Labor & Delivery Nurse

Overview

Description of Services: Inpatient obstetrics Labor, Delivery, Recovery, Post Partum Registered Nurses

Location: General Leonard Wood Community Hospital (GLWCH), Fort Leonard Wood, Missouri

Hours of Performance: The HCW shall be able to provide services 24 hours a day, 7 days a week including holidays. Shifts will be 8-12 hours in length. No guarantee can be made that the shift will end as scheduled. A minimum lunch/dinner break of 30 minutes will be given during the shift if patient care permits, but no longer than 60 minutes.

Scheduling: Work hours and days will be determined by GLWCH Maternal Child Unit (MCU) Leadership, the Contracting Officer Representative (COR), and confirmed by the Contractor. A schedule discussed between a contract HCW and a hospital staff member is not considered valid. Schedules are subject to change due to cancellations, staffing changes, emergencies, and unexpected events. The most a HCW can work is six consecutive days in a row followed by a minimum of a one day break is required. A minimum of 25 % (percent) of shifts covered will be required to be either night, weekend or holiday.

Benefits: PTO, sick leave, holiday leave, Life, Accidental Death and Dismemberment, Short Term Disability

Optional Benefits: Medical, Dental, Vision, 401(K) matching with employee participation in 401(K) plan

Responsibilities

• Provide specialized and comprehensive antepartum, intrapartum and postpartum nursing care to normal to high-risk obstetric patients. High-risk patients are characterized by the presence of real or potential complicated fetal or maternal conditions requiring continuous observation and intervention to prevent complications and maintain/restore maternal and fetal health. All high-risk/critical conditions and newborn care require close observation, assessment and documentation for acute changes in patient condition.
• As appropriate, assumes circulation role in the operating room for scheduled and emergent cesareansections and cesarean-hysterectomy. Provides nursing care to patients during post-anesthesia recovery.
• As appropriate, serves as the OB Triage Nurse, independently or in collaboration with Provider assesses and evaluates obstetrical outpatients 20 weeks gestation or greater presenting for care.
• Provides care to patients presenting for both complicated and uncomplicated pregnancy and labor concerns.
• Provides newborn care for vaginal deliveries, routine scheduled Cesarean and emergent cesarean sections.
• Implements routine or high risk transition care protocols for normal and high risk newborns following delivery.
• Possesses skills in the performance of newborn respiratory tasks.
• Performs newborn physical assessments using standardized newborn assessment tools.
• Provides nursing care consistent with established professional standards, guidelines, hospital protocols, and unit-level Standar Operating Procedures (SOPs).
• In the absence of a physician, independently determines and implements proper emergency interventions within scope of practice after identifying and interpreting maternal and/or fetal distress and newborns.
• Within given parameters, applies the knowledge of the pathophysiology of maternal or fetal disorders, identifies potential complications of pre-existing medical conditions and identifies or minimizes impact by developing or implementing strategies to prevent further compromise.
• Recognizes and executes nursing responsibilities related to technologies utilized in caring for the normal/high risk obstetrical and newborn patient.
• Administers complex medications by any route as ordered within the guidelines of nursing practice.
• Has knowledge of adverse effects and precautions, and initiates response measures as required.
• Examines and assesses obstetric patients and newborns.
• Uses seasoned judgment in selecting the course of action in implementing physician orders and interpreting their appropriateness to the patient's present condition.
• Utilizes advanced nursing assessment skills to identify difficult newborn care problems, formulate complex plans to meet the care needs and continually revises goals and objectives according to changes in newborn’s status.
• Administers and monitors oxygen therapy and interprets and responds to data.
• Operates and/or monitors the performance of sophisticated equipment used in the care of compromised newborns.
• Utilizes a broad knowledge of pharmaceuticals and intravenous therapy, including properties, indications, dosages, rates and side effects to manage the newborn’s condition.
• Closely monitors and documents the newborn’s response to such therapies, notifies the physician of changes in newborn’s status and able to anticipate changes to plan of care.
• Maintains accurate, current and complete nursing records in current military electronic health record system which reflect pertinent and factual observations of the newborn’s treatment and progress, plan of care, response to medications, discharge plans and follow-up.
• Obtains capillary and venous laboratory samples and makes interpretations based on lab reports. Notifies physician of abnormal findings.
• Assists with circumcisions and other newborn procedures.
• Assists physicians and anesthesia providers with complex procedures such as insertion of internal monitors, placement of epidural catheters, placement of invasive monitoring lines (e.g., arterial, cordis), and induction of general anesthesia.
• Maintains invasive lines and dressings in accordance with infection control policies and procedures.
• Assesses patient response through sophisticated clinical observations as well as detailed data analysis and accurately reports information to the physician to ensure the highest level of patient care.
• Discontinues invasive lines under established guidelines.
• Utilizes the nursing process to formulate a nursing plan of care relative to patients physiological, psychological, and sociological condition in order to provide ongoing and in-depth assessment of patient problems, strengths and limitations.
