Nurse Midwife (JR229486

Introduction

To heal, to teach, to discover and to advance the health of the communities we serve.

For positions that have only a rate listed, the displayed rate is the hiring rate but could be subject to change based on shift differential, experience, education or other relevant factors.

The Nurse Midwife maintains standards of the practice for nursing as defined by the American Nurses Association Code of Ethics, Nursing Scope and Standards of Practice and Nursing's Social Policy Statement.

The Nurse Midwifeactualizes the vision, mission, values, and balanced scorecard performance measures for Montefiore Medical Center.

The Nurse Midwifeparticipates in performance improvement/research activities; maintains professional practice standards and clinical expertise; and demonstrates leadership skills. The Nurse Midwifedemonstrates core and unit specific competencies based on the patient population served.

The nursemidwifeassumes complete responsibility for the care and management of essentially healthy women in accordance with themidwifery practice agreement and with institutional practice privileges.

The nursemidwifeparticipates in educational activities for healthcare students and assists with research studies.

Schedule:

12 hour shifts;
Rotating days and nights in 2 week blocks

Day shift start time: 8am

Night shift start time: 8pm

Under the supervision of the attending physician and using departmental protocols, manages antepartum,intrapartum, & postpartum patients presenting to our Labor & Delivery Unit.

Obtains physician consultation for the management of medical or obstetrical complications not addressed in departmental protocols.

• * Takes pertinent history.
• * Performs physical and pelvic examinations.
• * Orders laboratory and diagnostic tests including non-stress tests and evaluates results.
• * Provides counseling and teaching as needed.
• * Identifies risk factors and develops appropriate plans of management to address the same.
• * Documents patient care, assessment plan, intervention, and response.

Takes complete responsibility for patients during labor and delivery as long as their progress remains within the bounds of themidwifery collaborative agreement. Manages emergency situations such as postpartum hemorrhage, shoulder dystocia, or infant resuscitation in a conventionally approved manner until physician assistance arrives. Obtains physician consultation for plan of management for any medical or obstetrical complications.

• * Evaluates the status of labor and makes decisions on admitting patients to the labor area.
• * Performs admission physical examinations within 24 hours.
• * Orderslaboratory and diagnostic tests and evaluates results.
• * Evaluates progress of labor by vaginal exam.
• * Makes decision regarding ambulation of patient during labor.
• * Inserts and managescervical ripening according to departmental protocols.
• * Provides analgesia.
• * Requests conductionanesthesia.
• * Performs amniotomy.
• * Applies the external fetal monitor and tocodynamometer.
• * Applies internal fetal scalp electrode and intrauterine pressure catheter.
• * Evaluates fetal monitor tracings and consults with physician if abnormalities are present.
• * Monitors patients on I.V. oxytocin and regulates oxytocin infusion for induction or stimulation of labor.
• * Makesdecision regarding the position(s) of the patients during second stage labor.
• * Makes decisions regarding performance of delivery in the labor room or transfer to the delivery room.
• * Utilizes local infiltration or pudendal block.
• * Performs and repairs episiotomies.
• * Conducts spontaneous deliveries of vertex presentation.
• * Conducts spontaneous deliveries of cephalic presentations in multiples pregnancies with physician in attendance.
• * Manages the labors and conducts the deliveries of vaginal birth after cesarean section (VBAC).
• * Obtains a section of cord for cord gases.
• * Manages the third stage of labor.
• * Performs cervical and vaginal inspection.

• * Repairs minor vaginal and perineal lacerations. Seeks physician consultation for repair of cervical or extended vaginal lacerations.
• * Takes responsibility for management of uncomplicated patients in the recovery room.
• * Decides when the normal infant should be transferred to the nursery.
• * Requests attendance of pediatrician at delivery when neonatal problems are anticipated.

Takes complete responsibility for postpartum patients who are essentially healthy. Shares responsibility for post-op cesarean patients, in collaboration with attending physicians and in accordance with departmental protocols. Obtains physician consultation for plan of management for any medical or obstetrical complication.

• * Makes daily nursemidwifery assessment rounds, examines the patient, orders and interprets laboratory results, diagnostic tests, monitors the postpartum course, and documents findings and care.
• * Provides and documents postpartum teaching and counseling.
• * Writes medication andnon-medication orders.
• * Removes dressings,surgical sutures and staples.
• * Makes…