Duties Manages specialized perioperative care of patients for a wide range of procedures. Performs duty as circulator and, if required, those of a scrub person during surgical procedures. Takes counts of needles, sponges, labels, handles, etc., and assures proper disposition of surgical specimens. Completes perioperative documentation. Monitors numerous and complex equipment such as lasers, computerized monitoring stereotaxic device, cardiac monitor, etc. Monitors all ongoing processes- anesthesia, surgery, aseptic techniques, equipment functions, patient response, and initiates/intervenes with immediate corrective action. Responsible for quality assurance/risk management; notes and responds to breaches of standard procedures which compromise the patient or staff members. Implements individualized nursing plans, to include safety precautions, correct positioning, infection control precautions, aseptic practices, qualified personnel assignments, medications, supplies, equipment, etc. Assesses progress of surgical procedures and patients response through sophisticated clinical observations and detailed data analysis. Makes independent perioperative nursing judgements and appropriate revisions in the care plan based on moment-to-moment changes in the patient's condition and responses. Implements crisis intervention techniques to provide support to the family. Assists surgeons with complex or potentially life-threatening procedures and assists anesthesia providers as needed. Maintain lines and dressings in accordance with infection control practices. Plans the integrated continuity of care, working in collaboration with other health care providers (surgeon, anesthesiologist, radiologist, pathologist, etc.) to determine and meet patient needs. Independently establishes surgical nursing protocols and coordinates activities of all team members. Assesses patient's physiological, psychosocial status to formulate a data base (nursing care plan) to include preparing goals bases upon nursing diagnosis, and develop patient outcomes. Reviews physician's orders, charts, and nursing assessment of patient and family history. Recognizes, identifies, and interprets serious situations and calls physician or takes preplanned emergency measures. Informs surgical team of plans, keeps all applicable surgical team members informed of changes to operative plan of care. Briefs post anesthesia nursing staff nursing staff on perioperative nursing orders and other pertinent data such as surgical procedure(s) performed, patient problems, nursing diagnosis and actions, patient response, specialized care and equipment required to support the patient, etc. Conducts postoperative nursing assessment immediately following surgery to determine validity of nursing care plan, outcomes, and long-range patient goals. Serves as preoperative nurse in Same Day Surgery setting, as required. Maintains all National and Air Force standards of practice. Performs as team leader/assistant team leader/nurse specialist for 1-2 surgical specialties, as required. As the recognized subject-matter-expert in the specialty, is consulted whenever difficult or unusual problems arise pertaining to specified specialty. Plans, develops, and initiates innovative therapies/protocols. Provides consultation to the Flight Commander, Operating Room Nursing Section, Element leader, experienced as well as inexperienced perioperative nurses, and other health care providers. Assumes roles as a nurse coordinator of/or assists with Quality Assurance, Infection Control, In-Service, as required. May serve as Charge Nurse/Operations Officer, responsible for the entire operative suite, assignment of personnel, daily surgery changes, and the preparation of next day's surgery schedule. Participates in research projects involving new surgical procedures or new technologies. Recommends procurement of medical care and support equipment, as well as capital expense equipment. As the budget, supply, and equipment manager for the specialty, researches, evaluates, and conducts cost studies of products. Contacts vendors, technical representatives, appropriate logistics personnel, nurse experts in other medical centers who are using the item(s), arranges for loaner to evaluate; drafts detailed documents and justification for ordering. Evaluates daily supply needs, consumption, updates supply lists, establishes quality controls to check outdated supplies, considers alternate materials or cost savings measures to control cost and waste. May supplement same day surgery nurse roles (with adequate training) in SDS or PACU, if required. Rotates evenings, nights, and weekend shifts, as required. Performs unique operating room procedures, treatments, and medication administration. Assesses patient's response to medication. Makes necessary judgments prior to the administration of medication based on knowledge of the affects of the medication on the physiological processes and current condition of the patient. Administers medication orally, intramuscularly, subsutaneously, intravenously, topically, etc. Maintains continual awareness of usual dosages of medications and calls unusual dosages to the attention of the physician. Orders drugs and narcotics as needed. Provides for safekeeping and accurate accounting of controlled drugs and narcotics in accordance with Air Force Regulations, Medical Group Regulations, and Department of Nursing guidelines. Initiates emergency procedures to include cardiopulmonary resuscitation (CPR) and assisting with advanced cardiac life support measures. Performs a range of nursing procedures such as dressing changes, catherization, wound irrigation, intravenous fluid administration, blood transfusion, and oxygen administration. Sets up, operates, and monitors therapeutic and emergency equipment, i.e., EKGs, cardiac monitor, life-pak, and IVAC, oxygen analyzers, and ventilators. 20% Serves as preceptor/instructor for newly assigned graduate nurses medical students, interns, and residents on the principles of scrubbing, gowning, gloving, surgical site prepping, and the use of multidisciplinary high tech equipment. Provides guidance, orientation, on-the-job training and leadership to other professional perioperative nurses and to paraprofessional personnel. Training is provided while incumbent is performing critical perioperative duties. Responsible for ensuring all nurses and technicians in the section are thoroughly familiar in scrubbing and circulating on all types of surgery performed. Includes teaching the reason for use, and function of simple as well as highly complex and potentially dangerous instruments and equipment. Instructs pre-operative patients. Develops lesson plans and presents continuing education classes for staff members. Performs other duties as assigned.