Ministry of Health
NZ Government

ROLES AND RESPONSIBILITIES OF STAFF WORKING AT NATIONAL WOMEN's HOSPITAL

Contents

• Introduction
• Midwives
• Doctors

• Nurses

• Maori Health
• Physiotherapists
• Social Workers
• Radiologists, Sonographers and Radiographers/MRTs

• Clinical Psychologists

• Laboratory Technologists and Pathologists

• Chaplains

• Additional National Women's services and key contact people

• Consumer information and feedback

• National Women's Specialist Services

• National Women's is also the base for:

• Volunteers

• Managers

Introduction

At National Women's we have a comprehensive range of women's health and newborn services. Multidisciplinary services are provided by experienced practitioners with a range of skills and expertise. They include:

Midwives

Midwives provide care during pregnancy, labour, birth and after the baby is born. Midwives work in all areas of the maternity service but have a number of different roles at National Women's.

• Team Midwives work in all areas of the hospital maternity service. These small teams provide care antenatally, during labour and birth and postnatally.

• Home Care Midwives provide some maternity care as well as home-visits after mother and baby leave hospital. They are linked to hospital maternity teams and provide pregnancy care from the hospital community clinics.

• Domino Midwives are hospital-based midwives who provide continuity of care both in and out of hospital. They work in small teams of midwives for backup and relief purposes.

• Lactation Consultants provide education and support to staff who assist breastfeeding women and those who wish to breastfeed. They also provide specialised assistance to women referred with breastfeeding problems.

• the Alcohol Drug Addiction Pregnancy Team has particular expertise in assisting women with psychological issues and alcohol or drug dependency.

• a Psychiatric Liaison Nurse with mental health expertise is available to assist women during pregnancy and after the birth.

• Midwifery Students

Doctors

There are three levels of qualified medical staff at National Women's; specialists who are sometimes called consultants, registrars and house surgeons. Specialists have completed a minimum of 5 years advanced training in their particular area of practice. Registrars are doctors who are training to be specialists. Senior house officers and house surgeons are qualified doctors who have had at least six years of medical training and two years in clinical practice. Most of them are working towards general practice and are currently gaining more experience in the care of women and the newborn.

Doctors are involved with most of the services provided at National Women's.

• Obstetricians provide care during pregnancy and birth. They also specialise in the care of women when complications arise during pregnancy, labour or birth.

• Gynaecologists provide treatment for women with a range of gynaecological conditions. They provide clinics for women with premenstrual syndrome, pelvic pain, infertility, polycystic ovary syndrome, cervical or vulva conditions. They also run general gynaecology, menopause, family planning, vasectomy and urodynamic/bladder clinics.

• Gynaecological Oncologists have a special interest and expertise in cancers of women's reproductive organs.

• Physicians provide care to women with medical complications during pregnancy, birth and postnatally.

• Paediatricians specialise in the care of children. National Women's paediatricians have expertise in the care of babies who are unwell, premature or have special needs.

• Anaesthetists provide general, spinal, and epidural anaesthesia for childbirth and surgical procedures.

• Registrars are doctors in training to be obstetricians, gynaecologists, anaesthetists or paediatricians.

• House Officers/House Surgeons are doctors gaining experience in maternity care, gynaecology or paediatrics.

• Trainee Interns have passed their final exams and are having a year of clinical training before becoming a fully qualified doctor.

• Medical Students

The following visiting specialists are also available:

• Medical oncologists and Radiation Oncologists are  doctors who work with and assist the gynaecological oncologist.

• Psychiatrists advise and treat mental health problems.

• Cardiologists visit women and babies with heart conditions.

• Ophthalmologists visit to check the eyes of babies referred by the newborn service for assessment.

Nurses

Nurses work throughout the hospital in a range of roles.

• Gynaecological Nurses provide care to women with gynaecological problems.

• Gynaecological Oncology Nurses provide care to women receiving treatment for reproductive cancers such as cancer of the cervix, uterus, ovaries and vulva.

• Clinical Nurse Specialist works in the gynaecology oncology service to support and advise women with cancer.

• Enrolled Nurses work in the gynaecology, newborn and maternity services. They provide care to women and babies under the supervision of a registered nurse or midwife.

• Obstetric Nurses provide care to women and babies under the supervision of a midwife.

• Neonatal Nurse Practitioners are trained to look after premature or unwell babies at delivery, and to provide ongoing care as part of the paediatric team.

• Neonatal Nurses look after newborn babies in the neonatal intensive care unit (NICU) and the parent infant nursery(PIN)

• Karitane Nurses work in the neonatal unit providing care to healthy but small premature babies.

• Neonatal Homecare Nurses provide care to babies in the community, following discharge from hospital, who have been born prematurely or who have required special care.

• Operating Theatre and Recovery Room Nurses are registered nurses who assist the surgeon during operations and provide post-operative care.

• Nursing Students

Maori Health

He Kamaka Oranga Maori Health Management staff provide the strategic direction for Maori Health in all Auckland District Health Board. The following National Women's services have a particular focus on Maori wellbeing.

• Te Whare Awhina
  Te Whare Awhina was established to assist the wellbeing of patients by providing accommodation and support for their whanau.Te Whare Awhina is the whanau-family accommodation service located on the Grafton site. Preference for this accommodation is given to whanau-family members who have travelled to Auckland from other regions. The accommodation charge is a set fee of $5.00 per person per night. In some instances this charge varies, just check with your Kaiatawhai prior to them making a referral (phone 6296 or pager 934829).

• A Maori Health Advisor advises on matters relating to the needs of Maori using National Women's services.

