Rebecca Noem
Mesa,AZ
Summary
Accomplished RN with extensive experience in high-risk pregnancy care and obstetric triage assessment, honed at Chandler Regional Medical Center. Skilled in leading staff education initiatives and implementing infection prevention measures. Demonstrated success in improving patient outcomes, evidenced by a 15% decrease in postpartum hemorrhage. Passionate about advancing neonatal resuscitation techniques and fostering interdisciplinary collaboration.
Overview
44
44
years of professional experience
1
1
Certification
Work History
RN Labor and Delivery
Honor Health Mountain Vista Medical Center
Mesa, AZ
03.2012 - Current
- Care for patients in labor, performing ongoing assessments and interventions as needed per AWHONN guidelines and Policies
- Admit patients for labor induction, assess the mother's health, pregnancy history and birth plan. Examine cervix and report Bishop Score to admitting provider and establishing the plan of care.
- Perform OB triage and Medical Screening Exams per EMTALA standards, collaberate with emergency department staff when pregnant patients arrive with medical problems to coordinate care
- Prep, circulate and recover patients needing a cesarean section
- Transition newborns, provide resuscitation and ongoing care per NRP and STABLE guidelines. Provide skin to skin care as much as possible and educate patients regarding the benefits to baby and mother.
- Assist mothers and babies with breastfeeding, educate parents as to the benefits to mother and baby
- Float to postpartum and provide ongoing care and assessments, discharge couplets according to orders and provide education on postpartum care, infant care, child passenger safety, and follow up
- Float to nursery as a second nurse, assist with consoling infants in narcotic withdrawal, assist with gastric feedings via orogastric tube, assist with breastfeeding and bottle feeding according to mother's choice and provider's orders
- Have assisted extensively with unit education, leading postpartum hemorrhage drills, shoulder dystocia drills, preeclampsia and eclampsia classes, and assisting with breastfeeding education
- Prep, circulate and recover patients needing cervical cerclage
RN - Labor and Delivery
St. Thomas More Hospital
Canon City, CO
07.2011 - 02.2012
- Cared for laboring patients including those with emergency situations such as postpartum hemorrhage, preeclampsia, and trauma
- Cared for delivered mothers and their babies per protocols
- Received 2 weeks of self defense training due to the hospital being close to multiple state and federal prisons
RN - Labor and Delivery
Evans Army Community Hospital
Colorado Springs, Colorado
07.2010 - 07.2011
- Labor and Delivery RN in Army Hospital as a civilian nurse caring for laboring patients, assisted with epidural placement, performed labor inductions per orders and protocols, managed obstetric emergencies such as preeclampsia, postpartum hemorrhage, chorioamnionitis
- Prepped, circulated, and recovered patients needing cesarean sections per AWHONN standards.
- Per Hospital protocol, received six weeks of orientation to postpartum and six weeks of Level II nursery
- Worked with many residents and new physicians
- Resigned after one year due to hospital decision to place all civilian nurses on night shift
Clinical Coordinator RN
Mountain Vista Medical Center
Mesa, AZ
06.2007 - 06.2010
- Coordinated with healthcare team to manage unit activities on a daily basis
- Led pre shift huddle daily
- Made staff assignments at the beginning of shifts.
- Assisted with patient care and communication with providers, scheduled labor inductions and cesarean sections while assuring adequate staffing and bed availability
- Attended staff meetings and communicated details to those who were unable to attend
- Cared for laboring patients, those needing cesarean section, performed triage and medical screening exams, assisted with breastfeeding and helped lactation consultant with unit projects and education
- Attended several classes off campus including a two day workshop on Kangaroo Care given by the famous Dr. Nils Bergman from South Africa. He is the originator of Kangaroo Care, skin to skin care for sick and premature babies, and The Golden Hour, which is skin to skin care for term and late preterm babies. He has spent a lifetime studying the effects of infants removed from their mothers for medical reasons vs infants kept on their mothers' chests and receiving the same care they would receive if in the NICU or in a traditional hospital setting. I consider myself very fortunate to have been able to hear this man speak and have researched his work, and the work of others who have used his techniques and had equal success short and long term.
