1. A midwife belongs to the category of specialists.
2. A person with secondary medical education is appointed to the position of midwife
qualification category(s)
3. Appointment to a position and dismissal from it are made by order of the head of the institution
4. The midwife should know:
4.1. Laws Russian Federation and other regulatory legal acts on health issues.
4.2. Basic hygiene for women during pregnancy and after childbirth.
4.3. The course of normal labor and its variants.
4.4. Management of pregnancy during complications, basic methods of preventing and combating complications.
4.5. Rules of asepsis and antiseptics, sanitary and anti-epidemic regime of obstetric institutions.
4.6. Principles of prevention of gynecological diseases, basics of contraception and healthy image life.
4.7. Legislation on labor and labor protection of the Russian Federation.
4.8. Internal labor regulations.
4.9. Rules and regulations of occupational health, safety, industrial sanitation and fire protection.
II. Job responsibilities
Midwife:
1. Conducts therapeutic and preventive sanitary and educational work, patient care in accordance with the profile of the department under the guidance of a doctor.
2. Conducts preparatory work for the diagnostic and treatment activities of an obstetrician-gynecologist and their own activities.
3. Provides therapeutic and diagnostic assistance to pregnant women, women in labor, postpartum women, gynecological patients as prescribed by a doctor or together with him in the department, at an appointment in a antenatal clinic, at home.
4. Provides medical assistance during uncomplicated childbirth independently or with an obstetrician-gynecologist in case of pathology of childbirth, the postpartum period, conducts primary processing and, if necessary, primary neonatal resuscitation.
5. Provides emergency pre-hospital medical care in case of acute diseases and accidents according to the profile of the activity, followed by calling a doctor or referring the patient to a medical institution.
6. Informs the obstetrician-gynecologist, senior midwife, head of the department or doctor on duty about extreme situations in the patients’ condition, incidents in the department, wards, and offices.
7. Assists in some obstetric and gynecological operations.
8. Observes the health and development of children in the first year of life.
9. Provides home patronage to pregnant women, postpartum women, and gynecological patients with the implementation of organizational and therapeutic measures.
10. Conducts preventive examinations of women to identify gynecological diseases (together with a doctor or independently), and work on family planning.
11. Takes measures to comply with the sanitary and hygienic regime (compliance with the rules of asepsis and antiseptics, proper storage, processing, sterilization of instruments, devices, dressing material) in the department (antenatal clinic, office).
12. Prepares medical documentation established by the Ministry of Health of Russia for the relevant unit.
The midwife has the right
1. Receive the necessary information to accurately perform your duties.
2. Give instructions to junior medical personnel to comply with the sanitary and epidemiological regime of the department (office).
3. Make proposals for improving the work of junior and nursing staff.
4. Be a member of the Council of Midwives and Nurses, take part in the work of professional medical associations.
5. Improve your skills.
6. Receive a qualification category.
IV. Responsibility
The midwife is responsible for:
1. For improper performance or non-fulfillment of your job responsibilities provided for by this job description - within the limits determined by the current labor legislation of the Russian Federation.
2. For offenses committed in the course of carrying out their activities - within the limits determined by the current administrative, criminal and civil legislation of the Russian Federation.
3. For causing material damage - within the limits determined by the current labor and civil legislation of the Russian Federation.
I. General provisions
1. The midwife in the examination room belongs to the category of specialists.
2. A person with a secondary medical education in the specialty “Midwifery”, a specialization corresponding to the position held, is appointed to the position of midwife
3. Appointment to the position of midwife in the examination room and dismissal from it are made by order of the head of the institution in agreement with Art. midwife at the antenatal clinic.
