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Registered Nurse - Chief Nurse Of Acute Inpatient Operations (Cnaio)

Veterans Health Administration | Fresno, CA

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Posted Date 3/28/2025
Description The Chief Nurse of Acute Inpatient Operations (CNAIO) provides assistance to the Deputy Associate Director Patient Care Services/Deputy Nurse Executive (DADPCS/DNE) in guiding the overall management of the practice of nursing and the profession of nursing within VA Central California Health Care System (VACCHCS).VA offers a comprehensive total rewards package: VA Nurse Total Rewards

Pay: Competitive salary, regular salary increases, potential for performance awards
Paid Time Off: 50 days of paid time off per year (26 days of annual leave, 13 days of sick leave, 11 paid Federal holidays per year)
Retirement: Traditional federal pension (5 years vesting) and federal 401K with up to 5% in contributions by VA
Insurance: Federal health/vision/dental/term life/long-term care (many federal insurance programs can be carried into retirement)
Licensure: 1 full and unrestricted license from any US State or territory

Work Schedule: 0800-1630 M-F
Compressed/Flexible: N
Telework: Not eligible
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

The CNAIO is accountable for the clinical and administrative management of nursing practice within the assigned units/areas of responsibility at the VA Central California Care System (VACCHCS). The CNAIO collaborates with the Deputy Associate Director Patient Care Services/Deputy Nurse Executive (DADPCS/DNE) and with the Associate Director Patient Care Services/Nurse Executive (ADPCS/NE) on professional nursing issues and serves as an administrative resource for patient care activities, personnel management, organizational issues, and policy interpretation. Leadership of these diverse areas requires significant planning and decision-making skills in managing resources, guiding multiple staff and professionals, initiating performance improvement actions, facilitating communication across organizational boundaries, and participating in setting and achieving the VACCHCS and VISN 21 goals.

Major duties and responsibilities include, but are not limited to:
  • Assesses, plans, and evaluates the processes and daily operations, collaborating with the Deputy ADPCS/DNE to design and implement interdisciplinary programs within the service and health care system that support the overall operations of patient care.
  • Provides administrative oversight for areas of responsibility, and covers other areas as assigned/delegated.
  • Responds to internal and external communications, maintaining knowledge of and communicating standards of nursing practice and patient care, and developing systems to enhance overall operations and communications within the service.
  • Reviews reports routinely, performance measures, and other data for trends and early intervention; formulates follow-up plans with the service and other services as necessary.
  • Utilizes SIM tools in improvement efforts and has visual management presence in work area for tier checking and leaders standard work.
  • Provides leadership and direct supervision to the Nurse Leaders under Inpatient Operations.
  • Responsible for assessing and recommending the allocation of human and material resources, in determining staffing levels using NHPPD or other models, managing overtime, and plays a significant role in the recruitment and retention of nursing staff. Develops management leader standard work and standard operating procedures.
  • Ensures processes are in place for continued accreditation readiness and participate in environment of care rounds to survey nursing units.
  • Visible member of the Nursing leadership team.
  • Prepares recurring professional reports. Works towards achievement of high quality, safety, and cost- effective evidence-based outcomes on a continual journey of a high reliability organization. Collaborates with both administrative and clinical services to monitor quality and safety within the service and Health Care system.
  • Applies clinical performance improvement methods, collects outcome data related to policy, procedure, and regulatory compliance and in collaboration with other leaders, initiates performance improvement monitoring projects.
  • Utilizes data and comparative analytical processes in recommending design and implementation of innovative programs to improve service excellence, customer satisfaction, and compliance to patient care and regulatory standards.
  • Perform responsibilities as described in the facility Green Environmental Management System (GEMS) program as they apply to relevant environmental statutes, regulations, and Executive Orders.
Basic Requirements:
  • English Language Proficiency. In accordance with 38 U.S.C. 7403(f), no person shall serve in direct patient care positions unless they are proficient in basic written and spoken English.
  • Graduate of a school of professional nursing approved by the appropriate accrediting agency and accredited by one of the following accrediting bodies at the time the program was completed by the applicant: The Accreditation Commission for Education in Nursing (ACEN) or The Commission on Collegiate Nursing Education (CCNE); OR Individuals attending a master's level bridge program in nursing who have completed coursework equivalent to a bachelor's level degree in Nursing may have opportunity to become registered as a nurse with a state licensing board prior to completion of the bridge program. Upon achievement of a State license, the individual may be appointed on temporary basis and later converted to a permanent appointment upon successful completion and graduation from the bridge program. (Reference VA Handbook 5005, Appendix G6); OR In cases of graduates of foreign schools of professional nursing, possession of a current, full, active, and unrestricted registration will meet the requirement for graduation from an approved school of professional nursing to warrant an appointment as a Nurse who has completed an associated degree/entry level Nursing education program. Credit for foreign nursing education higher that associate degree/entry level requires a formal degree equivalency validation from a recognized equivalency evaluation accepted by VA such as International Consultants of Delaware (ICD).
  • Current, full, active, and unrestricted registration as a graduate professional nurse in a State, Territory or Commonwealth (i.e., Puerto Rico) of the United States, or the District of Columbia. Graduate Nurse Technician (GNT) Exception: Candidates who otherwise meet the basic education requirements, but do not possess the required licensure, may be appointed at the entry step of the grade and level applicable to the completed nursing education as a GNT on a 120-day temporary appointment while actively pursuing licensure (may be extended up to two years on a case-by-case-basis.)
NOTE: Grandfathering Provision - All persons currently employed in VHA in 0610 series and performing the duties as described in the qualification standard on the effective date of the standard (1/29/2024) are considered to have met all qualification requirements for the grade held including positive education and licensure/certification.

