Advanced Practice Nurse (Nurse Anesthetist) - Madigan Army Medical Center, Tacoma, Washington

This is a Direct Hire Authority (DHA) solicitation utilizing the DHA for Certain Personnel of the DoD Workforce to recruit and appoint qualified candidates to positions in the competitive service.

Joint Base Lewis-McChord, WA

Madigan Army Medical Center is seeking a Advanced Practice Nurse (Nurse Anesthetist).  The Madigan Army Medical Center NICU is a tight-knit, collaborative, interdisciplinary team focused on providing high quality care to critically ill children. The Department has low patient-staff ratios with many training and learning opportunities. 

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. 

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.


Madigan Army Medical Center
Joint Base Lewis McChord

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 Sea-Tac Airport and to the deep-water ports of Tacoma and Seattle. 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 now 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:

1. Provides the full range of anesthesia services, Monitored Anesthesia Care (MAC), GeneralAnesthesia and Regional Anesthesia for surgical operations, medical procedures, and obstetric services within the clinical areas of the main operating room (MOR), labor and delivery ward, pre-operative clinic, post-anesthesia recovery unit (PACU), and all anesthetic procedures outside of theOR (including, but not limited to the endoscopy clinic, the interventional cardiovascular suite, stonecenter, pediatric radiology and the emergency room). Determines the optimal type and method ofanesthesia care to administer for a broad range of surgical procedures at the MTF. Evaluates data,with respect to individualized anesthetic options and current practice guidelines, to determine anddiscuss the optimal anesthetic plan; obtains patient consent for the type of anesthesia to beutilized, expected outcomes and possible anesthetic complications. Gathers equipment, prepares,inspects, and ensures proper sanitation and function of equipment to be used in performance ofwork. Administers anesthesia via the most appropriate method for each patient’s procedure.Incorporates the use of inhalational and pharmacological agents to provide safe, depths ofanesthesia and analgesia to reduce negative side effects and the potential for complications.Provides continuous monitoring of vital signs, volume status, and patient positioning duringmedical/surgical procedures; maintains patient homeostasis via the use of parenteral fluids, bloodproducts, and vasoactive pharmacologic agents as needed to support circulatory andcardiopulmonary function. Interprets and addresses abnormal diagnostic data and changes in signsand symptoms; modifies anesthetic plan accordingly. Identifies emergency situations and criticalchanges in patients’ status; notifies surgeon and seeks assistance from the perioperative andanesthesia teams as needed. Collects data through patient interviews, observation, physicalexamination, and review of medical records, prior to scheduled surgery; consults with surgical ortreatment team on identified anomalies and concerns. Determines necessity for laboratory studies,coordinates ordering of lab tests and evaluates results. Provides immediate, post-operative care topatients transported to the PACU, ICU or recovery area; ensures patient airway, hemodynamicstability, optimal pain control and appropriate level of consciousness. Gives full report to receivingnursing and medical staff, detailing patient’s intraoperative course and steps utilized to attenuate orreduce any adverse reactions. Renders life-saving care and procedures in emergency situations;provides immediate and appropriate interventions to include advanced life support (ALS) andcardiopulmonary resuscitation (CPR) according to guidelines and within the scope of practice.Discriminates between normal and abnormal findings to treat underlying causes and conditions andstabilize the patient for transport to a higher level of care. Documents assessments, orders, andinterventions, appropriately, in the medical record. (60%)
2. Serves as an anesthesia resource consultant to a wide variety of medical, surgical, and nursingspecialties to delineate the latest advances in anesthesia practice. Evaluates data, with respect toanesthesia and evolvements within the field, to determine and discuss type of anesthesia to beused, and to explain expected outcomes and possible anesthetic complications. Reviews andevaluates current professional journals, anesthesia-related literature and peer-reviewed data tofacilitate discussion and aid in the determination of the optimal anesthetic plan, explaining expectedoutcomes and possible anesthetic complications to stakeholders. Collaborates with the anesthesia,surgical and multidisciplinary care team to deliver high-quality, holistic, evidence-based care. (20%)
3. Formulates and evaluates clinical care standards and treatment programs for effectiveness inmeeting patient needs. Recommends methods and processes to reduce resource consumption,ensuring the patient receives quality care at the most appropriate level. Participates indepartmental Quality Assurance and Quality Improvement (QA/QI) initiatives and continuousimprovement programs to validate standard of care delivery following an adverse patient safetyevent as well as to mitigate health risks when a new procedure or pharmaceutical agent isdeveloped; evaluates patient care processes and outcomes, maintains and/or improves the qualityof care delivered, and improves patient outcomes within the Anesthesia Service. Participates in thePeer Review (PR) and Ongoing Professional Practice Evaluation (OPPE) processes to ensure standardof care and provider performance criteria are met. Complies with the Joint Commission (TJC)accreditation standards. Maintains professional education recertification and privilegingrequirements as prescribed by the National Board of Certification & Recertification for NurseAnesthetists (NBCRNA). Participates in the DoD Outcomes Management Initiative to improve long-term and continuing health care outcomes for the patient population served. (10%)
4. Conducts and participates in educational programs that improve anesthesia nursing practice.Provides oversight and instruction to other CRNAs, students, and ancillary workers in the field ofanesthesia, in both clinical and administrative areas. Provides feedback and evaluations (verbal andwritten) to the student and appropriate school/residency program. Plans and sets up programs forweekly staff meetings; arranges for guest and consultant speakers for educational programs. Delivers in-services and educational lectures, workshops, and case studies for the purpose ofproviding knowledge, skill, and introduce the latest initiatives in the evolving anesthesiology field,to other CRNAs, anesthesiology staff, nurses, and health care professionals and paraprofessionals.(10%)

Perform other duties as assigned.