Supervisory Nurse (Clinical/Admin/Perioperative) - Defense Health Agency Civilian Corps, Falls Church, VA

Supervisory Nurse (Clinical/Admin/Perioperative) 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”. Lo w 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.

Serves as a Supervisory Nurse (Clinical/Admin/Perioperative) at a Medical Treatment Center (MTC) or Medical Treatment Facility (MTF) within the Defense Health Agency (DHA). Performs as the Clinical Nurse Officer-In-Charge (CNOIC) of an assigned subspeciality surgical services clinic. Provides administrative and clinical perioperative duties in support of the department and staff. Supervises, plans, organizes, directs, assigns work and evaluates work performed by subordinates. Participates in quality assurance activities and receives, investigates and acts on patient complaints involving clinic operations.

SUPERVISORY CONTROLS

Works under the general supervision of the Chief Nurse or Clinic Supervisor. The supervisor outlines the overall objectives and available resources. The employee plans and executes assignments and develops decisions both independently and in consultation with the Chief using assigned personnel; and, applies appropriate guidelines and professional nursing standards to patient assessment and unit nursing operations. Responds to medical situations in accordance with policies and accepted nursing practices without specific instructions. Assess patients’ condition and collaborates with physician to makes changes in nursing care plans. Work is reviewed for soundness and overall effectiveness and achievement of program goals and compliance with agency policies and practices in the management of the department.

MAJOR DUTIES

1. Responsible for the overall management and coordination of clinical nursing and administrative activities for the subspeciality clinic. Directly supervises and directs daily activities of all nursing professionals, paraprofessionals, administrative support personnel and volunteers in the assigned clinic. Plans work to be accomplished by subordinates, sets and adjusts short-term priorities, and prepares schedules for completion of work; assigns work to subordinates based on priorities, selective consideration of the difficulty and requirements of assignments, and the capabilities of employees; evaluates work performance of subordinates; give advice, counsel, or instruction to employees on both work and administrative matters; interview candidates for positions in the unit; recommend appointment, promotion, or reassignment to such positions; Listens and resolves complaints from patients and employees, referring group grievances and more serious unresolved complaints to a higher level supervisor or manager; effect minor disciplinary measures, such as warnings and reprimands, recommending other action in more serious cases; identify developmental and training needs of employees, providing or arranging for needed development and training; finds ways to improve production or increase the quality of the work directed; and develops access to care and performance standards. Approves and schedules leave.

Identifies, implements and/or recommends on-the-job-training, career development and professional enrichment programs, as appropriate. Acts as the primary trainer for newly arrived or promoted clinical administrative personnel and monitors development of their knowledge, skills and abilities to provide administrative support to clinical areas. Plans, implements and ensures competency-based orientation program for clinic support personnel and provider teams. Coordinates on the job training programs and provides staff development programs. Maintains staff in-service education records and ensures minimum annual attendance requirements are achieved. Provides advice, counseling and instruction on technical and administrative matters, promotes acceptance and adherence to such programs as Equal Employment Opportunity (EEO), and management employee relations. Works to resolve management employee relations issues. Works with the department’s Chief Nurse and senior Administrative Officer for staffing needs and strategic, cost-effective staff planning. Explains work requirements, methods, procedures and instructs subordinates on new procedures and provides advice and guidance when problems arise or on assignments that involve new or complex technologies. Responsible for the final review and improvement of work methods, clinical structure to improve production and increase quality of work directed. Ensures the clinic’s efficiency by preparing monthly schedules. Ensures appropriateness of DMHRSi, Staff Feeder Reports, personnel assignments and work schedules are maintained.

2. Provides an advanced level of specialized nursing care and direction of ambulatory and inpatients ranging from infants to the elderly. Plans, oversees and schedules clinic nursing/support staff activities in collaboration with the section/department Chief. Reviews and updates the section’s nursing policies and procedures, internal standing operating procedures and patient education criteria in accordance with hospital, Department of Surgery/ Nursing Services accreditation and nursing practices and standards. Reviews and updates local regulatory guides and directly assess their impact on current internal nursing operating activities. Monitors specific initiatives undertaken by coordinators at service level to ensure compliance with DHA, the organization, and departmental guidance and requirements. Ensures effectiveness of clinic nursing administrative operations by revising and refining operational activities, performance improvement, and internal control activities, to include identifying risk appraisals, conducting chart reviews, preparing reports of findings, identifying trends, and reporting on corrective actions taken. Receives, investigates and acts on all patient concerns in collaboration with the hospital Patient Experience Office. Serves as an active member of assigned committees, projects and programs. Educates subordinates on DHA, organization, Department of Surgery, The Joint Commission (TJC), and applicable policies.

Provides advice to the section/department Chief on nursing matters. Reviews, recommends changes and assists in the development of local internal regulations, procedures and on other matters pertaining to the Department of Surgery in consultation with the Chief Nurse. Attends Department of Surgery Administrative meetings/activities to enhance the quality and safety of management care practices, policy, procedures and programs.

