**Overview** Madigan Army Medical Center is seeking Critical Care RNs to join our growing team! 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. Located in the beautiful Pacific Northwest on the Puget Sound, in Washington State, Joint Base Lewis-McChord 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. On a clear day, 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/ . **Responsibilities** Duties: As a nurse specialist, the incumbent will provide an advanced level of specialized nursing care to all critically ill patients. Such patients are either recovering from major surgery or are characterized by the presence of real or potential life-threatening health problems due to the requirement for continuous observation and intervention to prevent complications and restore health. --In the absence of a physician, independently determines and implements proper emergency measures after identifying and interpreting life-threatening conditions by initiating life-saving measures. Within given parameters, initiates advanced cardiovascular life support measures by mixing and administering special, potent and lethal drugs (nipride, dopamine, atropine, nitroglycerin, dobutamine, etc.) as well as intravenous fluids. Administers special medications via oral, intramuscular, subcutaneous, intradermal, etc. (including intravenous push) routes. Defibrillates if ventricular fibrillation occurs without physician in attendance, under established guidelines. Performs various pulmonary ventilation treatments such as administration of oxygen and compressed air through various means. Administers a variety of respiratory therapy treatments as prescribed. --Assists physicians with complex or potentially life-threatening procedures such as cardioversion and insertion of invasive lines, e.g., arterial, venous, and pulmonary artery catheters. Discontinues invasive lines as ordered, under established guidelines. Maintains invasive lines and dressings as prescribed by Infection Control Policies/Procedures and Guidelines. Assists physician with preparation, insertion, and inflation of intra aortic balloon. Assesses patients' response regarding cardiac output, vital signs, peripheral perfusion, and level of consciousness. Performs continuous respiratory ventilation assessments evaluating blood gas results of both arterial and mixed venous. Makes appropriate adjustments in preparation for extubation, within established guidelines. --Independently formulates data base relative to patients' psychological, sociological, and physiological condition in order to provide assessment of the patients' problems, strengths, and limitations. Monitors patient's condition through data collected by continuous observation and precise calculation of fluid levels and vital signs. Determines, prescribes, and implements nursing orders. Evaluates nursing interventions based on patient's response and revises nursing care plan accordingly. --Develops meaningful goals to assist the critically ill patient and family in attaining the optimum level of physiological, sociological, and psychological balance within the limitations imposed by the illness. Provides constant support to patient and family by providing information on disease process, pre-operative and post-operative care, diagnostic procedures, use of equipment related to disease/care, expected and possible adverse reactions to medications, health maintenance, and illness prevention. On a consultation or referral basis, refers patient/family to allied health care providers such as Chaplain, Community Health Nurse, Social Worker, etc., as needed/required. --As an expert in the nursing care of critically ill patients in one or more areas (coronary care, surgical, neurological, medical, neonatal, etc.), serves as a resource person with whom other critical care nurses and other health care providers consult when particularly difficult problems in the care of critically ill patients arise. Serves as role model to experienced critical care nurses as well as those who are not fully trained. Provides guidance and leadership to other professional nurses and supervises Para-professional personnel. Provide orientation and on-the-job training for such personnel. Performs other duties as assigned. **Qualifications** Must be a United States Citizen. Must possess a valid Registered Nurse License that has not elapsed/expired. Must have an Associates, Bachelors or Master’s Degree in Nursing.This education must have been accredited by the Commission on Collegiate Nursing Education, Council on Accreditation of Nurse Anesthesia Educational Programs, Accreditation Commission for Midwifery Education, or an accrediting body recognized by the U.S. Department of Education at the time the degree was obtained. Madigan is non-smoking facility. Apply for this Job Online (https://careers-civilianmedicaljobs.icims.com/jobs/8311/nurse-%28clinical-critical-care%29/job?mode=apply&apply=yes&in\_iframe=1&hashed=-336268516) **Location** _US-WA-TACOMA_ **Job ID** _2024-8311_ **\# Positions** _2_ **Category** _Medical_ **Salary Range** _GS-11_ **Recruitment Bonus** _Negotiable_ **Relocation Assistance** _Negotiable_ **Student Loan Repayment** _No_