Charge RN
Chandler Regional Medical Center
Chandler, AZ
04.2000 - 05.2007
- Labor nurse in very busy Labor and Delivery unit doing approximately 350 deliveries a month. Worked the first 3 years as staff, caring for 2 laboring patients at a time, through delivery and recovery, circulated for cesarean sections, and performed OB triage and medical screening exams
- Cared for many high risk patients with preeclampsia, eclampsia, placental abruption, umbilical cord prolapse, fetal distress, fetal anomalies incompatible with life, twin pregnancies, and chorioamnionitis
- Hired as permanent charge after going through the interview process
- Made staff assignments based on experience, needs of the patient and nurse, supervised up to 18 RNs per shift, a health unit coordinator and scrub tech
- Watched up to 20 fetal monitoring strips at any given time, keeping eyes on these fetal heart rate patterns when at times many nurses would be caring for more than one patient.
- Supervised a 5 bed triage unit, a 4 bed overflow unit and a 4 bed pre op and PACU in addition to the labor patients
- Worked with several physicians to coordinate care, schedule patients for labor induction and cesarean section, place patients on hold when we had no beds available, and worked with postpartum and NICU charge nurses to coordinate care
- Attended several management classes in the community with other charge RNs, attended medical legal classes, attended many hospital based classes as well
- Worked with Director and other charge nurses to transition to a couplet care model from a traditional postpartum unit with a separate nursery, This involved being acutely aware of the difficulty some people have with change, and trying various techniques to assist those who were willing to learn with the necessary changes.
- Assisted with the development of new policies and procedures needed for couplet care
- Participated in the Clinical Ladder Program, attempting twice to work on a labor induction protocol and being told no, then on the third try being allowed to attempt it. I designed and completed a QI project, prior to developing the induction protocol, on complications associated with labor induction, especially prolonged labor inductions. We tracked incidents of chorioamnionitis, postpartum hemorrhage, failed induction leading to cesarean section, neonatal hyperbilirubinemia, and failed breastfeeding. I then met with several physicians individually to explain what we were going to do, obtained their cooperation, then designed the protocol. At that time there were no restrictions on labor induction other than not inducing people before 37 weeks without a true medical reason. There were no criteria such as Bishop scores and some physicians would induce most of their patients without a clear reason. After I developed the protocol, which involved looking at following ACOG standards strictly, obtaining a Bishop score upon scheduling the induction (which would be verified by the admitting nurse), requiring documentation of any medical reasons for the induction, providing patients with written information explaining the induction process including risks and benefits, not allowing anyone to schedule an elective induction before 39 completed weeks of pregnancy, and even allowing each provider one outlier each month, to address their concern that sometimes they just have a feeling that something is wrong, without medical evidence. We implemented the protocol, followed it for 6 months, then did another QI project to assess the changes. There was a 7% reduction in chorioamnionitis, 15% decrease in postpartum hemorrhage, 15% reduction in primary cesarean sections, and 10% reduction in nursery admissions due to hyperbilirubinemia. Breastfeeding success was harder to track due to underreporting and other issues. In the end, physicians, patients, and nurses were happy with the changes, as was management, so the project ended up winning an award by the NIH, which my manager got to accept.
- Another project I initiated there was the creation of a triage nurse who would be in the lobby of L&D. Prior to that, there would be as many as 20 pregnant patients waiting to be seen, and they were brought back to triage in order of arrival. At the time this was the only hospital in the southeast valley. I felt that this could be unsafe and eventually may lead to bad outcomes, so we designed a cubicle with a recliner where a nurse would take a brief history, vital signs and do an NST upon arrival of the patient, then send them to triage for the medical screening exam based on urgency of the situation. Over time it became apparent that this was a much safer thing to do, as we caught some fetal distress and severe preeclampsia before things could deteriorate.
