Madigan Army Medical Center is seeking Perioperative RNs to join our growing team! 

The facility is one of four Level II Trauma Centers in Washington State and participates in unique partnerships with civilian facilities to provide care to non-beneficiary trauma victims beyond the gates of Joint Base Lewis-McChord.

At Madigan you will practice alongside civilian and military health care experts and experience unique professional opportunities. Our staff serves by caring for our military but are not subject to military requirements. We operate within safe staffing standards - giving you time to provide exceptional care. 

Located in the beautiful Pacific Northwest on the Puget Sound, in Washington State, Joint Base Lewis-McChord (JBLM) is near the city of Lakewood, 10 minutes from Tacoma and 20 minutes from Olympia, the state capitol. JBLM is situated in a key location along Interstate 5, allowing easy access to Seattle, Tacoma, and the welcoming neighboring communities. Although the Army and Air Force missions have changed over the years, one thing has not changed—the natural setting of the base. Majestic Mount Rainier looms on the horizon, towering over the other peaks of the Cascade Range. From the mountains to the deep waters of Puget Sound and the Pacific Ocean, the local areas abound in natural beauty and outdoor recreation opportunities. Camping, hunting, fishing, hiking, boating and new sports are a way of life in Washington State.

Working for the Department of Defense comes with an abundance of benefits and perks to include competitive compensation packages, paid-time off, medical benefits, student loan repayments, and retirement package with Thrift Savings Plan to include matching employer contributions. For more information, please visit the following link: https://www.usajobs.gov/Help/working-in-government/benefits/

MAJOR DUTIES:

The functions of the Perioperative Nursing Service, Department of Anesthesia and Operative Services, are to provide professional and paraprofessional perioperative care of patients undergoing surgical procedures ranging from routine to high acuity or trauma cases with highly complex surgical care requirements; and to coordinate requirements in fourteen surgical specialties. The purpose of this position is to serve as an expert/resource advisor in one or more surgical specialties: and to perform perioperative nurse functions in a level two-trauma hospital.

1. Provides specialized perioperative care to patients undergoing procedures ranging from highly complex, high acuity (cardio thoracic, orthopedic, neurosurgical) or trauma (knife wounds, gunshots) surgery to routine (appendectomy, hysterectomy) procedures. Cases often involve referrals of patients from Air Force, Navy and Army medical facilities not equipped to perform complicated surgery such as re-do of coronary by-pass graft procedures, complicated open heart procedures, and craniotomy procedures for unusual tumors. The employee regularly encounters patients classed as the "sickest of the sick;" i.e., those not expected to survive 24 hours with or without surgery. The duties encompass preoperative, intraoperative and postoperative phases.
Preoperative: Assesses patient's physiological, psychosocial status to formulate a data base (nursing care plan) to include preparing goals based upon nursing diagnosis, and develop patient outcomes. Provides information on disease process and surgical procedure, teaches pre and post operative care, health maintenance and illness prevention to patient and significant other, Refers patient/family to allied health care providers such as social worker, chaplain, etc. Intraoperative: Manages care of patients for a wide range of procedures of an advanced nature and difficulty, where there is high susceptibility to infection and bodily functions are mechanically assisted by life support equipment. Performs duty as circulator and, if required, those of a scrub person during surgical procedures. Takes counts (needle, sponge etc.), labels, handles and assures proper disposition of surgical specimens. Completes perioperative documentation. Monitors numerous and complex equipment such as lasers, computerized monitoring devices, stereotactic equipment, cardiac monitor, ultra sonic tumor aspirator, etc. Monitors all ongoing processes - anesthesia, surgery, aseptic technique, equipment functions, patient response and initiates/intervenes with immediate corrective action. Responsible for quality assurance/risk management; notes and responds to breaches of standard procedures which compromise the patient or staff members. Implements individualized nursing plans to include safety precautions, correct positioning, infection control precautions, aseptic practices, qualified personnel assignments, medications, supplies, equipment, etc. Assesses progress of surgical procedures and patient responses through sophisticated clinical observations and detailed data analysis. Makes independent perioperative nursing judgments and appropriate revisions in the care plan based on moment-to-moment changes in the patient's condition and responses. Implements crisis intervention techniques to provide support to the family. Assists surgeons with complex or potentially life-threatening procedures and assists anesthesiologists with insertion of invasive lines. Maintains lines and dressings in accordance with infection control practices. Plans the integrated continuity of care, working in collaboration with other health care providers (surgeon, anesthesiologist, radiologist, pathologist, etc.) to determine and meet patient needs. Independently establishes surgical nursing protocols and coordinates activities of all team members. Postoperative: Briefs post anesthesia/SICU nursing staff on perioperative nursing orders and other pertinent data such as surgical procedures) performed, patient problems, nursing diagnosis and actions, patient response, specialized care and equipment required to support the patient, etc. Conducts postoperative nursing assessment immediately following and within 48 hours after surgery to determine validity of nursing care plan, outcomes, and long-range patient goals.

