CERTIFIED NURSE MIDWIFE

Position Summary:
This position is located in the Obstetrics and Women’s Health Department of the Sage Memorial Hospital (SMH). The incumbent serves as an Independent Licensed Practitioner, Certified Registered Nurse Midwife, who specializes in gynecologic health, reproductive and sexual health, family planning, primary care, preconception counseling, and maternity care from the first prenatal visit through postpartum period. Assignments also include providing consultations to others in the same or other specialties. Assignments may include various work shifts on nights, weekends, and holidays in addition to normal daytime work hours.

This list of duties and responsibilities is illustrative only of the tasks performed by this position and is not all-inclusive.

Essential Duties & Responsibilities:
• Provides independent diagnostic, preventive and therapeutic nursing and medical services for patients of varying complexity. Duties reflect the growing significance of evidence-based practice, evidence-based interventions, and population- based chronic care management. Initiates and implements strategies to evaluate outcomes of practice, practice patterns, and systems of care for women against National benchmarks.
• Assesses acute and non-acute clinical problems. Obtains and records a problem- oriented health history; orders and interprets related laboratory and diagnostic tests; performs a systematic physical examination and interprets abnormal and normal findings to form a diagnosis regarding physical, emotional, or social disabilities.
• Independently manages labor and childbirth in accordance with clinical privileges. Utilizes experimental theories and new developments in the solution of complex health care problems, not susceptible to treatment by accepted methods. Prescribes medications; initiates emergency care, as appropriate. Conducts interdisciplinary and interdisciplinary collaboration with physicians regarding patient management, to include evaluating and revising therapeutic plans and managing high-risk, unstable, or extremely complex patients, including the intrapartum setting. Makes a diagnosis by: utilizing critical thinking in the diagnostic process; synthesizing and analyzing the collected data; formulating differential diagnosis based on the history, physical examination, and diagnostic test results; establishes priorities to meet the health and medical needs of the individual, family or community.
• Provides comprehensive independent patient management services which may include the following if appropriate:
1) Writing admission, transfer, and discharge orders;
2) Documenting patient histories;
3) Ordering appropriate laboratory, radiologic and other tests and procedures necessary for patient assessment and diagnosis;
4) Ordering appropriate medication and treatments, the Nurse Midwife has full prescriptive authority.
5) Obtaining necessary clinical consultation when indicated.
6) Documenting through in-depth progress notes and dictation summaries;
7) Providing skillful monitoring of patients for possible adverse reactions to drugs or procedures that may require emergency treatment or revision of the prescribed regimen.
8) Performing emergency management procedures on unstable patients.
9) Exercising sound judgment and initiating emergency measures and interpreting observations to physicians;
10) Predicts and analyzes trends in patient conditions and develops a patient management plan in response to the data obtained;
11) Communicates and collaborates with the multidisciplinary team to ensure that patient management strategies are successful in meeting patient care and/or research needs.
12) Exercises responsibility and accountability for health promotion and patient education.
• Initiates and provides emergency care measures in the event complications occur to include resuscitation of the mother and newborn: intubation, administering oxygen, cardiopulmonary resuscitation (CPR), etc. Manages the treatment of hemorrhage and shock, starts intravenous therapy, prescribes and administers medications, and initiates lifesaving treatments. Maintains a process for systematic follow-up by; determining the effectiveness of the treatment plan with documentation of patient care outcomes, reassigns and modifies the plan with the patient and family as necessary to achieve health and medical goals. Together with the patient and family, establishes evidence based, mutually acceptable, cost-effective plan of care that maximizes health potential.
• Counsels patients and families in health education, for a diverse and complex patient population with consideration of the patient’s learning needs, learning readiness and impediments to the process. Serves as a patient advocate along with other health care professionals. Collaborates with the patient, family and significant others in developing plans that consider and respect the patient's cultural background, level of understanding, and available resources and support systems.
• Acts as a preceptor to graduate students, residents, nurse-midwives and/or nurse practitioners new to the organization. Performs clinical practice peer review and develops multidisciplinary quality improvement programs and projects. Collaborates with peers and other multidisciplinary team members to analyze and evaluate current systems of health care delivery and to identify and implement new practice patterns as appropriate.
• Demonstrates expertise in data management and computer skills. Reviews patient’s charts to collect relevant clinical data. Analyzes trends in patient responses.
• Recognizes patient issues that demand physician's immediate attention. Maintains and analyzes computerized data and independently develops charts, graphs, and statistical analyses from clinical data.
• Performs quality assurance and quality control activities as they relate to protocol adherence, protocol monitoring, data collection, data abstraction and data analysis.
• Provides clinical consultation during provision of patient care and utilizes epidemiologic data and incorporates evidence-based practice into new program development.
• Provides consultation to the healthcare team related to implementation and evaluation of specific protocols. Monitors and documents response to therapy and communicate findings to Chief Medical Officer with recommendations for appropriate intervention.
• Conducts patient care rounds and conferences. Presents patient cases and topics for patient care conferences for the express purpose of improving patient and research processes and outcomes.
• Provides specialty consultative services to colleagues in nursing, medicine and other disciplines.
• Completes administrative duties as assigned, including, but not limited to, completion of patient records, peer review, monthly reports, and attendance at required and assigned meetings. Participates in Quality Improvement programs and initiatives, ensuring compliance with Joint Commission and applicable standards.
• Performs other duties as assigned.