MAJOR DUTIES: 1. 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. 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. These routes include oral, intramuscular, subcutaneous, intra-dermal, topical, rectal, nasogastric, and respiratory. Administers potent intravenous (including IV push) drugs such as labor induction agents, anti-hypertensives, insulin, blood products, and magnesium sulfate; recognizes and responds to adverse effects, take 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 patients present condition. Performs treatments such as oxygen administration, amnioinfusion, placement of fetal scalp electrodes, and conduction of contraction stress tests. Performs the circulation role in the operating room for planned and emergent cesarean-section, dilatation and curettage, cerclage insertion, and cesarean-hysterectomy. Provides nursing care to patients undergoing surgical procedures and during post-anesthesia recovery. 2. Assists physicians and anesthesia providers with complex procedures such as insertion of internal monitors, placement of epidural catheters, and induction of general anesthesia. Maintains central 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. 3. Utilizes nursing standards of practice 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 patients 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 OB patient and family to attain an optimum level of physiological and psychosocial balance within the limitations imposed by any complications or illnesses. 4. Uses crisis intervention techniques to provide constant support to the patient and family in a high stress situation and environment. Provides 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. Makes referral of patients/family members to allied health care providers such as the community health nurse, social work, community agencies. 5. As required, may assume Acting Clinical Nurse Officer- In-Charge duties as needed. Makes decisions regarding priorities for patient care for shift assignments. Assigns duties and delegates patient care to other registered nurses, licensed practical nurses, operating room technicians, and nursing assistants, with consideration of the difficulty and requirements of the assignment and the qualifications and capabilities of the individual. This includes abilities to assign an equitable workload for shift staff, make timely, appropriate decisions related to personnel and patient care management in a stressful environment, and use authority of the position to maintain a productive work environment. Performance of this work requires a basic knowledge of personnel practices and procedures, of the hospital, unit and individual medical services policies sufficient to proficiently execute these functions when required. Performs other duties as assigned. Conditions of Employment - Appointment may be subject to a suitability or fitness determination, as determined by a completed background investigation. - A Personnel Security Investigation is required. - Selectees will be required to sign a statement (Condition of Employment) consenting to seasonal influenza vaccinations or must provide a recognized exemption. - This position is a Testing Designated Position subject to pre-employment screening and random drug testing. Selectees will be required to consent to participation in random drug urinalysis testing. - A pre-placement medical examination is required. - Immunization screening is required. Hepatitis B immunization is required for all positions with direct patient contact. Applicants may be required to show proof of other immunizations depending on the type of position. - Must be able to obtain and maintain current Basic Life Support (BLS) certification through the American Red Cross. Advanced certification (e.g., ALS) does not supersede BLS. - Must be able to obtain and maintain certification in Neonatal Resuscitation Program (NRP). - This position has specific initial background investigation and periodic re-verification requirements since its duties require interaction with children and youth under the age of eighteen (18) years of age on a recurring basis. - This position may require rotating shifts (i.e. work schedule that requires employees to continuously rotate from one shift to another at predetermined intervals). - Must be able to obtain and maintain Certification in Electronic Fetal Monitoring training. - Applicants must be able to fulfill non-privileged professional credential requirements. - This position may require the incumbent to work weekends and/or holidays.