Licensed Vocational Nurse - Progressive Care Unit

Job TitleLocation: Fort Sam Houston - Brooke Army Medical Center (BAMC), San Antonio, TXOperation Coverage: 7 days a week, 24 hours a day, including holidays.Pay: $28.50/hr, Health & Wellness $5.09*/hr worked (in lieu of benefits)Shift Lengths:8-hour shifts (with a 30-minute unpaid lunch/dinner break), or12-hour shifts (with a 30-minute unpaid lunch/dinner break).No more than 12 hours may be scheduled in a 24-hour periodBenefits: Vest vacation, sick leave, holiday leave, Life, Accidental Death and Dismemberment, Short Term DisabilityOptional Benefits: Medical, Dental, Vision, 401(K) matching with employee participation in 401(K) planResponsibilitiesPerform the same clinical duties as military/civil service nurses of similar experience; may be designated for team lead responsibilities or clinical orientation.Insert IV catheters, perform phlebotomy and arterial blood draws (with required training).Obtain patient and family history; observe, assess, and record symptoms, reactions, and progress; assist physicians and RNs during treatments and exams; complete admissions/discharges.Assess patient/family knowledge, provide education, and document care in the medical record.Develop and manage nursing care plans; instruct patients/families on proper care and health maintenance.Administer medications within scope of practice (IV, oral, subcutaneous, intramuscular, rectal, transdermal); monitor administration of blood products (cannot start transfusions).Perform direct patient care (range of motion, lifting, turning, transporting, positioning, hygiene care, changing linen/clothing, feeding patients).Manage care for patients with high infection risk or on life-support equipment.Ensure proper procedures with tissue/skin bank and blood bank.Provide professional oversight for CNAs/unlicensed personnel, and collaborate with other healthcare providers.Follow infection control protocols, respond to breaches, and participate in research/committees as needed.Participate in patient care conferences, nursing reports, and discharge planning.Demonstrate ability to manage interpersonal relationships, stay composed under stress, and act in emergencies (e.g., CPR, hemorrhage, trauma)The PCU LVN provides an advanced level of specialized comprehensive nursing for highly complex patients with real or potential life-threatening emergencies and involve labor intense nursing interventions. Plays an integral role in assisting the RN in observing the patient's changing conditions and participates in developing and updating in the electronic medical record the patient plan of care and nursing diagnoses, based on comprehensive assessments in accordance with recognized professional and institutional standards of practice and scopes of care. Observes and monitors: vital signs, symptoms of deterioration in condition, and assists the RN in the identification of normal and abnormal cardiac rhythms. Utilizing the early warning scoring system, takes emergent corrective action within his/her scope of practice. Initiates lifesaving measures, which include cardiopulmonary resuscitation and assisting the RN in performing arterial punctures and troubleshooting respiratory adjunctive therapy.Starts intravenous lines in accordance with institutional infection control standards. Works with non-titratable vasoactive drips and assist in management of non-titratable vasoactive drips (i.e.amiodarone, diltiazem) and other non-titratable continuous IV infusions (bumex, Lasix). LVNs are trained to assist in the management of ventilators and are validated through training and competencies to manage patients on long-term stable ventilators through tracheostomy. LVNs are trained to manage patients on continuous BIPAP/CPAP.Performs a vast array of direct patient care procedures to include but are not limited to: assist in the management of epidurals, range of motion exercises, lifting, turning, transporting and positioning patients, personal hygiene care, changing linen and clothing and feeding patients. Transports seriously ill patients for various diagnostic procedures.Administers and monitors the use of medications in accordance with Department of Nursing and unit level policies/guidelines. Assists in the administration of intravenous fluids Assist in the administration of anticonvulsants, insulin and thrombolytics and monitors patient condition per recommended guidelines; is familiar with correct dosages and potential side effects. Assists the RN with complex and potentially life-threatening procedures to include insertion of endotracheal intubation, invasive arterial and central venous catheters and chest tubes. Inserts intravenous catheters, performs phlebotomy and arterial blood draws. Monitors intake and output of fluids and notifies physician when caloric and fluid requirements have changed. Assesses patient vital signs, level of consciousness and other neurological and early interventions or escalation of care utilizing methods outlined in the PCU scope of service. Use emergency crash/code cart appropriately during patient emergencies. Maintains patency of patient airway to include suctioning patient nasopharyngeal airway, tracheostomy tube or endotracheal tube. After receiving PCU training, is able to manage chronic and stable mechanically ventilated patients.QualificationsEducation: Graduation from a State Board of Nursing–approved LPN/LVN training program, or Completion of equivalent military training that permits sitting for the state licensure exam.Licensure: Must hold a current, active, valid, and unrestricted LVN license from any U.S. state, D.C., or territoryCertifications: The LVN shall possess and maintain a current certification in Advanced Cardiac Life Support (ACLS).Experience: The LVN shall have at least one (1) year of full-time experience working as an LVN in an Adult Progressive Care Unit (PCU) or equivalent and a minimum of two (2) years (full-time) in clinical nursing within the last four (4) years. Complete BAMC Telemetry test within the first 30 days.