Summary

VA Portland Health Care System is a Complexity Level 1a Facility and provides extensive primary - secondary - tertiary - and quaternary care in outpatient - inpatient - residential - and community settings. VAPORHCS is a multi-site medical system that includes a major medical facility in Portland - Oregon - outpatient and residential facilities in Vancouver - Washington - and 10 Community Based Outpatient Clinics.

Qualifications

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
• There are no specific educational requirements for this occupation
• Education may be substituted for experience only at the GS-4 and GS-5 levels
• See the grade requirements part of this standard for information regarding educational substitutions
• Licensure or Certification
• Licensure or Certification is not required for this occupation
• however - it is strongly desirable at GS-6 or above as evidence of possession of the essential knowledge - skills - and abilities
• For certain functional areas at the higher levels or supervisory assignments - specific certifications appropriate to the specialty are indicated in this standard under "Titles and Certification/Registrations"
• For all specialties identified in this standard - Basic and Advanced Cardiac Life Support certifications are desirable
• Training which does not result in official certification does not meet this definition
• May qualify based on being covered by the Grandfathering Provision as described in the VA Qualification Standard for this occupation (only applicable to current VHA employees who are in this occupation and meet the criteria)
• Grade Determinations: GS-6 (a) Experience
• At least 1 year of experience comparable to the next lower grade level which demonstrates the knowledge - skills - abilities - and other characteristics related to the duties of the positions to be filled
• In addition - the candidate must demonstrate the following KSAs: (b) Demonstrated Knowledge - Skills - and Abilities 1
• Skill in setting up - operating - and performing calibrations as required on a variety of dialysis equipment
• 2
• Skill in performing and interpreting test results (dialysate chemistries - water treatment testing for contaminates - etc.) including the ability to analyze deviations from the expected norm and responding appropriately
• 3
• Knowledge of American Association of Medical Instrumentation (AMMI) standards and unit policies as they relate to water treatment
• 4
• Knowledge of physiological and psychological changes and conditions related to end stage renal disease
• 5
• Ability to calculate dialysis baths according to the physician's orders per patient by mixing critical concentrates - i.e. - calcium - potassium - and bicarbonate
• 6
• Knowledge of Basic Cardiac Life Support (BCLS)
• (c) Certification
• No certification is required
• however - it is desirable that employees at this level have BCLS (Basic Cardiac Life Support) certification
• (d) Assignment
• Hemodialysis Technicians at this level operate and monitor dialysis systems for chronic patients
• check patient condition and determine the proper treatment procedures - technique - and machine adjustments
• understand medical treatment for patients with renal failure
• administer prescribed medication and observe the patient for desired action or adverse reaction
• and recognize and react to signs and symptoms that signal the onset of complications of dialysis including hypotension - disequilibrium - seizures - and arrhythmias
• GS-7 (a) Experience
• At least 1 year of experience comparable to the next lower grade level which demonstrates the knowledge - skills - abilities - and other characteristics related to the duties of the positions to be filled
• This would be experience which provided knowledge the equipment - standard procedures - and typical machine problems and/or patient reactions to treatment
• In addition - the candidate must demonstrate the following KSAs (b) Demonstrated Knowledge - Skills - and Abilities 1
• Ability to assist the physician in more complex procedures such as central venous catheter insertion
• 2
• Ability to assist in training patients in home/self-care by teaching components of machine operation including water treatment and monitoring patients for compliance
• 3
• Ability to act as a mentor or preceptor to lower graded technicians
• 4
• Ability to analyze deviations from the expected - determine whether the deviations are machine or patient related - and respond according to the findings
• (c) Certification
• No certification is required
• however - it is desirable that employees at this level have BCLS (Basic Cardiac Life Support) and ACLS (Advanced Cardiac Life Support) certifications
• (d) Assignment
• At this level in addition to providing hemodialysis for chronic patients - hemodialysis technicians assist the physician during central venous catheter insertion - assist in the training of patients for home dialysis/self-care - and act as a mentor or preceptor to lower graded hemodialysis technicians
• At this level - the technician accepts responsibility and accountability for his/her own actions
• GS-8 (a) Experience
• At least 1 year of experience comparable to the next lower grade level which demonstrates the knowledge - skills - abilities - and other characteristics related to the duties of the positions to be filled
• This would be experience which provided knowledge of the more complex procedures - the pharmacology related to this occupation - and knowledge of related acute disorders and diseases and their effects on organs and methods of treatment
• In addition - the candidate must demonstrate the following KSAs: (b) Demonstrated Knowledge - Skills - and Abilities 1
• Knowledge of the hemodialysis process and equipment needed for home/self care including knowledge of common machine problems and repairs to such equipment
• 2
• Knowledge of the equipment and procedures for peritoneal dialysis
• 3
• Ability to assist the physician with percutaneous renal biopsies and peritoneal catheter insertion
• 4
• Ability to provide instruction to dialysis patients in home/self care and in the maintenance of the equipment
• 5
• Ability to provide instruction for physicians - nurses - and other personnel in dialysis procedures - equipment operation and maintenance - etc
• (c) Certification
• No certification is required
• however - it is desirable that employees at this level have BCLS (Basic Cardiac Life Support) and ACLS (Advanced Cardiac Life Support) certifications (d) Assignment
• This represents the full performance level
• At this level the hemodialysis technician serves as a member of a dialysis team performing dialysis on acutely ill patients including those within an intensive care setting
• Assignments involve performing both peritoneal and hemodialysis procedures
• The dialysis technician may participate in percutaneous renal biopsies - watching the patient during the procedure and properly processing the specimen
• Assists the physician in peritoneal catheter insertions and observes the patient for vital signs and provides post operative care
• Provides instruction and monitors patients for home dialysis
• Performs training of physicians - nurses - and technicians on hemodialysis and peritoneal dialysis techniques
• Preferred Experience: Prefer 2-3 Years outpatient experience - and more than 1 year of Inpatient experience
• References: VA HANDBOOK 5005/15 PART II APPENDIX G27 The full performance level of this vacancy is GS-8. The actual grade at which an applicant may be selected for this vacancy is in the range of GS-6 to GS-8. Physical Requirements: See VA Directive and Handbook 5019.

