ESSENTIAL: (40%)* Regularly assesses patient’s needs and provides skilled nursing services as prescribed by the physician authorized plan of care and accepted standards of evidence based nursing practice.
(30%)* Provides direct patient care including medication administration, treatments, education, call lights, assisting with transfers, responding to alarms, and other duties as appropriate
(20%)* Evaluates effectiveness of treatment plan and makes suggestions or participates in updating/revising the treatment plan in collaboration with other team members, utilizing current information to improve patient care.
(10%)* The RN is knowledgeable and compliant with all local, state and federal regulations and guidelines as well as hospital specific policies and procedures relating to care provided in the medical center.
OTHER DUTIES AND RESPONSIBILITIES:
Demonstrates the MidMichigan Health mission, vision and values.
Behaves in a courteous, professional manner at all times with patients, visitors, and co-workers.
Demonstrates the ability to interpret information and reports pertinent data to the physician..
Educate patient/family according to assessed learning needs considering readiness, ability, preferences, and cultural / spiritual variables.
Demonstrates the ability to organize and prioritize the needs of groups of patients or an individual patient.
Demonstrates a general ability to manage assignments and perform routine duties on the unit.
Instructs other team members when appropriate, explaining goals and rationale for individualized care.
Demonstrates understanding of clinical pathways and utilizes appropriately. –unit specific
Maintains a professional demeanor in all situations.
Documents in an accurate, clear, and concise way and includes pertinent clinical data.
Shares information and reports significant changes and/or abnormal findings to appropriate team members in a timely manner.
Participates in regulatory surveys.
Participates in the performance improvement activities.
Assists with orientation and ongoing competencies.
Provides a safe and secure environment for patient care.
Maintains knowledge with current trends and professional standards within a specialty .
Demonstrates understanding of role in emergency preparedness procedures.
Obtains prenatal history (prenatal L&D records) and antenatal care, gathering data and identifying risk factors. Performs physical assessment. Performs Leopold’s maneuvers for fetal position. Assesses fetal heart rate and identifies maternal-fetal risk factors. Palpates uterus to assess frequency, length and quality of contractions. Distinguishes, reports and records normal and abnormal conditions. Identifies life-threatening/emergency situations. Formulates conclusions, making a diagnosis.
Decides when to do or not to do a vaginal examination on the laboring patient. Assesses and evaluates dilatation and effacement of the cervix and station of presenting part via sterile vaginal examination. Distinguishes true labor from false labor. Assesses and evaluates suspected rupture of membranes. Visualizes pooling of amniotic fluid. Uses nitrazine paper to prepare slide for fern test or collects amnisure specimens. Performs and/or assists with sterile speculum examinations.
Assesses and documents family interaction/support system. Identifies support person and desired birthing plan. Assesses effectiveness of patient’s/family’s current coping mechanisms. Evaluates level of childbirth preparation. Explains diet and activity orders during labor. Communicates and documents admission data with physician, nursing staff, family and appropriate personnel. Prioritizes and delivers care based on information obtained from maternal-fetal labor assessment of status and initial exam. Identifies those patients with high-risk conditions that may require consultation and/or transportation to a tertiary center.
Assesses patient during all stages of labor, obtaining vital signs, fetal heart rate and patterns, and amount, color, and odor of amniotic fluid, etc. Continuously updates nursing care plan. Identifies common analgesic drugs, contraindications, dosage parameters, and acceptable routes of administration. Identifies and promptly initiates appropriate nursing intervention for maternal and/or fetal side effects of medication and/or complications.
Sets up sterile delivery or operating instrument table using strict aseptic technique according to specific physician’s request. Ensures presence and proper functioning of emergency/resuscitation equipment for mother and newborn and radiant warmer for infant if appropriate. Positions patient in desired delivery position, utilizing physiologic positioning. Performs perineum or abdominal scrub using sterile technique. Instructs coach/family in appropriate attire and hand washing technique per medical center protocol.
Notes and documents time of birth. Assesses Apgar scores at one and five minutes after birth. Assists with stabilization of at-risk neonate and performs cardiopulmonary resuscitation if indicated. Performs preliminary physical assessment for obvious physical abnormalities and notifies physician if abnormalities are noted. Correctly identifies newborn and mother, applying identification bracelets to both. Obtains necessary cord blood samples and sends them to the laboratory. Initiates newborn eye prophylaxis after initial bonding per Medical Center protocol. Assists in initial infant-parent-family bonding. Encourages immediate touch and eye contact as soon as possible after delivery. Answers patient-family questions about newborn. Assists with initial breastfeeding.
Notes and records delivery time of placenta. Notes and documents condition/ intactment of placenta and number of vessels in umbilical cord. Obtains cultures or specimen for laboratory analysis if indicated.
Assesses and documents maternal vital signs every 15 minutes for first hour, more frequently if the patient’s condition warrants, and until stable per Medical Center protocol. Institutes uterine massage and applies perineal ice pack if indicated. Assesses for maternal discomfort and distended bladder and uses nursing intervention if needed. Encourages and promotes the bonding process. Explains post-delivery procedures and postpartum routine to patient and family. Prepares patient for transfer to postpartum status and/or gives discharge instructions to mother for self and infant care.
If indicated, administers and documents oxytocin for induction/augmentation of labor after a physician, nurse midwife or qualified intrapartum nurse examines the patient. Performs continuous electronic fetal monitoring and immediately discontinues oxytocin if there is maternal-fetal intolerance.
Develops a nursing plan of care based on appropriate data and rationale.
Monitors status of patient and fetus if antepartum. Monitors status of infant. Performs physical care, technical procedures and maintains a therapeutic environment. Intervenes in emergency situations.
Evaluates and initiates changes in plan of care based on changes in status of patient. Evaluates and initiates changes in plan of nursing care based on changes in status of infant. Collaborates with other healthcare providers in order to achieve optimal outcomes.
Performs neonatal resuscitation if needed.
All other duties as assigned.
Education: * Associates Degree in Nursing required * BSN preferred
Credentials: * A current license as a Registered Nurse in the State of Michigan. * NRP required within one year of hire or transfer. * BLS certification is required within one month of hire or transfer. * Intermediate Fetal Monitoring preferred within one year or hire or transfer.
EXPERIENCE, TRAINING AND SKILLS
Interpersonal skills needed to communicate successfully with individuals and groups and interact with people at all levels to communicate ideas and concepts in a clear and understandable manner.
This position must show knowledge, ability, and competence in treating unit specific patient populations .
MidMichigan Health is a technology driven organization and employees need to demonstrate competency in Microsoft® Windows. An employee may be required to participate in further learning opportunities offered by MidMichigan Health.
Specialty certification preferred.
Internal Number: 9964
About MidMichigan Health
MidMichigan Health is a non-profit health system, headquartered in Midland, Michigan, affiliated with Michigan Medicine, the health care division of the University of Michigan. MidMichigan Health covers a 23-county region with medical centers in Midland, Alpena, Alma, Clare, Gladwin, Mt. Pleasant and West Branch. In addition to its Medical Centers, MidMichigan Health also offers both home health care and physician services, and has a strong commitment to medical education. MidMichigan Physicians Group provides urgent care and medical offices in more than 30 specialties and subspecialties including cardiology, hematology/oncology, orthopedics, vascular surgery, family medicine and more. The MidMichigan Health Foundation supports patients and families served by MidMichigan Health by raising funds for equipment, services and programs. Currently, MidMichigan has more than 7,400 employees, volunteers and physicians and provided more than $144 million in community benefits in fiscal year 2018.