4The midwife should know:
4.1. Laws of the Russian Federation and other regulatory legal acts on health care issues.
4.2. Fundamentals of the diagnostic and treatment process, disease prevention, promotion of a healthy lifestyle.
4.2.1. Basic hygiene for women during pregnancy and after childbirth
4.2.2. The course of normal labor and its variants.
4.2.3. Management of pregnancy during complications, basic methods of preventing and combating complications.
4.2.4. Principles of prevention of gynecological diseases, the basics of contraception and a healthy lifestyle.
4.3. Organizational structure of a healthcare institution.
4.4. Safety rules when working with medical instruments and equipment.
4.5. Labor legislation.
4.6. Internal labor regulations.
4.7. Rules and regulations of occupational health, safety, industrial sanitation and fire protection.
5. In his activities he is guided by these instructions, the hourly work schedule, methodological instructions and orders of the Ministry of Health of the Russian Federation.
6. The midwife reports directly to the doctor, with whom she also works with the senior midwife.
II. Job responsibilities.
The midwife should:
1. Prepare the workplace before the outpatient appointment. controlling the availability of the required amount of medical instruments, sterile material, ensuring proper order and sanitary condition of the office, setting a sterile table
2. Prepare for autoclaving required material, gynecological kits.
3. Carry out therapeutic and diagnostic manipulations for patients as prescribed by a doctor or together with him at an appointment in the housing complex. or at home:
- measurement blood pressure
- taking smears
- examination of the cervix on mirrors
- vaginal treatment
- changing the vaginal ring
- measurement of the pelvic bones, abdominal circumference, uterine fundus position
4. Conduct health education work with patients.
5. Provide emergency pre-hospital medical care in case of acute diseases and accidents according to the profile of activity, followed by calling a doctor.
6. Assist the doctor during medical procedures
7. Carry out home patronage for pregnant women, postpartum women, and gynecological patients with the implementation of organizational and therapeutic measures, clearly keeping a log of patronage records.
8. Together with the doctor, conduct preventive examinations of women in order to identify oncological and gynecological diseases, and work on family planning.
9. Take measures to comply with the sanitary-epidemiological regime (compliance with asepsis and antisepsis, proper storage, processing, sterilization of medical instruments, gloves, dressings, medical devices) in accordance with current instructions and orders.
10. Strictly observe the rules of personal hygiene, precautions when working with blood, and the prevention of occupational infections.
12. Comply with ethical and deontological standards
13. Comply with the rules of labor discipline, safety precautions, and fire safety.
14. Complete medical documentation established by the Ministry of Health of Russia.
15. Monitor the timely receipt of research results and paste them into the outpatient cards of patients.
13. If necessary, help patients prepare for examination.
14. Explain to patients the methods and procedures for preparing for laboratory, instrumental and instrumental studies.
15. Write out requirements for medicines, dressings and consumables, misinformation. funds and receive them from the head nurse.
16. Conduct a preventive examination of female representatives (examination skin, visual mucous membranes, examination and palpation of the mammary glands, peripheral lymph nodes, speculum examination of the cervix and vagina, anal examination of the uterus and appendages, digital examination of the rectum for women over 40 years of age if there are complaints..
17. Know the technique of taking a smear from the vagina and cervical canal and then sending it to a cytology laboratory for examination.
18. Refer persons with identified pathology to the appropriate specialist to clarify the diagnosis and prescribe appropriate treatment.
19. Conduct health education work among women.
20. Keep records and registration of ongoing preventive examinations and the results of cytological studies in established forms.
21. Systematically improve your skills.
22. Prepare medical documentation: referrals for consultation, statistical coupons and reports, extracts from outpatient records, control charts of dispensary observation, work diary of nursing staff.
III. Rights.
The midwife has the right:
1. Use conservative methods of treating patients as prescribed by the doctor, and carry out certain medical procedures.
2. Receive the information necessary to accurately perform your professional duties.
3. Make proposals for improving the work of a nurse and the organization of nursing in the institution.
4. Require the head nurse of the department to provide the post (workplace) with equipment, equipment, tools, care items, etc., necessary for high-quality performance
their functional responsibilities.
5. Improve your qualifications in the prescribed manner, undergo certification (re-certification) in order to assign qualification categories.