Duties

• The duties of this position include but are not limited to the following: The Medical Instrument Technician (MIT) performs invasive hemodialysis procedures utilizing highly - complex technical monitoring equipment under the direction or prescription of a qualified physician
• These procedures are performed upon patients who have diagnoses of End Stage Renal Failure - Acute Renal Failure - and Chronic Renal Failure
• The incumbent is proficient in the use of physiologic analytical equipment during diagnostic and therapeutic procedures in the Hemodialysis Unit
• They maintain current certification in Hemodialysis (CCHT - BONNET)
• They have specialized knowledge of anatomy - physiology - biological systems - and complex hemodialysis equipment
• The highly complex monitoring equipment requires calibration and collection of data related to physiologic changes during the procedure - and will require collection on a varying basis
• The patient populations treated are at a high risk for cardiopulmonary arrest and the technologist must be competent to assist with the rescue during these events
• Staff designated as Intermittent will provide a minimum of one (1) shift of availability per pay period to management in advance upon request
• Scheduling and confirmation of work schedule - shifts - and hours will be based on needs of agency
• The MIT will have knowledge of hemodialysis process and equipment
• The MIT performs the full range of complex hemodialysis treatments - which include Standard - Hi/Lo efficiency and Hi- Flux Dialysis methodology utilizing high tech hemodialysis filtration systems
• The technologist is proficient in accessing vascular systems on patients in order to initiate the treatment regimen
• The technologist has a thorough understanding of dialysate concentrates used in hemodialysis and is aware of the absolute exactness that is required in the delivery of the product to the patient
• The technologist independently performs computerized ultrasonic scans of vascular flow to determine possible stenosis and obstructive disorders
• The technologist understands all the critical alarms that are included on the hemodialysis equipment and responds appropriately
• As an active member of the healthcare team - the technologist recognizes abnormal or life-threatening changes in the patient's condition and notifies the RN or MD for immediate attention
• The MIT establishes access either through dialysis catheter - graft or fistula and monitors the patient throughout the hemodialysis treatment
• The technologist uses specialized equipment that requires precise adjustments to respond to individual patient conditions or test sequences
• The technologist determines technical factors - sets controls and operates complex hemodialysis equipment - instrumentation and reprocessing equipment
• The MIT must have knowledge and skill to perform diagnostic testing procedures with multiple measurement packages including ultrasound for graft flow
• Monitors reverse osmosis (RO) readings and tests the resulting water knowing it falls within American Association of Medical Instrumentation (AAMI) standards
• Maintains an organized system of documentation containing records of equipment calibration - maintenance and repair - water treatment logs - reuse calibration records and log sheets - and other documentation as required
• Maintains records such as a daily log of patients - medical devices used - and other statistical reports related to the care delivered within the unit
• Maintains records of patients treated - examinations performed - scans taken - procedure time - etc
• Utilizes computerized documentation for recording information or results
• Work Schedule: Days between Monday-Saturday Hours range between 5:30am-10:00pm Telework: Not Available Virtual: This is not a virtual position
• Relocation/Recruitment Incentives: Not Authorized Permanent Change of Station (PCS): Not Authorized PCS Appraised Value Offer (AVO): Not Authorized