The incumbents will be responsible for the assessment, plan, implementation and evaluation of nurse midwifery care delivered to antepartum, intrapartum, postpartum, and newborn patients based on established clinical nursing practice standards. The Nurse Midwife performs physical exams, collects and documents data, manages labor and spontaneous delivery, conducts diagnostic and therapeutic procedures, orders and schedules laboratory studies and professional consultations in collaboration with the patient’s medical and allied health team. The Nurse Midwife promotes safety and quality in clinical care and maintains an effective working relationship with support areas for optimum patient care.
- Ability and attitude to work and respond to the needs of culturally diverse clientele.
- Maintains professional and legal licensing standards.
- Evaluates patients and render care, within the scope of practice outlined by the Nursing Council of Jamaica.
- Teaches, counsels and assists patients and families regarding current health problems, health maintenance activities and preventive behaviours.
- Evaluates and modifies healthcare plans as related to patient compliance and outcomes, under the supervision of a physician.
- Admits, discharges, transfers, medicates and implements other orders as required for the management of patient care.
- Orders, performs and interprets screening and diagnostic procedures and tests, and appropriately communicates and documents information.
- Maintains detailed, legible and confidential medical records in accordance with established protocol.
- Assists Obstetrician in the Operating Room consistent with training and experience following policies, procedures and protocol as necessary.
- Acquires information on the most current developments and trends in the field of Midwifery through educational programs, in-service programmes, professional associations and literature.
- Participates in quality assurance activities.
TECHNICAL SKILLS REQUIRED:
- Assists Obstetrician with procedures relating to the ante, intra and post partum patient e.g. AROM.
- Scrubs and circulates for Caesarean Section and Tubal Ligation
- Performs vaginal examination and assesses effacement, dilatation, station, presentation, position of fetus.
- Set up a C/Section table
- Set up vaginal delivery table.
Interventions During Labour
- Change woman’s position as necessary.
- Coaches in breathing and relaxation technique.
- Does perineal preparation
- Provides emotional support
- Provides physical comfort measures.
- Conducts abdominal and pelvic assessment and reassessment to estimate time of delivery
- Supports, guides labor coach p.r.n.
- Mix, IV infusions using additives
- Starts IV lines
- Regulates IVs in order to titrate according to patients’ needs
- Uses heparin locks, keeps them clear
- Draws blood for laboratory studies
- Initiates and monitors blood products
- Use IV pumps
- Discontinues peripheral IV’s
- Administers IM, SC medications (analgesics, anticonvulsants, insulin, heparin, labour suppresants
- Administers narcotics, antibiotics
- Monitors IV drips
- Carries out Oxytocin induction/ and augmentation
OBSTETRIC TECHNIQUES AND PROCEDURES
- Carries out maternal / fetal surveillance using electronic monitoring, interpreting strips, reporting abnormalities promptly and recording.
- Intervening promptly and effectively or evidence of fetal or maternal compromise.
- Assesses and documents fetal status.
- Determines fetal presentation and position.
- Auscultates fetal heart rate (FHR) using fetoscope or electronically.
- Monitors uterine contractions using totransducer, untrasound, internal monitor
- Identifies FHR patterns – variability reactivity, decelerations – early, late, variable, tachycardia, bradycardia
- Assesses and documents maternal status – deviation from the norm – edema, deep tendon reflexes, clonuses, intake and output, testing of urine for glucose, protein, SG, ketones, vital signs according to stage of labour and patient stability.
- Assess and document progress of labour – contraction characteristic, changes in the woman’s behaviour, appearance, status of membranes
- Evaluate fetal activity.
- Prepare patient for and assist with ultrasound scan
- Conduct Stress (oxytocin challenge) and Non-stress tests and interpret results – report abnormalities promptly.
INTERVENTIONS DURING DELIVERY
- Prepare room for normal delivery
- Circulates on Ceasarean Sections
- Prepares patient for and assists doctor with Forceps/ Vacuum delivery
- Assists with Obstetric anaesthesia – general, regional and local -monitors those requiring special surveillance
- Provides care and monitor after rupture of membranes (SROM or AROM)
IMMEDIATE CARE OF THE INFANT AT BIRTH
- Assigns Apgar Scores
- Temperature maintenance.
- Collects cord blood samples
- Administers eye prophylaxis.
- Identifies infant using bracelet as per hospital policy.
- Physically examine newborn – identify anomalies, respiratory status.
- Suctions infant
- Transfers infant to newborn nursery.
- Weighs infant
- Initiates and or assists with resuscitation of the newborn as necessary
- Facilitates early establishment of bonding and breast feeding.
Academic qualifications and experience required for job
- Graduate of an accredited school of professional nursing.
- Current licensure with the Nursing Council of Jamaica as a registered nurse and registered midwife.
- Proficient verbal and written communication skills.
- Certification in midwifery or at least two (2) year’s experience in a maternity ward setting.
- Basic Life Support (BLS) Certification/ CPR/ Advanced Cardiac Life Support (ACLS) training evidenced with certification.
- Well developed interpersonal skills.
- Ability to work under pressure
- Exceptional Customer Service skills
- Excellent time management skills to balance patient needs and other required functions.
- Great team player