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OB-GYN (CLINIC/OFFICE) NURSE

Assess patients to identify appropriate nursing interventions, Dispense and administer


medications and treatments as prescribed by a physician, Monitor, assess, address,
document and report symptoms and changes in patients' conditions, Provide supportive
counselling and life skills programming, Conduct disease screening, Deliver
immunization programs

Assess patients to identify appropriate nursing interventions, Dispense and administer


medications and treatments as prescribed by a physician, Provide health education,
Provide supportive counselling and life skills programming

OB/GYN nurses provide a variety of functions related to the female reproductive system
from menstruation to menopause including childbirth. Some specialize in labor, delivery,
neonatal nursing (caring for newborns), and neonatal intensive care, in which they tend
to newborns with medical complications, including premature babies.

OB/GYN nurses also admit patients, perform administrative duties, take patient's
medical histories, and assist OB/GYN physicians and surgeons with gynecological
(pelvic) exams, ultrasounds and surgeries, including hysterectomies. They explain
procedures, offer advice and care to women who have had miscarriages or stillbirths,
and educate women regarding sexually transmitted diseases, birth control and pre-natal
care.

Those who specialize in obstetrics (OB) prepare mothers for birth and take post-delivery
care of mother and child. They review the fetus's development, execute vaginal exams,
determine fetal heart tones, monitor contractions, and assist mothers in labor with
breathing exercises. They prepare women who need Cesarean sections and assist
doctors with administering pain medication. After the baby is born, OB nurses apply the
mother and infant's ID bands, weigh and measure the infant, operate OB equipment for
nursery care, and assist with the baby's care. They also provide instruction in how to
care for the child after leaving the hospital.

DYSPLASIA CLINIC PROGRAM

Cervical dysplasia is the abnormal growth of cells on the surface of the cervix, the lowest
part of a woman's uterus. Although these cells are not cancer, it is considered a pre-
cancerous condition. The majority of cervical dysplasia is caused by an infection with
Human Papillomavirus (HPV).

The Cervical Dysplasia Program may also be referred to as the "Abnormal Pap Smear
Program." Our program was established to monitor your condition and may require
frequent follow-up visits. You may need treatment or to be followed for several years. By
not completing the recommended follow-up as directed by your GYN provider, you may
be placing yourself at increased risk for complications such as cervical cancer.

Newly diagnosed patients may be referred to our specialty clinic by their Primary Care
Manager (PCM) after they have had an abnormal Pap smear result. Patients with a past
history of abnormal Pap smears that are transferring from another base or civilian
provider may contact their PCM and request a referral to our Cervical Dysplasia
Program for ongoing care.

INJECTIONS

Depo-Provera and Lupron Depot:

Once you have received a prescription for Lupron/Depo-Provera, you can walk into the
OB-GYN clinic anytime Monday-Friday (except family days, federal holidays, and the
first Wednesday of each month) 0800-1100 and 1300-1500 to receive your injection

BLOOD PRESSURE CHECKS

No appointment is necessary; walk in Monday-Friday (except family days, federal


holidays, and the first Wednesday of each month) 0730-1145 and 1245-1600.

ULTRASOUNDS

An ultrasound is a technique to image the baby in the uterus and the pelvic organs by
using sound waves. The ultrasound is not a treatment, but is used for diagnostic
purposes and is not harmful to the fetus or the mother. In most cases, the first OB
appointment will include an ultrasound for fetal dating. At approximately 20 weeks,
another ultrasound will usually be done in radiology or off base for fetal anatomy. We do
not do ultrasounds to determine the sex of the baby.

CHILDREN

For the safety of our patients and their children, we recommend that you bring someone
to care for your child during your examination, or make appropriate child care
arrangements prior to your appointment. If your appointment requires an internal exam
and you do not have a caregiver for your child, your appointment may need to be
rescheduled.

PATIENT CONFIDENTIALITY

Every patient has the right to a confidential visit with their provider. We request that only
one person be present during the patient's exam.