6. Participate in the work of professional associations of midwives and other public organizations not prohibited by the legislation of the Russian Federation.
IV. Responsibility.
The midwife is responsible for:
1. For improper performance or failure to fulfill one’s job duties as provided for in this job description - within the limits determined by the current labor legislation of the Russian Federation.
2. For offenses committed in the course of carrying out their activities - within the limits determined by the current administrative, criminal and civil legislation of the Russian Federation.
3. For causing material damage - within the limits determined by the current labor and civil legislation of the Russian Federation.
Developed by Deputy
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The possibility of applying non-financial (non-financial) motivation methods at different stages of the personnel management system not only includes policies and procedures on non-material remuneration of employees, but also practices in the field of selection, adaptation,... 
The need to analyze the personnel policies of an enterprise usually arises: during the period of internal transformation of the company - reorganization, stage of rapid growth, reduction, liquidation; under the influence of external factors - changes labor legislation, practitioner and... The procedure for approving personnel policies can be carried out at the level of: HR Director General Director Board of Directors. If the final approval of a particular personnel management policy is the responsibility of the organization’s Board of Directors or... 
The personnel policy should include the following concepts and sections: The main content of the personnel policy This section defines the objectives that the enterprise’s personnel policy is intended to help achieve, or the ultimate goal of the policy. For example, the goal... This section provides organizations with practical information on how to develop HR policies and procedures. This manual is intended for employees of the HR department. It will be useful for those who are just starting to develop... 
1. General Provisions
1.1. The position of a midwife is filled by a person with secondary medical education.
education in accordance with the current rules for admission to medical
activities.
1.2. A midwife is hired and fired by the head of the nursery.
educational and preventive institution.
1.3. The midwife is subordinate to the obstetrician-gynecologist and
senior midwife
1.4. In her work, the midwife is guided by the provisions on maternity
home and antenatal clinic (department) and other regulatory and legal
acts approved by the Ministry of Health of the Russian Federation.
2. Job responsibilities
2.1. The main task of the midwife is to carry out medical and professional
lactic and health education work in the field of obstetrics and hy-
necology under the guidance of a doctor from a medical institution.
2.2. In accordance with the main task, the midwife carries out:
2.2.1 medical care for pregnant and gynecological patients,
fulfills doctor's orders in the maternity hospital (ward), antenatal clinic,
tion and at home;
2.2.2 preparation of an outpatient appointment conducted by a doctor;
2.2.3 preparing women for the upcoming examination by a doctor;
2.2.4 acquaintance of women with the internal regulations and the name
the established regime in the department and monitoring their implementation;
2.2.5 assistance to the doctor during medical procedures and surgical procedures
nal manipulations in outpatient and inpatient settings;
2.2.6 medical assistance during childbirth and performs primary treatment
ku newborns;
2.2.7 home patronage for pregnant and postpartum women;
2.2.8 outpatient appointments with gynecological patients (together with
doctor or, in appropriate cases, independently);
2.2.9 conducting preventive examinations of women in order to identify
research on gynecological diseases (together with a doctor or in the appropriate
in most cases independently);
2.2.10 control over compliance with the sanitary and hygienic regime in
institution (department, antenatal clinic, etc.);
2.2.11 carrying out sanitary educational work among women on
maternal health issues;
2.2.12 work aimed at compliance with legislation on environmental protection
women's health;
2.2.13 control over the work of junior medical personnel.
