Nurse (Clinical) - Defense Health Agency Civilian Corps, Falls Church, VA

Nurse (Clinical) Joint Base San Antonio

Time to invest in some new footwear because if you’re San Antonio-bound, you’d better show up in boots! The Alamo City is one of the military’s most envied postings and is often referred to as “Military City USA”. Low cost of living, affordable homes, and the lack of state tax on retirement income are a few financial perks to living and retiring in this Texas city. A robust job market that seems partial to government and defense/security contracting ensures employment opportunities for spouses or transitioning service members. San Antonio is the country’s seventh fastest growing city yet has somehow managed to retain a “small town feel.” Quality schools and friendly locals (most with military ties) are additional  perks to living in San Antonio.

Some things you should know before you get here: trucks are the norm (the bigger, the better), love for The Spurs (NBA) runs deep, the H-E-B obsession is real (it’s a grocery store), rodeos are life, and don’t call it “San Antone”—that’s just wrong. The community boasts a vibrant Hispanic population, and enhances everything from the food, to the music, to community events. You don’t necessarily need to speak Spanish to get around, but you’d better know how to say barbacoa, tamales, and cascarones.

Name brand shopping (IKEA is the latest arrival of note), restaurants, and all variety of entertainment all add to San Antonio’s quality of life. SeaWorld, the San Antonio Zoo, Six Flags Fiesta Texas, and downtown museums are all fun outings for kids and families. Tube or kayak down a river, play or fish in the lakes, or relax by San Antonio’s famous downtown River Walk. Museums, art galleries, and historical landmarks—remember The Alamo?—round out San Antonio’s cultural offerings. Tex-mex cuisine arguably originated here, and some up and coming culinary trendsetters are making a name for themselves in the Pearl District downtown, alongside several notable breweries.

San Antonio has over 300 days of sunshine with some hot summers, mild winters and pleasant spring and fall seasons. San Antonio is in Bexar County (it’s pronounced “BEAR”) in south central Texas, and is just south of the gorgeous Hill Country. It’s only about two hours from Austin, the beach, or the desert.

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.

MAJOR DUTIES:

The primary purpose of this position is: To serve as a supervisor, providing planning, directing, organizing, and exercising control over nonsupervisory nursing employees in assigned outpatient clinic within the Military Treatment Facility (MTF). Oversees personnel who are providing highly specialized diagnostic, laboratory, and surgical services to patients with cardiac and vascular diseases.

The organizational location of this position is: 59th Medical Wing, 59th Medical Operations Group, 59th Medical Specialty Squadron, Cardiology Flight (SGMCns.
Serves as a Clinical Head Nurse, Cardiology Flight. Provides supervision, staffing, scheduling, support, and administrative oversight to all Cardiology services. Supervises all nursing care activities and directs all professional and paraprofessional nursing health care providers assigned to the Flight. Exercises first-line supervision over selected personnel. Plans, organizes, and directs the nursing activities of the clinic, ensuring clinic operations comply with legal and regulatory requirements and meet customer needs. Develops goals that integrate organization and clinic objectives. Researches, interprets, analyzes and applies DoD regulations, AF Instructions, MAJCOM policies and MTF guidance. Establishes policies and procedures for accomplishment of clinical operations. Plans and schedules work in a manner that promotes a smooth flow and even distribution. Coordinates plans and schedules with other organization managers and customers as appropriate. Identifies need for changes in priorities and takes action to implement such changes. Plans work to be accomplished by subordinates, sets and adjusts short-term priorities, and prepares schedules. Assigns work to subordinate employees based on organization priorities and consideration of difficulty and requirements of assignments such that the experience, training, and abilities of staff are effectively utilized to meet organization and customer needs. Balances workload and provides advice, guidance, and direction on a wide range of clinical and administrative issues. Structures assignments to create effective and economical positions. Serves as a resource person with whom other staff nurses and other health care providers consult when particularly difficult problems in care of chronically ill patients arise. Serves as a role model to experienced nurses as well as those not fully trained. Provides guidance and leadership to other professional nurses and provides instructions and training to paraprofessional personnel, including on-the-job training, as necessary. Instructs cardiology fellows and medicine residents in specific procedures related to all cardiac procedures. Reviews organization mission, functions, and manning. Identifies requirements and initiates requests for additional resources including personnel, overtime, equipment, supplies, and space to ensure success in meeting goals and objectives. Provides advice to Flight and/or Squadron Commander of significant issues and problems related to work accomplishment. Establishes metrics and analysis systems to ensure actions are timely and reviewed at critical points. Accepts, amends, or rejects work presented by subordinates. Performs self-inspection and presents detailed and comprehensive report with any corrective action taken to supervisor. Follows-up to ensure complete and quality resolution of discrepancies. Assesses and revises policies and procedures as needed to find ways to improve quality, timeliness, and efficiency of work. Promotes positive attitude toward change, and acts as a change agent. Supports and encourages leadership and innovation among sta

