NursingNetUK

Detailed job description and main responsibilities

Role Summary 

This is an exciting opportunity to work as part of a well-established community multidisciplinary respiratory specialist team consisting of respiratory nurse specialists', highly specialist respiratory physiotherapists. The Respiratory MDT’s key aims are: 

• To deliver evidence-based care for patients with COPD in the Surrey Downs area 
• Develop integrated respiratory service pathways through audit and evaluation 
• Promote health through patient empowerment, health education and self-management skills 

Principle Duties to include: 

• Referred to the service to enable prompt assessment, diagnosis and treatment according to agreed policies, protocols and guidelines. 
• Request and perform appropriate diagnostic and/or therapeutic interventions in order to provide a holistic assessment of the patient within agreed policies and guidelines. 
• Be responsible for prescribing such treatments as are deemed clinically appropriate, in line with local guidelines, the Nurse Prescribing Formulary and Trust protocols for Non-Medical Prescribing. 
• Lead in the professional development needs of junior team members within the service. 
• Be proactive in offering health promotion and participate in health promotion activities, including health needs assessment for the caseload and local population. 
• To manage complaints according to Trust policy and within professional guidance. Research and Development 
• To contribute to the development of evidence-based practice using audit and other tools including user and stakeholder feedback 

Key Clinical Duties 

1) Respiratory Nursing 

• To work independently as a respiratory nurse specialist practising holistic evidence-based, guideline management strategies 
• To prioritise workload and manage own patient caseload, including planning and evaluating care provided. 
• To be professionally and legally accountable for all work undertaken. 
• To ensure that, as a lone worker in the community, appropriate risk assessments are undertaken to ensure safety at all times. 
• To practice advanced standards of clinical assessment through history taking and physical examinations as an autonomous practitioner using highly specialised skills with advanced clinical reasoning; analyse findings, recognise and diagnose exacerbations of respiratory conditions and differentiate from other diagnoses (eg heart failure) and appropriately seeking advice from within the team or in-patient Respiratory Consultant. 
• To interpret clinical assessment findings, using medical assessment tools such as spirometry; blood tests, etc. 
• On the basis of assessment findings make recommendations to the patient and other health care professionals on the best course of intervention, and initiate appropriate treatment plan as indicated. This may be through use of independent nurse prescribing, and initiation of standby medication or via direct discussion with GPs. 
• To promote self-management of respiratory conditions, through disease specific education, Health promotion, including stop smoking (with appropriate referral to the specialist Stop Smoking Team), nutrition (with referral to the specialist dietetics and speech and language therapy teams), psychological interventions (with appropriate referral to integrated psychology service) and exercise. 
• To participate in community pulmonary rehabilitation provision where required and will encourage cross supportive working. 
• To triage and review patients referred to the service and AECOPD pathway using agreed protocols and procedures. 
• To carry out follow up assessments and treatment in patient’s homes, liaising with other team members as required. Collaborate with community based professionals such as GPs, district nurses and home carers to promote continuity of care for patients. 
• Collaboratively identify patients’ goals in relation to their respiratory condition and facilitate meeting these through education and support, empowering them to manage their long term condition effectively, seeking advice and support when required. 
• To act as a resource to all professionals involved in the care of respiratory patients 
• To be responsible for keeping contemporaneous up to date patient records by ensuring all relevant information is documented on EMIS nursing progress notes and write specific reports as required 
• To initiate and implement changes in clinical practice which improve standards of care and health outcomes for patients 
• In conjunction with other professionals, develop standards of practice against, which quality of care may be measured 
• To identify and address clinical issues and incidents within the community in order to improve the quality of care 
• To identify and resolve patient related or service problems and prioritise demanding and conflicting needs. 

2) Oxygen Caseload 

• To assist and support HOSAR Nurse for patients referred for Respiratory/Oxygen Assessment, in the most appropriate setting, identifying and managing clinical risks, within a specialist field and be responsive and adaptable to the perpetual changes in patients’ clinical states. 
• To assist the delivery of oxygen services as outlined in the service specification with responsibility for related work streams. 
• To provide education and support to patients, and their carer’s, and support local development with support networks on oxygen, respiratory and pulmonary rehabilitation 
• To actively engage with GP practices in delivering care to patients requiring oxygen, providing specialist advice and support when required to primary health care professionals on their patients’ treatments and on-going management. 
• To assist when required in conducting regular reviews of the Oxygen patients on the Concordance report 
• To assist and provide support when required maintaining high standards of clinical care throughout the oxygen service team by keeping up to date with clinical developments, analysing current research, critiquing new guidance, lead audit and service evaluation within specialist area and implement changes in clinical practice dependent on results 
• To use professional judgement when dealing with patients who display adverse behaviour towards the use of oxygen and the removal of oxygen where appropriate. 
• To undertake Capillary Blood Gas analysis as appropriate to the patient’s needs. 
• To provide specialist clinical advice, teaching and instruction to patients, relatives, carers and other professionals, regarding the management of patients within the area of Oxygen therapy 
• To ensure patients with conditions requiring Oxygen get timely access to appropriate services and care/treatment in the most appropriate setting for the individual – primary or secondary liaising with other appropriate services as necessary. 
• Liaise and develop communication links with other health professionals/specialists around other disease areas where patients require oxygen therapy to ensure continuity and holistic care is seamless, eg pulmonary rehabilitation. 
• Plan for emergency situations to make sure that oxygen supplies are continued for patients in line with service specification and contingency planning policy. 
• To assist in the development of care pathways to ensure that patients requiring oxygen therapy flow seamlessly between the different levels of care according to their needs and this will involve linking with other related respiratory services. 
• To be responsible for the safe use of equipment used in assessment or implementing oxygen therapy and ensure all team members adhere to trust and departmental medical devices policies, including competence to use equipment through teaching, training and supervision 

3) Education 

• To be responsible for identifying own training and development needs to maintain expert level of practice and to maintain CPD portfolio to reflect this. 
• Identify the training needs of other professionals in relation to Chronic Respiratory Care, both within primary and secondary care and plan, implement and evaluate teaching programmes. 

• Employ a range of methods in education and training appropriate to the topic, participants, facilities available and event. 
• To lead in the development of University based respiratory training courses for pre-registration nursing students within the specialist (respiratory) area when requested. 
• To organise and provide respiratory training session for GP's, nurses and allied health professionals as requested 
• Lead in the use of research based practice linking this to relevant service development. 
• Act as role model and mentor to other team members and students. Identify and attend any personal and relevant training for this role. 
• To participate in appraisal using reflective practice. 

4) Management 

• Manage own respiratory clinical diaries and templates. 
• To act as a change agent and innovator, planning, instigating and evaluating change through robust cycles of audit. 
• To lead in the development and maintenance of collaborative relationships, partnerships and networks aimed at influencing and improving health outcomes for respiratory patients 
• To assist and develop COPD services to improve practice and health outcomes are underpinned by local and national guidance, patient and carer needs and utilisation of multidisciplinary skills to formulate and test new developments 
• To contribute to measuring the effectiveness and productivity of respiratory/COPD disease management provided through the collection and correlation of data for the team annual reports 
• To develop and implement evidence based clinical practice within the team 
• To be responsible for the upkeep and maintenance of equipment used in the respiratory service reporting all equipment defects in order for them to be repaired or replaced. 

5) Communication/Collaboration 

• To work collaboratively with members of the respiratory team and other clinical specialities, i.e. ILTs, GP practice, palliative care team, in order to provide seamless, high quality care in the borough