3. Rights and obligations
3.1. When carrying out her work, the midwife is obliged to:
3.1.1 follow the rules of asepsis and antisepsis, store correctly,
process and sterilize medical instruments, dressings
rial, etc.;
3.1.2 carry out simple laboratory tests (urine on
protein, blood group, hemoglobin and sedimentation rate
erythrocytes-ESR);
3.1.3 perform, if necessary, the duties of an operating nurse;
3.1.4 maintain the medical system established by the Ministry of Health of the Russian Federation
Qing accounting documentation;
3.1.5 provide first emergency medical aid in case of acute
diseases and accidents, followed by calling a doctor to the patient
or by sending him to the nearest treatment and prevention facility;
3.1.6 when recognizing the pathological course of labor and postpartum
during the first period, immediately call a doctor or transport the woman (if
its transportability) to a medical hospital;
3.1.7 inform the obstetrician-gynecologist or manager, and in their
failure to inform the doctor on duty about all detected serious complications or
diseases in pregnant women, patients or cases of serious violation of the
established order;
3.1.8 systematically improve your professional qualifications.
3.2. The midwife has the right:
3.2.1 use conservative treatment methods as prescribed by a doctor
patients and carry out some medical procedures, as well as intravenous
injections;
3.2.2 administer potent substances, drugs, intravenously
antishock drugs for patients for health reasons (if it is impossible -
timely arrival of the doctor to the patient);
3.2.3 in the presence of a doctor and under his supervision, perform transfusions
blood flow, assist during surgery;
3.2.4 carry out some obstetric interventions in case of emergency
yahs that threaten the life of the woman in labor or the postpartum woman (discharge of the placenta by external
appointments, manual examination of the postpartum uterus, separation and isolation
placenta, examination of the cervix for bleeding);
3.2.5 stitch up perineal tears of the I and II degrees.
4. Responsibility
4.1. The midwife is responsible for violations of the rights of citizens in the region.
health protection authorities resulting from non-compliance or improper
performing her professional duties in accordance with the law
legislation of the Russian Federation.
4.2. In case of violation of citizens' rights in the field of health protection
due to the midwife’s dishonest performance of her professional duties
duties resulting in harm to the health of citizens or their death,
it is obliged to compensate for damage in the amount and manner established by law
government of the Russian Federation.
4.3. For violation of labor discipline, legislative and regulatory
but legal acts, the midwife bears disciplinary, material, administrative
regulatory and criminal liability in accordance with the current legislation
by the Russian Federation.
Sample response to ticket No. 1
Responsibilities of a midwife at a antenatal clinic.
The midwife assists the doctor during the appointment of pregnant and gynecological patients. Before the appointment begins, she prepares the office, instruments and medical documentation. By the time the doctor arrives, a pelvis meter, a measuring tape, an obstetric stethoscope, a device for measuring blood pressure, and oilcloth or paper pads should be prepared in the office. The instrument table should have sterile vaginal speculums, forceps, long tweezers, and probes for taking smears. On a separate table, it is necessary to prepare sterile material in containers: cotton balls, swabs, sticks, gloves, as well as glasses for taking smears, medications are needed: 90% alcohol, 5% iodine solution, 5% potassium permanganate solution, furacillin (1: 5000), 1% alcohol solution of brilliant green, sterile solutions, ointments and emulsions for medical procedures. Before the start of the appointment, the midwife must bring into the office from the registry the outpatient cards of women who have signed up for an appointment and select from the alarm card file the individual cards of pregnant women and postpartum women who are scheduled to appear at the antenatal clinic that day. In addition, she is required to prepare forms for prescriptions, referrals for tests, consultations with specialists, and hospitalization. Before examining the doctor, the midwife weighs the pregnant women, measures their blood pressure (in both arms), and records the obtained data in individual cards. During the appointment, the midwife actively helps the doctor: she calls women one by one, participates in their examination, gives them instruments, and fills out medical documents as directed by the doctor. The district nurse must be proficient in certain diagnostic methods and techniques for performing certain procedures:
· Measurement of the pelvis, abdominal circumference and height of the uterine fundus in pregnant women
· Application of special techniques for external obstetric examination
· Taking smears from various parts of the woman’s genitourinary system
· Carrying out therapeutic gynecological procedures
After the appointment, the midwife prepares instruments and materials for the next sterilization, checks the availability of medications and replenishes them, and sends the materials taken for analysis to the laboratory. Medical documents with pasted tests are placed in a file cabinet in accordance with the day of the next appearance. After finishing work in the office, the midwife visits pregnant women, postpartum women and gynecological patients at home (patronage). The tasks of patronage include:
Finding out the general condition and complaints of women visited
· Familiarization with their life
· Training in the rules of hygiene for pregnant women, postpartum women, and care for newborns
· Checking the execution of the assigned mode
· Sanitary education work
When patronizing pregnant and postpartum women, it is necessary to pay attention to Special attention on a balanced diet and compliance with all doctor’s recommendations. The midwife records the data received after the visit in detail on a visiting leaflet, which she pastes into the pregnant woman’s individual chart, and reports her observations to the doctor.
