Duties Performs duties as Registered Nurse in inpatient obstetrics Labor, Delivery, Recovery, Postpartum (LDRP) Unit, providing comprehensive specialized nursing care to routine through high risk antepartum, intrapartum and postpartum obstetrical patients and their infants at Bayne-Jones Army community Hospital. Uses a wide range of nursing knowledge, skills and abilities applicable to the work. The obstetrical nursing care provided may involve patients with combined medical-surgical conditions. High-risk/critical conditions are characterized by the real or potential complicated fetal or maternal conditions requiring close observation, assessment, intervention and documentation for acute changes in patient condition to prevent complications and maintain/restore maternal and fetal health. Theses high-risk/critical conditions may include, but are not limited to; pregnancy induced hypertension, pre-eclampsia, eclampsia, functional gestational diabetes mellitus, multiple gestation, pre-term labor, postpartum hemorrhage, uterine rupture, amniotic emboli, tachypnea, hypoglycemia, high or low birth weights, and infants requiring protective isolation. Provides nursing care to patients during the antepartum, intrapartum or postpartum stages of labor. Possesses skills in the performance of the following infant respiratory care tasks: lung auscultation, transcutaneous pulse oximetry, bulb and DeLee suctioning, chest PT for the respiratory compromised neonates. Obtains capillary and venous blood samples from infant, makes interpretations based on lab reports, notifies infants physician of abnormal findings and intervenes with appropriated actions as indicated. Provides nursing care to neonates that are consistent with established Bayne-Jones Army Community Hospital protocols and unit-level standard operating procedures (SOPs). Performs newborn physical assessments utilizing current Bayne-Jones Army Community Hospital Computerized Assessment Forms. Possess the necessary knowledge and skills required to assist/support the initiation of successful breastfeeding during the infants initial transition period. When required, provides neonatal resuscitation in accordance with American Academy of Pediatrics Neonatal Resuscitation Provider (NRP) guidelines. In prolonged cardiac, respiratory arrest, assist with Umbilical Artery Catheter/Umbilical Vein Catheter (UAC/UVC) placement, chest tube placement, and/ or peripheral intravenous placement. 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. Assist with the orientation process for all newly assigned: active duty, Federal employees and contract staff members assigned to the Labor, Delivery, Recovery and Postpartum Unit. Assists with the clinical training and supervision of: Physician Assistance rotating through the Labor, Delivery, Recovery and Postpartum Unit. May serve as clinical preceptor to: under graduated, graduate and the Army Medical Department Center & School Obstetrician/Gynecologist (OB/GYN) Nursing Course students rotating through the Labor, Delivery, Recovery and Postpartum Unit. 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 patients 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 appropriated 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 patients present condition. Administers complex medications by any route as ordered within the guidelines of nursing practice. These routes include oral, intramuscular, subcutaneous, intradermal, topical, rectal, nasogastric, respiratory and intravenous. Incumbent has knowledge of adverse effects and precautions, and can institute and assist with remedial measures as necessary. Remains constantly aware of patients condition and is able to recognize and provide emergency oxygen, cardio-pulmonary resuscitation and other emergency measures as appropriate. Applies in-depth knowledge of a large number of laboratory and other diagnostic studies orders. Interprets findings and reports to the physician those findings which indicate a detrimental variation in the progress of the patient. Executes follow-up physicians orders. After reevaluating patients condition, plans, directs and/ or implements comprehensive nursing care utilizing scientific and professional principles as the basis for all techniques and procedures performed. 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. Actively participates in multidisciplinary discharge planning conferences with nursing staff. Provides emotional support to patients, family members and significant others. 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. Recovers C-section (c/s) on the Labor, Delivery, Recovery, Postpartum Unit. 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. Orients and provides on-the-job training for new personnel, professional students and volunteers through formal and informal instruction. Provides formal classes on specific clinical topics for the unit in-service program. Attends all hospital and Department of Nursing mandatory in-services programs. Documents patients acuity data, enters it into the Workload Management System for Nursing internet (WMSNi) system. 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. 2.Charge Nurse Duties: When assigned by the Clinical Head Nurse, functions in the role of Charge Nurse. The Charge Nurse makes patient care assignments based on qualifications, capabilities and skills of available staff; married with the complexity and/or difficulty of individual patient care requirements. The Charge Nurse, will be responsible for the overall clinical supervisions of each shifts assigned civilian, military and volunteer professional and paraprofessional staff. When it is needed and or indicated the Charge Nurse will provide written documentation of work performance of the staff under their supervision. Displays a consistently positive, supportive attitude toward the Clinical Nurse OIC, the goals and initiatives of the unit, Labor, Delivery, Recovery, Postpartum Unit the OB/GYN Clinic and the Progressive Care Unit. Actively participates in problem resolution of Labor, Delivery, Recovery, Postpartum unit issues. Serves as a resource person with whom other obstetrical nurses and other health care providers consult when particularly difficult problems in the care of obstetrical patients arise. Serves as a role model. Provides guidance and leadership to professional and non-paraprofessional staff. As the Charge Nurse, works collaboratively with contact physicians and PAs. In the absence of a physician, independently determines and implements proper emergency interventions within scope of practice after identifying and interpreting fetal or maternal distress. Performs other duties as assigned.