Nursing/Physician Assistance Services #49110

Nursing/Physician Assistance Services, #49110
Occupational Family: Health and Human Services
Pay Band Range: 3 - 6

Concept of Work

This Career Group provides career tracks for licensed practical nurses, registered nurses, certified nurse practitioners, and physician assistants performing nursing and physician assistant care and treatment to patients. Employees perform responsibilities ranging from entry level to management and include those who provide direct nursing care, charge nurses, nursing consultants, clinical specialists, certified nurse practitioners, licensed physician assistants, and nursing supervisors, managers and directors. Licensure by the Virginia Board of Nursing or Medicine is required.

Roles Comprising This Group

These roles describe the collective characteristics of the work performed by employees in the Nursing/Physician Assistance Services Career Group. The roles define the typical career paths for employees who pursue careers as licensed practical nurses, registered nurses, certified nurse practitioners, and physician assistants.

Although all of these occupations are nurses or physician assistants, each warrants a separate career track. Each of these career paths requires different knowledge, skills, abilities, and licensure requirements and may not lead to the other for career progression. However, a role for each of these occupations represents different levels of work, or career progression. Career paths may exist within a single role, extend to other roles in this Career Group, or to roles in other occupationally related Career Groups.

PAY BAND	PRACTITIONER ROLES	ROLE CODE	MANAGEMENT ROLES	ROLE CODE
3	Licensed Practical Nurse	49111
4	Registered Nurse I	49112
5	Registered Nurse II Nurse Practitioner I Physician Assistant	49113	Registered Nurse Manager I	49115
6	Registered Nurse III Nurse Practitioner II	49114	Registered Nurse Manager II	49116

Role Descriptions

These roles are distinguished based upon the Compensable Factors of Complexity, Results, and Accountability and are used for position classification. These factors should be used for classification and compensation analysis. Recruitment and selection standards must be based on knowledge, skills, and abilities as indicated in the Employee Work Profile.

Licensed Practical Nurse

Code: 49111

Pay Band: 3

SOC: 29-2061*

The Licensed Practical Nurse role provides career tracks for licensed practical nurses performing duties ranging from entry level to first line supervision. Employees provide a variety of patient care activities such as administering medications, maintaining patient records, and assisting in the treatment and direct care of patients.

Licensed Practical Nurse

COMPLEXITY	The scope of services involves assisting in direct patient care. Applies knowledge of principles and practices of practical nursing and pharmacology acquired through formal education and training. Contacts are made with patients in the provision of practical nursing care.
RESULTS	Work impacts the quality of practical nursing care and patient comfort. Successful application of skills results in positive patient outcomes.
ACCOUNTABILITY	Receives guidance, direction and supervision from a R.N., nursing supervisor, manager, medical professional, or administrator. May take venipuncture specimens. Work requires some discretion and judgment and is clearly defined by the licensure regulations. May supervise or provide work direction to nursing aides or direct service staff.

Registered Nurse I

Code: 49112

Pay Band: 4

SOC: 29-1111*

The Registered Nurse I role provides career tracks for registered nurses performing responsibilities ranging from entry level to journey level. Employees’ responsibilities include providing professional nursing care and treatment to patients by conducting needs assessments, developing, implementing and evaluating treatment plans and providing patient care and education through case management.

Registered Nurse I

COMPLEXITY	Scope of services involves all aspects of professional nursing care. Applies knowledge of principles and practices of professional registered nursing care acquired through formal education and training. Contacts are made with patients, medical support staff, supervisory nurses and physicians in the provision of professional nursing care.
RESULTS	Work impacts the quality of patient care. Successful application of skills enhances positive medical outcomes.
ACCOUNTABILITY	Receives guidance and direction from a nursing supervisor, manager or medical professional or administrator. Develops total patient assessment, which requires considerable judgment and decision-making. Provides leadership to LPNs and other medical and direct service support staff. Work requires frequent use of discretion and judgment in patient assessment and case management.

These two roles provide a dual career track for nurses and physician assistants.

