Nurse Midwife

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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.

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• 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 the midwifery 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.
  *Orders laboratory and diagnostic tests and evaluates results.
  * Evaluates progress of labor by vaginal exam.
  * Makes decision regarding ambulation of patient during labor.
  * Inserts and manages cervical ripening according to departmental protocols.
  * Provides analgesia.
  * Requests conduction anesthesia.
  * 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.
  *Makes decision 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 nurse midwifery 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 and non-medication orders.
  * Removes dressings, surgical sutures and staples.
  *Makes appropriate discharge plans and obtain consults from other specialties as needed.
  *Prepares patients for postpartum tubal ligation. Provides teaching and counseling for the patient and her newborn.
• Takes complete responsibility for family planning in post-partum patients who are essentially healthy.
  
  *Provides contraceptive counseling and care.
  a. Provides oral contraceptives Depo-Provera and the contraceptive ring.
  b. Inserts and removes IUDs.
  d. Inserts and removes hormonal implants.
  e. Provides counseling concerning spermicide, contraceptive sponges, films, condoms and natural family planning methods.
  f. Provides counseling concerning sterilization and abortion.
• Prescribes medications and educates the patient and families about the drug regimen, interactions and side effects.
  *Zero error tolerance.
• Participates in educational activities for healthcare learners, including Medical, Nursing, PA, Midwifery, students, residents and other visiting leraners..
  * Conducts didactic sessions.
  *Provides supervision of clinical activities.
  * Participates in evaluation of students.
• Maintains competency.
  * Attends Grand Rounds of Department of Ob/Gyn.
  * Attends conferences related to specialty area.
  *Meets ACNM Continuing Competency Requirement.
  *Maintains BLS, NRP and annual mandatory inservices.
• Participates in departmental QI activities.
  * Refers cases for review of management, as appropriate.
  *Participates in departmental QI meetings.
  *Participates in performance improvement initiatives.

• BSN Required
• Masters degree Required
• 4-6 years satisfactory clinical nurse-midwifery experience may be substituted for a Masters Degree
• OHS Fit Test Required
• OHS Annual Assessment Required
• Current New York State license as a Registered Nurse Required
• Current New York Midwifery License Required
• Certification for prescriptive rights by NYS Department of Education Required
• Current DEA registration Required