Reviews patient consults in the section and directs consults to the appropriate departments. Consults with CAMO on consult issues and defers consults to external providers when appropriate. Schedules and re-schedules appointments as appropriate. Performs telephone consults with patients and assists patients to complete forms pertaining to home health, insurance and workman’s compensation. Serves as a mentor and role model to staff in the department and others in the organization.

3. Serves as a perioperative Nurse in a subspecialty surgical clinic. Provides nursing care of ambulatory health care recipients. Provides general research assistance and clinical nursing support to augment principal investigator and may assist the investigator on research projects. Performs direct patient care, treatments procedures and diagnostic tasks. Provides comprehensive nursing care to patients based on nursing assessments, physicians, medical care plan as well as the physical, mental, social, and emotional needs of the patient. Reviews medical records of patients to determine the reason for procedure(s), laboratory results, allergies, requirements for prophylactic medications as well as past medical history prior to the procedure. Screens urine samples for evidence of preoperative infection. Primary duties are in the subspeciality clinic and ambulatory operating areas. Provides occasional support in the operative areas as necessary. Documents in patient medical and clinic records based on clinical practice guidelines. Performs perioperative nursing care to patients undergoing intraoral procedures such as nasal surgery, facial plastic surgery, sinus endoscopic surgery, otologic surgery laryngeal surgery and/or laser procedures. Verifies patient's operative procedures and ensures continuity of nursing care. Makes physiological assessments of patients to include monitoring vital signs, cardiovascular, respiratory and renal status. Screens patients for substance abuse and verifies medical and environmental allergies. Makes a psychological assessment of patient to determine cultural needs, level of understanding, coping mechanisms and expectations. Provides emotional support. Charts information concerning patients' condition, patient assessment, medication administered, care provided and patient's response to care and treatment. Inserts and maintains peripheral intravenous devices on IV conscious sedation patients. Administers medication via intramuscular, topically, IV, and IV piggyback route. Monitors appropriate administration and patient's reaction during all surgical procedures by using equipment including blood pressure, EKG, and pulse oximetry. Instructs patients and family members on disease processes and surgical procedures, teaches pre- and post-operative care, health maintenance and illness prevention. Implements health promotions teaching strategies to patients and their families. Implements crisis intervention techniques to provide support to the family. Coordinates health care needs by collaborating with other professional in the Medical Center. Refers the patient/family to allied health care providers. Provides triage to patients and recognizes conditions that require immediate evaluation and treatment. Coordinates patient education activities, reviews, maintains and updates education material.

Assists with clinical research by data collection, performance of related treatment/procedures and related patient education functions. Ensures staff prepare instruments for sterilization correctly, utilizes appropriate technique and materials in preparation of laboratory specimens and in laboratory testing. Monitors and maintains compliance with universal precautions requirements. Develops and maintains patient education programs and instructional material based on the patient needs and clinic population. Establishes and maintains clinic nursing policies and procedures according to DHA, organization and Department of Surgery guidelines.

Provides clinical oversight related to infection prevention and quality improvement compliance and readiness programs. Identifies and establishes prioritized aspects of care. Identifies indicators for monitoring to ensure collection of data, data analysis and to implement corrective action. Ensures safe environment for patients and staff by employing prescribed monitoring and safety measures.

Identifies and reports various trends in support of infection prevention by following pre-established criteria. Annotates and responds to breaches of standard procedures which compromise the patient or staff members reporting though Patient Safety Reporting System (PSRs) or other approved safety report systems to address and mitigate future risks and reoccurrence. Maintains, communicates and displays infection prevention trends pertinent to clinical practices. Maintains and/or updates the clinic’s procedures and instructions on infection prevention measures. Reviews and reports responses from Infection Prevention Committee back to the clinic and department.

Provides training and instruction to the clinic’s nursing, paraprofessional staff, newly assigned staff and residents on manufacturer instructions for use (MIFUs) on proper disinfection, cleaning, assemble, disassemble and transport of endoscopic equipment to include video camera systems and lasers; and, provides training and simulation for safe and proper use in accordance with organizational guidance/policy.

4. Establishes, maintains, reviews and updates internal policies and standard operating procedures followed by paraprofessional staff and volunteers in the clinic. Coordinates patient education activities concerning patient role in health maintenance and restoration. Reviews reference materials and arranges to obtain new and updated reference materials. Ensures a healthy and hygienic environment for patients and staff by employing prescribed monitoring and safety measures. Ensures effectiveness of the clinic’s nursing and administrative operations and continually reviews and refines activities, procedures and instructions. Develops and updates staff competency-based skill check list and clinic orientation program. Manages clinic and patient records. Implements and maintains the section’s quality assurance and internal control activities for the clinic,. Performs risk management appraisals, conducts monitoring and evaluating activities. Prepares reports of findings, identifies trends and acts on patient complaints involving clinic operational matters. Ensures the clinic meets and exceeds all accreditation standards for ambulatory care, admission procedures, patient education, discharge planning, patient rights and ensures that documentation requirements are met. Gathers data from procedures and office records to prepare monthly reports for the Department of Surgery. Assists during data collection on a variety of research projects.

