Nurse (Operating Room)

Overview

 

Nurse (Operating Room), Joint Base Lewis-McChord, WA (Madigan)

Joint Base Lewis-McChord, WA

Joint Base Lewis-McChord, its affiliated clinics and dental clinic are located at Fort Lewis, Washington, near the city of Tacoma. Madigan AMC is one of only three designated Level Two trauma centers within the U.S. Medical Command.

 

 

Tacoma is a progressive city of 200,000 nestled between Seattle and the state capital of Olympia. The region offers the attractions of larger metropolitan areas, with a hometown feel. World-class museums, hotels and theaters draw thousands to downtown Tacoma while the shores of the Puget Sound and Mount Rainier inspire outdoor enthusiasts. The Broadway Center for the Performing Arts, Chihuly Bridge of Glass, Emerald Downs Racetrack, Emerald Queen Casino, Fort Nisqually Living History Museum, Lakewold Gardens, and the Mount Rainier Scenic Railroad represent a small sampling of the region's varied entertainment options. The city offers excellent schools, universities, parks, festivals and regional shopping centers.Tacoma-Pierce County Chamber of CommerceMadigan Army Medical CenterJoint Base Lewis McChord

Responsibilities

Major Duties:

 

Incumbent serves as an Operating Room Nurse providing perioperative nursing care in a multi-service operating room providing a full range of surgical nursing services supporting complex and extensive surgical procedures. Intra-operatively manages nursing care of patients of all ages undergoing major surgical procedures of various types such as dental rehabilitation, cesarean childbirth, general, gynecological, orthopedic, neurological, genitor-urology, ophthalmology, plastic and reconstructive, podiatry, thoracic, vascular, and ears, nose and throat. Patients range in age from pediatric to geriatric and civilian traumas at select locations or specific circumstances. Performs duties in support of all phases of perioperative care (e.g., preoperative care, intraoperative, and Post Anesthesia Care Unit - PACU) and sterile processing.

 

1. Performs circulating roles of a perioperative nurse. Ensures sterile technique and anticipates the surgical team’s needs. Collaborates with surgeons in one or more surgical services to assess, coordinate, plan, and implement the newest approaches and practices to deliver efficient, cost-effective surgical care for the beneficiary population. May circulate or scrub to support surgical cases. Coordinates with physicians and other staff, preoperatively, to develop a multi-disciplinary, intra-operative plan of care. Responsible for aseptic technique during the preparation for and duration of the operative procedure, accuracy of sponge, instrument and needle counts and adequacy of supplies. Opens all sterile packs and supplies, according to aseptic technique. Notes and responds to breaches of standard procedures that compromise the patient or staff members. Reviews and edits surgeon's preference cards for desired medications, equipment, and surgical supplies. Sets up, uses, reprocesses, and maintains all unit/department-specific equipment. Monitors and utilizes simple and highly technical equipment, such as lasers, electrosurgical generators, sterilization equipment, video towers, operative microscopes, endoscopes, multiple complex surgical instruments and drills, implants, positioning devices, insufflators, and robotic equipment. Ensures equipment is working properly, preoperatively, and throughout surgical procedures. Monitors all operative processes; anesthesia, surgery, sterile technique, equipment functioning, and patient responses. Initiates and intervenes with immediate corrective action. Responsible for process improvement and risk management in the clinical areas. Engages in evidence-based practice, quality improvement, and process improvement projects.

Conducts initial perioperative assessment, acquiring pertinent information, such as allergies, NPO status, and consent. Implements individualized nursing care plans to include safety precautions, correct positioning, infection control precautions, aseptic and/or sterile practices, dispensing and/or administering medications. Logs out and prepares controlled drugs and administers to the patient as prescribed. Utilizes the perioperative nursing process to identify patient problems and generate a nursing diagnosis. Implements individualized nursing care plans to include safety precautions, correct positioning, infection control precautions, aseptic and/or sterile practices, dispensing and/or administering medications. Logs out and prepares controlled drugs and administers to the patient as prescribed. Documents patient's status, on a continual basis, and revises plan of care as needed. Prepares nursing notes indicating medications given, prosthesis used, patient positioning, draping and padding of pressure points. Maintains medical record, keeping a log of implants, devices, instructions, and product information.

