Practical Nurse - FT Irwin,CA

About the Position: This position is located at Weed Army Community Hospital in Fort Irwin, California.

Fort Irwin is located in the high desert of the Mojave, 40 miles north of Barstow, CA and the home of the National Training Center (NTC).  The NTC is the Army’s premier training site and trains over 50,000 troops a year in preparation for deployments worldwide.  We support the NTC’s mission to “Train the Force”.  Our organization has the mission to provide world-class healthcare to the 12,000 Soldiers and Family Members of the NTC, Fort Irwin and Yuma Proving Grounds (Yuma, AZ), as well as to support the rotational training units. Weed Army Community Hospital (WACH) is a small community hospital supported by over 400 military and civilian staff members with an inpatient capacity of 20 beds including both Mother/Baby and Medical/Surgical Wards.

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/

Serves as a Licensed Practical Nurse for a Defense Health Agency (DHA) Medical Treatment Facility (MTF). Performs direct patient care and care coordination activities such as referral management, order reconciliation, and activity tracking.

1. Obtains information from patient and/or family/guardians/caretakers to identify major complaints, symptoms, or reason for seeking health care. Takes all vital signs (blood pressure, temperature, pulse, respirations, pain level, height, weight, measurement of head circumference, and length); performs a behavioral health screening. Documents patients' chief complaints and other pertinent information in the health record. Documentation will also include medication reconciliation, screening tools, and behavioral health intake surveys. Participates in promoting patient compliance with health activities in accordance with RESPECT-Mil. Coordinates and facilitates care coordination, communicates relevant information according to the medical plan of care and nursing assessment, and documents accordingly in the health record. Prepares assigned rooms for clinic schedule. Attends clinic huddle to review scheduled patients with Primary Care Manager to coordinate delivery of care.

2. Provides individualized nursing care to patients of all ages based upon the physician’s medical care plan, the nursing assessment, and the physical, mental and emotional needs of the patient. Assists the physician with various examinations and diagnostic procedures. Examinations requires being able to lift up to 50 lbs. to assist in lifting and repositioning patients who need help. Prepares procedure rooms by ensuring required equipment, consent forms, etc. are available. Sets up and maintains a sterile field; understands the proper positioning of patients required for various procedures. Administers oxygen, IV fluid and prescribed oral, rectal, subcutaneous and intramuscular medications. Performs inhalation treatments, fingerstick glucose, urine dipsticks, visual acuity, phlebotomy, dressing changes, and surgical instrument cleaning and packaging after use. Collects and prepares laboratory specimens according to local SOPs. Assures accurate care and handling of specimens. Performs routine procedures, such as EKGs, eye, throat, nasal and/or wound cultures, dressing changes, ear irrigation, and application of bandages. Recognizes adverse signs and symptoms immediately and calls for assistance. Sets up, operates and monitors specialized equipment, such as cardiac monitor, defibrillator, etc. Performs point of care testing (POCT) checks. Ensures logged entry per local SOP, POCT, and MTF guidance. Review MHS-Genesis messages throughout the day and address appropriately with PCM or Team RN.

3. Screens and reviews immunization records IAW AR 40-562 and unit Standard Operating Procedures to select required immunizations, correct dosages, and routes of administration. Review requires transcription of information to medical records and official school forms. Documents administration on required forms manually. Administrative duties include inputting data into the computer and retrieving information such as laboratory and diagnostic procedure results. Other computer related duties include the use of the MHS-Genesis and MEDPROS entry. Documents administration utilizing IAW Ambulatory Quality Assurance criteria. Assists with scheduling of follow-up appointments, provides direction for additional medical care/diagnostic testing such as lab, x-ray, referral management, pharmacy, Nurse Case Manager (NCM), etc. Reviews, at the minimum, next day schedule to include copy forward, the Healthcare Effectiveness Data and Information Set (HEDIS) metrics, procedure preparation, wellness screening paperwork, etc. Review patient appointments, 24-78 hours prior to scheduled appointment and identifies opportunities to provide patient and PCM continuity or access to care via other options.

4. Administers oral, intradermal, subcutaneous, intramuscular immunizations to all age groups IAW established protocols. Maintains accountability for actions and control of vaccines. Documents interventions and patients’ response to care. Communicates relevant information to healthcare team. Recognizes signs and symptoms of untoward effects of immunization and/or allergen extracts. Maintains certification in Basic Cardiac Life Support and demonstrates ability to initiate cardiopulmonary resuscitation in the event of an anaphylactic reaction and/or cardiopulmonary arrest.

5. Informs and educates patients and/or family regarding self-care procedures. Instructs patients and family/guardians/caretakers, regarding normal verses adverse reactions to immunizations and treatment for normal reactions of discomfort. Reviews laboratory results and brings abnormal results to attention of physician. Per physician’s instruction, telephones patient regarding follow-up required and documents in records. Performs patient education for special needs such as medication administration, inhaler and spacer use, self-dressing changes, ostomy care, fingerstick and glucose meter use, drawing up and injection of insulin and glucagon, and asthma home monitoring with peak flow meters and nebulizer use. Educates patients and/or family/guardians/caretakers on requirements for care and medications. Completes necessary paperwork for school (sick slips, asthma care plan, etc.), for provider signature. Also teaches patients early warning signs for early detection of diseases.

6. Performs both administrative and logistical tasks as a member of the healthcare team for the clinic by contributing to maintaining the environment and resources to deliver healthcare. Reviews expiration dates for medications, vaccines, and supplies; and initiates the reorder. Coordinates with designated clinic administrative staff for maintenance of adequate vaccines and supply levels. In the absence of the medical receptionist, assists with the responsibilities for checking patients into the system, completion of records and other clerical duties as assigned. Reviews laboratory results and brings abnormal results to the attention of the physician and per physician’s instructions, telephones patients regarding any follow-up care that is required. Duties include the use of automated systems (i.e. MHS-Genesis, Medical Operational Data System (MODS) and the Medical Protection system (MEDPROS). Reviews chart for coding compliance and ensures all procedures are documented to obtain accurate capture of workload. Attends mandatory training as directed by supervisor or command. Will be trained in documenting adverse medication reactions in the VAERS or local system. Participates in and may coordinate performance improvement activities. Maintains Automated Time Attendance and Production System (ATAAPS)/Defense Medical Human Resource System-internet (DMHRSi) compliance.

Performs other duties as assigned.