• Monitors patient condition through data collected by continuous observation and precise calculation of fluid levels and vital signs through the use of complex monitoring equipment.
• Applies in-depth knowledge of a large number of laboratory and other diagnostic studies. Interprets findings and reports to the physician those findings which indicate a required change in care.
• Based on periodic changes in maternal and fetal condition and response, determines validity/feasibility of previously written orders, writes nursing orders, and implements, evaluates and documents the effectiveness of all nursing orders. Continuously revises care plan accordingly.
• Develops meaningful goals to assist the normal or high-risk obstetrics (OB) patient and family to attain an optimum level of physiological and psychosocial balance within the limitations imposed by any complications or illnesses.
• Frequently uses crisis intervention techniques to provide constant support to the patient and family in a high stress situation and environment.
• Gives information on disease process, pre and post-operative care, diagnostic procedures, use of equipment related to disease/care, expected and possible adverse reactions to medications, health maintenance, and illness prevention.
• Possesses skills in the performance of the following newborn respiratory care tasks: lung auscultation, transcutaneous pulse oximetry, bulb and DeLee suctioning, chest PT for the respiratory compromised newborns.
• Provides nursing care to newborns that are consistent with established protocols and unit-level standard operating procedures (SOPs).
• Performs newborn physical assessments utilizing current Computerized Assessment Forms.
• Possess the necessary knowledge and skills required to assist/support the initiation of successful breastfeeding during the newborns’ initial transition period.
• Provides comprehensive nursing care to patients/families experiencing perinatal and neonatal loss.
• Coordinates care and ensures follow-up for patients and family members who have experienced perinatal and neonatal loss.
• Assists the Labor, Delivery, Recovery, and Postpartum Clinical Nurse Officer in Charge in other patient care and administrative duties as assigned.
• Utilizes the nursing process to formulate the patient’s care plan. Uses a nursing data base to obtain patient history. Completed a full psychosocial/ physiological nursing assessment on all newly admitted patients. Identifies and prioritizes patient care problems. Generates and documents the appropriate nursing diagnosis for the patient care problem identified. Identifies, documents and implements nursing orders appropriate to patient care problems. Evaluates and documents the effectiveness of nursing care provide and revises care plan as needed. Uses seasoned judgment in selecting the course of action in implementing physician orders and interpreting their appropriateness to the patient’s present condition.
• Teaches patients and family members about disease processes, normal newborn and postpartum care, pre and post-operative cares, pre and post diagnostic procedures; expected and possible adverse reactions to medications; health promotion. Initiates discharge planning/teaching upon admission of each patient.
• Provides nursing services for obstetrical patients to include: observation and assessment of the condition of antepartum, intrapartum and postpartum women and pre-operative, intra-operative, and post-operative of obstetrical patients such as those undergoing cesarean sections, bilateral tubal ligations, etc. Care meets maternal and fetal physical and psychological needs to include: transporting, lifting, moving, and positioning patients, providing continuous fetal assessment; providing physical and emotional support during labor and delivery, surgery and in emergency situations. Care includes nursing services for obstetrical patients recovering form regional and general anesthetics, C-section and recovery of Csection on the MCU.
• Applies extensive knowledge of procedures to the comprehensive nursing care of patients. Observes, interprets and communicates patient progress and / or adverse changes to the appropriate members of the health care team.
• Utilizes and instructs others in the use of simple and specialized equipment appropriate to the area.
• Conducts antepartum testing and fetal heart rate (FHR) monitoring on high-risk obstetrical patients, interpreting tracing and reporting findings to the physician. Instructs patients on the rationale for testing.
• Assist physicians and nurse midwives in examination and treatment in the delivery room. Delivers babies in emergency situation. Circulates during emergency cesarean sections. Initiates emergency action and performs Cardiopulmonary Resuscitation (CPR) as necessary.
• Observes and assesses neonatal condition and adjustment to extrauterine life. Recognizes signs of distress and initiates emergency actions.
• Sets up, operates and maintains a variety of medical equipment in the labor, delivery, recovery, postpartum unit to included fetal-monitors, respiratory and oxygen therapy equipment, intravenous infusion pumps, suctions, infant warmers, delivery tables, etc.
• Confers with obstetrical physicians concerning instruments, sutures, special equipment and procedures unique to vaginal /instrument/cesarean delivery. Setup of the delivery room and handles supplies and equipment including delivery lights, oxygen, suction machines, material/fetal cardiac monitors, etc.
• Assumes responsibility for aseptic technique maintenance during procedures, accuracy of sponge and needle counts and adequacy pf supplies. Assures accurate care and handling of specimens.
• Provide health promotions, counseling, and education.
• Administer medications, wound care, and numerous other personalized interventions.
• Direct and clinically supervise care provided by other healthcare professionals.
• Communicate and collaborate with a diverse group of people for the purpose of informing the healthcare team of plans/actions, for teaching/education to benefit the patient/family and organization.

