Overview
The position Advanced Practice Nurse (Nurse Anesthetist) is located at Tripler Medical Center, Honolulu, HI.
About the Position: This position is located within Tripler Army Medical Center (TAMC) in the Directorate of Surgery Department of Obstetrics and Gynecology in Honolulu, Hawaii.
The Island of Oahu in Hawaii is often nicknamed (or translated as) "The Gathering Place". It is currently the most populated Hawaiian Island. The city of Honolulu is the largest city, state capital, and main deep water marine port for the State of Hawaii. As a jurisdictional unit, the entire island of Oahu is in Honolulu County, although as a place name, Honolulu occupies only a portion of the southeast end of the island. Well-known features found on Oahu include Waikiki, Pearl Harbor, Diamond Head, Hanauma, Kane’ohe Bay, Kailua Bay, North Shore, and the resort destination, Ko’Olina.
Oahu is also known for having the longest rain shower in history, which lasted for 200 consecutive days. Kāneʻohe Ranch reported 247 straight days with rain from August 27, 1993 to April 30, 1994. The average temperature in Oahu is around 70–85 °F (21–29 °C) and the island is the warmest in June through October. The weather during the winter is cooler, but still warm with an average temperature of 68–78 °F (20–26 °C).
Responsibilities
POSITION DUTIES:
Serves as a Nurse Anesthetist providing services for patients undergoing a wide variety of surgical operations. Participates in the pre-operative assessment of the surgical patient by reviewing the clinical chart and interviewing the patient in order to ascertain the physical status, and recommend the specific type of anesthesia. Administration of general anesthesia to induce the patient to the proper state of narcosis. Manages patient condition throughout surgery, which involves interpreting and utilizing data from a variety of monitoring devices and determining the need for and applying appropriate supportive therapy. Manages the post-anesthesia care of patients by reviewing clinical chart; conducting interviews to determine presence or absence of complications; and assuring continuity of care from surgery to recovery room. Maintains medical records and reports on assigned surgical patients. Participates in the selection, inventory; ordering, cleaning and maintenance of equipment and supplies necessary for anesthesia services. Maintains professional knowledge and proficiency in nursing through continuing education, staff meetings and workshops. This position is recognized as an essential medical emergency response team member who is trained in airway management and will respond to medical emergency to secure airway by intubation, control ventilation, obtain venous access for the delivery of life-saving medications and administer life-saving medications. Works collaboratively with the physician in management of selected complex medical problems. Provides full range of emergency services or crises intervention in the absence of the physician, including lifesaving emergency procedures in order to stabilize a patient. Works independently of Anesthesiologist. Considered licensed independent practitioner. In the absence of the Chief, Anesthesia Nursing Service and if the anesthetist is the most experienced anesthetist available, may serve as Acting Chief, Anesthesia Nursing Service, assuming all responsibilities commensurate with that position.
- 1. Determines appropriate techniques, drugs, and equipment for use in the administration of anesthesia to all patients undergoing any and all forms of surgical and/or diagnostic procedures. Administers anesthesia by inhalation, endotracheal intubation, intravenous, hypobaric and hyperbaric subarachnoid block, epidural block, axillary block, intravenous block, transtracheal and superior laryngeal block, local infiltration, and topical application. Induces anesthesia to proper levels and manages patient’s anesthetic care throughout surgery. Determines need for and administers parental fluids, including blood, and plasma. Sets up intravenous solutions and maintains proper flow rate. Performs invasive monitoring techniques and interprets the information obtained through the use of these monitors. Administers vasopressor and hypotensive drugs as required. Observes the patient during surgery for signs to accomplish and maintain the proper stage of anesthesia and to prevent overdose. Adjusts the level of administration of anesthetic agents and adjunctive drugs and utilizes proper methods to support patient's respiratory, circulatory, and renal functions. Gives immediate post anesthetic care to patients for the extent of time required to provide patent airway, adequate fluid volume and urinary output, and freedom from possibility of shock or other adverse reactions during transport to and stay in the recovery room. In emergency situations, when a physician is not present or immediately available, initiates appropriate measures, to include resuscitative measures during cardiac or respiratory arrest. Assumes responsibility for care, sanitation and inspection to ensure proper functioning of all equipment used.
