Provide nursing care, treatment and follow-up of patients, according to doctors’ prescriptions, protocols applied in service and universal hygiene standards/precautions, in order to ensure the quality and continuity of care for the targeted population. The nurse is responsible for nursing care at MCH.
· 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.
· Carry out all procedures as written in the MSF protocols;
· At all times ensure that the woman can deliver safely by detecting early, any situation that may become averse to a normal delivery. Immediately report findings to the FMO/Gynaecologist;
· Supervision of LHV in all aspects of maternity care;
· Ensure thorough handover at the end of the working hours
· 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;
· 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;
· Perform or delegate the duties of transfer of woman to another institution by preparing the woman and her attendants and completing appropriate paperwork;
· Attend team meetings; and
· Participate in training sessions and involve self in self-learning activities.
· Establish rapport with the woman and her attendant/s;
· Work alongside women who present in labour, or any pregnant woman presenting complains and observe if the woman needs admission for a normal delivery or prenatal care observation. This is achieved through discussion using the triage questionnaire and physical examination of the pregnant woman; and
· Identify those women who are at risk and immediately inform the FMO/Gynae.
· Working in the triage area to carry out first consultations of the patient and establish if patient need admission or medical consultation according to the triage questionnaire and physical examination (general conditions, BP, PS, Temperature, FHR)
· Prioritize emergency cases and immediately informing FMO and/or gynaecologist about them.
· Assisting doctors in the ER for medical consultations and admissions which include drawing blood, cannulation, haemocue, blood glucose testing, and urinalysis.
· Fill in triage documents for all patient and provide patient consultation form for all patient who don’t need medical consultation and/or admission
· Communicate and explain to the patient and attendant about condition of patient and the decision made about patient’s admission.
· Inform supervisor or FMO on duty (during evening and night time) about any patient/attendance complains in waiting or triage area or ER.
· Carrying our daily/ weekly checking of equipment including cleaning of emergency equipment
· Assisting with weekly drug order and monthly stock inventories
· Participating in filling our daily consumption sheets and re-ordering stock if required
· Checking and ordering of weekly stock in the emergency room
· Collaborating with cleaning staff to maintain a good standard of hygiene in the ER and triage area
Observation And Labour Room Responsibilities
· 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 FMO/Gynae immediately;
· Perform artificial rupture of membranes (only if needed) using aseptic technique;
· Administration and checking of medications as charted by doctor
· Recognising and assisting with management of obstetric emergencies
· Informing doctor of abnormal progress of labour/ complications of labour
· Assisting Doctor with complicated deliveries
· To recognise problems in the second stage of labour
· Safe management of the third stage of labour
· To assist in the management of Obstetric emergencies
· Suturing of episiotomy and second degree vaginal Perineal tears using aseptic technique
· Regularly auscultation of the fetal heart during labour and delivery as per MSF protocol
· Perform safe management of the third stage of labour and inspect and document the findings from the examination of the placenta. Report 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;
· Assist in management of obstetric emergencies; and
· Competently conduct infant resuscitation.
1- Responsibilities To The Woman In The Post Partum Period
· Monitor and document vital observation, fundal height, contractions of the uterus, urine output and general physical and psychological health of the post-partum woman;
· Perform and document post-natal checks regularly and recognise and respond to problems post- delivery (eg. PPH, hypertension);
· 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;
· Ensure vital and post-natal observations are completed and documented prior to discharge and inform MSF/Gynaecologist of any abnormalities; and
· Arrange follow up appointments as needed.
Responsibilities To The Infant In The Post Partum Period
· Through regular observation ensure temperature, respirations and colour are maintained and document findings as per MSF protocol;
· Through regular observation document urine and meconium output;
· Observe breast feeding abilities of newborn and mother and discuss with mother;
· Complete the newborn check and report findings to MSF/Gynaecologist and document prior to discharge; and
· Ensure vital observations are completed and documented prior to discharge and inform MSF/Gynaecologist 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