MEDICAL RECORDS

Only OB records are maintained in the OB-GYN Clinic. If you need a copy of your
records because you are separating or PCSing, please provide the clinic with a copy of
your (sponsors) orders, as well as a 48- hour notice to make the copies. If you need a
copy because you're being followed by a provider off base, a medical release must be
filled out and placed in your chart. It is a HIPAA violation to send, fax, or give out
protected health information (PHI) to another medical facility without approved consent.

MEDICATION REFILLS

Prescriptions with refills should be called in to the Satellite Pharmacy by calling (850)
883-8160. If your prescription has expired, please call 883-8600, to leave a message for
a health professional in the clinic between the hours of 7:30 a.m. - 4 p.m.

SERVICES

We provide full-service, comprehensive women's health care in a family oriented and


empathetic atmosphere. Our primary goal is to provide quality, personal preventive
health care for a woman through all stages in her life.

Annual GYN Exam

GYN exams are an integral part of a woman's comprehensive health care and can help
you prevent illness, detect cancers (such as cervical, uterine and breast cancer) at an
early and potentially more treatable stage, and provide health care before, during and
after pregnancy.

All of our physicians and nurse practitioners would be pleased to schedule an GYN
exam with you.

Pregnancy

Being pregnant can be a wonderful and exciting time in your life, but can also be filled
with questions and concerns. If you're pregnant, or think you might be, our physicians or
nurse practitioners are ready to help.

Other Services

4-D ultrasound at all locations. 4-D gives you a 3-dimensional video of the baby in the
womb. DVD's are available for you to keep.

Essure, Implanon, Mirena and many other birth control options.

Urinary incontinence diagnosis and treatment

What They Do

OB/GYN nurses provide a variety of functions related to the female reproductive system
from menstruation to menopause including childbirth. Some specialize in labor, delivery,
neonatal nursing (caring for newborns), and neonatal intensive care, in which they tend
to newborns with medical complications, including premature babies.

OB/GYN nurses also admit patients, perform administrative duties, take patient's
medical histories, and assist OB/GYN physicians and surgeons with gynecological
(pelvic) exams, ultrasounds and surgeries, including hysterectomies. They explain
procedures, offer advice and care to women who have had miscarriages or stillbirths,
and educate women regarding sexually transmitted diseases, birth control and pre-natal
care.

Those who specialize in obstetrics (OB) prepare mothers for birth and take post-delivery
care of mother and child. They review the fetus's development, execute vaginal exams,
determine fetal heart tones, monitor contractions, and assist mothers in labor with
breathing exercises. They prepare women who need Cesarean sections and assist
doctors with administering pain medication. After the baby is born, OB nurses apply the
mother and infant's ID bands, weigh and measure the infant, operate OB equipment for
nursery care, and assist with the baby's care. They also provide instruction in how to
care for the child after leaving the hospital.

The OB/GYN Department is a Women’s Ambulatory clinic which provides


comprehensive women’s health care to women military personnel and eligible
beneficiaries. Well woman exams and gynecology services are provided to women from
adolescence through post menopause. This includes annual exams, birth control,
treatment for sexually transmitted disease, emergency contraception and medical and/or
surgical management of women’s health problems.

Birth control counseling

Obstetric and gynecologic ultrasounds, including early testing for birth defects and
3D/4D imaging when indicated

Well women exams (including yearly PAP tests) are performed at the Mary Elizabeth
Walker Center (MEWC). Please call 760-380-3124 to schedule a Well Woman Exam.

Routine Birth Control, including IUD placement, can be done at the MEWC.

Pregnancy Tests:

Pregnancy tests are available at the clinic every Monday, Wednesday, and Friday from
0800-1100 hours. Eligible beneficiaries must present a valid government ID.

Pregnancy test results are available every Monday, Wednesday, and Friday from 1300-
1600 hours. In order to ensure patient confidentiality, results must be picked up in
person by the patient. A valid government ID is required to receive results.

If you are new to Fort Irwin, please ensure that you are registered in DEERS prior to
coming to the clinic. You need to be in the Weed Army Community Hospital database in
order for us to process the request.

