Nurse Midwife

City/State:

Bronx, New York

Grant Funded:

No

Department:

OBGYN - Department Admin

Bargaining Unit:

1199 RN

Work Shift:

Day

Work Days:

ROTATING SCHEDULE

Scheduled Hours:

Hours Vary

Scheduled Daily Hours:

12 HOURS

Hourly Rate:

$90.00

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.

To learn more about the “Montefiore Difference” – who we are at Montefiore and all that we have to offer our associates, please click here.  

Job Summary

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 Midwife actualizes the vision, mission, values, and balanced scorecard performance measures for Montefiore Medical Center.
The Nurse Midwife participates in performance improvement/research activities; maintains professional practice standards and clinical expertise; and demonstrates leadership skills. The Nurse Midwife demonstrates core and unit specific competencies based on the patient population served.
The nurse midwife assumes complete responsibility for the care and management of essentially healthy women in accordance with the midwifery practice agreement and with institutional practice privileges.
The nurse midwife participates in educational activities for healthcare students and assists with research studies.

Essential Functions

• Takes complete responsibility for the antepartum care of essentially healthy women. Under the supervision of the attending physician and using departmental protocols, manages antepartum patients requiring hospital admission. 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 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 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.
  * Performs venipuncture and starts intravenous infusions.
  *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 Prostaglandin gel according to departmental protocols.
  * Provides analgesia.
  * Requests conduction anesthesia.
  * Performs amniotomy when the vertex is at 0 station or lower and charts indication.
  * 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 following the initial stabilization/monitoring by the physician.
  *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 including bimanual compression of the uterus as necessary.
  * Performs cervical and vaginal inspection.
  * Repairs minor vaginal and perineal lacerations. Seeks physician consultation for repair of cervical or extended vaginal lacerations.
  * Repairs third degree extensions with the physician in attendance.
  *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.
  *Performs immediate appraisal of the newborn.
  * Performs newborn physical examination.
  * Signs birth certificate of the delivery. (Operative deliveries require physician to sign birth certificate). GG.Performs circumcision of the neonate.
• 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 non-medication orders.
  *Writes medication orders.
  * Removes surgical sutures and staples.
  *Makes appropriate discharge plans.
  *Prepares patients for postpartum tubal ligation. H. Provides teaching and counseling for the patient and her newborn.
• Takes complete responsibility for gynecological and family planning patients who are essentially healthy.Obtains physician consultation for plan of management for any abnormal findings.
  *Takes pertinent history.
  *Performs physical and gynecologic examinations.
  *Obtains laboratory and diagnostic tests and evaluates results.
  *Provides contraceptive counseling and care.
  a. Provides oral contraceptives Depo-Provera and the contraceptive ring.
  b. Inserts and removes IUDs.
  c. Fits and prescribes diaphragms.
  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.
  *Diagnoses and manages common gynecologic conditions.
  *Provides and documents other health teaching and counseling as needed.
• 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 students.
  * Conducts didactic sessions.
  *Provides supervision of clinical activities.
  * Participates in evaluation of students.
• Participates in educational activities for healthcare students.
  * 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.

Qualifications

• BSN Required
• 4-6 years satisfactory clinical nurse-midwifery experience may be substituted for a Masters Degree. Required
• OHS Fit Test Required
• OHS Annual Assessment Required
• Registered Nurse New York 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

Montefiore Medical Center is an equal employment opportunity employer. Montefiore Medical Center will recruit, hire, train, transfer, promote, layoff and discharge associates in all job classifications without regard to their race, color, religion, creed, national origin, alienage or citizenship status, age, gender, actual or presumed disability, history of disability, sexual orientation, gender identity, gender expression, genetic predisposition or carrier status, pregnancy, military status, marital status, or partnership status, or any other characteristic protected by law.