PICU 

The 24 bed Paediatric Intensive Care Unit is a busy mixed general and cardiac ward with 1000 admissions per year, 40% of which are post op cardiac patients. We are a designated ECMO, Major Trauma Centre, and High Consequence Infectious Disease (HCID) Centre. There is a separate staffed 15 bed High Dependency Unit.

This post offers a unique opportunity to work in a high performing and internationally recognised children’s hospital. Successful candidates will gain broad experience in paediatric intensive care including cardiac surgery/cardiology, ECMO, and acute illness management. The clinical shifts are staffed by a hybrid of middle grade resident Drs, Clinical Fellows and ACPs. Clinical shifts are 12.5hrs each, and the successful candidate will cover long days, nights and weekends pro-rata. Self-rostering for ACPs is in operation, and there are lots of opportunities for training and development. There is Consultant Intensivist on-site cover 24/7

Job Summary:

This multi-professional role is designed to transform and modernise pathways of care, enabling safe and effective sharing of skills across traditional professional boundaries (HEE, 2017).  Advanced clinical practice focuses on four pillars:

·         Clinical Practice

·         Leadership

·         Education

·         Research

The post holder will work autonomously at an advanced level of clinical practice, providing direct delivery of care that utilises advanced clinical assessment and reasoning skills to deliver safe and effective care that additionally enhances positive outcomes and experiences for infants, children, and young people within the Trust.

The post holder will demonstrate a high degree of autonomy in decision making skills in acute, complex, and uncertain situations whilst holding accountability for decisions made within the service and in partnership with other professionals.

The post holder will work collaboratively with the multi-disciplinary team, both within the service and across the Trust. They will be expected to cover days, nights and some weekend shifts, dependent on service need (with agreement reached locally in their job plan). The job plan will be comprised of 80% clinical practice with the remaining 20% of hours used for supported, service improvement related activities across the other advanced practice pillars of leadership, education and research. Service improvement hours will be agreed locally (as part of a yearly development review) and may be rationalised during times of significant service need/challenge.   

Main Duties and Responsibilities

1.    Work autonomously within their scope of practice, managing highly effective consultations (both face-to-face and via digital technology), with advanced communication skills and higher-level decision-making, while role modelling excellence in all aspects of advanced practice.

2.    Use highly developed expertise, critical thinking and advanced decision-making skills to conduct autonomous clinical assessments, procedures, laboratory tests and/or diagnostics that fall within their individual scope of practice and are relevant to the service client group.

3.    Utilise highly developed clinical knowledge and advanced skills to diagnose, plan, implement and initiate changes to care where required. This will include monitoring and evaluating the response to treatment through analysis and interpretation of on-going clinical observations, re-assessments, clinical tests/investigations/procedures.

4.    Modify practice to manage risk appropriately where there may be complex and unpredictable events, including unpredictable clinical responses in emergencies situations (including the deteriorating child), utilising clinical judgement and decision making to initiate appropriate interventions and treatments including escalation and referral.

5.    Work autonomously in unpredictable situations, being responsive and flexible to meet the needs of the service.

6.    Evaluate own accountability and responsibility (and that of others when appropriate) to ensure safe, high quality, and effective practice, within the context of managing complex, unfamiliar and unpredictable situations.

7.    Evaluate own performance, acting in ways that demonstrate self-awareness of, and reflection on, own professional practice, including the ability to autonomously adapt practice to meet clinical need. 

8.    Utilise excellent communication skills, that support effective communication between the multi professional team and the patient / family, to deliver a patient focused service with effective co-ordination of care (included as part of complex care packages and/or environments.)

9.    Ensure practice is informed by current, evidence-based research, that reflects professional guidance and is delivered in line with their scope of practice and Trust policies/guidelines.

10. Counsel and support the child, young person, and family through the treatment process, utilising advanced communication and decision-making skills which also include responsibility for escalation and/or referral (when required.)

11. Initiate, adjust, administer or supply medications and/or medical devices while practicing within the legal parameters for their profession and within their area of competence. e.g as an independent prescriber, supplementary prescriber, annotated with medical exemption, POM-A, or POM-S, or functioning under PGD, or PSD.

12. Work within the advanced practice governance framework/structure both locally and nationally that includes full engagement with Trust governance processes (including full participation in the PDR, CPD and clinical supervision processes).

13. Comply with all Trust policies and procedures and escalate when actions are needed outside of these agreed standards, including compliance with all Trust mandatory training. 

14. Promote and lead family centred care, maintaining a safe, friendly and welcoming ward, department, and/or other environment for children, families, visitors and colleagues.

15. Provide up-to-date information and communication records for families, colleagues and shared care centres in conjunction with the multidisciplinary team.

Successful applicants will be expected to fulfil the local PICU illustrations/competencies within 6 months of employment. There is a strong established PICU ACP team who will mentor and support the development of PICU clinical skills and critical thinking.