OB RN, Midwifery Practice

Nature and Scope

Summary of Position

The Obstetric Registered Nurse provides maternal and newborn care within “The Plumas Model” - an integrated approach to restoring rural maternity care by connecting a midwifery-led freestanding Birth Center, a hospital-based Standby Perinatal Unit (SPU), and a Rural Health Clinic for prenatal and postpartum services. Enabled by California Senate Bill 669 through a 10-year pilot program, the SPU provides emergency obstetric and neonatal support for patients transferred from the Birth Center or presenting to the Emergency Department. This role integrates three essential functions, supporting continuity of care across outpatient, intrapartum, and hospital-based perinatal services. This role is autonomous and requires participation in program management and quality and process improvement, in the context of development of the new model of care.

• Rural Health Clinic

Provide case management, nursing assessments, screening, patient education, and follow-up for prenatal and postpartum patients. Identify concerning symptoms, facilitate timely provider evaluation, and coordinate referrals and services that support continuity of care across the Plumas Model.

• Freestanding Birthing Center

Provide health education through PHPS (formerly CPSP), helping women prepare for pregnancy, birth, and postpartum recovery. Serve as the second birth attendant within a midwifery-led model that supports physiologic birth with minimal intervention. Assist during labor and delivery, assess maternal and newborn well-being, support infant feeding and early bonding, and recognize changes requiring consultation or transfer.

• Standby Perinatal Services

Respond to service activation as part of a specialized obstetric and neonatal response team, similar in function to a rapid response team. Provide nursing assessment, monitoring, stabilization, and coordination for patients transferred from the Birth Center or presenting to the Emergency Department with urgent or emergent obstetric needs. Collaborate with the obstetric team and hospital teams to support emergency care and transfer to a higher level of care when indicated.

Location

This position has a unique role in supporting and working in three distinct care settings: the birth center, the rural health clinic, and the hospital standby perinatal services. Locations include Quincy, Greenville as well as supporting a mobile clinic.

Compensation

Compensation for Benefited, Full-Time Pay Scale

• Base Rate: $4,041.60–$5,762.40 per pay period (or $105,081.60–$149,821.24 annually)
• Starting pay is determined using our clinical pay scales, which feature 13 steps recognizing up to 30 years of relevant experience.
• Eligible employees may also receive shift differential and holiday pay

Job Status / Shift Information

Full Time, benefited

Qualifications

Experience

Required

• Minimum of 3 years of labor and delivery nursing experience. Experience must be within the past 5 years or actively renewing/engaging in clinical practice.
• Experience working within a midwife-led or collaborative obstetric model.

Preferred

• Rural health, birth center, or critical access hospital experience
• Experience in perinatal education, quality improvement, or program development

Education

Required

• Current unrestricted California Registered Nurse license
• Current BLS
• Current NRP certification
• Current Intermediate Fetal Monitoring certification
• Within 6 months of hire:
• Spinning babies training
• STABLE certification
• Within 1 year of hire:
• Advanced Life Support Obstetrics (ALSO) certification
• Advanced Fetal Monitoring certification
• Commitment to maintaining obstetric proficiency through shifts at a higher-level labor and delivery services as required under California SB699.

Knowledge/Skills/Abilities

• Interest in healthcare innovation, pilot programs, or policy-guided care models
• Cross functional flexibility within evolving clinical workflows
• Able to support the patient and their families across the continuum of care
• Able to function and thrive in a rural collaborative obstetric model
• Sound clinical judgement, communication skills, and ability to work independently in low-volume, high acuity situations.
• Team player that utilizes standard work and protocols to achieve a common goal.
• Competent in the assessment and identification of the needs of the childbearing family and appropriately communicates and functions within the multidisciplinary team.
• Promotes a positive attitude for good interpersonal and interdepartmental relationships. Shows consideration for and maintains good relations with others and is mindful and respectful of other people's needs, rights, and feelings.
• Practices under the midwifery model of care.

