Midwife

  Birth unit Main responsibilities in the birth unit -          Give the job related care while respecting medical prescriptions and protocols that apply in the service. -          Ensure admission of patient and follow up of labour and referrals if and when necessary -          Manage normal delivery in collaboration with the head midwife and doctor. -          Provide care to the new-born -          Ensure the follow up of the new-borns and the mothers in the maternity ward -          Prepare the discharge of mothers and their babies -          Maintain documentation and communication to the supervisor.   Task description in the birth unit Care -          Admission of parturients -          Welcome patients; take history and vital signs - decide whether hospitalisation is needed -          Register and complete a hospitalisation file -          Explain the ward’s functioning, provide needed linen   Follow up of labour -          Follow up of every parturient’s labour and fill in the parthogram efficiently once the active fase of labour has started -          Inform the head midwife / doctor when labour doesn't evolve correctly -          In case of induction or stimulation of labour with oxytocin, verify the medical prescription and respect MSF protocol   Normal deliveries -          Carry out delivery with active management of the 3rd stage of labour -          Carry out first care of the new-born; in case of complications, carry out resuscitation of the new-born   Complicated and prolonged labour and deliveries -          Detect prolonged labour or delivery and signs of complications. Notify the head midwife or doctor -          According to experience and with the agreement of the head midwife, take charge of the following cases of prolonged labour or delivery in collaboration with the head midwife or doctor labour obstruction due to ruptured membranes and stimulation of labour with oxytocin or misoprostol, shoulder dystocia, breach delivery, face presentation, twin delivery -          According to experience and with the agreement and collaboration of the head midwife, take charge of the following complications post-partum haemorrhage, first trimester haemorrhage (miscarriage,...) third trimester haemorrhage, manual vacuum aspiration (in case of incomplete abortion), umbillical cord prolaps, hypertension, pre- eclampsia and eclampsia, threatened premature delivery (tocolytics and lung ripening), foetal intra uterine death, artificial placenta delivery and uterine revision, labour with scarred uterus or overstretched uterus -          According to experience and with the agreement of the head midwife, administer certain medication independently: Paracetamol, Metoclopramide, Oxytocin, Methylergometrine, Misoprostol, Salbutamol, Nifédipine, Magnesium sulphate, Amoxycilline, Ampicilline, Metronidazole, Gentamycine according to the situation -          Stabilize and refer complications according referral criteria. Document and notify the head midwife and/or doctor.   Follow up of new-borns and the mothers in the maternity ward -          Take vital signs of every patient according to the rhythm indicated in the ward’s protocols -          Distribute-administer the medication according to the prescribed time -          Make a tour in the ward with the responsable midwife or doctor. -          Ensure daily post-natal follow up: pain control, hight of the uterus, colouring of the conjunctives, breastfeeding, medication, drip, bladder catheterisation etc. -          Supervise new-born care daily: temperature, weight, umbillical cord, fontanelle, skin condition etc. -          Supervise the carrying out of vaccination (VPO and BCG) of new-borns -          Be assured of a correct nutritional state, a good hydration (liquid balance if necessary) and intestinal transit of patients -          Assist mother with breastfeeding -          Provide counselling on family planning and prescribe methods according protocol.   Discharge -          Ensure health education of patients; advise mothers on useful topics for their home return; breastfeeding, emergency signs of post-partum complications and danger signs in the newborn. -          Ensure the patient’s correct understanding of possible treatment -          Verify that the patient has received the documents: birth certificate, vaccination card, etc -          Ensure the disinfection of the bed; make sure that linen, blankets are taken to the laundry room -          Complete and gather the patient’s file and hand over to the head midwife   For the night shift: -          Inform the expat midwife by phone in case of problems which are not manageable by the employee   Hygiene / asepsis, waste disposal and stock keeping -          Keep the ward clean and tidy -          Sort waste and use appropriate containers and bins (sharps, combustible waste, domestic waste) -          Follow cleaning and instrument sterilisation procedures -          Respect universal hygiene and asepsis rules during care -          Watch over the hygiene of the patients -          Watch over the ward’s medication and renewable stock   Quality and continuity of care: -          Respect the medical secret, and guarantee confidentiality -          Respect dignity and the intimacy of hospitalised patients. Assure a maximum of patients’ comfort -          Update the files of patients and new-borns -          Participate