NURSE (CLINICAL/OB-GYN), Tacoma, WA

At Madigan you will practice alongside civilian and military health care experts and experience unique professional opportunties. 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/

POSITION DUTIES:

Perform the full range of professional nursing duties for antepartum, postpartum, newborn and GYN/post-surgical patients for all ages from infant to geriatric and support the MAMC MCH Department through cross-training in support of providing professional nursing care across the department. Responsible for planning comprehensive family centered nursing care and carries out the therapeutic plan of care based on Nursing Standards of Care to include:

a. Patient Assessment of both mother, infant/pediatric and GYN patients (physical, emotional, and social aspects), evaluation, monitoring and intervention.

b. Patient and family education (assess educational needs of patient and family age group ranging from 12 to 50 plus years).

c. Patient Safety (maintains supports and preserves safe environment).

d. Patent Comfort.

e. Patient Rights (protects patient's basic rights and promotes effective customer service/relations, adheres to advance medical directives per hospital protocols) and maintains patient confidentiality.

1. Provides nursing care to low and high-risk obstetrical patients their newborn infants and GYN/post-surgical patients. The high-risk postpartum population includes cesarean section, post-delivery bilateral tubal ligation, hypertensive disorders in pregnancy, post-partum
MgSO4 therapy, and those patients complicated with postpartum infection, hemorrhage, or prior medical/surgical history placing them at risk for complications. The high risk antepartum population includes, but is not limited to, patients diagnosed with gestational
diabetes, premature labor, hyperemesis gravidarum, multiple gestation, placenta previa, hypertensive disorders in pregnancy, premature rupture of membranes, infectious disease processes and medical/surgical conditions directly during the pregnancy such as appendicitis
and gastroenteritis, etc. The newborn infant population includes well newborns cared for at the mother's bedside. High-risk infants include infants requiring phototherapy or bili blankets, infants with temperature instability, hypoglycemic, Early-onset sepsis, and infants with feeding difficulties. For the gynecology and post-surgical patients patient, provides care and support to patients undergoing change in body image, women responding to grief or suffering pregnancy loss, and terminally ill patients. Provides comprehensive lactation support for patients opting to breastfeed; promotes alternative feeding methods in support of breastfeeding, and provides family-centered education and support. 

2. As a Charge Nurse, performs a variety of administrative and managerial duties as an extension and in support of the Chief Nurse Officer In Charge (CNOIC).

a. Assigns and adjusts patient care duties in accordance with staff's expertise and scope of practice, patient condition and acuity, and changing needs of patient, family and unit. Makes nursing care assignments and provides work direction and technical guidance to nonprofessional personnel.

b. Monitors, oversees, and evaluates staff performance, orientation, and training, nursing care and services. Ensures appropriate priorities; responsiveness to emergencies; effectiveness of practice, patient management, bed utilization; customer service and relations; open communications; and a safe environment.

c. As required, prepares and revises personnel time schedules; is active in unit to hospital level activities to include, but not limited to, committee meetings, staff development, continuing education, and preceptor programs; performance improvement process and preparation of reports and/or research related to nursing issues and concerns.

d. Assesses, intervenes, and evaluates mother and infant according to standards of care and specific unit guidelines.

e. Provides family centered care involving patients and family in the plan of care and teaching activities. Identifies mother and infant discharge planning need and coordinates with other members of the health care team, the necessary interventions to provide support prior/after discharge. 

3. Administers oxygen, IV fluids, electrolyte solutions, blood and blood products, prescribed medications, and treatments following the five rights for administering medications. Passes unit specific medication verification test. Manages nasal-pharyngeal, oropharynx, tracheal and gastric suction and other drainage tubes, specialized biomedical equipment and physiologic monitors such as infusion pumps, pulse oximeter, vital sign machines, radiant warmers, isolettes, phototherapy lights, bili blankets, apnea monitors, oxygen support devices, etc.

a. Performs/assists with invasive/non-invasive procedures to include collection of laboratory specimens and other samples as required. Performs diagnostic screens, such as urine for sugar and acetone, specific gravity, blood for glucose monitoring, and emergency life support measures. Performs catheterization, inserts nasogastric tubes and performs gavage feedings. Transports patients to other services, departments, and/or facilities, when necessary.

b. Provides sufficient information to patient(s), parent(s) and/or guardian on: pre and Post-operative education; disease process and complications; medication administration

c. Documents nursing process, patient status, care and services. Orients, trains and supervises assigned personnel, students and volunteers. Manages unit operations, personnel, bed utilization, and mission requirements. Completes 24 hour and ward status report for both infant and mother.

d. Must successfully complete unit specific competency based orientation program for both mother and infant which includes: Accucheck III Glucose Monitoring, EKG Lifepack 15, Apical and fetal heart rate, fetal movement counts, staple removal, catheterization, administration of blood products, Rhogam administration, Depoprovera and Rubella vaccine, phlebotomy, wound care, oxygen therapy, obtaining blood specimens via venipuncture and heelstick, insertion and maintenance of nasogastric tubes, gavage feeding and administration of antibiotics. Use of specific equipment includes; IV infusion pumps, Patient Control Analgesia (PCA), Patient Control Epidural Analgesia Pump (PCEA), Doppler, Tympanic Thermometer, Vital Sign and Accucheck machines, Infusion syringe, suction and oxygen in crash cart and patient rooms. Additionally, must complete an abbreviated department level competency based orientation in support of the obstetric/gynecologic/post-surgical adult, neonate, and pediatric patient population.

e. For the gynecological patient, provides pre and post-operative education, family planning counseling, contraceptive information and sexual counseling. On admission, and throughout hospitalization

g. Participates in Quality Improvement, Internal Control Management Program, and Utilization Training. Provides neonatal resuscitation measures as necessary. Assess infant thermoregulation, infant feeding patterns and identification of problems with the newborn infant.

h. Enters, retrieves and updates information on the Composite Health Care Computer (CHCS), and Essesntris Workload Management System for Nurses (WMSN), Defense Human Resources Information Systems internet (DMHRSi), and Automated Time Attendance and Production System (ATAAPS); data entry proficiency is required. As required, serves in absence of the Head Nurse. 

Perform other duties as assigned.

US Citizenship required

At least one year of licensed clinical experience AFTER licensure as a registered nurse at the time of application