OB Registration:

Once a pregnancy is confirmed by our lab or you are pregnant transferring from another
facility, you must attend OB Registration Class. Upon receipt of your pregnancy test
results, you will schedule an appointment for registration. If you are transferring, please
call or stop by the clinic to schedule an appointment. Please bring any OB records
regarding your current pregnancy with you. You will complete paperwork regarding past
medical, surgical, and family histories. You will then review your information with a
Licensed Practical Nurse or Registered Nurse.

OB Orientation:

OB Orientation is offered twice a month on Monday mornings from 0900-1100 hrs at the
Blackhorse Chapel (across from the hospital). This is a mandatory class for all newly
registered and new OB transfer patients. It provides information on local resources and
reviews the expected plan of care.

Exception to policy is given to those women that have already delivered at Weed Army
Community Hospital within the last 12 months. Your class date will be given to you at OB
Registration.

OB Emergencies:

The OB/GYN clinic does not have same day appointments.

Any patients experiencing an emergency less than 20 weeks gestation needs to report
to the nearest emergency room. The phone number to the WACH ED is 760-380-3114.

Any patient greater than 20 weeks can report directly to the Mother Baby Unit (MBU).
The MBU phone number is 760-380-3185.

If you have a question and would like to speak to a Registered Nurse, please call the
clinic during duty hours. After duty hours, weekends, and holidays you can call the MBU
or 1-866-835-1647 (Tricare After-Hours Nurse Triage Line).

Patient Education:

We offer a variety of educational opportunities to include OB Orientation, Expectant


Parent Class, and Breastfeeding Basic Class. Please contact the clinic for dates, time,
and location. A Breastfeeding Support Group is offered at the Mary Elizabeth Walker
Clinic on a monthly basis. Please contact 760-380-7340 for more information.

They provide routine health screening, contraception, pregnancy care and menopause
management. They also diagnose and treat specific disorders of the reproductive
system including menstrual irregularities, abnormal Pap smear, endometriosis, infertility,
high risk pregnancy and gynecologic cancer.
Nurses in OB Associate:They assist the care providers with patient education and
counseling, lab tests, surgery scheduling, follow-up calls, and even hospital visits to the
OB and surgical patients. Jan is a lactation consultant. You will always find one of them
available for a quick call-back if you have any questions or concerns. They stay current
with continued education and training. They are a great support system for any patient,
from birth control to post menopausal issues. Any expectant mother would also feel
secure with these great nurses helping them through pregnancy and after delivery.

Certified Nurse Midwife: Yearly gynecological exam, Family Planning, Health


Maintenance Counseling for STDs, Menopause, fertility.Prenatal and post partum care.
Bedside support in the hospital , labor until birth. Also natural pain control option, can
also order pain medication including epidural.

Annual Exams • Birth Control • Breast Screening • Infertility • Menopause Clinics •


Urinary Leakage • General Gynecological Surgery • Minimally Invasive Surgical and
Office Procedures • Osteoporosis (DEXA) • Certified Ultrasound Services • Lab
Services.

Annual Wellness Exams


Pelvic Exam
Pap smear
Breast Exam

Contraception
Pills
Patch (OrthoEvra)
Vaginal ring (Nuvaring)
Implant (Implanon)
Injection (Depo Provera)
IUD (Mirena and Paragard)
Diaphragm

Ultrasound
We offer a screening ultrasound to our pregnant patients at 19-22 weeks. An ultrasound
examination at this time of the pregnancy allows an assessment of the baby’s growth
and development. Abnormal conditions (congenital anomalies or birth defects) may be
detected. The ultrasound also helps confirm the due date. Most insurance companies
provide coverage for this type of ultrasound examination. Please be aware that not all
birth defects can be detected by ultrasound. Some abnormalities are too small to be
seen or appear later in pregnancy. Some organ systems may be more difficult to assess
because of the baby’s position or the size of the mother. We do not regard this
examination as the making of a keepsake video and do not give out a videotaped copy
of the ultrasound. We also do not allow video cameras in the room during the
examination. We ask that you limit the number of people that accompany you to three.
While there are businesses that perform 3-D and 4-D ultrasound examinations as
keepsakes, these types of ultrasound examinations are usually not medically indicated
and are not covered by insurance unless there is a medical reason for performing the
exam. We do not perform 3-D and 4-D ultrasounds in our office.

