Duties Serves as Nurse Midwife in a Medical Treatment Facility, providing leadership in Obstetric/Gynecology nursing skills, knowledge, and judgments that foster the delivery of safe and quality care in the areas of antepartum, intrapartum, postpartum, neonatal, family planning, and gynecological care. Incumbent applies a mastery of nursing within the evolving profession of the advanced practice, Certified Nurse-Midwife. Provides independent and collaborative primary care or specialty, comprehensive and therapeutic health care services, in the Medical Treatment Facility. Practices evidence-based care, with competency in assessment, diagnosing and management of a full range of healthcare services for women from adolescence to beyond menopause, nursing theory, research, and advanced clinical practice in an obstetrics/gynecology department, primary care clinic, inpatient obstetrical unit or other medical treatment facility. Provides comprehensive primary health care to mothers and babies throughout the maternity cycle within the framework of the medically directed healthcare environment. 1. Implements and adapts medical theories and technologies, paralleling the latest advancements in scientific evidence, medical initiatives, and evolving obstetrics/gynecology healthcare technologies. Adapts treatment to new, experimental, and ground-breaking theories in the focus of diverse patient care for women, ranging from inpatient to outpatient settings, as well as from available risk management data, supporting the investigation of new drugs. Analyzes epidemiological, biostatistical, environmental, and other appropriate scientific data, related to individual, aggregate, and population health. Duties reflect the growing significance of evidence-based practice, evidence-based interventions, and population-based chronic care management. Critically appraises existing medical literature/journals to determine and implement the optimal evidence for patient care plan. Initiates and implements strategies to evaluate outcomes of practice, practice patterns, and systems of care for women against National benchmarks. Serves as project lead or associate in the design, implementation, monitoring, and evaluation of obstetrics/gynecology healthcare. Provides care for newborns in the initial neonatal period. Provides for medical consultation or referral for those women or newborns with significant deviations from normal. Provides individual, family, and group education about obstetrical processes, associated disease states, diagnostics tests, the therapeutic regimen including medication, diet and follow up care, methods of adapting medication, treatment to current lifestyles, self-care, and where to go for urgent/emergent services. 2. Incumbent integrates the art and science of both nursing and midwifery into practice. Assesses acute and non-acute clinical problems. Completes routine obstetrical and maternal diagnostic testing, i.e. NST, BPP, CRL and AFI. Discriminates between normal and abnormal findings in order to make a nursing and clinical diagnosis regarding physical, emotional or social disabilities. Obtains and records a problem-oriented health history, orders and interprets related laboratory and diagnostic tests, performs a systematic physical examination and interprets abnormal and normal findings to form a diagnosis regarding physical, emotional, or social disabilities. Independently manages labor and childbirth in accordance with clinical privileges. Utilizes experimental theories and new developments in the solution of complex health care problems, not susceptible to treatment by accepted methods. Prescribes medications, initiates emergency care, as appropriate. Conducts interdisciplinary collaboration with physicians regarding patient management, to include evaluating and revising therapeutic plans and managing high-risk, unstable, or extremely complex patients, including the intrapartum setting. 3. Participates in patient care rounds and conferences, presenting patient cases/topics and communicating patient management strategies to members of the patient care team. Implements the patient therapeutic care plan, with significant emphasis in the areas of patient/family education, assessment, and support. Responsible for initiating, implementing, and overseeing disease management/education programs for women, addressing the education/self-care needs, identified by the patient/family. Provides teaching to patients and their families regarding disease processes and diagnostic tests, therapeutic regimen, including medication, diet, follow-up care, and methods of adapting medication and treatment to current lifestyles. Performs within a holistic paradigm, providing counseling to patients and their families in prevention of illness, maintenance of health, and attainment of physical, mental, and social well-being. Oversees compliance/adherence with the preventive health care needs of all adult patients visiting the obstetrics/gynecology clinic. Develops a therapeutic environment, which facilitates a trust relationship with the practitioner. Provides telephonic advice and consultation to patients, parents, and family with questions regarding obstetrical processes, associated disease states, women health maintenance, and neonatal concerns. 4. Serves in a leadership position and is recognized as a consultant and role model to other health care professionals, colleagues, professional groups, and universities. Evaluates care delivery models and strategies, using concepts related to community, environmental/occupational health, and cultural and socioeconomic dimensions of health. Designs, directs, and evaluates quality improvement methodologies. Supervises and instructs nursing, midwifery, physician assistant, and medical students, as well as, family practice residents in obstetrical and women health maintenance clinical experiences. Coordinates or conducts in-service education programs for other healthcare professionals. Serves as an advisor/member of committees as needed. Participates in ongoing peer review with other advance nurse practitioners. Acts as a preceptor to graduate students enrolled in physician assistant or nurse practitioner programs, and medical students. Integrates fully into Graduate Medical Education programs as staff providers/supervisors for interns and students in the outpatient and inpatient settings. Coordinates and/or conducts in-service education programs for health care professionals and serves as an advisor/member of committees, as assigned. Prepares manuscripts, studies, and lectures for professionals and/or community groups, consistent with proper channels of communication. Develops, reviews, and updates policies, protocols, standards of nursing practice, operating procedures, and scope of practice, in collaboration with multidisciplinary members of the healthcare team. Participates in national and international conferences and workshops, sharing new methodologies which facilitate advancement in the obstetrics/gynecology healthcare profession. 5. Serves as care coordinator for patients with specific health needs. Provides care coordination with outside agencies and in-house consultants and liaison with other services to include social work, pharmacy, nutrition, medical supply, radiology, Tricare Healthcare Finders, Tricare Case Managers, Wellness Center, Family Practice GB, off-site Prenatal and the Well Woman Clinics, in-house Mother Baby, Labor and Delivery units, Patient Representative Office, Patient Affairs, and other healthcare providers. If indicated, provides liaison with Health Care Providers, community-based programs, and the family so that all understand the health care plan and their responsibilities within it. If indicated, coordinates technology based needs and ensure the patient and/or family understands support equipment operation, maintenance, and trouble shooting. Facilitates appropriate communication among referral specialists, the family, and the community-based programs. If indicated, facilitates assessment, teaching, and training with home health nurse agencies, or Community Health Nurse Composite Healthcare Computer System Telephonic Consult referral. Works in collaboration with the Supervisory Clinical Nurse with case management issues. Performs other duties as assigned.