WY - RN - L&D - Varied Shifts

LD/PP/Delivery Attendance
ABOUT: The team of the Women's Health and Nursery unit welcome approximately 200-240 babies to the world every year. We are a level I nursery (36+ week neonates) From labor & delivery, antepartum to postpartum, and well newborn to special care nursery, you will have the opportunity to provide a broad range of support in an environment of family centered care. We also provide personalized care to post-op GYN surgical patients. Our C-sections are performed in our own OR suite and are scrubbed and circulated by the OR staff. The OB RN then provides primary care of the newborn, with support of an MD or Pediatric Nurse Practitioner in attendance. This position works in a cohesive, friendly team environment consisting of RN's, Obstetricians, Pediatrician, Pediatric Nurse Practitioner, Family Practice, and Anesthesia Providers. This position reports directly to the Women's Health Director and Clinical Coordinator.
SHIFTS: 12 hours - varied. Staffing guidelines follow AWHONN recommendations with low nurse/patient ratios. Two nurses on always even when unit is closed. Director; Clinical Coordinator; and House Supervisors are available as need for clinical support

Work Environment: All private LDRP Suites, Nursery, Centralized fetal monitoring; electronic documentation (PeriGen and Epic); Client Panda radiant warmers, Tele-NICU consults and available for resuscitation. Views of Heart, Rattlesnake, and Carter Mountains, and 45 minutes from the East entrance of Yellowstone, 3 hours from Grand Tetons

Unit specific education requirements: AWHONN Fetal Monitoring (basic, intermediate, advanced), NRP, BLS, S.T.A.B.L.E.

SKILLS: Skilled in labor, delivery, postpartum and nursery care are essential. Special care nursery skills required. Must know principles and practice of sterile technique and infection control. Must be skilled in technical aspects of mother/infant care. Able to perform effectively in highly stressful situations. Must be able to interact effectively with a wide variety of people. Excellent communication skills.
ESSENTIAL FUNCTIONS:1. Perform admitting assessments, review history and develop plan of care. Initiate fetal heart monitor, perform vaginal exams, interpret fetal heart tones and determine frequency duration and intensity of contractions.
2. Monitor progress of laboring mothers, interpret fetal heart monitor and notify physician when appropriate for progress or problems. Assist mother and labor coach with breathing exercises, pain management techniques and administer pain medication as ordered. Prepare birthing room for delivery using strict sterile technique.
3. Prepare mothers for elective or emergency Cesarean Section by following written C-Section protocol. Provide emotional support to mother and coach, obtain proper consents and pre op diagnostic studies and coordinate smooth transfer to surgery
4. Assist physician with initiation of Pitocin inductions and monitor progress of labor: mix IV Pitocin drips, adjust flow rate or pump according to physician's orders, be alert for abnormalities or problems.
5. Document nursing care properly in ERH.
6. Assist physician in administering care during labor: artificial rupture of membranes, initiation of internal fetal monitoring or intrauterine pressure catheter, initiation of Pitocin drip or other IV medications, sterile vaginal exams or other procedures. Assist anesthesia with the administration of spinal or epidural anesthetic.
7. Perform immediate post-delivery care of mother and infant: determine Apgar scores, DeLee suction and bulb suction infants, apply ID and security bands, weigh and measure infant, administer medications to mother and infant as ordered, assist physician with resuscitation, perform fundal message and monitor vital signs and lochia as needed, promote infant/parent bonding and obtain newborn identification per policy.
8. Perform post-partum care and provide patient education to mother: check lochia, episiotomy, and fundus, provide instruction in childcare, breast feedings and self-care to mother, monitor vital signs per policy, report problems to physician.
9. Perform nursery care on infant: operate OB equipment (Client Panda Warmers, B450 monitor, phototherapy light), assess infants and vital signs, assist with circumcision, coordinate stabilization and transfer of unstable infants, perform or assist with all types of feedings (breast feeding, nipple feeding or gavage feeding), initiate isolation if indicated, draw blood from umbilical catheters (but not percutaneous arterial punctures). Assess gestational age, give bath, perform hearing screening, assist with circumcision, and any other treatments.
10. Administer medications, solutions and treatments per physician's order: Display knowledge of administration and effects of medications used and operate V/PCA pumps correctly.
11. Initiate and maintain IV and oxygen therapy on infants under the direction of a physician.
12. Admit and care for post-surgical patients. Monitor and assess per post-anesthesia protocol.
13. Perform discharge teaching for all patients.
14. Provide required care for OB/OBS patients.
SECONDARY FUNCTIONS:1. Adhere to principles of infection control in delivery of OB care: restrict
visitors per policy, enforce policy regarding cover ups, scrub clothes and handwashing, assure housekeeping department cleans area adequately, enforce isolation policies for care of infant and mother, instruct parents in principles of infection control, assure routine cleaning by nursing staff is done on prescribed basis, demonstrate excellent sterile technique.
2. Adhere to general policies of the OB Department: assure proper consent for birthing room and support persons in birthing room, keep computer stats up to date, schedule special services (i.e., steak dinners), adhere to Baby X policy, estock medications and supplies, check crash cart, insure newborn safety, etc.
3. Display knowledge of specialized OB equipment instruments and procedures.
4. Stock OB department, order supplies, request maintenance or ancillary support services.
5. Display knowledge of specialized resuscitation protocol for infants: NRP, CPR technique, drug dosages, fluid requirements, thermoregulation, stabilization and transport.
6. Participate in in-services and staff meetings
7. Float to other areas of hospital only as a "float" (CNA duties) or VOS (Visual Observation Sitter)

The following procedures will not be performed by an RN in the OB Department: 1. Intubation of adults or infants. 2. Percutaneous arterial punctures (RN's may draw blood from umbilical catheters if trained to do so). 3. Episiotomies in precipitous deliveries.
4. Placement of electrode for internal fetal monitoring will be permitted after competency validation. 5. Umbilical vessel catheterization. 6. Placement of intrauterine pressure catheter.

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