Vaccines are recommended for all adults to protect them from infectious diseases.
Vaccination is acknowledged to be one of the most cost effective public health strategies
available in preventing infectious and communicable infections. Many adults are taking
a proactive role in their healthcare these days by eating better and exercising, but forego
one of the simplest preventative care measures available, adult vaccinations.

On average 50,000 adult Americans die from vaccine-preventable diseases and from
complication of influenza, pneumococcal infections, and hepatitis B each year. These
diseases and others can be prevented by vaccines and are very effective, but
underused. Some adults incorrectly assume that the vaccines they received as children
will protect them for the rest of their lives.? This is true for certain diseases, however
vaccinations for certain disease must be repeated periodically to maintain immunity.

Ambulatory OB/GYN Nursing


This Conference will enable you to better:

Assess and manage common and complex women’s health problems, including PCOS,
pelvic pain, abnormal vaginal bleeding, sexual dysfunction, and abnormal pap test.

Identify contemporary management strategies for a variety of high-risk obstetric


complications, including obesity, hypertensive disorders, first trimester complications,
gestational diabetes, perinatal infections, and OB office emergencies.

Examine common myths and misconceptions related to contraceptive management and


plan to revise protocols based on the evidence.

Provide appropriate pharmacotherapy for select women’s health and obstetric


conditions.
Describe common areas of medical-legal risk in ambulatory OB/GYN care.

OUR UNIVERSITY TRAINED OB GYN SPECIALISTS ARE PLEASED TO OFFER YOU


PROFESSIONAL SERVICES WITH CARE COMPASSION AND SKILL

Services We Are Proud To Offer:

OBSTETRICS
HIGH RISK PRENATAL CARE
LOW RISK PRENATAL CARE
OFFICE ULTRASOUND EVALUATIONS

GYNECOLOGY

ABDOMINAL HYSTERECTOMY
ABDOMINAL SACROCOLPOPEXY
ABNORMAL BLEEDING
BLADDER PROBLEMS
BREAST EXAMS
CONTRACEPTION INTRAUTERINE DEVICES
COLPOSCOPY
CRYOSURGERY
DEPO PROVERA
ECTOPIC PREGNANCY
EMERGENCY CONTRACEPTION
ENDOMETRIAL BIOPSIES
ENDOMETRIOSIS
EXCISION OF MOLES/SKIN TAGS
ESSURE OFFICE STERILIZATION
FAMILY PLANNING
GENERAL GYNECOLOGY
HORMONAL IMBALANCE
HOSPITAL CONSULTS
HUMAN PAPILLOMA VIRUS
INFERTILITY
LAPAROSCOPIC BURCH PROCEDURES
LAPAROSCOPIC HYSTERECTOMY
LAPAROSCOPY
LASER TREATMENT
LEEP EXCISION OFFICE TREATMENT
LIBIDO/SEXUAL DYSFUNCTION ISSUES
MENOPAUSAL MANAGEMENT
NORPLANT REMOVAL
NOVASURE OFFICE ENDOMETRIAL ABLATIONS
OFFICE CONSULTS
OFFICE GYNECOLOGY
OFFICE PERMANENT STERILIZATION
OFFICE SURGERY
OVARIAN CYSTS
PAP SMEARS
PRECONCEPTUAL CARE
PREMENSTRUAL STRESS SYNDROME
ROUTINE PHYSICAL EXAM
SEXUALLY TRANSMITTED DISEASE TESTING &TREATMENT
STERILIZATION PROCEDURES
SUPRACERVICAL HYSTERECTOMY
TREATMENT OF FIBROIDS
UROGYNECOLOGY
VAGINAL HYSTERECTOMY
VAGINAL SURGERY
VAGINITIS
WEIGHT LOSS
WELL WOMEN PHYSICALS

Obstetrical Services
Natural Labor And Childbirth Tell me more →
Pain Relief In Labor Tell me more →
Inductions Of Labor Tell me more →
Vaginal Births After Cesarean Sections Tell me more →
Cesarean Sections Tell me more →
Twins Tell me more →
High-Risk Pregnancies Tell me more →
Ultrasound Tell me more →
Home-Birthing Consultation/Transport Tell me more →
Transfer Patients