Registered Nurse II/Nurse Practitioner I/Physician Assistant	Code: 49113*	Pay Band: 5	SOC: 29-1111and 29-1071
Registered Nurse Manager I	Code: 49115	Pay Band: 5	SOC: 11-9111*

The Registered Nurse II/Nurse Practitioner I/Physician Assistant role provides career tracks for registered nurses, certified nurse practitioners, and physician assistants. The first career track is for registered nurses whose responsibilities range from advanced level focusing in a specialty area of nursing or research to having either charge or supervisory responsibilities. The second career track is for certified nurse practitioners performing entry level to journey level responsibilities that require an advanced level of nursing certification and license. The third career track is for physician assistants performing entry to advanced responsibilities that require training and license as a physician assistant.

Registered Nurse II (charge, supervisory, specialty area)

COMPLEXITY	Scope of work ranges from responsibility for a nursing specialty area, working supervisor to charge nurse. Contacts are made with patients, staff nurses, supervisory, manager level nurses, physicians and other program or management staff. Assignments range from increased clinical or administrative responsibility to supervision of registered nurses, LPNs or other medical support staff. May perform clinical research and study activities, develop research protocol, gather and analyze data and prepare abstracts for publication.
RESULTS	Work impacts the quality and effectiveness of patient care. Oversight of nursing services is significant. May serve as point of contact for a medical specialty area within a nursing program.
ACCOUNTABILITY	Responsible for mentoring and developing others. Responsible for guidance and/or supervision of nursing, medical and direct support staff. May assign staff, evaluate clinical and administrative issues, and evaluate performance. Judgment is exercised over issues of patient care and performance of staff.

Nurse Practitioner

COMPLEXITY	Applies knowledge acquired through formal education in an accredited program. May be designated according to field of specialization. Scope of work includes performing comprehensive physical examinations and preventive health measures, ordering and performing therapeutic and diagnostic procedures, and prescribing controlled substances and devices in accordance with current regulations. Contacts are made with patients in the provision of care and physicians for their consultation.
RESULTS	The availability and oversight of a physician may limit the severity of complications. Patients receive general health care services and treatment.
ACCOUNTABILITY	Interprets and evaluates diagnostic test results. Records physical findings. Develops and implements patient management plans; instructs and counsels patients regarding plans. Performs work with ready access to supervision and guidance from a physician. Refers complex cases beyond the scope of practice to a physician or specialist.

Physician Assistant

COMPLEXITY	Applies knowledge acquired through formal education in an accredited program. Scope of work includes performing comprehensive physical examinations, performing therapeutic procedures, administering and ordering diagnostic procedures, and prescribing controlled substances and devices in accordance with current regulations. Contacts are made with patients in the provision of care and physicians for their consultation.
RESULTS	The availability and oversight of a physician may limit the severity of complications. Patients receive general health care services and treatment.
ACCOUNTABILITY	Practice requires that the Board of Medicine be apprised of the supervising physician(s) and the way in which the Physician Assistant will be utilized. Develops and implements patient management plans; instructs and counsels patients regarding plans. Records physical findings. Interprets and evaluates diagnostic test results.

The Registered Nurse Manager I role provides career tracks for management-level registered nurses responsible for a component or multiple components of a nursing program. Responsibilities include leadership and management of nurses, programs, resources, and research programs.

Registered Nurse Manager I

COMPLEXITY	Applies knowledge of the principles of supervision, management, leadership, and administrative functions. Contacts are made with patients, staff nurses, supervisory nurses, physicians, and other clinical, program, or management staff concerning management of a nursing program.
RESULTS	Work impacts the quality and effectiveness of patient care. Impact on services is significant. Develops nursing unit objectives, policies and standards. Develops standards for patient care, delivery of services and training and development of staff.
ACCOUNTABILITY	Leads, supervises, and manages RNs and medical support staff. May assign staff, evaluate clinical and administrative issues, evaluate performance of patient care by staff, assist with budget preparation and management, and direct all nursing programs for a unit or program. Exercises judgment over issues of patient care, performance of staff, and utilization of resources.

These two roles provide a dual career track for nurses.

