This position is located in the Department of Nursing Services, Evans Army Community Hospital (EACH), Fort Carson, CO. Incumbent serves as Supervisory Clinical Nurse in one or more of multiple clinical areas: Surgical Screening Clinic, Operating Room, and, as required, Recovery Room. Directs professional and paraprofessional nursing personnel, both military (E-1 to 0-5) and civilian GS- 4 to GS-11), assigned to various patient care areas. The position requires knowledge of management processes, skills and procedures and knowledge of civilian personnel policies, union contracts, labor relations policies, and regulations pertaining to military and civilian employees. The position requires expert knowledge and clinical competence in the provision of nursing care for a wide variety of medical disorders, i.e., critical care, general surgery, orthopedics, obstetrics, gynecology, oncology, cardiology, respiratory, pediatric, psychiatric, acute minor illnesses, emergency care, triage, endocrine disorders and trauma, including the normal course of diseases, anticipated complications and indicated therapeutic interventions. Teaches and mentors professional and paraprofessional nursing staff, assisting with complex nursing and diagnostic procedures. Professional knowledge of nursing concepts, principles, and practices are required to assess the needs of assigned patients and monitor care. May be required to assume the role of Clinical Nurse Officer in Charge or Evening Night Supervisor. May require on call and working rotating clinical shifts. 1. SUPERVISORY DUTIES a. Plans and organizes work. Through charge nurses who direct, coordinate and oversee work of their respective units within the Department, plans work schedules and sequence of operations to ensure safe, quality, patient care. Ensures an adequate level of staffing. Changes organization of work and assignment of functions to improve workflow and services provided. Prepares plans to meet significant changes in workload and justifies revisions in staffing levels, work priorities and deadlines. Plans for the adequate provision and accountability of supplies. Composes and submits reports pertaining to work operations, continuous quality improvement and risk management issues. Coordinates patient care activities, manages clinic and patient records. Follows quality improvement and internal control activities to include risk appraisals, chart audits, trend identification and reporting corrective actions. Receives, investigates, and documents on patient complaints pertaining to their time in the Emergency Department. May be required to complete periodic workload reports and automated data system reports. Attends administrative meetings and participates in assigned committees. b. Assigns and reviews work. Ensures that work output is of an acceptable quality and quantity. Ensures that work is equitably assigned to employees. Makes nursing care assignments to various skill levels of professional and ancillary health care personnel. Assigns staff to patient care duties based on patient condition/status, expertise and scope of practice. Monitors and oversees staff performance to ensure work is accomplished in an acceptable, safe, and timely manner. Responsible for narcotic accountability. Monitors and oversees staff during orientation/preceptorship periods. Responsible for all nursing operations within assigned work area. Provides employees direct administrative and technical guidance on work requirements and procedures. Monitors the quality and effectiveness of patient care rendered, nursing documentation, and the safety of the patient care environment in accordance with clinical, medical, medico-legal, requirements, nursing standards, policies and regulatory controls and protocols. Initiates changes to operating practices, policies and procedures that will promote effective, efficient, and quality health care to patients and supports the goals of the hospital and governing medical agencies and organizations. Ensures subordinate staff is kept current on applicable changes. Attends staff and required hospital and nursing committee meetings and participates in quality assurance and performance improvement initiatives and programs. Develops, plans, implements and monitors the Nursing Quality Improvement Plan for assigned work area and participates in the Nursing Services Quality Improvement Process. Serves as a resource to staff regarding institutional policies and procedures pertinent to the care of patients in specific assigned work area. Instructs subordinates in the use of simple and specialized equipment in the clinic as well as safety precautions in their use. c. Serves as immediate supervisor/rater/senior rater for military and civilian nurses, para-professional and administrative personnel assigned to the unit. Plans, organizes work to be accomplished, establishes priorities, makes assignments, monitors progress in terms of timeliness and accuracy of work performed, and makes temporary reassignments of employees between jobs to meet workload demands. Establishes performance standards and prepares performance appraisals. Gives advice, counsel or instruction to employees on both technical and administrative matters. Makes decisions on work problems presented by employees, hears and resolves group grievances and effects disciplinary action such as warnings and reprimands involving non-supervisory subordinates and recommends action in more serious cases. Determines need for and recommends developmental and training needs of employees. Accomplishes reviews for improvement of performance to ensure the most effective and efficient operation. Interviews and recommends candidates for