The primary purpose of this position is to provide comprehensive nursing care to non-urgent, urgent, and emergent patients in the emergency department. The organizational goals or objectives of this position are to provide nursing care to a broad range of patients from pediatrics through geriatrics presenting to the Emergency Department. Major Duties 1. Provides comprehensive professional nursing care to all patients presenting to the MTFs emergency department such as cardiac, medical, neurological, hematological, oncology, neonatal, and other medical specialties that require adaptation of established nursing procedures. Performs rapid patient triage and assigns appropriate triage category. Patient conditions include such ailments as acute myocardial infarction, abdominal pain, pediatric issues, obstetrical, neonatal, trauma, orthopedic injuries, neurological complaints, fever and flu-like symptoms. 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. Communicates patient status to physicians and supervisory nursing personnel. Accompanies and assists physicians with complex and potentially life-threatening procedures such as the insertion of arterial and venous catheters, chest tubes, and endotracheal tubes. 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 medications prior to arrival of the physician and administering drugs on the physicians directive. Performs various pulmonary ventilation treatments such as administration of oxygen, nebulizer treatments, and peak flow measures. Inputs patient care information in manual or automated record systems. 2. Mixes and administers prescribed medications orally, intramuscularly, subcutaneously, intravenously, topically, etc., and knows which drugs will alter the effects of another drug if administered concurrently prior to the administration of medicine. Assesses patients response to medication. Administers intravenous fluids blood volume expanders including blood transfusions, and infrequently used and special drugs. 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, respirators, ventilators, various intravenous infusion pumps and defibrillators. Sets up, operates, and monitors therapeutic and emergency equipment, i.e., EKGs cardiac monitor, life-pak, and IVAC, and oxygen analyzers. 3. Participates in continuing education program to update and/or maintain skills and knowledge to meet annual requirements. Participates in departments in-services, meetings/briefings, and in continuing quality improvement measures. Participates in evaluation of the quality and effectiveness of activities/services of the unit by organizing nursing monitoring and evaluation activities. Participates in planning care conferences and with other nurses and nonprofessional personnel to determine and communicate the steps needed to achieve the aims of the total staff. 20% 4. Assesses patient and family to include physical and psychological needs. Provides instructions to patient/significant other and/or family members. Provides individualized, thorough instructions prior to diagnostic procedures. Emphasizes the preventive, curative, and restorative aspects of instructions. Follows established protocols using professional judgment in individualizing instructions to meet each beneficiarys needs. Directs the activities of ancillary personnel engaged in carrying out the nursing and administrative duties. Ensures assignments are compatible with the individuals skill level. Performs patient teaching with patients requiring special approaches. 5. Serves as a resource person with whom other Emergency Department nurses and other health care providers consult when particularly difficult problems in care of critically ill patients arise. Serves as a role model to experienced emergency department 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. Performs other duties as assigned.