Registered Nurse III/Nurse Practitioner II	Code: 49114	Pay Band: 6	SOC: 29-1111*
Registered Nurse Manager II	Code: 49116	Pay Band: 6	SOC: 11-9111*

The Registered Nurse III/Nurse Practitioner II role provides career tracks for registered nurses and the certified nurse practitioners. The first career track is for registered nurses that provide expert nursing services or statewide nursing program consultation, typically for a medical specialty area. Some employees may require advanced education and/or certification as a Registered Clinical Nurse Specialist. The second career track is for certified nurse practitioners performing responsibilities that require an advanced level of certification and/or license as a Certified Nurse Practitioner.

Registered Nurse III (nursing consultation/clinical nurse specialist)

COMPLEXITY	Provides comprehensive services according to the specialized training received from an accredited program. Provides expert consultation on complex nursing issues. Contacts are made with patients, staff nurses, supervisory, manager level nurses, physicians and other program staff.
RESULTS	Work impacts the quality and effectiveness of patient care. Impact on services is significant.
ACCOUNTABILITY	Responsible for mentoring and developing others. Judgment is exercised over issues of nursing program consultation.

Nurse Practitioner II (certified nurse practitioner)

COMPLEXITY	Scope of work includes performing physical examinations and preventive health measures, ordering and performing diagnostic procedures, and prescribing controlled substances and devices in accordance with current regulations. Contacts are made with patients in the provision of care and more limited contact with physicians for their consultation.
RESULTS	The limited availability of physician oversight increases the consequence of error. Work significantly affects the health of patients due to higher level of independence.
ACCOUNTABILITY	Performs work under limited access to a physician or works in an environment where physician availability is typically limited. Works independently with minimal supervision providing diagnosis and treatment according to protocol.

Registered Nurse Manager II

The Registered Nurse Manager II role provides career tracks for nurses having management-level responsibilities for all aspects of a comprehensive nursing program.

Registered Nurse Manager II

COMPLEXITY	Scope of work involves providing direction to an agency nursing program. Work requires extensive knowledge of nursing management. Contacts are made with field practitioners, physicians, and other clinical, program, and management staff.
RESULTS	Work impacts the level and quality of nursing services, standards of nursing practice, and allocation of resources.
ACCOUNTABILITY	Ensures quality of nursing care. Develops goals, objectives, and standards of nursing. Directs subordinate nurse managers and supervisors. Determines overall direction of comprehensive nursing and health care programs and budgets.

*Statistical Reporting

This Career Group includes, but is not limited to, those in the following Standard Occupational Classifications:

11-9111	Medical & Health Services Managers
29-1111	Registered Nurses
29-2061	Licensed Practical & Licensed Vocational Nurses
29-1071	Physician Assistants

New Effective Date: 11/01/01

History

Previous class titles (listed by new role title).

Licensed Practical Nurse

CLASS CODE	CLASS TITLE	GRADE
44051	Practical Nurse A	6
44181	Corrections Nurse Technician	7
44052	Practical Nurse B	7
44053	Psychiatric Practical Nurse	7

Registered Nurse I

CLASS CODE	CLASS TITLE	GRADE
42011	Public Health Nurse	11
42141	Registered Nurse	11

Registered Nurse II/Nurse Practitioner I/Physician Assistant

CLASS CODE	CLASS TITLE	GRADE
42012	Public Health Nurse Senior	12
42142	Registered Nurse Clinician A	12
42021	Public Health Nurse Supervisor	13
42051	Certified Nurse Practitioner	14
44195	Physician’s Assistant - Category I	14

Registered Nurse III/Nurse Practitioner II

CLASS CODE	CLASS TITLE	GRADE
42061	Public Health Nurse Consultant	15
42052	Certified Nurse Practitioner Senior	15
42147	Registered Clinical Nurse Specialist	16

Registered Nurse Manager I

CLASS CODE	CLASS TITLE	GRADE
42143	Registered Nurse Clinician B	13
42022	Public Health Nurse Manager	14
42144	Registered Nurse Coordinator	14

Registered Nurse Manager II

CLASS CODE	CLASS TITLE	GRADE
42023	Public Health Nurse Manager Senior	15
42062	Public Health Nurse Coordinator	16
42145	Registered Nurse Manager A	16
42063	Public Health Nurse Director	17
28202	Nursing Board Executive Director	15
42146	Registered Nurse Manager B	17