CRNA

Fargo VAMC

The Fargo VA Health Care System provides medical care and services through the Veterans Health Administration to veterans residing in North Dakota, western Minnesota and northern South Dakota. The health care system is a general medical/surgical/psychiatric facility with 42 acute beds and an attached 38-bed Community Living Center (CLC) providing extended care. Veterans are referred to the Minneapolis VA Health Care System for tertiary care. The health care system also supports 10 community-based outpatient clinics (CBOC), located in Bismarck, Devils Lake, Dickinson, Grafton, Jamestown, Grand Forks, Minot, and Williston, N.D., as well as Fergus Falls and Bemidji, Minn. During the last two years, outpatient visits for the healthcare system and the CBOCs have steadily increased to well over 100,000 per year. The health care system had over 2,000 admissions into the hospital each year over the last two years. The CLC provides extended care through admissions of over 400 patients each year during the past two years.

Basic Responsibilities:

• Provision of care in the most complex surgical procedures.
• Perform and document a preanesthetic evaluation of the patient before surgery including requesting consultations, additional diagnostic and/or laboratory studies in consultation with the anesthesiologist.
• After concurrence with the plan by the anesthesiologist, initiation of the planned anesthetic technique that may include general, regional, MAC, or local anesthesia. Interventions include administration of fluids, medications, ventilator support, provision of homeostasis, provision of adequate pain relief and management of anesthesia and surgical side effects.
• Induction of general anesthesia and initial airway management.
• Endotracheal intubation for surgical or procedural cases. Placement of endobronchial tubes or blockers for procedures requiring one lung ventilation or lung isolation.
• Central line placement; Pulmonary artery (Swan-Ganz) catheter placement
• Peripheral nerve blocks.
• Central neuraxial blocks.
• Epidural blood patches.
• Adjustment of anesthetic drugs and techniques utilized in the maintenance of anesthesia.
• Sedation for field blocks or MAC as discussed in the anesthetic care plan.
• Manages emergence from anesthesia after discussion and concurrence from the anesthesiologist.
• Provide anesthetic for: electroconvulsive therapy not requiring intubation; elective cardioversions; ICD checks.
• Participates on the Code Blue Team, primarily to manage the patient's airway, but also to perform other tasks which they are qualified to perform, as directed by the Code Team Leader.
• Emergency airway management throughout the facility, following the ASA Difficult Airway Algorithm and department protocols, as requested.
• Administer sedation or local anesthesia to facilitate urgent/emergent endotracheal intubation.
• Placement of intravenous lines throughout the facility, as requested.
• Management of epidural catheters for post-op pain relief within a protocol guideline ordered by the anesthesiologist.
• Placement of arterial lines as requested by the ICU's.
• Initiation of an anesthetic in an emergency that threatens the patient with loss of life or limb prior to the arrival of the anesthesiologist on-call.
• Participation in staff meetings, mortality and morbidity conferences and other committees as assigned by the Chief Nurse Anesthetist or Chief Anesthesiologist.
• Maintains anesthesia equipment in constant readiness and cleans equipment in accordance with hospital guidelines, SOPs, manufacturer's recommendations and CDC guidelines.
• Prepares drugs properly for use in anesthesia administration per department SOP • Precepts CRNA students.
• Ensures that OR/anesthesia safety regulations and procedures and infection control policies and procedures are observed.
• Complies with Joint Commission National Patient Safety Goals.
• Fully complies with medical center Correct Site/Universal Protocol requirements, including pausing activities during pre-operative time-out.
• Complies with VA and Joint Commission documentation requirements.
• Labels specimens according to medical center policy.
• Participates in continuous improvement activities.
• Participates in outcomes evaluation and recommendations for practice improvements.
• Conducts in-service programs for the department and other services within the medical center.

Qualifications:

• Graduate from an approved School of Nursing and hold an unencumbered current state licensure as an Advanced Practice Registered Nurse.
• Must have reserved a Board Certificate.
• CRNA shall have a current license to practice medicine in any State, Territory, or Commonwealth of the United States or the District of Columbia.
• Should have at least one full year (12 months) experience as a CRNA.

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