2. Serves as project officer/unit coordinator for 1-2 surgical specialties. Serves as unit coordinator for selected committees such as Quality Assurance, Infection Control, Inservice, etc. Serves as Charge Nurse in absence of Head Nurse, overseeing 2-30 personnel. Rotates as Charge Nurse on evening, night, weekend, and holiday tour of duty. May serve as Floor Coordinator, responsible for the entire operative suite, assignment of personnel, surgery changes for that day and the preparation of next day's surgery schedule.

3. Serves as a nurse specialist in 1-2 surgical specialties, advising, and providing consultation to Chief, Operating Room Nursing Section, Head Nurses of both operating rooms and experienced as well as inexperienced perioperative nurses and other health care providers. As the recognized expert in the specialty, is consulted whenever difficult or unusual problems arise. Predominantly assigned to the high acuity, sickest of the sick, or trauma patients. Plans, develops and initiates innovative therapies /protocols (e.g., standardization of emergency craniotomy procedures; patent ductus arteriosus protocol for operating room and neonatal intensive care staff; organ harvest protocol for multidisciplinary teams coming from hospitals throughout the United States). Maintains adequate and functional supplies and equipment for that service, revising instrument sets and procedure specific surgeon preference cards, offering related in-service programs and functioning as the liaison between the operating room head nurse and surgeons of that specific service.

4. Recommends procurement of medical care and support equipment MEDCASE, a hospital-wide five-year plan for items over $25,000) as well as capital expense equipment (CEEP items $2,500-$25,000). As the budget, supply, and equipment manager for the specialty, researches, evaluates, and conducts cost studies of products. Contacts vendors, technical representatives, appropriate logistics personnel, nurse experts in other medical centers who are using the item(s), arranges for loaner equipment and supplies to evaluate; drafts detailed documents and justification for ordering. Evaluates daily supply needs, consumption, updates supply lists, establishes quality controls to check outdated supplies, considers alternate materials or cost savings measures to control cost and waste.

5. Participates in research projects involving new surgical procedures or new technologies.

6. Serves as preceptor/instructor for newly assigned graduate nurses, BSN students from local colleges, nurses from the Army's operating Room Nurse Reserve Course, reservists, etc. Teaches medical students, interns, and residents principles of scrubbing, gowning, gloving, surgical site prepping, the use of multidisciplinary high tech equipment, etc. Provides guidance, orientation, on-the-job training, and leadership to other professional perioperative nurses and to paraprofessional personnel. Training is provided while incumbent is performing critical perioperative duties. Responsible tar ensuring all nurses and technicians in the section are thoroughly familiar in scrubbing and circulating on all types of surgery performed. Includes teaching the reason for use, and function of simple as well as highly complex and potentially dangerous instruments and equipment. Instructs patients pre/postoperatively. Develops lesson plans and presents continuing education classes for staff members. Develops and presents formal classes for the postgraduate Operating Room Nurse Resident Course in the specialty assigned. Provides feedback both orally and in writing to students and submits performance reports to course directors.

Performs other duties as assigned.