Responsibilities

General

• Knowledge and appropriate administration of medications routinely used in the perinatal setting.
• Documentation of patient assessments and care are complete, clear, and concise.
• Initiates the chain of command per hospital policy in dealing with patient care problems or urgent safety concerns.
• Maintains supply items in all care settings.
• Assures the department is maintained in a clean and safe manner for employees and patients by assuring necessary equipment and supplies are maintained to perform such duties/service. This includes lab QC in the birth center and RHC.
• Assists with evaluating and implementing recommendations from the hospital’s committees including but not limited to Infection Control, Quality Assurance, etc.
• Engages in continuous performance improvement (PI) projects. Maintains accurate statistical data and compiles monthly reports for administration and/or medical staff as requested. Assists with tracking of quality and performance improvement for the SB669 project.
• Assists in the development of departmental goals.
• Contributes to the development of a new competency and training program for the model.
• Supports baby friendly and breastfeeding environment.
• Maintains current knowledge and skills to keep abreast of current changes in the healthcare field, as well as to maintain professional status
• Attends all mandatory training and educational programs to maintain necessary competency, including but not limited to, licensure and/or certification.
• The perinatal educator utilizes the nursing process to assess plan and implement and evaluate group and individual client learning. The focus is to promote informed, responsible decision making and active participation in client/family health care.
• Assesses patient risk and assists with appropriate referrals to perinatal or other health care specialties as needed
• Educates patients on the necessary lifestyle changes involved in a diabetes diagnosis, including nutrition, medication, physical activity, and glucose testing
• Responsible for providing lactation management services to expectant and new parents. These functions are performed in accordance with the hospital’s philosophy, policies, procedures and standards. Provide and facilitate education for nursing mothers, nursing staff, and other health care team members.
• Responsible for accurately assessing and documenting patient barriers to education.
• Responsible for providing appropriate patient education as determined by patient and care team.
• Support preventive, relationship-based care in alignment with rural health best practices
• Strong proponent of the midwifery model of care.
• Assists in the orientation, training, and mentorship of peers, students and other healthcare providers (including midwives, nurses, and physicians), both from within theregion and from other institutions and jurisdictionsContributes to risk management initiatives within the region to improve client safetyand reduce adverse outcomes.
• Participates in the OB Committee, providing administrative support as
• Participation in community health coalitions and health care outreach.
• Other duties as assigned.

Birth Center

• Provide scheduled on-call coverage as birth attendant assisting the midwife.In collaboration with the midwife, provide the following: safe, respectful, evidence-based care during labor, birth, and the immediate postpartum period.
• Responsibilities include maternal and fetal assessments, labor support, assistance during delivery, newborn assessment and stabilization, documentation, and timely recognition and response to maternal or neonatal complications.
• Participates in emergency interventions and coordination of transfer when indicated, consistent with professional scope of practice, demonstrated competency, and established clinical protocols.
• Provides patient and family education
• Leads group education classes.
• Participates in maintaining a clean, safe, welcoming, and birth-ready environment. Responsibilities include preparing the birth suite for patient arrival and completing post-birth room turnover following discharge, including cleaning and disinfecting equipment and surfaces, handling soiled linens and waste, restocking supplies, and restoring the birth suite to readiness for the next patient, in accordance with established infection prevention and environmental services protocols.

Rural Health Clinic

• Serve as a perinatal educator within the Rural Health Clinic during scheduled, non-delivery hours
• Provide patient and family education and work to strengthen continuity between outpatient care and intrapartum services
• Care coordination for prenatal and postpartum patients, for both social determinants of health (SDOH) needs as well as coordination of collaborative care for patients delivering at other facilities.
• Coordinate antepartum telemedicine programs with the telemedicine coordinator
• Coordination of NB screening programs.
• Coordination of strategic quality initiatives.

Standby Perinatal Services

• Provides on-call coverage for emergent triage.
• Provides support for the CNM and Physician when a perinatal or neonatal patient presents to the Emergency Department or Standby Perinatal Service for triage.
• Support rapid assessment, stabilization, and escalation of care for transfer to another facility or the operating room for delivery or procedure.
• Act as a clinical bridge between ED, OR, outpatient services, and higher levels of obstetric care
• Support hospital-wide readiness and perinatal safety protocols
• Coordinate maternal and neonatal telemedicine programs
• Able to perform an accurate initial primary assessment of patient and determine immediate needs of patient and family
• Interpret fetal heart patterns and appropriately determine if findings are reassuring or non-reassuring. Ability to clearly and timely communicate assessments to CNM or physician.

Benefits / Perks

Benefits for Eligible Employees

The following benefits are available to eligible full-time and part-time employees following applicable waiting periods:

• Comprehensive medical, prescription drug, dental, and vision plans
• PDH Employee Discount Program, which waives applicable deductibles and coinsurance for eligible services received at Plumas District Hospital
• Generous paid time off (PTO) accrual
• Paid leave for continuing education, bereavement, and jury duty
• Employer-sponsored retirement plans featuring:
• A 3% employer contribution
• An employer match of 50% of employee contributions, up to the plan maximum
• $20,000 in employer-paid life insurance
• Voluntary benefit options, including additional life insurance, long-term disability insurance for full-time employees, and identity theft protection
• Potential loan-forgiveness opportunities for eligible healthcare professionals
• Educational and career-development support, including Certified Medical Assistant training, an LVN-to-RN step-up program, and tuition reimbursement

On average, employer-provided benefits add approximately 40% to the value of an employee’s total compensation package.

Perks Available to Employees

• Paid sick leave, with five days awarded annually based on the employee’s anticipated work schedule
• Available to benefit-eligible employees and non-benefited employees scheduled to work at least 30 shifts during the calendar year
• An inclusive, supportive, and connected work environment
• Discounted rates at the PDH Child Care Center