The LHV is responsible for providing care at the maternity department under the direct technical supervision of the nurse supervisor
The LHV must be supervised in all maternity care by a registered nurse.
The LHV is responsible to the Nurse for all activities in Delivery and Post-Natal areas.
· Observation of activities in line with the MSF protocols and procedures must be evident;
· All staff must encompass respect for women’s basic human rights, including respect for women’s autonomy, dignity, feelings, and choices;
· Work across all sectors of maternity;
· Arrive at work on time; and
· Facilitate cohesive team work.
· Recognize when a normal delivery has the potential to become abnormal and report immediately to the Nurse and/or Supervisor;
· Carry out all procedures as written in the MSF protocols;
· Together with the Nurse, at all times ensure that the woman can deliver safely by detecting early, any situation that may become averse to a normal delivery;
· Together with the Nurse, communicate and explain to the woman and her attendants all the processes that are happening and make decisions with their involvement;
· Clearly and in professional detail, document all factors affecting the woman prior to, during and following delivery; and
· Ensure all documents of each woman are checked by the Nurse prior to transfer to another area of the hospital, and/or discharge, and/or transfer to a different hospital.
· Execute all daily and weekly checks and cleaning of equipment, restocking, inventories, re-ordering;
· Adhere to MSF hand hygiene and waste management procedures;
· Collaborate with cleaning staff to ensure high standard of hygiene and cleanliness in all areas;
· Be cognisant with the procedures to follow after accidental exposure to blood;
· When instructed by the Nurse perform the duties of transfer of woman to another institution by preparing the woman and her attendants and completing appropriate paperwork;
· Attend team meetings;
· Participate in training sessions and involve self in self-learning activities;
· Distribute patient food on time;
· Send the laundry in the morning with correct documentation;
· Handover baby towels; and
· Under supervision of the nurse, hand over medical equipment.
Observation And Labour Room Under Supervision Of The Nurse
· Establish rapport with the woman and her attendant/s;
· Competently observe, document and report the progress of a woman’s labour;
· Examine woman using palpation, vaginal examination if necessary, number, strength and length of contractions and vital observations as per MSF protocol;
· Establish and document foetal health and well-being as per MSF protocol;
· Commence partograph if the woman is equal to or greater than 4cm dilatated. If not use the progress notes until the partograph commences;
· Document using the partograph and/or progress notes and ensure that any change in status of the woman or her foetus is identified early, evaluated, documented and reported to the Supervisor and/or Nurse immediately;
· Perform ARM when instructed by the Nurse using aseptic technique;
· Conducting normal deliveries under supervision of a registered nurse
· Performing vaginal examinations
· Taking and recording vital signs during: early labour, active labour and postpartum period, as per MSF protocol.
· Auscultation of foetal heart during first and second stage as per MSF protocol
· Administration of oral medications under direct supervision of a registered nurse or doctor
· Administration of oxytocin in the third stage under direct supervision of a registered nurse or doctor
· Recognising and assisting with management of obstetric emergencies
· To ASSESS AND REPORT POTENTIAL PROBLEMS in the second stage of labour
· Safe management of the third stage of labour, under supervision of a registered nurse
· To assist in the management of Obstetric emergencies
· Informing the nurse, of abnormal progress of labour/ complications of labour
· Perform episiotomy when instructed by the Nurse using aseptic technique;
· Suture tears (if instructed by the Nurse) and episiotomy using aseptic technique;
· Perform safe management of the third stage of labour and inspect and document the findings from the examination of the placenta. Report to the Nurse and document any abnormalities;
· Encourage immediate skin to skin contact following birth;
· Ensure vitamin K and routine vaccinations are given to the newborn and are then documented according to MSF protocol and on the appropriate form;
· Competent to conduct basic neonatal resuscitation, under supervision of a registered nurse
· Accompanying patient to theatre for caesarean section, and USING aseptic technique.
· Receiving baby at caesarean section and assist the NBU doctor in providing resuscitation
· Completing maternity register
· Listens to patients complaints AND RESPOND BY REPORTING TO, the nurse supervisor.
· Monitor and document vital observation, fundal height, contractions of the uterus, urine output and general physical and psychological health of the post-partum woman;
Responsibilities to the Woman In The Post-Partum Period Under Supervision Of the Nurse
· Perform and document post-natal checks regularly and recognise and immediately report to the Nurse any abnormal observations;
· Encourage and assist the woman to establish breast feeding;
· Educate the woman and attendants regarding the benefits of breast feeding, breast care and cleanliness, personal hygiene, care of sutures, vaginal bleeding and the type of loss to expect in the coming days, (especially secondary PPH), postpartum infections, options for family planning, care of self psychologically, and diet; and
· Ensure vital and post-natal observations are completed and documented prior to discharge and inform the Nurse of any abnormalities.
Responsibilities To The Infant In The Post-Partum Period
· Through regular observation ensure temperature, respirations and colours are maintained and document findings as per MSF protocol. Report any abnormalities to the nurse immediately;
· Through regular observation document urine and meconium output and report any abnormalities to the nurse immediately;
· Observe breast feeding abilities of newborn and mother and discuss with mother; and
· Ensure vital observations are completed and documented prior to discharge and inform Nurse of any abnormalities.
Medecins Sans Frontieres Doctors Without Borders (MSF) is an independent medical humanitarian association providing medical assistance to people in need, irrespective of race, religion, creed or political conviction. MSF has started work in Pakistan since 1986 as an independent, self-governed organi ...Read More