Ensures fiscal responsibility and provides guidance and oversight of the section’s logistical program requirements. Plans for the acquisition of special equipment and supplies. Determines requirement for supplies and materials needed for daily use in the clinic. Manages the section’s performance improvement projects. Monitors all aspects and phases of projects and recommends goals and actions for improvement to the Clinic Chief and educates staff regarding findings. Recommends procurement of medical care and support equipment to include CEEP, SUPERCEEP and MEDCASE logistical documentation and requirements. Researches, evaluates and conducts cost analysis of products for the budget, supply and the clinic’s equipment manager. Contacts vendors, technical representatives, appropriate logistics personnel, appropriate medical personnel currently using items to arrange for loaner equipment to evaluate, drafts detailed documents and to write justification for ordering purposes. Tracks clinic procedures and channels for processing supplies and equipment. Orders supplies and medications to be stocked in the clinic. Maintains stock levels for operative sets, inventory, supplies and pharmaceutical. Maintains account for narcotic and other drugs used in clinic area and minor procedure room in accordance with DHA, organization and Department of Surgery guidance/policy.

Coordinates health care needs and collaborates with other professionals within the local organization and/or from DHA as needed. Serves as a liaison between physician investigators and the clinical nursing staff regarding implementation of clinical research protocols and to monitor nursing staff protocol implementation responsibilities in the clinical area.

5. Performs nursing and technical tasks in support of physicians of the assigned subspecialty clinic. Sets up various scope equipment. Prepares for and assists with the performance of surgical procedures such as intraoral procedures, nasal surgery, facial plastic surgery, sinus endoscopic surgery, repair and reconstruction of head and neck trauma, laryngeal surgery, tracheostomy care, facial reconstruction after removal of tumors of the neck and neck region and other and/or other subspecialty surgeries. Assists physician/surgeon with complex or potentially life-threatening procedures. Maintains lines and dressings in accordance with infection prevention practices. Plans integrated continuity of care and works with other health care providers to include surgeons, anesthesiologists, speech/audio pathologists, etc. to determine and meet the patient needs. Establishes internal surgical nursing protocols and coordinates activities of the clinic’s team members. Monitors all ongoing functions, patient responses and initiates/intervenes with immediate corrective action. Implements individualized nursing plans to include safety precautions. Makes appropriate patient care assignments using qualified competent personnel. Ensures completion of clinical and perioperative documentation noting surgical procedures and patient responses. Revises the care plan based on changes in the patient's condition and responses.

Serves as a scrub, circulating or nurse supervisor during operative procedures performed in the Outpatient Minor Procedure rooms. Prepares and ensures proper functioning of complex equipment required for completion of the procedure as well as sustaining equipment maintenance. Briefs post anesthesia nursing staff on perioperative nursing orders, surgical procedure performed, patient problems, nursing diagnosis and actions, patient response, specialized care and equipment required to support the patient during post-op recovery and other pertinent data. Conducts pre- and post-op nursing assessment immediately following or within 48 hours after surgery to determine validity of nursing care plan, outcomes and long-range patient goals. Ensures daily logs are maintained for all monitoring equipment to include EKG, BP, Pulse oximeter and defibrillator, etc. Coordinates any necessary corrective actions to maintain safe patient care outcomes with the appropriate staff member. Ensures emergency drugs and crash carts are in place and ready for use, and, ensures the proper compliance report submission is completed in accordance with the organization and Department of Surgery. Completes surgical counts to include needles, sponges, etc. and labels, handles and ensures proper disposition of surgical specimens. Monitors equipment such as microscopes, laser, cardiac monitor, pulse oximetry and EKG to be operational. Monitors and maintains oversight of the cleaning and sterilization of equipment and procedure rooms.

Perform other duties as assigned.

Basic Requirements:

US Citizenship required

Employee must have a current, active, unrestricted, valid Registered Nurse license in at least one US state or province/territory of the United States.

Employee must have a current Basic Life Support (BLS) certification.

Advanced Cardiac Life Support (ACLS) is highly desirable.

Position is Designated Testing Position (DTP) for drugs.

Position requires the incumbent to have passed a Child Background Check (works with Adolescent patient).

Position may require incumbent to work alternate shifts.

* This position is subject to drug testing if the incumbent:

Has direct patient contact or performs diagnostic or therapeutic functions

Extracts or works with patients' body fluids or tissues; prepares patient specimens for examination, performs specialized or non-routine tests on body fluids or tissue samples, or confirms patients' test results

Maintains, stores, safeguards, inputs, fills or distributes drugs and medicines

This position has a mandatory seasonal influenza vaccination requirement and is therefore subject to annual seasonal influenza vaccinations. Applicants tentatively selected for appointment to this position will be required to sign a statement (Condition of Employment) consenting to seasonal influenza vaccinations.