If a nurse visits a pregnant woman who has missed her next appointment with the doctor, she conducts a thorough examination, paying special attention to edema, measures blood pressure, and in long-term pregnancy, measures the abdominal circumference and the height of the uterine fundus, and determines the position of the fetus. Having made sure that there are no deviations from the normal development of pregnancy, honey. The sister sets the next date for the woman to report to the antenatal clinic. If there is the slightest sign of pregnancy complications, it is necessary to accompany the woman to a consultation, and, if necessary, call an emergency doctor for hospitalization in an obstetric hospital.
The position of a FAP midwife is being introduced to provide pre-medical care medical care assigned to serve the female population.
The appointment and dismissal of a FAP midwife is carried out by the chief physician of the relevant municipal health care institution by subordination in agreement with the head of the FAP in the prescribed manner.
A FAP midwife is guided in her activities by the current legislation and other regulations of the Russian Federation, the administration of a constituent entity of the Russian Federation, the health department of the administration of a constituent entity of the Russian Federation, the head of the municipal health care institution to which the FAP is subordinate, the “Regulations on the medical and midwifery station” and the job description.
The FAP midwife is obliged to:
1. Conduct outpatient visits to pregnant and gynecological patients according to the established schedule and serve them at home.
2. Keep records and patronage of pregnant and postpartum women: conduct psychoprophylactic preparation of women for childbirth, promote rational feeding and modern methods contraception, participate in work with socially disadvantaged families, family planning. In providing medical care to pregnant women, carry out close interaction with the antenatal clinic of the municipal health care institution, to which the FAP is subordinate.
3. Conduct an examination of all women (including taking smears for cytology) who applied for the first time during the year to the FAP, regardless of age and nature of the disease. Refer women with identified pathology or suspected disease to an obstetrician-gynecologist for the next stage of medical care.
4. Carry out promptly and in full the prescriptions of medical specialists when organizing dynamic observation and treatment at the place of residence for gynecological patients and pregnant women.
5. Provide urgent and emergency pre-hospital medical care for conditions that threaten human life and health.
6. Carry out the simplest physiotherapeutic procedures: ultraviolet irradiation, paraffin therapy, solux.
7. Participate, under the guidance of doctors from medical institutions, in carrying out:
Periodic and targeted medical examinations of women for early detection of patients with gynecological, sexually transmitted and precancerous diseases;
Activities in a group of women of fertile age at high risk;
Dynamic examinations of patients registered at the dispensary.
Maintain control charts (form No. 030/у) for dispensary patients in the prescribed manner and ensure their timely attendance at medical specialists.
8. Carry out, under the guidance of doctors from medical treatment institutions and specialists from the Center for Sanitary and Epidemiological Supervision, a set of sanitary, hygienic and anti-epidemic measures in the event of an unfavorable epidemiological situation in the service area. Know the clinic of especially dangerous infections and the tactics of nursing staff when identifying them.
9. Study the working and living conditions of women, promptly make proposals to the district obstetrician-gynecologist for their rational employment and social rehabilitation.
10. Participate under the leadership of the head of the FAP in the provision of medical care in emergency situations.
11. Comply with the sanitary and anti-epidemic regime established by regulatory documents.
12. Draw up and submit, in a timely manner, to the head of the FAP current (monthly) and long-term (annual) action plans for medical care of women and children.