in collecting needed data for monthly reports -          Participate in the morning meetings of the medical team -          Make sure of a good hand-over of the different shifts (day-night-day) and with the person who replaces during the midday break. Use the hand over journal in which every patient must be mentioned -          Respect care protocols and the mode of administering treatment -          Be present at trainings and justify each absence to the head midwife   out patient  Main responsibilities out patient   -          Ensure ante-natal care   -          Ensure post-natal care for mothers and their baby(s) -          Ensure family planning consultation -          Guarantee quality and continuity of care to patients -          Guarantee that hygiene rules, asepsis and waste disposal are respected   Task description Ante-natal consultations -          Provide health promotion education in group or indivudually for patients consulting and assist with care as and when necessary -          Offer a complete follow up of patients according to the protocols -          history -          clinical examination (palpation, auscultation, uterus height measurement, fetal heart rate, vital signs) -          preventive treatment (tetanus immunization, anaemia prevention, …) and curative (if needed) -          Ensure that routine laboratory tests are performed, interprete the results and adapt the approach if necessary -          Detect pregnancy relied complications and adapt follow up if needed -          Inform and refer to the head midwife or doctor in case of complications/problems exceeding one's own competence -          Fill in antenatal files and registers   Family plannning -          Provide health promotion education in group or indivudually for patients consulting and assist with care as and when necessary -          Ensure appropriate individual counselling (information) so women can opt for the method of their choice, knowing indications, contra-indications and the secondary effects of each method -          Ensure a basic clinical examination to exclude contra-indications -          Administer and/or provide the method of contraception according to its use and protocol -          Inform and refer to the head midwife or doctor in case of complications/problems exceeding one's own competence -          Fill in family planning files and registers    Post-natal consultations -          Provide health promotion education in group or indivudually for patients consulting and assist with care as and when necessary -          Offer a complete follow up of the mothers according to protocols -          history -          clinical examination (measurement of uterus height, vital signs, condition of the pereneum and breasts) -          preventive treatment (tetanus immunization, anaemia prevention etc.) and curative (if needed) -          Offer a complete follow up of the new-borns according to protocols: -          weight, care of the umbillical cord -          preventive treatment (vaccination, eye ointment) -          Ensure that routine laboratory tests are performed, interpret the results and adapt the approach if necessary -          Detect complications relied to the post-natal period and adapt the follow up if needed -          Inform and refer to the head midwife or doctor in case of complications/problems exceeding one's own competence -          Fill in post-natal files and registers     Hygiene / asepsis, waste disposal and stock keeping -          Keep the consultation room clean and tidy Sort waste and use appropriate containers and bins (sharps, combustible waste, domestic waste) Follow cleaning and instrument sterilisation procedures Respect universal hygiene and asepsis rules during care Adequate follow up of used medication during consultations: manage stock files, place a weekly order and calculate monthly consumptions   Quality and continuity of care: -          Respect the medical secret, and guarantee confidentiality -          Respect dignity and the intimacy of patients. Assure a maximum of patients’ comfort -          Participate in collecting needed date for monthly reports -          Participate in the morning meetings of the medical team -          Respect care protocols and the mode of administering treatment -          Be present at trainings and justify each absence to the head midwife     Prohibitions -          To consume alcohol or other drugs during working hours -          To sleep during working hours -          To ask money or other benefits from patients -          To use funds or equipment of the organisation for private purposes without explicit authority of a responsable of MSF -          To leave the workplace during working hours without explicit authority of a responsable of MSF In case of non respect of the above rules sanctions can be applied. They include a range from written warning to dismissal for serious mistakes (without compensation), in accordance with the MSF internal regulations and work code.   Others At all times, the nurse/midwife informs the supervisor before leaving duty.   The work of MSF is characterized by a great flexibility and a certain mobility. This is the more so as this function can evoluate in time and according to clinic demands. The employee may find himself in circumstances in which he has to take on other tasks and functions in the  MSF project.     -