Provides oversight to personnel delivering an advanced level of comprehensive professional specialized nursing care to chronically ill cardiac patients while they are undergoing cardiac procedures with a variety of conditions ranging from normal to those having complex conditions requiring sophisticated and highly technical care and treatment. Procedures include diagnostic and therapeutic cardiac interventions. Patient conditions include, but are not limited to, acute myocardial infarction, post-operative thoracic, vascular, organ transplant as well as status post multi-system trauma organ failure. Patients may be characterized by the presence of actual or potential life-threatening cardiovascular problems and therefore require continuous observation and intervention to prevent complications and restore or maintain stability. Implements care management regimens consistent with evidence-based clinical practice guidelines. Coordinates care with facility and community resources, as appropriate. Assesses nursing needs to provide safe and efficient nursing care. Independently plans, schedules, and provides comprehensive nursing care without specific instructions, and solves all but the most acute problems on own initiative. Discusses the needs of the patient, the kind of physical care and personal relationships and behavioral patterns to be enforced and those to be avoided. Prepares patients and assists physicians with complex and potentially life-threatening procedures such as chemical stress tests, tilt tests, cardioversion and TEE. Continually observes, monitors, and assesses patients conditions. Interprets signs and symptoms of deterioration in condition and takes corrective action. In the absence of a physician, independently determines and implements emergency measures after identifying and interpreting life-threatening conditions. Initiates life-saving measures such as advanced cardiopulmonary resuscitation. This includes such actions as calculating dosages, mixing potent and potentially lethal drugs prior to arrival of the physician and administering these drugs on the physician’s directive. Assists with other diagnostic procedures such as chemical stress tests, tilt tests, cardioversion and TEE. Chronologically records all patient care information in manual or automated record systems. Coordinates and directs supplemental nursing coverage to the Coumadin clinic in the absence of the Coumadin Clinic Nurse, ensuring continuation for processing of lab values and appropriate follow-up with patients and their physicians, as well as any patient teaching requirements. Organizes back-up coverage for the Cardiac Rehab program, ensuring completion of all duties associated with rehab visits both in the clinic and in the Fitness Center. Duties in the Fitness Center include all administrative tasks in addition to performing vital signs; both telemetry and visual monitoring of patients during exercise. Identifies and administers age-specific pharmaceuticals including normal dosages, routes of administration, indications/actions, and adverse reactions. Mixes and administers prescribed medications orally, intramuscularly, subcutaneously, intraveneously, topically, etc., and knows which drugs will alter the effects of another drug if administered concurrently prior to the administration of medication. Assesses patient’s response to medication. Administers intravenous fluids including blood transfusions, and infrequently utilized and special drugs. Orders drugs and narcotics as needed. Provides for safekeeping and accurate accounting of controlled drugs and narcotics in accordance with Air Force Regulations, Medical Center Regulations, and Department of Nursing guidelines. Sets up, operates, and monitors sophisticated technical equipment such as cardiac monitors, various intravenous infusion pumps, and defribrillators. Sets up, operates, and monitors therapeutic and emergency equipment, i.e., EKGs, cardiac monitor, life pak, and IVAC and oxygen analyzer. Provides individualized, interdisciplinary, thorough instruction to patients and/or family members based on health care and prevention needs, developmental stage, and discharge plan. Emphasizes the preventive, curative, and restorative aspects of instructions. Provides instructions and oversight to personnel engaged in nursing duties. Improves patient care outcomes through education and nursing care delivery based on evidence-based practices. Advances nursing practice through self-assessment and creates culture of inquiry. Promotes patient safety and process improvement through risk management.

