Physician Assistant/Surgical Critical Care

Summary

Join the VA St. Louis Health Care System's Surgery Service as a Surgical Critical Care Physician Assistant (PA) in the Surgical Intensive Care Unit (SICU). Practice to the full extent of your education, training, and certification while delivering advanced, evidence-based critical care to the nation's Veterans alongside an expert interdisciplinary surgical team.

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Duties

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The Surgical Critical Care Physician Assistant (PA) is a licensed practitioner with advanced education and national certification who provides evidence-based care for critically ill Veterans in the Surgical Intensive Care Unit (SICU). The PA functions within Surgery Service and practices to the full extent of their education, training, and clinical privileges, with prescriptive authority for an assigned patient panel or program.

• Advanced Assessment & Diagnosis
  • Performs comprehensive initial histories and physical examinations for SICU patients. Screens patients to determine needs for further health care and applies clinical judgment to manage complex, high-acuity surgical patients including those presenting with sepsis, multi-organ dysfunction, post-surgical complications, and trauma. Demonstrates critical thinking in assessing and managing complex clinical situations unique to the surgical ICU environment.
• Therapeutic Interventions
  • Initiates and manages complex critical care treatments including mechanical ventilation (invasive and non-invasive), weaning protocols, hemodynamic monitoring via arterial lines, central venous catheters, and Swan-Ganz catheters, and vasopressor titration. Supports peri-operative evaluation and care of patients requiring SICU-level services, including post-operative management of general surgery, vascular, thoracic, cardiac, ENT, orthopedic, and neurosurgical patients. Adjusts plans of care as needed to achieve optimal patient outcomes.
• Medication Management
  • Prescribes and adjusts medications based on critical care needs, including vasoactive agents, anti-arrhythmic agents, blood component therapy, and high-risk infusions, utilizing independent prescriptive authority including controlled substances.
• Diagnostic Test Ordering & Interpretation
  • Orders and interprets advanced diagnostic studies including laboratory tests, X-rays, electrocardiograms (EKGs), and other studies within scope of practice. Applies findings to guide clinical decision-making for critically ill surgical patients.
• Complex & Emergency Procedures
  • Independently performs credentialed procedures within the PA's scope of practice, including central line placement, arterial line placement, intubation, chest tube management, and lumbar puncture. Initiates emergency interventions for patients in life-threatening situations, including cardiopulmonary resuscitation (CPR) and defibrillation, life-threatening arrhythmia management, synchronized cardioversion, treatment of acute respiratory failure, life-threatening injury, and compartment syndromes (abdominal, thoracic, and extremity).
• Interdisciplinary Collaboration
  • Serves as a primary point of contact for patient care within the SICU. Collaborates with the surgical intensivist, admitting teams, nursing, pharmacy, respiratory therapy, and case management to coordinate individualized care plans. Participates in structured clinician-to-clinician hand-offs to ensure safe, high-quality care transitions.
• Performance & Quality Improvement
  • Participates in required Performance Improvement programs and engages in evidence-based practice and clinical practice guidelines to continuously improve care delivery. Participates in patient satisfaction surveys conducted under the auspices of the Surgical Care Line. Contributes to research support activities as directed, including clinical trials and evaluation of alternative health care delivery systems.
• Professional Development
  • Assumes responsibility for ongoing professional development by attending relevant training, regularly reviewing current literature, and meeting continuing education requirements to maintain competence and licensure. Participates actively in staff and section meetings to support educational development across the team.
• Patient & Family Education
  • Provides education and counseling to patients and families on preventive care, medical conditions, and prescribed treatments. Offers Veteran-informed care with sensitivity to TBI, PTSD, MST, substance use disorders, polytrauma, and combat-related injuries.
• Professionalism & Safety
  • Adheres to Life Safety Management, infection control, and emergency preparedness procedures. Follows universal precautions and isolation protocols. Maintains annual certification for applicable Reusable Medical Equipment (RME). Maintains accurate and timely documentation in the Electronic Health Record (EHR) in full compliance with VHA privacy policy requirements. Promotes a culture of safety by proactively identifying and reporting actual or potential patient safety events, near misses, and system flaws.

Work Schedule: Monday-Friday - Tour negotiable upon selection.

