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”. 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.
Responsibilities
MAJOR DUTIES:
Serves in dual position as the Pulmonary Lung Nodule Tracker and as a Clinical Nurse for Pulmonary Disease Services providing comprehensive professional nursing care to adult patients. Responsible for planning, coordinating and delivering health care to pulmonary patients, their families/significant others; counseling and educating patients/families/significant others regarding lung cancer risks, assessments, diagnostic tests and clinical interventions, as well as other health care professionals; participating in discharge planning; and participating in research. As the Pulmonary Lung Nodule Navigator, is responsible for the identification and management of a specifically identified population of patients who require special monitoring (potentially catastrophic and/or chronic illness, high risk, high cost and multi-service, multi-provider users and patients). These solitary pulmonary nodule patients have health problems associated with complex healthcare needs, requiring management at all levels of inpatient and outpatient treatment. Typically, these patients require specialized care and placement within the DOD health care system, local health care network or TRICARE Service network.
1. Pulmonary Lung Nodule Navigator: Facilitates communication and coordinates medical services between all members of the health care team and medical facilities thus minimizing fragmentation in the delivery of services for patients undergoing surveillance for solitary pulmonary nodules throughout Pulmonary Disease Services. Serves as primary point of contact for lung nodule patients after initial diagnosis and until surveillance is no longer required. Responsible for monitoring, coordinating care and educating lung nodule patients and families as they move through the Brooke Army Medical healthcare system and network. Responsible facilitating patient tracking by scheduling of referral and follow up appointments, procedures, tests, results, and chest conferences. Responsible for managing the pulmonary nodule tracking database. As the lung nodule navigator collaborates with all of the pulmonary medical team on the design and use of the nodule registry. Ensures data quality is not corrupted. Verifies CT scan orders are placed, notifies patients by mail to schedule their scans, ensures the test is performed within the timeline ordered, notifies physicians of CT scan results, enters follow-up testing requirements into the database, ensures patient follow-up of results is documented in the electronic health record, and physicians are notified when patients fail to complete ordered tests. Collaborates with physicians on patient management. Screens patients for clinical trials as offered. Identifies and resolves unmet needs of the patient, i.e. emotional support, patient education, etc. Functions as a consultant and, by interview, assists the lung nodule patient and family to cope with an existing problem or situation. Consultation consists of problem solving this may be with an individual, group, agency or colleagues. Problems usually concern, but are not limited to standards of care, testing modalities, facilities and delivery systems/processes. Responsible for ensuring optimal patient outcomes for the patient diagnosed with a solitary pulmonary nodule and his/her family by means of biopsychosocial assessment, coordination with the interdisciplinary services, and evaluation of the nursing process. Essential activities are provided throughout the continuum of care and span multiple environmental settings with diverse systems, providers, and levels of care. Intervenes or interacts, when necessary, with all relevant components of the client's health care system. Assesses individual patient/family and staff need for education, method of preferred learning and readiness to learn. Responsible for screening, scheduling and performing group and individual education on lung cancer screening for qualifying patients. Develops patient education materials and refers patients to smoking cessation classes. Identifies and resolves unmet needs of the patient, i.e. emotional support, patient education, etc. Develops educational materials and provides instructions and learning opportunities which help explain disease, treatment, side effects, and expected outcomes and which involves the patient in his/her own care. 50%
Clinical Nurse Duties: Provides an advanced level of specialized nursing care to labor intense and critically ill patients requiring an intermediate level of technological interventions in the Bronchoscopy and Fluoroscopy suites while they are undergoing bronchoscopy, pleural biopsies, laryngoscopy, thoracentesis, fine needle aspiration, tunneled catheter insertion, and other pulmonary procedures within the field of pulmonary disease. Obtains patient history, pertinent family history, and advanced medical directive information. Observes, assesses, and records symptoms, reactions, and progress; assist physicians during treatments and examinations; administer medication; administer prescribed treatments, completes admission and discharge, convalescence and rehabilitation paperwork. Performs pre-procedure screening, provides patient education, and coordinates with anesthesia services as required. Typically, patients will require conscious sedation. Such patients are also characterized by underlying pulmonary disease with the potential for life threatening pulmonary or cardiac complications. Sedation patient requires continuous observation and intervention to prevent complications and restore or maintain stability. Initiates life-saving measures. These measures include calculating dosages, preparing and administering potent and potentially lethal resuscitation drugs, preparing the patient for endotracheal intubation, administering oxygen therapy, defibrillating the patient, regulating and monitoring the infusion of intravenous fluids, blood volume expanders, and blood transfusions to maintain blood pressure, and preparing the patient as the need arises for chest tube insertion. In the absence of the physician, selects and directs technicians and/or nurses in the administration of emergency procedures and/or medications. Directly assists physicians during bronchoscopy procedures to control bleeding by preparing and administering Tranexamic Acid, Epinephrine and chilled saline via the bronchoscope Assists with conscious sedation on patients undergoing procedures in the bronchoscopy suite. Recovers patients undergoing procedures with General Anesthesia administration. Continually observes, monitors, and assesses patient's condition. Interprets signs and symptoms of deterioration and takes corrective action. Obtains and maintains vascular access for patients with implanted ports, and, or insertion of peripheral intravenous lines for the administration of intravenous fluids, sedation/ analgesia, and resuscitation medications. Prepares equipment for, and performs invasive hemodynamic monitoring as required for patients undergoing procedures within the clinic.
Initiates and monitors capnography for sedation analgesia procedures. Provides primary support to several subspecialty clinics of pulmonary to include the Ambulatory Sleep Clinic, Xolair-(Allergy/Asthma) Clinic, Smoking Cessation Program, and Asthma/Congestive Obstructive Pulmonary Disease management and other high risk pulmonary disease states. Assists in the scheduling of patients; prepares paperwork and studies for the LIP; relaying important information telephonically between the LIP and the patient; serving as a liaison for scheduling of follow-up appointments to include appointments within pulmonary and in other clinical areas (e.g. PFTs, exercise studies, CT scans, ECHO, subspecialty consults); and correspondence with high-risk patients. Assesses patient/family knowledge level, develops and implements a plan of instruction and documents demonstrated level of understanding. Manually and/or electronically documents in patient medical record all patient care and patient progress or lack of progress. Verifies transcription of physician orders. Calls reports to the appropriate unit/ward utilizing Situation, Background, Assessment, Recommendation (SBAR) standardized healthcare communication and pertinent data such as surgical procedures performed, patient problems, nursing diagnosis and actions, patient response, specialized care and equipment necessary to support the patient. Performs telephone triage, communicates with other health care providers and updates pulmonary clinicians, assist with other pulmonary education. Perform duties in accordance with established infection control protocols. Responsible for quality assurance/risk management and responds to breaches of standard procedures which compromise the patient or staff members. 50%
Performs 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.