- 2. Provides supervision and teaching to Student Registered Nurse Anesthetists (SRNA), residents in pulmonary fellowships, Emergency Medical Technicians in training, Family Practice Residents, ancillary workers and students in the field of anesthesia in both clinical and administrative areas. Plans and set up programs for weekly staff meetings, arranges for guest and consultant speakers for educational program. Delivers in-service and educational lectures, workshops, and case studies for the purpose of providing knowledge and skills to other CRNAS's, anesthesiology staff, nurses, and other health care professionals and paraprofessionals.
- 3. Interviews patients in order to evaluate their physical and mental conditions with respect to anesthesia, to determine and discuss type of anesthesia to be used, and to explain expected outcomes and possible anesthetic complications. Review patient's chart and recommends type of anesthesia. Consults with anesthesiologist on ASA III or greater and only when necessary on desired course of action when patient's physical or mental condition, history, and/or extenuating circumstances seem to be an extreme complicating factor.
- 4. Administers and evaluates actions of new drugs. Manages actions of new drugs once they are administered to patients. Reports results of new drugs to the anesthesiologist, Evaluates results obtained from methods of work and implements suggestions for change in related work. Implements results of new anesthesia methods and techniques after approved by anesthesiologist.
- 5. Participates in the development of anesthesia patient care audit processes. This involves reviewing anesthesia records for certain case types to determine the validity and correctness of procedures and methods used, for the purpose of elimination procedures which may be inefficient or potentially harmful and to establish the best methods and procedures for use in specific treatment categories. May participate in the review of the broader types of patient care processes as a member of the Service's audit committee. These retrospective audit processes are in accordance with guidelines set up by the Joint Commission on Accreditation of Hospitals, Responds to emergency situations requiring resuscitative care.
PERFORMS OTHER DUTIES AS ASSIGNED.
Qualifications
Who May Apply: US CitizensIn order to qualify, you must meet the education and experience requirements described below. Experience refers to paid and unpaid experience, including volunteer work done through National Service programs (e.g., Peace Corps, AmeriCorps) and other organizations (e.g., professional; philanthropic; religious; spiritual; community; student; social). You will receive credit for all qualifying experience, including volunteer experience. Your resume must clearly describe your relevant experience; if qualifying based on education, your transcripts will be required as part of your application. Additional information about transcripts is in this document.Basic Requirement for Advanced Practice Nurse (Nurse Anesthetist):Degree: A graduate or higher level degree from an accredited professional nursing educational program in Anesthesia is required. This education must have been accredited by the Commission on Collegiate Nursing Education, Council on Accreditation of Nurse Anesthesia Educational Programs, Accreditation Commission for Midwifery Education, or an accrediting body recognized by the U.S. Department of Education at the time the degree was obtained. (Note: You must attach a copy of your transcripts.).Foreign Degree: A degree from a Foreign Nursing School. Official certification from the Commission on Graduates of Foreign Nursing Schools is required for individuals who graduated from foreign nursing schools.Licensure: A current, active, full, and unrestricted license or registration as a professional nurse from a State, the District of Columbia, the Commonwealth of Puerto Rico, or a territory of the United States; and you must have passed the National Council Licensure Examination.Licensure: A current, active, full, and unrestricted license or registration as a professional nurse in the specialty of Anesthesia or related specialty from a State, the District of Columbia, the Commonwealth of Puerto Rico, or a territory of the United States.Exemption: You are exempt from the basic requirements above if you are a current federal employee occupying a position in the 0610 occupational series and have been continuously employed in this occupational series since September 27, 2017 or before. Applicants claiming this exemption must meet the requirement below. Note: You will be required to provide appropriate documentation to the respective Human Resources Office to validate your status.Degree or diploma from a professional nursing program approved by the legally designated State accrediting agency at the time the program was completed by the applicant.Active, current registration as a professional nurse in a State, District of Columbia, the Commonwealth of Puerto Rico, or a territory of the United States.