13. Maintain approved accounting and reporting forms of medical documentation and promptly submit reports on the work done to the head of the FAP.
14. Comply with fire safety and labor safety rules in the workplace.
15. Regularly engage in health education, hygienic training and education of the population, organize the work of a mother and child school.
16. Carry out work in accordance with the principles and norms of medical ethics and deontology.
17. Systematically improve the level of professional training: take an active part in regional seminars, meetings for paramedics, Midwife Days; periodically travel to frontline medical posts to exchange work experience and familiarize themselves with the relevant medical literature. Improve professional qualifications in advanced training courses (cycles) in institutions (departments) of postgraduate education at least once every five years in accordance with the established procedure. A FAP midwife has the right:
1. Within the limits of their competence, conduct an examination, establish a diagnosis, the timing of pregnancy, prescribe treatment, perform medical procedures and preventive measures.
2. Use all approved instructional and methodological materials published by the healthcare authorities of the Russian Federation and the healthcare department of the administration of a constituent entity of the Federation concerning the activities of the FAP.
3. Make proposals to improve the work of the FAP and improve the system of medical care in the service area.
4. Improve professional qualifications in advanced training courses (cycles) in institutions (departments) of postgraduate education at least once every five years in accordance with the established procedure.
5. Enjoy established benefits in accordance with current legislation.
The midwife of the paramedic and obstetric station is responsible for the provision and level of provision of pre-hospital medical care to pregnant and gynecological patients, as well as for sanitary and educational work among the population on issues of maternal and child health.
The midwife is directly subordinate to the head of the medical and obstetric center, and the methodological supervision of her work is carried out by the obstetrician-gynecologist of the medical institution, who is responsible for providing obstetric and gynecological care to the population in the territory of the FAP operation.
The midwife begins the examination of each pregnant woman with a study internal organs: cardiac activity, measurement of blood pressure (on both arms), examination of pulse, urine for protein (by boiling). The midwife currently studies the health status of pregnant women based on measuring height, body weight (over time), the presence of edema, pigmentation, the condition of the mammary glands and nipples, and the condition of the abdominals.
Carrying out a special obstetric examination, the midwife measures the external dimensions of the pelvis and, through a vaginal examination, determines the gestational age and internal dimensions of the pelvis. In the second half of pregnancy, measures the height of the uterine fundus above the womb, determines the position and presentation of the fetus, and listens to its heartbeat.
On general analysis blood, group affiliation, determination of the Rh factor, antibody titer, Wasserman reaction, general urine test, the pregnant woman is sent to the nearest laboratory. Here, a bacteriological study of the vaginal flora is carried out to determine the degree of purity, the discharge of the urethra, cervix and vagina for gonococcus, and the reaction of vaginal secretions. X-ray examinations in pregnant women (x-ray of the chest, fetus, pelviography, etc.) are performed only if there are strict indications.
A thorough examination of pregnant women makes it possible to identify various pathological conditions, on the basis of which these pregnant women are identified as high-risk groups and require the closest attention to them during pregnancy; during childbirth and the postpartum period, high-risk groups are identified for cardiac pathology, bleeding in the postpartum and early succession periods, inflammatory and septic complications after childbirth, endocrinopathies -- diabetes mellitus, obesity, adrenal insufficiency and other types of obstetric and somatic pathologies.
All individual cards of pregnant women at risk are usually marked with appropriate color markings, indicating in a certain color the risk of a particular pathology (red for bleeding, blue for toxicosis, green for sepsis, etc.).
The midwife performs a significant amount of work at the FAP, so the midwife's office must be equipped with scales, a gynecological chair, mirrors, sterilizers, a measuring tape, an obstetric stethoscope, a pelvis, and everything necessary for taking smears for cytological examination.
To provide emergency obstetric care, the FAP must have an obstetric bag equipped with everything necessary for delivery and treatment of the newborn (Appendix A).
