for associated action relative to the patient's ventilatory and oxygenation status. Performs maintenance and quality control procedures of blood gas analyzers. Completes all record keeping activities associated with blood gas analysis. Performs a full range of non-critical pulmonary function testing in accordance with standards set forth by the American Thoracic Society. Evaluates the patient to determine need for supplemental oxygen upon discharge. VII. HEMODYNAMIC MONITORING The incumbent is responsible for the collection and analysis of mixed venous samples. VIII. EQUIPMENT AND SUPPLY MANAGEMENT The incumbent will ensure that:
Equipment is assembled in the manner recommended by the manufacturer. Ensures that all respiratory equipment is functioning properly and is being used in the appropriate manner. Work Schedule:
Monday - Friday 7:
30am - 4pm Financial Disclosure Report:
Not required 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. Registered Respiratory Therapist. Has a certificate as an RRT from the NBRC (National Board for Respiratory Care) and a registry number, or a certificate from another body which the NBRC recognizes as its credentialing equivalent. This includes registration based on either:
(1) Having fulfilled the requirements and passed the registry examination administered the NBRC since 1983, or (2) Having fulfilled the requirements and passed the registry examination for a registered inhalation or respiratory therapist administered by the (1) National Board for Respiratory Therapy from July 1974 through 1982 or (2) American Registry of Inhalation Therapists from 1961 through June 1974. Grade Determinations:
In addition to meeting the basic requirements stated above, the following qualifications criteria must be met in determining the appropriate grade assignment of candidates. GS-8. Candidates must have all of the following:
At least 1 year of successful experience related to respiratory therapy at the GS-7 level or equivalent. Qualifying experience at this level is work which includes duties such as:
administering assisted and controlled ventilation to patients with tracheotomies and other complex medical problems requiring frequent adjustments in ventilator parameters; administering and monitoring advanced ventilator techniques such as positive end expiratory pressure and continuous positive airway pressure; developing plans for weaning patients from ventilators; assessing the respiratory status of patients using data acquired through physical observation and clinical analysis of blood gas data, chest x-rays, and electrocardiogram to determine the effectiveness of therapy being administered and to make recommendations to physicians regarding changes in treatment; performing the most difficult respiratory therapy procedures to maintain ventilation, including endotracheal intubation, tracheal lavage, and tracheotomy care; and providing in-service training to others in various specialized areas of respiratory care. Demonstrated knowledge and ability needed to perform complex respiratory procedures with minimal supervision. Is able to participate with physicians and nurses and other staff in planning respiratory treatment, with great reliance on the individual's knowledge of the equipment. Demonstrated knowledge and ability to provide emergency or critical respiratory care; service as a shift leader or supervisor or sole responsible respiratory therapist on a shift; and to plan and conduct training sessions with respiratory therapy students, hospital staff, patients, and family members. References:
VA HANDBOOK 5005 PART II APPENDIX G11 The full performance level of this vacancy is GS-8. Physical Requirements:
See VA Directive and Handbook 5019.
- Department:
0601 General Health Science - Salary Range:
$63,039 to $90,758 per year
Estimated Salary: $20 to $28 per hour based on qualifications.
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