We accept transfer patients who have had previous prenatal care and are less than 35
gestational weeks on a case by case basis. This is to ensure that all transfer patients are
able to fully gain the experience of our collaborative model.
Gynecological Services
Annual Well-woman Exams Tell me more →
Abnormal Bleeding Tell me more →
Pelvic Pain / Endometriosis Tell me more →
Family Planning / Contraception Tell me more →
Infertility Evaluation / Treatment Tell me more →
Abnormal Pap Smears / Colposcopy Tell me more →
Menopausal Care / Bioidentical Hormones Tell me more →

Excellence is our goal, and our patients can expect the best possible medical
care. We provide a full range of services, including:

Nurse Practitioner: Laura has previously practiced in a family practice office, allergy
clinic, and urgent care center. Gynecological services provided include:
Care pre and post menopause, including hormone replacement
Prescriptions
Birth control counseling and management (including Mirena IUD, Paraguard IUD, and
the NuvaRing)
Evaluation and treatment of common infections
Health and wellness counseling
Annual physical exams, including Pap smears
Screening and referral for other health problems
STD screening and follow-up

Annual GYN Exams


Premarital Exams
Cancer Screening
Abnormal Periods
Abnormal Pap Smears
Endometriosis
Birth Control
Breast Exams
Infertility
Full Obstetrical Services
In-Office Ultrasound
In-Office Ablation
Laparoscopic Surgeries
Menopause Management
Bladder Control Problems
Treatment of Pelvic Pain

SERVICES OFFERED at Women's Health and Perinatal Center

Annual Exams (Pap smears)


Birth Control Methods
Natural Family Planning
Menstrual Irregularities
Postmenopausal Bleeding
Breast Complaints
Pelvic Pain

Annual Pelvic and Breast Exams:


During the annual exam the provider will routinely perform a breast exam and a PAP
smear. While doing the PAP smear the provider may also perform a rectal exam. If you
are uncomfortable with any aspects of the exam please let your provider know. The
annual exam may not include other important tests/exams you may need on an annual
basis. Please see your PCM to schedule a yearly physical exam.

SUB-SPECIALITY SERVICES PROVIDED IN THE WOMEN'S HEALTH CLINIC


INCLUDE:
Reproductive Endocrinology and Infertility
Urogynecology
Gynecology
Dysplasia

REPRODUCTIVE ENDOCRINOLOGY AND INFERTILITY


Criteria: Referral from provider

An Endocrinologist is a physician with special expertise in offering:


Tubal Anastomsis
Superovulation
In Vitro Fertilization
Female Endocrine Disorders
Intrauterine Insemination
Donor Sperm
Donor Egg
Donor Embryo

NOTE: Although these services are listed, they may involve going to a Network facility
and paying a portion of the cost.

UROGYNECOLOGY
Criteria: Referral from provider

A Urogynecologist is a physician with special expertise in problems such as:


Loss of Bladder or Bowel Control
Difficulty Urinating
Pelvic Organ Prolapse
Difficulty Defecating
Although your PCM may have some knowledge about these problems, an
urogynecologist may be able to offer additional expertise. Specialized diagnostic test
may be needed for a complete and accurate diagnosis. These tests may include the
evaluation of bladder function and vaginal support. If additional expertise and testing is
needed, ask your PCM to consider sending a consultation.

GYNONCOLOGY
Criteria: Referral from provider

A Gynecologic Oncologist is a physician with special expertise in female cancer such as


Uterine Cancer
Ovarian
Cancer
Vulver Cancer
Vaginal Cancer
Difficult gynecologic surgeries

DYSPLASIA CLINIC:
Criteria: Patient's having an abnormal pap smear are seen in Dysplasia Clinic.