vacant positions. Recommends awards or bonuses for employees and changes in position classification. Instructs on new and existing policies and procedures and assists in interpreting and applying regulatory guidance. Tracks expenditures, manages the budget and accounts for all unit equipment. Assures military personnel are in compliance with Medical Company directives and rosters. Assures adherence to equal opportunity and safety programs in accordance with established policies and procedures. Conducts staff meetings and coordinates in-service training. Conducts periodic review and revision of staff competency orientation folders. Establishes and maintains clinic nursing policies and procedures in compliance with Evans Army Community Hospital Nursing Service policies. Relays pertinent information regarding these policies and procedures to subordinate staff. Maintains records, reports, manuals, procedure guides, and job descriptions and performance standards. Supervises the clinic Performance Improvement Program, Infection Control Program and Patient Safety Program in conjunction with the NCOIC. 2. TECHNICAL DUTIES a. As a clinical nurse, provides comprehensive nursing care to patients to include critically ill patients in outpatient and inpatient units: Surgical Screening Clinic, Recovery Room, Pre-Op, Operating Room, Sterile Processing Department, Post-Anesthesia Care Unit, Pre-Admission Unit, Infusion Therapy Clinic, Emergency Room, Labor and Delivery Recovery and Post-Partum (LDRP) Unit, Medical Surgical Unit, Inpatient Behavioral Health Unit or Outpatient Clinics, based on the work area assigned, using knowledge of professional nursing theories, principles, and procedures; knowledge of clinical skills to provide specialized services to patients; knowledge of emergency and resuscitative measures; knowledge of pharmaceuticals sufficient to mix and administer special, potent, and potentially lethal drugs; and skill to operate specialized medical equipment. Observes, monitors, and assesses patient's condition; recognizes, identifies, and interprets serious situations; determines and implements proper emergency measures; performs various pulmonary ventilation functions; administers prescribed medications; operates and monitors highly complex technical equipment, i.e., hemodynamic monitoring devices, etc. Independently reacts to emergencies, collaborates with physician, makes changes in nursing care plans, assesses patient's condition, and implements nursing care plans. Participates in the training of military and civilian students. b. Possesses comprehensive, advanced knowledge of clinical area assigned: Surgical Screening Clinic, Operating Room, and Recovery Room Provides comprehensive nursing support to all patients in the Perioperative Center to include Phase I and Phase II recovery based on American Society of PeriAnesthesia Nurses (ASPAN) guidelines and American Association of Operating Room Nurse (AORN) Perioperative Nursing Standards of Practice and Care. Advises attending physicians of abnormalities in patient's data in a timely manner. Ensures that all requirements for surgery have been accomplished prior to their departure for their procedure. Coordinates timely arrival of patients for procedures. Obtain necessary labs, radiological tests, and cardiac work-up according to orders and Anesthesia Protocol. Alerts surgeon and anesthesiologist of abnormal results and initiates consults as needed. Coordinates with anesthesiologist for further evaluation and additional work-ups. Instructs patients and families regarding pre-operative preparation and initiates post-operative teaching. Provides patient with written instructions for admission process and assists as needed. Provides patient and family counseling in order to provide support and information on possible reactions to surgical procedures and medications. Documents abnormal findings and actions taken in nursing notes. Completes preparation of chart with necessary documentation. In the absence of a physician, independently determines and implements proper emergency measures after identifying and interpreting life-threatening conditions and initiating life-saving measures, such measures include Advanced Cardiac Life Support (ACLS) and mixing and administering special, potent and potentially lethal medications such as nipride, atropine, lidocaine, etc. Performs various pulmonary ventilation treatments such as administration of oxygen and compressed air through various means. Performs waived laboratory testing. Assists anesthesiologists with complex procedures such as epidural catheter insertion, blood patches, and regional blocks. Administers medications (oral, subcutaneous, IM, IV), including potent narcotics, in accordance with physician's orders. Observes patient for adverse reactions and takes immediate counteractions as required to restore condition. Advises physicians of actions taken and ensures proper documentation of nursing care provided on standardized nursing forms. Sets up, operates and monitors highly complex technical and specialized medical equipment such as cardiac monitors, oxygen delivery systems, arterial lines, chest tubes, defibrillators, suction devices, pulse oximeter, hemodynamic monitoring devices and hypothermic devices, etc. Competent with access, care and maintenance of various types of venous access devices to include, but not limited to Peripherally Inserted Central Catheters (PICC), Central Lines, port-a-cath, Hickman line, etc. Provides infusion therapy for medication, blood products and intravenous infusions. Consults with physician regarding medical and nursing management of patient care needs. Performs other duties as assigned.