Requirements

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Conditions of employment

• All qualified candidates encouraged to apply. Open to U.S. Citizens but non-citizens may be appointed when it is not possible to recruit qualified citizens.
• All applicants tentatively selected for VA employment in a testing designated position are subject to urinalysis to screen for illegal drug use prior to appointment. Applicants who refuse to be tested will be denied employment with VA.
• Selective Service Registration is required for males born after 12/31/1959.
• Must be proficient in written and spoken English.
• Subject to background/security investigation.
• Selected applicants will be required to complete an online onboarding process. Acceptable form(s) of identification will be required to complete pre-employment requirements (https://www.uscis.gov/i-9-central/form-i-9-acceptable-documents). Effective May 7, 2025, driver's licenses or state-issued identification cards that are not REAL ID compliant cannot be utilized as an acceptable form of identification for employment.
• Must pass pre-employment physical examination.
• Participation in the seasonal influenza vaccination program is a requirement for all Department of Veterans Affairs Health Care Personnel (HCP).
• As a condition of employment for accepting this position, you will be required to serve a 2-year trial period during which we will evaluate your fitness and whether your continued employment advances the public interest. In determining if your employment advances the public interest, we may consider:

  - your performance and conduct;

  - the needs and interests of the agency;

  - whether your continued employment would advance organizational goals of the agency or the Government; and

  - whether your continued employment would advance the efficiency of the Federal service.

  Upon completion of your trial period, your employment will be terminated unless you receive certification, in writing, that your continued employment advances the public interest.

• Complete all application requirements detailed in the "Required Documents" section of this announcement.

Qualifications

Applicants pending the completion of educational or certification/licensure requirements may be referred and tentatively selected but may not be hired until all requirements are met.

Physician Assistant Basic Requirements

• Master's degree in any discipline or a bachelor's degree in any discipline with one year of experience as a Physician Assistant ~AND~
• Successfully passed the PA National Certifying Exam (PANCE) (or are you in the process to taking the exam) ~AND~
• Currently hold, or will hold, a full and unrestricted license to practice in a State, Territory, or Commonwealth of the United States or in the District of Columbia.

Preferred Experience: Candidates with the following experience are strongly encouraged to apply: 2+ years in a surgical, medical, or trauma ICU setting (SICU, MICU, CVICU, or similar); post-operative management of surgical subspecialty patients; mechanical ventilation and hemodynamic monitoring; procedural experience including central line and arterial line placement, intubation, chest tube management, and lumbar puncture; active DEA registration with controlled substance prescriptive authority; and familiarity with Veteran-specific considerations including TBI, PTSD, MST, polytrauma, and combat-related injuries.

Grade Determinations: Grades will be determined based upon resume review and finalized prior to Conditional Offer of employment.

Reference: For more information on this qualification standard, please visit https://www.va.gov/ohrm/QualificationStandards/.

The full performance level of this vacancy is 01. The actual grade at which an applicant may be selected for this vacancy is in the range of 01 to 03.

Physical Requirements: More information can be found in the VA Handbook 5019.

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: https://sites.ed.gov/international/recognition-of-foreign-qualifications/.

Additional information

This job opportunity announcement may be used to fill additional vacancies.

This position is in the Excepted Service and does not confer competitive status.

VA encourages persons with disabilities to apply. The health-related positions in VA are covered by Title 38, and are not covered by the Schedule A excepted appointment authority.

If you are unable to apply online or need an alternate method to submit documents, please reach out to the Agency Contact listed in this Job Opportunity Announcement.

Under the Fair Chance to Compete Act, the Department of Veterans Affairs prohibits requesting an applicant's criminal history prior to accepting a tentative job offer. For more information about the Act and the complaint process, visit Human Resources and Administration/Operations, Security, and Preparedness (HRA/OSP) at The Fair Chance Act.

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Candidates should be committed to improving the efficiency of the Federal government, passionate about the ideals of our American republic, and committed to upholding the rule of law and the United States Constitution.

Benefits

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A career with the U.S. government provides employees with a comprehensive benefits package. As a federal employee, you and your family will have access to a range of benefits that are designed to make your federal career very rewarding. Opens in a new windowLearn more about federal benefits.

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Eligibility for benefits depends on the type of position you hold and whether your position is full-time, part-time or intermittent. Contact the hiring agency for more information on the specific benefits offered.