RN - Labor and Delivery
Tempe St. Lukes Hospital
Tempe, AZ
03.1991 - 04.2000
- RN in labor and delivery, cared for laboring patients, those needing cesarean section, and performing OB triage, also floated to nursery which was not certified at that time, and postpartum
- Learned to start IVs on infants, provide hood oxygen and monitor responses, draw blood and blood cultures on babies, and care for patients from many cultures due to proximity to ASU
- Cared for many high risk patients with no prenatal care who presented to that hospital frequently
- Taught Childbirth Preparation Classes to the community, was sent to a Certification Course and became a Certified Childbirth Educator
- The unit closed in 2000 which was my reason for leaving
RN Labor and Delivery
Flagstaff Regional Medical Center
Flagstaff, AZ
03.1990 - 03.1991
- Trained in Labor and Delivery and Postpartum
- Learned labor, delivery, postpartum care, breastfeeding, and circulating in cesarean sections
RN Staff
State of Arizona Training Program
Coolidge, AZ
05.1985 - 02.1990
- Managed complex cases involving multiple diagnoses or treatments.
- Stocked clinical workstations and procedure rooms with necessary supplies.
- Collaborated with health groups to plan or implement programs designed to improve overall health of communities.
- Learned a great deal about Developmental Disabilities including various neurological conditions, genetic anomalies, congenital anomalies, and birth injuries
- Learned from Neurologists who would come to the facility monthly to examine patients and develop treatment plans
- Learned to manage tracheostomies, gastric tubes, colostomies, hydrocephalus, Down Syndrome, and brain damage resulting from child abuse or birth injury
- Learned to manage seizures and witnessed thousands of seizures over time, several per day on average, treating with oral medication management and responding to status epilepticus on a regular basis, providing emergency care using basic resuscitation techniques and providing IV medications such as Valium or Versed
- This is where I developed a passion for the prevention of child abuse and the prevention of birth injuries and birth asphyxiation, as I witnessed the consequences daily
RN Shift Supervisor
Pinal County Nursing Center
Florence, AZ
05.1981 - 05.1985
- Night supervisor in long term care facility
- Performed wound care and dressing changes
- Administered oral and topical medications
- Provided end of life care
- Supervised up to 6 CNAs
- Assessed residents and documented condition and progress in the medical record
- Supervised the County Morgue and unlocked the morgue when new bodies arrived, documented their arrival and departure to various funeral homes
Education
Associate of Applied Science - Nursing
Central Arizona College
Coolidge, AZ05-1985
Nursing
Grand Canyon University
Phoenix, AZSkills
- Obstetric triage assessment
- High-risk pregnancy care
- Antepartum testing proficiency
- Infection prevention measures
- Umbilical cord blood sampling
- Neonatal resuscitation
- Staff education and skill practice
- Preterm labor interventions
- Epidural administration assistance
- Labor induction techniques
- Advanced fetal monitoring
- Preeclampsia and eclampsia care
- Electronic fetal heart rate interpretation
Certification
- NRP
- BLS
- ACLS
- Advanced Fetal Monitoring Certification (C-EFM)
- STABLE
- Past Certifications include Childbirth Educator, Inpatient Obstetric Nursing, and Child Passenger Safety Technician
Languages
Spanish
Limited
Timeline
RN Labor and Delivery
Honor Health Mountain Vista Medical Center
03.2012 - Current
RN - Labor and Delivery
St. Thomas More Hospital
07.2011 - 02.2012
RN - Labor and Delivery
Evans Army Community Hospital
07.2010 - 07.2011
Clinical Coordinator RN
Mountain Vista Medical Center
06.2007 - 06.2010
Charge RN
Chandler Regional Medical Center
04.2000 - 05.2007
RN - Labor and Delivery
Tempe St. Lukes Hospital
03.1991 - 04.2000
RN Labor and Delivery
Flagstaff Regional Medical Center
03.1990 - 03.1991
RN Staff
State of Arizona Training Program
05.1985 - 02.1990
RN Shift Supervisor
Pinal County Nursing Center
05.1981 - 05.1985
- NRP
- BLS
- ACLS
- Advanced Fetal Monitoring Certification (C-EFM)
- STABLE
- Past Certifications include Childbirth Educator, Inpatient Obstetric Nursing, and Child Passenger Safety Technician
Associate of Applied Science - Nursing
Central Arizona College
Nursing
Grand Canyon University
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