Under the general supervision of the OB/GYN chief of Service for clinical issues and the Department Administer for administrative issues, functions as a Midwifery Lead of the healthcare team.  Coordinates departmental operations that ensure quality patient care in a safe, healing environment that is patient and family centered. Demonstrates responsibility and accountability for own professional practice. Has appropriate clinical skills to be an expert resource. Is available and supportive to employees and understands priorities/needs of the department. Is a staff role model for professional Nurse-Midwifery practice.  May recommend to management in efficient resource allocation by assuring appropriate scheduling and coverage. Demonstrates performance consistent with the strategic plan of the organization and the KP mission, vision and values.
Under the general supervision of an Ob-Gyn Physician, manages the medical care of patients throughout the maternity cycle, including the antepartum, intrapartum, postpartum and gynecological periods. Provides standard maternity care and counseling to expectant women following ambulatory care and inpatient standardized procedures, protocols, policy and procedures and instructions regulated by the State of California Nurse Practice Act and Southern California Permanente Medical Group.

• The Lead Certified Nurse-Midwife demonstrates proficiency by exhibiting the following skills, competencies, & behaviors: Leadership: Directs reviews, assigns & organizes the work of at least three (3) or more Certified Nurse-Midwives. Applies the KP Nursing mission, vision, values & behaviors in daily practice. Understands needs & sets priorities for the department. Provides professional leadership & direction of Certified Nurse-Midwives in order to maintain efficient delivery of effective patient care. Coordinates departmental operations & delegates tasks appropriately. Is an excellent staff role model for professional Midwifery practice (e.g. CNM/MD Collaborating for Outcomes, Just Culture, Quality, Service, & Safety). Supports & enhances the leadership skills of the staff RNs, LVNs & MAs/CNAs (& other ancillary staff as appropriate). Upholds compliance with Kaiser Permanentes Policies &Procedures, Principles of Responsibilities, applicable State & Federal laws ®ulations, accreditation & licensure requirements. Upholds the standards of the California Nurse Practice Act, American Nurses Association (ANA) Standards of Nursing Practice, ANA Code of Ethics for Nurses and the American College of Nurse-Midwives. Champions new ideas. Actively collaborates with others through the change process. Acts as a resource, preceptor & mentor to new employees, residents, registry, students, & other team members in department specific operations & patient care activities. Collaborates with or refers to manager/clinical nurse specialist/educator any outstanding issues or concerns on the unit. Demonstrates ability to identify & resolve problems in collaboration with work teams across the continuum. Ensures compliance with regulatory requirements, policies, procedures, & standards of practice. Participates in activities related to patient flow, including admission & discharge processes. Facilitates inter-professional/interdisciplinary communication & collaboration.


• Nursing Process: Serves as a resource for clinical concerns, scope of practice & applicable State & Federal regulations as well as operational concerns of providers & staff. Possesses experience & skills to be a resource for providers, RNs, LVNs, MAs, CNAs, (& other ancillary staff as appropriate). Demonstrates flexibility in work schedule to meet departmental needs. Actively involved in assigning, orienting, & precepting & coaching staff and students as needed.


• Documentation: Conducts audits & ensures that documentation reflects thorough assessments, incorporates physical & psychosocial findings, diagnostic tests, learning needs, barriers, multidisciplinary education plans & age appropriate care.


• Clinical Outcomes: Participates/leads various aspects of department operations, staff competencies, department committees, Unit Based Teams (UBTs), new projects, quality efforts, & educational programs. Demonstrates knowledge of patients specific conditions commonly seen in the department & care required. Interfaces with leadership, peers, physicians, other healthcare providers, & support staff regarding performance, as necessary.  Actively participates, champions & motivates other staff in quality improvement, patient care, workflow, & improvement in clinical initiatives & working conditions of the department.  Provides input on employees performance evaluations through provider and patient feedback, peer review and chart review.


• Workplace Safety: Adjusts staffing needs of the department to assure quality patient care, patient & staff safety, efficiency, productivity & working conditions of providers & staff. Actively models Labor-Management Partnership (LMP) Workplace Safety principles & practices.


• Patient Care Experience/Customer Service: Acts as a role model for staff regarding providing a patient care experience that exceeds members expectations. Ensures timely & appropriate management of patients. Participates in a smooth transition for patients across the care continuum.  May participate in daily leadership rounds and documents rounding activities on unit rounding log (as appropriate).


• Team Commitment: Ensures support of the collaborative LMP environment through unit-based teams (UBTs). Identifies & supports staff professional/clinical development needs (i.e. certification, presentations, reward/recognition). Motivates staff to attain their fullest potential in improving performance, attendance, access, and service & quality outcomes.  Assures departmental meeting information is consistently communicated.  Confronts difficult or conflict situations constructively & seeks appropriate assistance.


• Fiscal Responsibility: Participates in resource allocation (assignments, scheduling, and certain equipment/supply management). Collaborates & assists with leadership, physicians, & peers in scheduling, workflow & throughput to promote quality patient care, patient & staff safety, efficiency, productivity & working conditions of providers & staff.


• Professional Development:  Attends Professional Development Educational programs. Takes responsibility for professional growth & development.


• In addition to the Certified Nurse Midwife Job Details, The Lead CNM shall demonstrate proficiency by exhibiting the following skills, competencies & behaviors:


• Under the supervision of an Ob-Gyn physician, manages the care of women during labor and delivery.


• Obtains an accurate medical, obstetrical, gynecological and psycho-social history of the present pregnancy.


• Observes signs of the members general and obstetrical health status.


• Performs complete physical examinations including the pap smear, breast examination, abdominal examination, pelvic examination and clinical pelvimetry.


• Records all findings of examinations, histories and significant observations in the patients chart.


• Determines pregnancy status during gestation, presentation and position of fetus and fetal heart rate.


• Determines whether all findings are within normal limits.


• Orders appropriate laboratory examinations such as chest X-ray, ultrasound, CBC, urinalysis, blood type and Rh factor, serology tests.


• Consults with and obtains orders from an obstetrician for any special care or diagnostic procedure and refers to other services as necessary.


• Institutes preventative measures and detects abnormal conditions, obtains consultation and assistance from physicians as needed.


• Teaches, counsels and guides individual members regarding their individual health care.


• Determines the need for social services, genetics or mental health services and refers as appropriate.


• Evaluates patients general and obstetrical health status.


• Provides health supervision, care and family planning advice to women during antepartum and postpartum periods.


• Evaluates fetal status by performing such procedures as abdominal palpation and ultrasound examinations to estimate fetal weight, presentation and position, approximate station and fetal heart rate.


• Able to perform internal and external fetal monitoring and interpretation.


• Consults with obstetrician regarding questionable findings.


• Determines members degree of labor and whether member is to be admitted to labor and delivery.


• Independently conducts normal spontaneous vaginal deliveries.


• First assists at Cesarean Sections and gynecological surgeries.


• Performs immediate care of the newborn.