NURSE (Clinical/Emergency)

Fort Leonard Wood, Missouri is home of the U.S. Army Maneuver Support Center of Excellence, Army Chemical, Biological, Radiological, and Nuclear School, Army Engineer School, and U.S. Army Military Police School.  Fort Leonard Wood trains and educates nearly 90 thousand troops a year.  Surprisingly, the Fort also trains Marines, Airmen, Sailors, Coast Guardsmen and international students from allied nations. With more than 22,000 military members and their families, Ft Leonard Wood provides us with a diverse and well skilled population.   

Fort Leonard Wood, situated in the heart of the Ozark Mountains, is a sportsman’s paradise with some of the most beautiful scenery, hosting many large lakes, rivers, streams, and forests ideal for fishing and hunting. Fort Leonard Wood covers more than 61,000 acres located in Pulaski County with a population of nearly 52,607.  Bordering the installation to the north are the towns of Waynesville and St. Robert, with an estimated combined population of 9,170.  The installation is situated between St Louis and Springfield, Missouri 1 ½ to 2 hours respectively. Also 30 minutes equidistant between Rolla and Lebanon along I-44. It is also a great place to raise a family along with a low cost of living. 

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

Serves as a clinical nurse in the Emergency Department providing a full range of professional nursing care and treatment to a wide variety of patients, from newborn to geriatrics in critical condition as a result of trauma, suicide attempt, cardiac arrest, respiratory distress, drug overdose, fall, etc. Provides continuous observation and monitoring and must intervene to prevent complications to restore hemodynamic stability within hospital and Emergency Medical Services (EMS) transport to higher care. Provides coordination and management of patient care to patients and families and within a continuum of care. Performs triage within the scope of practice. Delegates patient care activities as appropriate within a care management assignment. Functions within professional and hospital standards. (LPNs, Combat Medics and Paramedics work under the supervision of the Clinical Nurse)

1. Assist the physician in the performance of Advance Cardiac Life Support (ACLS), Advanced Trauma Life Support (ATLS), Pediatric Advanced Life Support (PALS) and other complex specialized procedures to include insertion of a chest drainage tube, tracheotomies, emergency thoracotomies, gastric lavage, initiating mechanical ventilation, lumbar puncture to restore normal physiological function or prevent deterioration of patient’s condition. Independently recognizes life threatening situations and acts to correct these. Administers oxygen, intravenous fluids, blood transfusions and all types of medications during emergent events to include intravenous, interosseous, subcutaneous, intramuscular, by mouth and rectal routes. Operates specialized medical equipment such as resuscitators, defibrillators, electrocardiographs, oxygen apparatus, portable ventilators, heating and cooling devices, intravenous pumps, rapid intravenous infusers, and infant servo- warmer. Implements physician orders and initiates a nursing plan of care for individual patients. Assesses patient status and documents appropriately. Keeps physicians informed of any changes or the need for additional treatment. Changes dressing, preps wounds, removes sutures, inserts urinary catheters, inserts oral and nasogastric tubes, and applies splints and dressings. Collects urinary, stool, sputum, genital, and blood specimens. Prepares specimens for lab and transport as required. Arranges transfers of patients to appropriate inpatient care areas upon release by the physician. Arranges the transfer of patients to higher levels of care. Accompanies critical patients as deemed by the physician to a higher level of care. Performs nursing skills within a ground ambulance. Trained as ACLS provider, holds primary responsibility for critical patients during transfers within the medical facility. 

2. As a Charge nurse in the Emergency Department, performs a variety of administrative duties and data collection as an extension of and in support of the Clinical Nurse Officer in Charge (CNOIC). Makes nursing care assignments to various skill levels of professionals and ancillary health care personnel. Monitors and oversees staff performance to ensure work is accomplished in an acceptable, safe, and timely manner. Ensures that patient’s responses to treatment and medical/surgical emergencies are appropriately documented. Verifies and annotates all physician orders written during tour of duty. Ensures that staff document legibly, accurately, and completely all nursing interventions in the patient record. Advises attending physicians of significant changes in patient condition on a timely manner. Responsible for narcotic accountability. Monitors and oversees staff during orientation/ preceptorship periods. Responsible for all nursing operations in the Emergency Department in the absence of the Clinical Head Nurse and assistant Head Nurse. Makes independent triage decisions based on assignment skills for all patients entering the Emergency Department. 

3. As a Triage Nurse, independently conducts patient assessment and assigns priority of care based on patient's presenting signs, symptoms, or clinical manifestations using established protocols as a guide. Administers medications, based on protocol, for certain conditions to prevent deterioration of patient's condition. Notifies provider immediately and takes appropriate emergency action for life-threatening conditions. As a Staff Nurse, makes independent triage decisions based on assessment and management skills for all ambulatory patients seen in the Emergency Department. Screens patient health history, complaints, medications, and identify health related conditions that may impact the patients’ health status. Screens patient lab data and notify physician of abnormal lab results. Performs point of use testing consisting of glucometer specimens and rapid strep, documents results and performs daily quality control testing. Ensures authorization for procedures has been appropriately completed and documented. Monitors patients or directs monitoring of patients during and after procedures. Coordinate patient referral to ancillary healthcare, Community Health, Dietary, and Social Work. Functions within the scope of practice for a Professional Registered Nurse, hospital regulations, and policies. Coordinates patient care activities. Manages clinic and patient records. Follows quality improvement and internal control for the ambulatory setting to include appraisals, chart audits, trend identification and reporting of corrective actions. Receives, investigates, and documents on the complaints pertaining to their shift in the Emergency Department. Knowledgeable and able to speak in an informed manner on topics regarding sexual assault and care of sexual assault patients. Familiar with Sexual Assault Medical Forensic Examiner (SAMFE) policies, procedures, regulations, and documentation, and ensures these are up to date within the department. 

4.Independently instructs and demonstrates to patients/family/ significant others how to provide self-care to include wound care, changing dressing, and catheter care. Instructs patients in self-medications of prescribed pharmaceutical agents. Reinforces physician instructions and encourages patient in maintenance and self-care. 

Performs other duties as assigned.