Exercises supervisory personnel management responsibilities. Advises and provides counsel to employees regarding policies, procedures, and directives of management. Selects or recommends selection of candidates for vacancies, promotions, details, and reassignment in consideration of skills, qualifications, and mission requirements. Develops, modifies, and/or interprets performance standards. Explains performance expectations to employees and provides regular feedback on strengths and weaknesses. Holds employees responsible for satisfactory completion of work assignments. Appraises subordinate workers performance ensuring consistency and equity in rating techniques. Recommends awards when appropriate and approves within-grade increases. Hears and resolves employee complaints and refers serious unresolved complaints to higher level management. Initiates action to correct performance or conduct problems. Effects minor disciplinary measures such as warnings and reprimands and recommends action in more serious disciplinary matters. Prepares documentation to support actions taken. Identifies employee developmental needs and provides or arranges for training (formal and on-the-job) to maintain and improve job performance. Encourages self-development. Approves master leave schedule assuring adequate coverage for peak workloads and traditional holiday vacation time. Demonstrates sensitivity to ideas of subordinates. Promotes a positive culture in order to procure trust. Promotes an environment in which, employees are empowered to participate in and contribute to effective mission accomplishment. Addresses subordinates concerns, whether perceived or real, and follows up with appropriate action to correct or eliminate tension in the workplace. Provides a work environment that is free from all forms of discrimination, harassment, and retaliation. Supports the agency’s EO program through allocation of personnel to participate in community outreach and recruitment programs, ensures full cooperation of employees with EO office officials. Explains classification determinations to subordinate employees. Discharges security responsibilities by ensuring education and compliance with security directives for employees with access to sensitive material. Recognizes and takes action to correct situations posing a threat to the health or safety of subordinates. Periodically reviews position descriptions to ensure accuracy, and the most effective utilization of personnel resources. The Supervisory Nurse may be assigned to temporarily cover for the Flight Commander during times when he/she is absence and coverage is delegated.

Represents the MTF with a variety of installation and functional area organizations. Establishes, develops, and maintains effective working relationships with MAJCOM, base, and civilian healthcare organizations. Meets with key customer and coordinating officials to assess customer satisfaction, explain organization policy and procedures, and resolve problems that arise. Receives, investigates, and acts on patient complaints. Participates in special projects and initiatives and performs special assignments. Identifies the need for special projects and initiates milestones and goals. Attends and participates in assigned committees, projects, and programs. Evaluates reports by analyzing facts and performing appropriate research and prepares detailed responses. Determines appropriate recommendations for unresolved or unusual problems and performs follow-up. Maintains standards set by TJC, and participates actively in hospital Nursing Executive Function meetings. Monitors TJC survey readiness, and participates in facility-wide mock reviews. Serves as mock TJC surveyor. Keeps staff informed of current PI, focus PDCA, patient safety, HIPAA rules, and any other TJC initiatives. Researches and determines or recommends appropriate actions or interpretation of issues that impact organization, installation, command, or agency.

Provides oversight of others’ continuing education requirements and programs to update/maintain skills and knowledge to meet annual requirements. Uses clinical nursing skills appropriate to patient population being served. Maintains currency of skills and knowledge through ongoing in-service training, briefings, annual core competencies, and continuing education. Participates in quality improvement activities. Participates in professional development activities and maintains professional affiliations. Participates in evaluation of the quality and effectiveness of activities/services of the unit by organizing nursing monitoring and evaluation activities. Maintains environmental, safety, and infection control standards. Attends required annual training to include fire and safety training. Maintains certification in Basic Life Support and Advanced Cardiac Life Support, as required. Performs other duties as assigned.

Performs other duties as assigned.

Basic Requirements:

US Citizenship required

Position requires current, active, valid and unrestricted nursing licensure in any state or province of the United States.

Current Basic Life Support (BLS) certification.

Advanced Cardiac Life Support (ACLS) required or must be able to pass certification within 6 months of employment.

Pediatric Advanced Life Support (PALS) required or must be able to pass certification within 6 months of employment.

Must be willing and able to take and pass the BAMC Conscious Sedation Class and Test within 45 days of employment.

This position is designated Testing Designated Position (TDP) for drugs.

Position requires State Criminal History Repository Check.

Required to work rotate shifts. The shifts may be 8, 10, or 12 hours long; weekends and holidays.

Immunizations required.

Position requires pre-employment physical due to heavy lifting.