Certified Nurse Midwife (Full-Time) at MEMORIAL HEALTH SERVICES in LONG BEACH, California

Job Description:

Position Summary

A Certified Nurse-Midwife (CNM) is an individual educated in the two disciplines of nursing and midwifery, and who possesses evidence of certification according to the requirements of the American College of Certified Nurse-Midwives (ACNM).

The CNM provides a full range of primary health care services for women from adolescence on. These services include primary care, gynecologic and family planning services, preconception and prenatal care, childbirth and the postpartum period, and treatment for sexually transmitted infections. Provides initial and ongoing comprehensive assessment, diagnosis and treatment. Conduct physical examinations; prescribe medications including controlled substances and contraceptive methods; admit, manage, deliver spontaneous vaginal births, first assist in cesarean sections, round daily, and discharge patients; order and interpret laboratory and diagnostic tests and order the use of medical devices. Promote healthy living, disease prevention, and individualized wellness education and counseling.

Essential Functions and Responsibilities of the Job

In conformance with State Law, Nurse-Midwives practice under the supervision of an attending physician who has current privileges in the Department of Obstetrics and Gynecology. "Supervision" does not require the physical presence of the supervising physician. However, the supervising physician will be available within 30 minutes.

• The Certified Nurse-Midwife is authorized to manage and care for normal patients during the antepartum, intrapartum, post partum and intraconceptual periods.
• Conducting deliveries and caring for the newborn infant, including preventive measures and the detection of abnormal conditions.
• Obtaining physician consultation and assistance.
• Providing emergency care until physician assistance can be obtained.
• In addition, the Scope of Practice for the Certified Nurse-Midwife of OCMMC includes first assistance on Cesarean Section and Gynecological surgery after satisfying Department proctoring requirements as defined elsewhere in this document.
• A Certified Nurse-Midwife and physician jointly manage the care of a woman or newborn who has become medically, gynecology, or obstetrically complicated.

Principle Duties and Responsibilities:

A. ADMISSION

• Evaluates labor status for admission or discharge home.
• Reviews prenatal record and perform a physical exam.
• Obtains and dictates/writes complete history and physical as indicated.
• Counsels patients in the appropriate birth alternatives within the Department policies.
• Orders and interprets laboratory/diagnostic data.
• Initiates protocols and standardized procedures when appropriate.

B. LABOR

• Manages essentially normal intrapartum patients.
• Evaluates labor progress.
• Assesses fetal status, including the use of external and/or internal monitoring.
• When indicated, orders appropriate medications and solutions, including oxytocin, as specified by Department standardized procedures.
• Performs amniotomy when indicated.
• Assess size of fetus by using clinical estimate.
• Applies fetal scalp electrode and/or intrauterine pressure catheter as indicated.
• Amnioinfusion as indicated.
• Evaluates need for appropriate analgesia.
• Decides with the patient the need for epidural anesthesia and requests the anesthesiologist for his/her evaluation.
• Informs pediatrician and supervising obstetrician of anticipated fetal complications.
• Identifies complications, i.e., cord prolapse, fetal distress, abruptio placenta, etc., and institutes emergency measures until physician assistance is obtained.

C. DELIVERY

• Performs spontaneous vaginal delivery.
• Administers local anesthesia.
• Performs episiotomy when necessary. Repairs episiotomy/lacerations as needed.
• Requests NICU RN, Respiratory Therapist, and if indicated, Neonatologist presence for delivery of an infant with significant meconium fluid.
• Arranges delivery of the placenta and collection of cord blood and cord gas as indicated.
• Obtains appropriate cultures for prolonged rupture of membranes/chorioamnionitis.
• Orders appropriate antibiotics for chorioamnionitis after obtaining physician consultation.
• Identifies complications, i.e.: shoulder dystocia, hemorrhage, retained placenta, etc., and institutes emergency measures until physician assistance is obtained.
• Dictates/writes appropriate orders, notes, and summaries.

D. MEDICATIONS

• As specified by approved standardized procedures, Certified Nurse-Midwives may provide drug therapy as specified by department protocols and hospital formulary.

E. POST PARTUM

• Evaluates the mother and infant status in the immediate post partum period.
• Encourage family bonding, support the members as seems appropriate to their needs.
• Initiates routine post partum orders.
• Signs birth certificates.
• The Certified Nurse-Midwife performs rounds and the discharge of post partum patients per Department procedures; "Daily Evaluation and/or Discharge of Post Partum Patients" per standardized procedures.

Essential Job Outcomes

• Nurse-Midwifery Practice is the management of care of newborns and women, antepartally, intrapartally and/or gynecologically.
• Other duties as assigned

Experience

• Post education/training work experience as a CNM is preferred, but not required (new graduates will be considered)

Education

• Must have graduated from an accredited nurse midwifery program
• Be ACNM Board Certified (American College of Nurse-Midwives)
• Possess current California RN, Midwife, Furnishing and Federal Drug Administration Licenses
• Midwives must recertify every 5 years through AMCB and must meet specific continuing education requirements