If your pap smear has cervical cells that appear to be abnormal, you will be referred to
the Dysplasia Clinic for further examination, testing and/or treatment. If your pap smear
was completed in the Women's Health Clinic, you will be contacted by the Dysplasia
Clinic for scheduling. If your pap smear was performed by your PCM, your PCM nurse or
provider will inform you to contact the Dysplasia clinic for scheduling. Two days prior to
your Dysplasia Clinic visit, avoid douching, spermicidal foams, creams, jellies, or vaginal
medications (except as directed by your physician; such compounds may wash away or
hide abnormal cells). A pregnancy test result is required on the majority of patients
before the appointment. During a dysplasia appointment the provider will perform a
Colposcopy and, if necessary, scrapings or biopsies. It is important to inform the
provider of possible pregnancy prior to the exam for this may change your treatment
plan.

INJECTIONS: Depo-Provera and Lupron depot Shot Administration:


Lupron and Depo-Provera injections are given in the Women's Health Center on
Monday, Wednesday, and Friday from 8:30 to 9:30. Please call our receptionist at (937)
257-1160 to request your medical records prior to your injection.

PERINATAL CLINIC SERVICES INCLUDE:

Pregnancy tests
Pregnancy care
Fetal Monitoring
Genetic Counseling
Ultrasounds

Care Offered:
Pregnancy tests are done at the Perinatal Center on a walk-in basis Monday-Friday
between the hours of 0800-1200. Please wait until you are two weeks late on your
menses (period) before coming for a pregnancy test. If your home pregnancy test was
positive, still wait the two weeks to obtain a pregnancy test from the Perinatal Center,
this will ensure an accurate test. Prenatal Care will begin after a positive pregnancy test
result. If your pregnancy test was performed in the Perinatal Clinic, and the result is
positive, we will schedule you for an OB orientation class. This class is an hour in length.
During this visit, you will interview with a nurse, fill out paperwork information required for
your OB record, and receive a time and date for your new OB appointment with the
physician. This appointment is scheduled approximately 10-12 weeks of pregnancy. If
you performed a home pregnancy test, which was positive, you are two weeks (or more),
late on your menses, and you have not visited the Perinatal Center for a Pregnancy
Test, please contact or come visit us right away.

MATERNAL-FETAL MEDICINE:
Our Perinatal Center here at Wright-Patterson AFB is proud to have a Maternal Fetal
Medicine (MFM) doctor on its staff. An MFM, is a Perinatologist with special expertise in
High-Risk pregnancies. Services also include Genetic Counseling, Prenatal Diagnostic
Appointments, and a high-risk team to manage complicated OB cases.

ULTRASOUND:
An ultrasound is a technique to image the baby in the uterus and the pelvic organs by
using sound waves. The ultrasound is not a treatment but is used for diagnostic
purposes and is not harmful to the fetus or the mother. A pamphlet is available upon
your request. Ideally, fetal surveys are conducted at approximately 20 weeks for all OB
patients.

SUB-SPECIALITY SERVICES PROVIDED IN THE PERINATAL CENTER INCLUDE:


Maternal-Fetal Medicine and High Risk OB
Genetic Counseling
Bereavement Counseling for Perinatal Loss
Breastfeeding Coordinator

CLASSES OFFERED INCLUDE:


Prenatal Breastfeeding
Childbirth
Lamaze
Please contact the Perinatal Center for additional information.

BIRTHING CENTER

The staff of the OB/GYN Flight at Wright-Patterson has seen their dream come true. The
newly renovated facility will provide a "home like" environment for our military population.

Our Labor, Delivery, Recovery, Post-partum suites (LDRP) provide a highly technical
environment that transforms into a home like surrounding. Our private rooms are
equipped with state of the art birthing beds, monitoring capabilities, sophisticated
warmers, central monitoring and computerized documentation terminals with flat
screens.

The same place transforms after the baby's birth: birthing bed with added comfort
mattress, cabinets that hide monitors and equipment, dual-purpose warmers, rocking
chair for mom to cuddle the baby and lets not forget about the support person: a nice,
comfortable chair that transforms into a bed allows your support person to get a few
"ZZ"'s while being available to help you with the new baby! A TV with DVD/VCR to listen
to your favorite music, watch movies or obtain the additional knowledge needed for self-
care, baby's care and safety through our educational tapes collection.