This position is eligible for the Education Debt Reduction Program (EDRP), a student loan payment reimbursement program. You must meet specific individual eligibility requirements in accordance with VHA policy and submit your EDRP application within four months of appointment. Approval, award amount (up to $200,000) and eligibility period (one to five years) are determined by the VHA Education Loan Repayment Services program office after complete review of the EDRP application. To qualify for this position, applicants must meet all requirements within 30 days of the closing date of this announcement. Basic Requirements: Citizenship. Citizenship of the United States. (Non-citizens may be appointed when it is not possible to recruit qualified citizens in accordance with chapter 3, section A, paragraph 3g, this part.) 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. Hemodialysis Technicians operate and monitor kidney dialysis instruments to provide dialysis treatment to patients with kidney failure or to maintain patients with irreversible kidney disorders. The agencies that offer national certification are Nephrology Certification Commission (NNCC), Board of Nephrology Examiners, Inc., Nursing and Technology (BONENT), National Nephrology Certification Organization (NNCO), and the International Certification Commission for Clinical Engineering and Biomedical Technology (ICC) in conjunction with the United States Certification Commission (USCC). English Language Proficiency. Medical Instrument Technicians must be proficient in spoken and written English. 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: In addition to the basic requirements for employment, the criteria discussed in the Hemodialysis heading, or that defined in the appendices, must be met when determining the grade of candidates. GS-6: 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: 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). Certification. No certification is required; however, it is desirable that employees at this level have BCLS (Basic Cardiac Life Support) certification. GS-7: 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: 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. 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. GS-8: 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: 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. 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. Preferred Experience: Certified Clinical Hemodialysis Technician preferred. References: VA Handbook 5005/54, Part II, Appendix G27, June 7, 2012. 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: The work requires heavy lifting and carrying (over 45 pounds), straight pulling (up to 6 hours), pushing (up to 2 hours), reaching above the shoulder, use of fingers, walking (up to 6 hours), standing (up to 2 hours), repeated bending (up to 6 hours), the ability to distinguish basic colors, and hearing (aid permitted). Must be able to work with hands in water and be able to work closely with others. ["The Medical Instrument Technician (MIT) Hemodialysis is a specialized position which understands the principles of dialysis, as well as elements of treatment provided, and complications encountered. The MIT is able to recognize and react to signs and symptoms that signal the onset of complications of dialysis, take appropriate action, and report the complications to a dialysis nurse. The MIT assists staff physicians by carrying out a variety of clinical and supportive tasks under general supervision of the Hemodialysis Nurse Manager. The MIT works efficiently and carries full responsibility for the quality of work produced and the operation of highly specialized equipment and computer systems in the Hemodialysis Section. Some of the duties, roles, and responsibilities include: Explain the basics of the dialysis procedure to the patient as necessary. Take and record the patient's pre-dialysis weight, temperature, blood pressure, pulse rate, and respiration rate. Initiate and terminate dialysis by establishing and maintaining a circulatory access for therapy by inserting needles into AV fistulas and vein grafts. Verify good blood flow prior to dialysis treatment and adjust needle placement to allow for optimal blood flow rates. Assemble supplies and prepare equipment for each dialysis treatment. Inspect equipment settings including pressures, conductivity (proportion of chemicals to water), and temperature to ensure conformance to safety standards. Inspect venous and arterial pressures as registered on equipment to ensure pressures are within established limits. Calculate fluid removal or replacement to be achieved during dialysis procedure. Monitor patient for adverse reaction and hemodialysis machine for malfunction. Take and record the patient's post-dialysis weight, temperature, blood pressure, pulse rate, and respiration rate. Receive requests or instructions from the RN on stable, chronic renal failure patients, and independently carry out assignment under the supervision of an RN to perform hemodialysis using the appropriate dialyzer, treatment time, prescribed dialysate concentrate and machine settings. Any change in the dialysis prescription will be made after consultation with an RN. Recognize and react to signs and symptoms that signal the onset of disequilibrium, such as hypotension, low blood sugar, seizures, and arrhythmias. Perform a variety of personal care or nursing care activities as directed and supervised by the RN. This may include procedures to obtain diagnostic tests, such as, blood specimens, glucose testing, EKGs. Assist nurses and physicians during medical emergencies or at times when more intensive care is required. Document all tasks performed and data collected on the patient flow sheet. Service, inspect, test, evaluate, modify, maintain, and document dialysis equipment and systems using manufacturer's recommendations and VA policy and Procedures. Care for a variety of equipment including dialysis machines, reverse osmosis (RO), and water treatment instruments. Instruct staff in the safe use and care of dialysis equipment. Ensure maximum performance and safety through specialized application of electronics and mechanics. Understand the American Association of Medical Instrumentations (AMMI) Standards and monitor the RO for variation, adjust and document accordingly. Perform preventive maintenance and calibration of all dialysis equipment/systems to ensure device safety, proper operation, and diagnostic and/or therapeutic efficacy, using standard test equipment and industry standards (JCAHO, NFPA, UL, VA CSA, AAMI). Maintain maintenance records and machine repair. Respond to inspections for JCAHO and work closely with Biomed to ensure correct policy and procedures are being followed for dialysis equipment. Document all repair and inspection incidents as required by accrediting bodies (JCAHO, CAP). Mentor or precept lower grade technicians. Analyze deviations from the expected in dialysis patients and determine if they are machine or patient related, respond according to the findings. Provide instruction to home dialysis/self-care in the maintenance of the equipment. Monitor and instruct other dialysis technicians in the correct procedure and follow thru for water, dialysate, portable machines, and dialysis machine culturing as well as endotoxin testing. Accept responsibility and accountability for own actions, as well as serving as role model of lead technician responsibilities. Work Schedule: 10 Hour Rotating Shifts with every other weekend off, possible TODs: 0500-1530, 0630-1700, or 0900-1730 Telework: Not Available Virtual: This is not a virtual position Functional Statement #: 000000 Relocation/Recruitment Incentives: Not Authorized EDRP Authorized: Contact the VISN 20 EDRP Coordinators, Stacy Hermann or Taia Henderson @ V20CompensationTeam@va.gov Permanent Change of Station (PCS): Not Authorized Financial Disclosure Report: Not required"]

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