The following Scope, Education and Dimension criteria must be met to qualify for Nurse IV:
  • Scope: Executes leadership that is characterized by substantial and continuous responsibility and accountability for population groups or integrated programs that cross service and/or discipline lines and influence organizational mission and health care.
  • Education: Master's degree in Nursing (MSN) and 4 years of professional nursing experience, one of which is specialized nursing experience equivalent to Nurse III and meets all dimension requirements for Nurse IV; OR Master's degree in a *related field with a BSN and 4 years of professional nursing experience, one of which is specialized nursing experience equivalent to Nurse III and meets all dimension requirements for Nurse IV; OR a Doctoral degree in nursing and 3 years of professional nursing experience, one of which is specialized nursing experience equivalent to Nurse III and meets all dimension requirements for Nurse IV; OR a Doctoral degree in a *related field with a BSN and 3 years of professional nursing experience, one of which is specialized nursing experience equivalent to Nurse III and meets all dimension requirements for Nurse IV. *Note: Foreign education programs/degrees are not creditable as related degrees.
  • Dimensions:
    • Leadership. Leads health care delivery by leveraging evidence-based practices, industry-leading research, and innovative care models. Drives a shared vision and successfully leads change to improve performance and attain measurable outcomes at the program or service level.
    • Business Acumen. Transforms health care by implementing new processes, technology, informatics, and data analytics using business models and fundamental concepts of resource management at the program or service level.
    • Inspiring an Industry-Leading Culture. Employs an industry leading, shared decision-making culture. Cultivates a diverse and inclusive workforce that serves Veterans, families and caregivers of all backgrounds and builds trust, cultural competencies and catalyzes dynamic teams at the program or service level.
    • Communication and Relationship Management. Directs the effective use of relationship management principles to achieve positive customer service experiences that are consistent with professional organizational values, beliefs and practices at the program or services level.
    • Professional and Social Responsibility. Operationalizes a culture of holistic care, health advocacy and health equity. Applies ethical principles in decision-making at the program or service level. Advances nursing knowledge through health science research and the translation and dissemination of evidence into practice to maximize the value to Veterans and the community.
Reference: For more information on this qualification standard, please visit https://www.va.gov/ohrm/QualificationStandards/.

Physical Requirements: This position requires visual acuity, keen hearing, clear distinctive speech, and manual dexterity. This position requires potentially extended periods of continued walking, standing, stooping, sitting, bending, pulling, and pushing. Transferring patients and objects may be required. The incumbent may be exposed to infected patients and contaminated materials and may be required to don protective clothing in isolation situations or operative/invasive procedures.

The incumbent may occasionally be exposed to patients who are combative secondary to delirium, dementia, or psychiatric disorders. The incumbent must be a mature, flexible, sensible individual capable of working effectively in stressful situations, able to shift priorities based on patient needs. Must complete annual Employee Health requirements, such as annual TB screening or testing, as a condition of employment.IMPORTANT: A transcript must be submitted with your application if you are basing all or part of your qualifications on education.

Note: Only education or degrees recognized by the U.S. Department of Education from accredited colleges, universities, schools, or institutions may be used to qualify for Federal employment. You can verify your education here: http://ope.ed.gov/accreditation/. If you are using foreign education to meet qualification requirements, you must send a Certificate of Foreign Equivalency with your transcript in order to receive credit for that education. For further information, visit: http://www.ed.gov/about/offices/list/ous/international/usnei/us/edlite-visitus-forrecog.html.
Salary135,598.00 - 180,335.00 Annual

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