Qualifications

• Degree: Associates Degree of Nursing
• Education: Graduate from a college or university accredited by Accreditation Commission for Education in Nursing (ACEN) or the Commission on Collegiate Nursing Education (CCNE).
• Certifications: HCW shall have and maintain, at all times and at contractor expense, current certification in: Basic Life Support (BLS), Advanced Cardiac Life Support (ACLS), Neonatal Resuscitation Provider (NRP), Pediatric Advanced Life Support (PALS) by way of an American Heart Association or American Red Cross training program. Online courses do not satisfy the requirement for any training. Recertification shall be maintained at contractor expense in a current status at all times while the HCW is performing services under this contract. Advanced Life Saving Obstetrics (ALSO) or Emergencies in Clinical Obstetrics (ECO), Intermediate Fetal Heart Monitoring, and Sugar, Temperature, Airway, Blood pressure, Lab work, and Emotional support (STABLE) is required.
• Experience: One year of experience as a Labor and Delivery Nurse as identified in the TO.
• Licensure/Registration: HCW must possess a current, full, active, and unrestricted license to practice as a Registered Nurse in any state, US Territory or District of Columbia.

AKAHI ASSOCIATES LLC

AKAHI Associates is a premier provider of healthcare workers to various military treatment facilities across the United States. With a corporate office in Honolulu, Hawaii and recruiting office in San Antonio, Texas we specialize in providing skilled, trained and highly successful healthcare workers, including RNs, CRNAs, Physicians, LPN/LVN, Licensed Social Workers, and many more.

We have a strong focus on providing our government customers with quality and superior service.

Akahi Associates is an equal opportunity employer and Minorities, Females, Veterans, and Disabled persons are encouraged to apply. For further information, please click the link below to view the EEO Is The Law poster.

Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability or protected veteran status.

Only qualified individuals who are being considered will be contacted for an interview.