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Certified Nurse Midwife

Employer
Partners HealthCare
Location
Madbury, New Hampshire
Closing date
Dec 2, 2023

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Discipline
Certified Nurse Midwife (CNM)
Specialty
Labor and Delivery
Position Type
Nurse
Hours
Full Time
Work Setting
Hospital / Medical Center
Wentworth-Douglass Hospital, an affiliate of Mass General Brigham, is committed to supporting patient care, research, teaching, and service to the community. We place great value on being a diverse, equitable and inclusive organization as we aim to reflect the diversity of the patients we serve. At Mass General Brigham, we believe in equal access to quality care, employment and advancement opportunities encompassing the full spectrum of human diversity: race, gender, sexual orientation, ability, religion, ethnicity, national origin and all the other forms of human presence and expression that make us better able to provide innovative and cutting-edge healthcare and research.

Wentworth-Douglass Hospital remains among the nation's top hospitals for patient experience as a recipient of the Healthgrades 2021 Outstanding Patient Experience Award for the eighth consecutive year. Wentworth-Douglass Hospital is renowned as one of the largest acute care hospitals in the Seacoast region of New Hampshire and Southern Maine. At Wentworth-Douglass, we value people who contribute to patient-centered care that enhances community health; we recognize and reward those who share our values and transform our patients' lives. We invite you to explore opportunities, cultivate community wellness and professional growth.

Cares for childbearing mothers during preconception, prenatal, labor and delivery, and postpartum periods, and provides family-planning counseling and gynecological care. Offers an alternative childbearing experience to low-risk, uncomplicated patients; the experience is considered more natural and intervention-free. Encourages active participation of the mother and their family during pregnancy and childbirth. Provides holistic, continuous care, safe clinical management, education, and, in some cases, primary care for women's health needs. This care includes preventative measures, the promotion of normal birth, the detection of complications in mother and child, the accessing of medical care or other appropriate assistance and the carrying out of emergency measures. Supports women during the normal childbirth process, and also ensures that mothers who have more complex health needs receive the care most suited to them from other members of the multidisciplinary healthcare team.

1. The Certified Nurse Midwife (CNM) at Wentworth Health Partners will be responsible for caring for patients from adolescence throughout the lifespan, including managing pregnancy, labor and birth. The CNM will work within our teams and will assist in delivering premium care to each and every patient. The CNM at Wentworth Health Partners shall practice within a scope as outlined in the American College of Nurse Midwifery (ACNM) Core Competencies for Basic Midwifery Practice.

2. Midwifery Management Process - The Midwifery Management Process, which applies to all areas of nurse-midwifery clinical care, identifies the following job duties/responsibilities of nurse-midwives:

a. Evaluate the woman or newborn

b. Identify problems or diagnoses and healthcare needs based on the collection of subjective and objective data

c. Anticipate any potential problems or diagnose

d. Evaluate the need for intervention, collaboration, or referral with other healthcare team member

e. Develop a comprehensive plan of care in partnership with the mother

f. Ensure the efficient implementation of a plan of care

g. Evaluate the effectiveness of the plan of care

3. Nurse-midwives independently manage primary health screening, health promotion, and the care from adolescence throughout the lifespan using the midwifery management process. Job duties and responsibilities include:

a. Adhering to nationally defined goals and objectives for health promotion and disease prevention

b. Assessing the physical, mental, and social health

c. Making screening and immunization recommendations as to promote health and detect and prevent disease

d. Implementing management strategies and therapeutics as to facilitate health and promote healthy behavior

e. Identifying normal and deviations from normal in the following areas:

  • ii. Cardiovascular/hematologic
  • iii. Endocrine
  • iv. Eyes, ears, nose, and throat
  • v. Gastrointestinal
  • vi. Mental health
  • vii. Musculoskeletal
  • viii. Neurologic
  • ix. Respiratory
  • x. Renal
f. Implementing strategies and therapeutics for treating common health problems, including infections, self-limited conditions, and mild or stable presentations of chronic condition

g. Overseeing issues related to the preconception period, such as:
  • ii. Individual/family readiness for pregnancy
  • iii. Factors such as family and genetic/genomic risk
  • iv. Factors such as environmental and occupational factors, lifestyle, nutrition, and medications
  • v. Health and lab screening
  • vi. Fertility awareness, symptoms of pregnancy, cycle charting, etc.
  • h. Overseeing issues related to gynecologic care, such as:
  • ii. Human sexuality
  • iii. Common screening tools and diagnostic tests
  • iv. Common gynecologic problems
  • v. Contraceptive methods
  • vi. Sexually transmitted infections
  • vii. Counseling regarding sexual behaviors
  • viii. Counseling, clinical interventions, and/or referral for unplanned pregnancies, infertility, and sexual/gender concerns
i. Overseeing issues related to the peri-menopausal and post-menopausal periods, such as:
  • ii. Physical, mental, and sexual effects of menopause
  • iii. Health maintenance and promotion counseling and educating
  • iv. Managing/alleviating common discomforts
  • j. Overseeing issues related to the antepartum period, such as:
  • ii. Maternal and perinatal morbidity and mortality
  • iii. Confirming and dating pregnancy
  • iv. Promoting a normal pregnancy
  • v. Addressing common discomforts of pregnancy
  • vi. Health risks, such as domestic violence, infections, and substance use/abuse
  • vii. Emotional, psychosocial, and sexual changes during pregnancy
  • viii. Guidance regarding birth, breastfeeding, parenthood, and change in family dynamics
  • ix. Addressing placental physiology, embryology, fetal development, and indicators of fetal well-being
k. Overseeing issues related to the labor and birth period, such as:
  • ii. Confirming and assessing labor and its progress
  • iii. Maternal and fetal status
  • iv. Managing complications, abnormal intrapartum events, and emergencies
  • v. Facilitating the woman's physiologic labor progress and supporting her psychosocial needs during labor and birth
  • vi. Coping with labor pain
  • vii. Pharmacologic and non-pharmacologic strategies for facilitating maternal coping during labor
  • viii. Spontaneous vaginal birth
  • ix. Performing episiotomy repair and first/second degree lacerations
l. Overseeing issues related to the postpartum period, such as:
  • ii. Physical involution following a pregnancy that ended in a spontaneous or induced abortion, preterm birth, or term birth
  • iii. The management of strategies and therapeutics that facilitate a healthy puerperium
  • iv. Discomforts of the puerperium
  • v. Self-care
  • vi. Psychological coping and healing following pregnancy
  • vii. Readjustment of relationships and roles
  • viii. Facilitating lactation
  • ix. Resuming sexual activity, contraception, and pregnancy spacing
4. Midwifery Care of the Newborn - CNMs independently manage the care of the newborn immediately following birth, up to 28 days of life. Job duties/responsibilities during this time include:

a. Maintaining the maternal and fetal history and assessing the risk factors of the newborn

b. Preparing and planning for birth based on the ongoing assessment of the mother and fetu

c. Facilitating the physiologic transition for newborns by:
  • ii. Establishing respiration
  • iii. Cord clamping and cutting
  • iv. Regulating the newborn's body temperature
  • v. Establishing newborn feeding
  • vi. Overseeing the bonding and attachment between mother and newborn
  • vii. Providing emergency treatment, such as stabilization and resuscitation
d. Evaluating the newborn

e. Developing a plan of care for the newborn for the first 28 days of life in conjunction with the family

f. Overseeing preventive care of the newborn (testing, screening, eye ointment, vitamin K, etc.)

g. Addressing issues such as:
  • ii. Minor and severe congenital malformations
  • iii. Poor transition following birth
  • iv. Infections
  • v. Post-partum depression and its effect on newborns
  • vi. End-of-life care for stillbirth
h. The CNM provides for consultation, collaborative management, or referral, as indicated by the health status of the client. CNMs practice in accord with the Standards for the Practice of Midwifery, as defined by the ACNM.
  • ii. Is certified by the ACNM designated certifying agent.
  • iii. Shows evidence of continuing competency as required by the ACNM designated certifying agent.
  • iv. Is in compliance with the legal requirements of the jurisdiction where the midwifery practice occurs.
  • v. Demonstrates knowledge of and utilizes federal and state regulations that apply to the practice environment and infection control.
  • vi. Demonstrates a safe mechanism for obtaining medical consultation, collaboration, and referral.
  • vii. Uses community services as needed.
  • viii. Demonstrates knowledge of the medical, psychosocial, economic, cultural, and family factors that affect care.
  • ix. Demonstrates appropriate techniques for emergency management including arrangements for emergency transportation.
  • x. Promotes involvement of support persons in the practice setting.
  • xi. Collects and assesses client care data, develops and implements an individualized plan of management, and evaluates outcome of care.
  • xii. Demonstrates the clinical skills and judgments described in the ACNM Core Competencies for Basic Midwifery Practice.
  • xiii. Practices in accord with the ACNM Standards for the Practice of Midwifery.
  • xiv. Maintains written documentation of the parameters of service for independent and collaborative midwifery management and transfer of care when needed.
  • xv. Has accessible resources to provide evidence based clinical practice for each specialty area which may include, but is not limited to, primary health care of women, care of the childbearing family, and newborn care.
  • xvi. Uses records that facilitate communication of information to clients, consultants, and institutions.
  • xvii. Provides prompt and complete documentation of evaluation, course of management, and outcome of care.
  • xviii. Promotes a documentation system that provides for confidentiality and transmissibility of health records.
  • xix. Maintains confidentiality in verbal and written communications.
  • xx. Participates in a program of quality management for the evaluation of practice within the setting in which it occurs.


5. Professional Development - Ensures improvement in practice setting by assuming responsibility for self-development and life-long learning. Provides guidance to others in the practice.

a. Provides mentorship to the office clinical staff in policies and procedures that impact the care of patients and promotes clinical competence and the acquisition of new skills for clinical staff.

b. Collaborates in the development and implementation of educational plans for identified learning needs of clinical colleagues.

6. National Research Corporation Health (NRC)

a. Works effectively and cooperatively with other members of the team to identify opportunities for improvement in NRC results and actively participates in recommending plans of action to address any identified issues.

7. Other duties/responsibilities.

a. Provides other functions common the nurse practitioner role for which the APRN is educationally and experientially prepared.

b. Call responsibility shared equally with other employed provides, as needed, in the practice.

Qualifications

Experience Minimum Required

• Certified Nurse Midwife (CNM) accreditation

Education Minimum Required

• Bachelors in Nursing, and Masters in Advanced Clinical Practice or graduate of post masters certificate program for nurse practitioner.

Special Skills Minimum Required

• Verbal and communication skills, presentation skills, computer skills.

Licensure and/or Certifications Required

• NH RN and ARPN License in good standing. Certification in good standing in Midwifery.

• APRN, Registered Nurse (NH).

EEO Statement

Wentworth-Douglass Hospital is an Equal Opportunity Employer. By embracing diverse skills, perspectives and ideas, we choose to lead. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment.

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