Nhs Western Isles

WESTERN ISLES NHS BOARD

JOB DESCRIPTION

1 JOB IDENTIFICATION

JOB TITLE: Integrated Midwife

DEPARTMENTS: Maternity Unit Western Isles Hospital/Community

JOB HOLDER REFERENCE:

NO OF JOB HOLDERS

2  PURPOSE

Delivers full range of ante-natal care and provides full range of health promotion, education and social care.

Provides full range of intra-partum care and the delivery of infant, initiating resuscitation when necessary.

Delivers full range of post-natal care for mothers and their babies in the hospital and community setting.

Works as an autonomous practitioner, within the remit of departmental guidelines and in liason with other health professionals in the community setting.

JOB SUMMARY

To work as an autonomous practitioner in delivering the full range of ante-natal, intra-partum and post-natal care of all pregnant women and their babies in the hospital or community setting.

Additionally there is the requirement to initiate the resuscitation and stabilisation of the compromised neonate, plan and undertake the appropriate neonatal care until transfer to a tertiary centre or until their recovery.

The postholder will be expected to take charge of the hospital maternity unit on a daily basis to enable the more senior members of staff to fulfil the required remit of their post.

Required to take management responsibility for the hospital in the absence of the designated lead nurse on evening shifts and weekends.

3 ORGANISATIONAL CHART

4. MAIN DUTIES AND RESPONSIBILITIES OF THE POST

KNOWLEGDE TRAINING AND EXPERIENCE

Registered Midwife Qualification - essential

Registered General Nurse certificate.1st/2nd level optional

Minimum experience of 1year post –registration

Continuous professional development to meet the Nursing and Midwifery Council’s requirements.

Annual update in obstetric emergencies and neonatal resuscitation.

Advanced Life Support Obstetrics and Neonatal Advanced Life Support certificates, preferred.

The postholder is required to be trained in or to receive training in Infection Control, Health and Safety, Fire, Moving and Handling and Immediate Life Support.

ANALYTICAL AND JUDGEMENTAL SKILLS

Requires an ability to interpret patient data, recognise midwifery anomalies and initiate appropriate investigation, treatment or referral.

Requires ability to liase with other health care professionals within multi-disciplinary team.

Requires an ability to accurately carry out patient orientated risk assessments and to implement and evaluate specific interventions to manage risk e.g. using nutritional risk score to ensure appropriate levels of nutrition.

Requires interpreting infant and maternal drug prescriptions in accordance with N.M.C. guidelines, and being able to calculate drug quantities and volumes for safe administration by the prescribed route e.g. intramuscular or intravenous.

Requires an ability to recognise contra-indications associated with specific medications and to implement interventions to mediate against such contra-indications e.g. bleeding and the use of anti-coagulants.

PLANNING AND ORGANISATIONAL SKILLS

To competently prioritise and manage own daily caseload, with the ability to reorganise schedule in accordance with workload variations.

Required to undertake ante-natal clinics in hospital and in community with sole responsibility for managing appointments and taking full responsibility for the care management of the patients.

To competently organise the safe management of the department when in charge.

PHYSICAL SKILLS

A developed degree of skill and expertise is required to perform tasks within midwifery remit. e.g.

Abdominal palpation

Vaginal examination

Venepuncture

Cannulation

Injection

Episiotomy (surgical incision of perineal tissue)

Perineal Suturing

Delivery of infants

Routine infant blood sampling e.g. P.K.U.

Driving whilst in community.

RESPONSIBILITY FOR PATIENT /CLIENT CARE

Provides specialist advice in a wide range of categories e.g.

Health promotion ante-natally and post-natally

To risk assess patients throughout their pregnancy

Give breast-feeding advice or appropriate feeding advice.

During the intra-partum, assess progress in labour advise patient on clinical findings and document the detail, with onward referral to Obstetrician when necessary.

Undertakes the management of labouring patients, acting autonomously in decisions regarding their care.

Develop care plan specifically for each individual’s need.

Provide Air Ambulance escort when required for inutero transfer or for maternal or neonatal transfer.

COMMUNICATION AND RELATIONSHIP SKILLS

Daily, whilst on shift, receiving and advising on complex and sensitive information e.g. confidential information re.social, sexual and medical history.

Counselling clients in relation to ante-natal blood screening and in giving results.

Communicate relevant data in verbal, written and electronic format.

Require an ability to negotiate on behalf of the client, regarding personal circumstances e.g. in relation to housing needs.

Daily requirement to be able to convey distressing and unpleasant detail with empathy and sensitivity to client and partner.

Daily requirement to teach and motivate mothers and fathers in the skills of infant care.

Display a positive attitude to diverse cultures and to facilitate different forms of communication that embraces the philosophy of social inclusion.

Attend and participate in meetings and disseminate information to staff at department level.

RESPONSIBILITY FOR POLICIES/SERVICE DEVELOPMENT

Regularly develop and implement policy in partnership with colleagues e.g.

Restructuring of midwifery services in locality.

To be aware of all Western Isles N.H.S. Board policies, and make colleagues, and where appropriate, members of the public aware of the existence of relevant policies.

RESPONSIBILITY FOR FINANCIAL AND PHYSICAL RESOURCES

Daily responsibility for stock maintenance and reordering as required.

Responsible for ensuring the safe maintenance of all equipment and to assemble, operate, dismantle and leave ready for next use all necessary equipment. e.g.. I.V. pumps, syringe drivers.