• The Whare Rapuora Women's Health Clinic, based in Glen Innes, provides midwifery and antenatal services.

• A Maori Health Worker for the gynaecology service is based in the Colposcopy Clinic.

• Mauri Oranga Maori Midwives provide a holistic team approach to midwifery practice based on te taha wairua, taha hinengaro, taha tinana, taha and whanau.

Physiotherapists

The National Women's Physiotherapists provide a broad range of women's health services. These include:

• assessment and treatment for women using the maternity service who have muscle, joint and soft tissue pai

• assessment and treatment for bladder problems and lymphoedema

• Physiotherapy Students

Social Workers

The Social Work and Counselling Service provides counselling particularly in areas of grief and loss for individuals, couples and family/whanau. The service also offers discharge planning, liaison with community services and advocacy.

Radiologists, Sonographers and Radiographers/MRTs

• Radiologists are doctors who specialise in diagnostic imaging (ultrasound, x-ray, CT scan, MRI)

• Sonographers perform ultrasound scans. They work with Radiologists or Obstetricians who have an ultrasound qualification.

• Radiographers/Medical Radiation Technologists (MRTs) carry out x-ray examinations. They work with Radiologists.

Clinical Psychologists

Clinical Psychologists are specifically trained to work with individuals, couples, families and groups.

• Women's Health Psychologists provide a service for women to aid decision making during medical consultations, as well as psychological therapy for women having gynaecological treatment and procedures.

• A Clinical Psychologist specialising in child development works in Newborn Services.

Laboratory Technologists and Pathologists

• Laboratory Technologists carry out blood, urine, faecal and microbiology tests. They take blood for testing purposes, to identify blood types, cross matching and for analysis.

• Laboratory Assistants work in the laboratories

• Scientific Officers carry out research activities

• Pathologists are doctors who specialise in areas such as cytology, microbiology, biochemistry, haematology, histology and post-mortems.

• Fertility Laboratory Staff carry out semen analysis and prepare sperm and embryos for fertility treatments.

Chaplains

• Chaplains Chaplaincy services are available to people of any faith or none. Chaplains respect each person's belief and culture, and maintain confidentiality. They provide emotional and spiritual support and can liaise with a person's community spiritual support. Their role includes listening, counselling, consultation on religious, ethical and personal concerns; as well as prayer, church sacraments and blessings of persons and spaces.

• Chaplaincy Assistants are trained volunteers who visit patients.

• Chaplaincy Students

Additional National Women's services and key contact people:

• Security Officers in uniform are available 24 hours of the day.

• Clinical Dietitians advise on nutrition and food for pregnant and breastfeeding women. They can provide advice to women who have diabetes or severe morning sickness and answer questions about nutrition matters for other women using a National Women's service.

• A Play Therapist and Play Assistant are based in the playroom and licensed early childhood centre on level 10. This is available to the children of patients and visitors, as long as the parents are on the National Women's Hospital sites.

Consumer information and feedback

At National Women's, all concerns and comments are taken very seriously. Any concerns about the care provided, can be discussed with the person in charge of the particular service. Complaints Co-ordinators, Quality of Service Manager, and Privacy Officers are also available on site.

National Women's Specialist Services

In addition to the more commonly used women's health services, National Women's also provides a number of services for women requiring specialist care. These services include:

• a Pre-conception service

• the Department of Anaesthesia with anaesthetists, anaesthetic technicians and the Pain Service for women requiring pain management expertise.

• a Woman's Assessment Unit for women with antenatal or postnatal complications, but who may not require admission. Inductions of labour are usually commenced in the Unit.

• the Early Pregnancy Assessment Unit provides care for women with early pregnancy problems (eg. ectopic pregnancy, miscarriage) as well as for women with acute gynaecological pain and bleeding.

• Medical and Diabetes Clinics for pregnant women.

• the Maternal Mental Health Team which provides a service for women with mental health needs related to pregnancy, childbirth and parenting in the first year after the birth.

• the Fertility Plus service which provides assessment, counselling education and a range of assisted reproductive treatments for infertile couples.Also at fertility plus is the recurrent pregnancy loss clinic.

• a Gynaecology Oncology service

• General Gynaecology, Pre-menstrual, Menopause, Endocrinology, Family Planning, Vasectomy, Pelvic Pain and Urodynamic/Bladder Clinics.

• the Epsom Day Unit which provides a termination of pregnancy service.

National Women's is also the base for:

• Parentcare, a support group for families who have or have had a baby in intensive care or special care.

• the University of Auckland's Department of Obstetrics and Gynaecology which is responsible for teaching medical students and training post-graduate doctors. The Department carries out research and provides a clinical service.

• the Research Centre in Reproductive Medicine which encourages and supports research into problems that effect women and their babies.

• the University of Auckland's Department of Neonatal Paediatrics looks after babies in the hospital, carries out research as well as training medical students and post-graduate doctors.

• the International Cochrane Menstrual Disorders and Subfertility Review Group.

staff from the the Genetic Service (based in Grafton) visit National Women's to see families requiring counselling and advice on hereditary conditions and suspected foetal abnormalities.

Other staff working in the hospital include administration and management, clerical staff, ward clerks, cleaners, orderlies, staff, grounds and trades people, florist/gift-shop and café staff as well as those involved with equipment and the delivery of supplies.

Red Cross Volunteers

provide training and supervision to teams of volunteers who help out on the wards. They are available to arrange flowers and run errands.

Managers

Managers work to make life easier for the people who actually provide health services to women. Every level of management must enhance the role of health care providers and be working towards the reduction of bureaucracy, duplication, waste and inefficiency.