 

Responds to the needs of the surgeon, anesthesia provider, and patient during each surgical procedure. Assists physician with examination, as well as treatment prior to, during, and following invasive procedures. Assists with patient positioning for surgical procedures. Assures patient is free from skin injury and burns. Assists anesthesia providers with administering local, regional, and general anesthesia as well as assisting with the insertion of invasive monitoring lines. Assists the anesthesia team with induction and extubation. Communicates progress and/or changes to the patient, family, and members of the health care team, throughout surgical procedures. Provides oversight of sedated patients prior, during, and post-procedures. Initiates emergency measures, as appropriate. Assists during codes and emergencies. Promptly reports abnormal assessments, or changes in patient’s status, to the anesthesiologist and surgeon. Administers topical, intravenous, and intraoperative medications. Schedules and manages post-procedure cases, as required. Incumbent may perform all, or one or more functions, involving preoperative, intraoperative, or postoperative duties, as directed.

Preoperatively provides for psychological and physical needs of patient. Provides for the physical needs of the patient to include helping to transport, lift, move and position the patient. Provides information and patient/family teaching about disease processes, pre-a and post-operative care, and surgical procedures. Before entering the surgery or pre-op areas, nurse talks to patient and answers any final questions prior to surgery and ensures the patient understands the procedure and has signed all the appropriate consent forms. 

 

2. Provides direction and on-the-job training to military and civilian personnel, para- professionals, medical students, residents, and other healthcare professionals. Orients and welcomesinterdisciplinary staff members. Serves as role model, preceptor, and teacher for personnel. Acts as patient education facilitator, providing individual and family teaching/counseling. Influence policy and procedural documents in accordance with national standards, best practices, and emerging evidence. Identifies, implements and/or monitors quality, process, and evidence-based practice improvements. Delegates duties and tasks to others, following assessment of patient needs and capabilities, and determines the scope of responsibilities, with awareness of staff members skills and abilities.

Operates and assists in the care and handling of a variety of supplies and highly specialized equipment to include pneumatic and electric saws and drills, electrosurgical units, cavitron, fiberoptic lighting systems, etc. Ensures electrical equipment is properly grounded; and that equipment is dissembled, cleaned, oiled, if necessary, reassembled, sterilized, and stored correctly. Maintains specialty materials, supplies, and equipment and communicates adequate levels to meet the surgery schedule demand. Coordinates care, handling, assembly and sterilization of instruments. Arranges with vendors for equipment demonstrations and training programs on new equipment. 

 

3. As required, functions as charge nurse of a particular shift, assuming the responsibility for promoting quality, cost-effective nursing care, within the framework of the medical treatment facility (MTF) philosophy and mission objectives. Within that function, incumbent is delegated authority and as the responsibility to implement, coordinate, and direct nursing care for assigned shift. Identifies, distributes, and balances workload and tasks among personnel, based on their competency level and experience; makes adjustments to assignments to ensure timely accomplishment of tasks and procedures. Monitors and reports on status and progress of work, reviews completed work to ensure supervisor's instructions on work priorities, methods, quality, and deadlines have been met. Resolves simple, informal complaints of employees, patients, and other interdisciplinary team members, and refers unusual issues to supervisor or appropriate management person. Completes all training requirements designated by facility, supervisor, or accrediting agencies; participates in continuing education programs to update and/or maintain skills and knowledge to meet licensing requirements. 

 

Performs other duties as assigned.

Qualifications

Who May Apply: US CitizensIn order to qualify, you must meet the education and/or 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 Nurse (Clinical/Operating Room):Degree: A graduate or higher level degree, bachelor's degree, associate degree, or diploma from an accredited professional nursing educational program is required. This education must have been accredited by the Commission on Collegiate Nursing Education (Note: You must attach a copy of your transcripts.)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.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.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.In addition to meeting the basic requirement above, to qualify for this position you must also meet the qualification requirements listed below:Education/Experience: A diploma, associate degree, or bachelor's degree in Nursing from a professional nursing program and possession of at least one full year of professional nursing experienceOREducation: A PhD or equivalent doctoral degree from a professional nursing educational program or related medical science field.EXEMPTION: You are exempt from the qualification 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 one of the requirement below. Note: You will be required to provide appropriate documentation to the respective Human Resources Office to validate your status.Completion of all requirements for a doctoral degree (Ph.D. or equivalent) from a professional nursing programOR3 full years of progressively higher level graduate education from a professional nursing program