Authorised to order and administer class`C` drugs.

Always demonstrate economic use of ward equipment, services, resources and facilities.

RESPONSIBILITY FOR HUMAN RESCOURCES

When on duty required to advise and demonstrate practice for midwifery workload in mentoring students on placement.

Required to teach and supervise perineal suturing to colleagues until competency is achieved.

Required to take charge of ward department and labour suite in the absence of ward manager on a daily basis.

RESPONSIBILITY FOR INFORMATION AND RESOURCES

Responsible to fulfil the legal requirement, to complete partogram for labouring woman and the documentation of her care.

Responsible to fulfil the legal requirement, for the completion of the notification of birth for Registrar.

Responsible for the electronic recording of maternal and infant data for Scottish Birth Record which is held centrally in Edinburgh.

Responsible for the daily recording of all relevant detail pertaining to the pregnant woman and her infant from first booking till transfer to the care of the Health Visitor.

RESPONSIBILITY FOR RESEARCH AND DEVELOPMENT

Participate in the data collection for various audits, e.g.. Breast Feeding, Infection control.

FREEDOM TO ACT

Clinical specialist with autonomy to undertake care and make decisions in the treatment and management of the ante-natal and labouring woman.

Acts as single handed autonomous practitioner undertaking the management and care of labouring women taking the necessary decisions determined by the patient’s condition.

Clinical specialist with autonomy to perform neonatal assessment at delivery and during the required period of care.

Acts autonomously initiating neonatal resuscitation at birth and taking all necessary decisions as indicated by situation.

Clinical specialist with autonomy to undertake the management of all aspects of care of the postnatal woman and her infant.

All the above care is administered within the sphere of professional guidelines both local and national.

5. SUPPORTING EVIDENCE

PHYSICIAL DEMANDS OF THE JOB

Required to manoeuvre heavy machinery and beds on a daily basis, e.g. transfer of patients to and from theatre, moving cardio-tocograph monitor to patient’s bedside

Pulling and moving cots, incubators and I.V. stands.

Driving skills required whilst working in community.

MENTAL EFFORT

On every shift required, prioritising caseload and working demands.

Periods of intense mental effort required in caring for the labouring woman for an undefined time.

Concentration and precision required when performing episiotomy at delivery.

Precision, concentration and good hand and eye co-ordination required for suturing.

Considerable mental effort required to be exercised in carrying out the daily examination of the ante-natal woman, post-natal woman and infant.

Work pattern is unpredictable with continuous interruptions e.g. obstetric emergencies, telephone enquiries

Intense concentration required for calculating and calibration of infant and adult drug regimes.

EMOTIONAL EFFORT

Daily involvement, in emotional and distressing incidents e.g. in imparting upsetting information to patients, relatives and other colleagues.

Daily requirement to counsel and support clients and partners in coming to terms with their distress or personal difficulties e.g. labouring patient or patient with unrealistic expectations.

Required to give peer support in dealing with emotional traumas when encountered e.g. non- viable pregnancy (miscarriage), foetal death.

Required to manage episodes of challenging behaviours from patients and members of the public as and when they arise.

WORKING CONDITIONS

Daily exposure to hot atmospheric working conditions in clinic, labour suite, neonatal nursery and ward.

Daily exposure to soiled linen, body fluids and soiled sanitary products.

Daily exposure to sharp instruments with potential for injury. e.g. needles.

6 STANDARD ELEMENTS

Confidentiality

All personal health information is held under strict legal and ethical obligations of confidentiality. NHS Staff must follow guidance (NHS Code of Practice on Protecting Patient Confidentiality) before disclosing any patient information. All staff must respect confidentiality of all matters that they may learn relating to their employment, other members of staff, patients and their families.

Health and Safety:

Assist in maintaining own and others’ health, safety and security.

This involves:

a)  Complying with NHS Western Isles’ health and safety policies, procedures and participating in mandatory training.

b)  Maintaining a safe working environment and reporting any issues of concern as appropriate.

NHS Western Isles attaches the greatest importance to the health and safety of its employees.

It is the Board policy to do all that is reasonable to prevent personal injury and hazard to health by protecting staff and others including the public from foreseeable hazards compatible with the provision of proper services to patients. The Board expects its entire staff to take reasonable care of their own health and safety and that of others who may be affected by their acts or omissions at work. More detailed information is given in departmental safety policies where appropriate.

Supporting equality, diversity and rights.

This involves:

(a)  Acting in ways consistent with the Board’s policies and procedures.

(b)  Treating those you come into contact with equitably and with respect.

(c) Recognizing the need for aids or adaptations.

JOB DESCRIPTION AGREEMENT

I, (Print name)………………………… confirm that the job description/person specification attached have been discussed with me and are an accurate and up-to-date account of the duties and responsibilities and skills/qualifications required to undertake the post.

Job Holder’s Signature:

Date

Head of Department Signature:

Date

WESTERN ISLES NHS BOARD

PERSON SPECIFICATION

Job Title: Integrated Midwife

Department: Maternity/community

Location: Western Isles Hospital/Community

WESTERN ISLES NHS BOARD

STAFF GROUP: Midwifery

Job Title: Staff Midwife

POST REFERENCE NUMBER:

(To be completed by Human Resources)

Date:

The undersigned confirm that the job description(s) and/or person specification(s) attached have been discussed with us and they are an accurate and up-to-date account of the duties and responsibilities and skills/qualifications required to undertake the post.

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