Detailed job description and main responsibilities

DUTIES AND RESPONSIBILITIES

Clinical Practice

·       Works as a competent practitioner for acute/critical care nursing and acts as a clinical role model. Possess advanced patient assessment skills and demonstrates specialist knowledge in practice.

·       Co-ordinates patient care particularly in the out of hours period delegating the workload effectively to other team members.

·       Demonstrates awareness of own limitations in practice and seeks advice and support from senior medical staff or critical care where appropriate.

·       Participates in medical emergencies or peri-arrest situations as a member of the cardiac arrest/emergency team as an Advanced Life Support provider (ALS).

·       Able to identify and manage other medical emergencies as per agreed protocols and act as a primary responder for acutely unwell patients.

·       Supervises the management of ‘patients at risk’. Initiates diagnostic work-up in the acute situation by ordering blood tests, CXRs and sepsis screening where appropriate.

• Accept referrals from other health care professionals and can refer patients directly to other specialties/disciplines.
• Develop and record a treatment plan consistent with the outcome of assessment and most probable diagnosis.

·       Advises on respiratory support and the care of patients with tracheostomies or those receiving CPAP and NIV outside designated critical care areas.

·       Establishes patient monitoring as appropriate and sets up invasive monitoring once the relevant lines are in situ.

·       Assists in the escalation of critically ill patients ensuring their safe and timely transfer.

·       Follow up of unwell patients, post critical care admission and discharge.

·       Reviews fluid regimes and prescribes intravenous fluids as per patient group directives or qualified Non-Medical Prescriber (NMP).

·       Demonstrates advanced specialist skills, knowledge, and expertise in clinical practice. Supervises others as appropriate.

·       Instigates and contributes to the Trust clinical policy development as appropriate

·       Safely administers prescribed medication and monitors the effects; assesses the practice of junior staff.

·       Promotes health through coordinated activities and programmes with patients, colleagues, and carers.

·       Demonstrates the ability to develop and use flexible and innovative approaches to practice which are appropriate to the needs of the patient group and consistent with the aims of the Trust.

·       Demonstrates proficiency in the use of all equipment used in the care and management of critically ill patients and can demonstrate and explain their use to junior staff.

·       Monitors and promotes high standards of nursing care and documentation. Evaluates planned care regularly according to ward/unit standards and appropriate model of nursing.

·       Communicate complex clinical and supporting information/findings to patients and significant others according to individual situations.

·       Ensures patients’ views are sought and considered in the decision-making process and due regard is given to patients’ customs, values, and spiritual beliefs.

·       Exercises professional accountability and responsibility in changing environments and across professional boundaries.

·       Non-Medical Prescribers [completed NMC accredited training; contemporary in their practice and on the approved Trust database] may prescribed medication for patients within the agreed Scope of Practice for CCOT. They should not prescribe medication for patient/staff where they are not clinically involved i.e., they must review the patient before prescribing medication.

Professional

·       Provides effective visible clinical leadership, leading the team, assessing, implementing, and evaluating patient care whilst paying attention to the individual needs of both the patient and nursing team.

·       Liaises and deputises for the Lead Nurse on matters relating to CCOT.

·       Assists the Divisional Lead Nurses, Senior Nurses and Clinical Night Managers in the provision of nursing care and operational management to include staffing levels, skill mix, patient acuity, ensuring activity targets and clinical standards are met maintaining a safe environment for patients and staff alike.

·       Identifies key risks and takes remedial action to mitigate them. Escalates concerns appropriately by completing clinical incident reports in accordance with Trust Risk Management policy.

·       Provides information or investigates complaints/incidents as required. Assists in taking appropriate action to reduce further risk or occurrence.

·       In conjunction with senior inter-professional colleagues is aware of the need for and the implications of change and is an effective change agent.

·       Conducts Individual Performance Reviews with staff ensuring the development of appropriate learning objectives are recorded with the personal development plan.

·       To be responsible for managing a group of staff and participate in recruitment and selection and management of absence.

·       Ensures he/she maintains their own continuous professional development to meet the registration requirements of the NMC.

Quality

• To be aware of the policies, procedures, and philosophies of the Trust, understanding health and safety requirements and ensure that all duties and responsibilities are carried out within these guidelines.
• Regularly lead audit within own clinical area, preparing results for evaluation of the service and initiating changes in clinical practice derived from the outcomes.
• Participates in the inter-professional research undertaken by the Critical Care Outreach Service or Multi-professional Team.
• Ensures that the results of evaluations are used to sustain or improve quality of care programmes. Leads on the development of safe and effective care 24/7.
• Participates in audit. Evaluates the quality of care delivered as an on-going and cumulative process and develops educational programmes to meet deficits in care/issues highlighted through clinical governance.
• Participates in the Trust/Directorate/Department Clinical Governance programmes.
• Actively reports incidents and encourages reporting of incidents. Undertakes incident investigations as directed by the Lead Nurse, Divisional Associate Chief Nurse, and Governance Teams.
• Assists in the development of Trust policies as appropriate.

Education

• Deliver training to Trust staff as part of CCOT teaching faculty e.g., BLS (Basic Life Support), AIM, (Acute illness Management, and NTSP (National Tracheostomy Safety Project), and support the ALS (Advanced Life Support), course as an ALS provider.
• Develop and deliver specific and relevant teaching programs for all disciplines.
• Support, supervise and assess clinical competencies of nursing staff and other members of the multidisciplinary team.

• Identify training needs and prepare and provide learning materials within clinical areas.
• Provide clinical and educational support for staff trust wide, in relation to the assessment and management of the acutely unwell/deteriorating patient, and resuscitation.