Clinical Nurse Specialist: Lead nurse

Job summary

We have an exciting opportunity for an established cardiac nurse with strong cardiac rehabilitation experience to join the Sussex Cardiac Centre in Brighton to lead and manage our Cardiac Rehabilitation team. We are looking for someone with excellent management and leadership skills to develop the service in line with national and local drivers, maintain certification with the National Cardiac Rehabilitation Audit (NACR), and developing an integrated Cardiac Rehabilitation service utilising the skills of the wider multiprofessional team.

You will be part of a cardiac centre providing tertiary care to the Sussex population, along with secondary care to local patients. The caseload includes patients following cardiac surgery, coronary intervention, myocardial infarction, defibrillator implantation and heart failure.

Main duties of the job

You will need to have excellent clinical skills in order to provide specialist nursing care into this service, and to provide the support and supervision to the team.

As the lead nurse and manager you will provide clinical leadership and management for the cardiac rehabilitation service at the Royal Sussex County Hospital (1600 patients per annum, local and non local) and at the Princess Royal Hospital (400 local patients per annum).

About us

At UHSussex, diversity is our strength, and we want you to feel included to help us always put the Patient First, as shown in our Outstanding for Caring CQC rating. Your uniqueness and experiences will be part of our creative and innovative community where everyone is encouraged to succeed. We have a range of Staff Networks to help break down barriers, and can offer a buddy to help new members settle in. We're proud to be a Disability Confident Employer (Level 2) and a Veteran Aware Trust.

We treat our patients and staff with the same compassion and empathy we expect for ourselves. We're here for them when they need us, and we go above and beyond to meet their needs. This can be seen in our Wellbeing Programme for staff which is extensive and designed to support you when you need it - because we know that to look after others we must first look after ourselves.

As a university trust and a leader in healthcare research, we value learning, teaching and training so that we can be the best that we can be. From the moment you start with us and throughout your career we will help you to grow and develop. We hope that in choosing UHSussex you are choosing a long and happy career where you will be able to see the difference you make and feel valued for all that you do.

We look forward to receiving your application and the start of your journey with UHSussex.

Job description

Job responsibilities

Communication

Deliver complex and sensitive information to patients about their clinical condition following a significant health event, such as a myocardial infarction, cardiac surgery, out of hospital cardiac arrest, device implantation, and other interventional cardiac sensitivity and empathy to support the patient from a social and employment perspective and in the need for lifestyle changes. Communicate life-changing issues such as medical complications to patients and provide support to patients and their families. Use advanced communication skills to facilitate lifestyle changes using motivational skills. Support verbal communication by providing written educational material to patients, carers and healthcare professional to ensure understanding of complex issues. Assess discharged patients over the telephone, triaging calls, recognising red flags and providing appropriate clinical advise. Acts as a patients advocate in issues concerning their care. Refer patients with complex issues and challenging behaviour to the clinical psychologist after obtaining the patients consent. Represent the Cardiac Rehabilitation team in internal and external meetings as required to communicate the performance of the service. Present at national and international conferences. Provide written and verbal reports to GPs and other members of the multidisciplinary team regarding treatment changes and recommended management of care. Communicate results of tests results to patients and GPs. Maintain accurate records regarding all patient contacts, including telephone consultations. Ensure that confidentiality and adherence to the Data Protection Act in relation to own practice is maintained. Deliver group education to patients. Seek opportunities to publicise and promote the service. Explore the use of digital communication to facilitate collection of data for NACR. Lead the communication with other Cardiac Rehabilitation professionals to develop an integrated cardiac rehabilitation team. Gain patient feedback on the service and act on findings.

Service Delivery and Improvement

Lead and manage the cardiac rehabilitation team across 2 hospital sites RSCH and PRH. Deliver operational leadership on a daily basis ensuring safe staffing for all aspects of the service and managing clinical risk. Provide strategic leadership in line with national and local policy and priorities. Develop an integrated cardiac rehabilitation team spanning different professional groups. Develop hybrid models of cardiac rehabilitation to include face to face exercise programmes and virtual models such as REACH-HF and the Heart manual. Ensure the education programme in phase 3 remains contemporary, and utilise innovative ways for education delivery. Ensure complaints and plaudits are handled in a professional manner and following policy. Report any untoward incident or accident and ensure that appropriate investigation, corrective action and documentation takes place. Lead on the implementation of Trust policies relevant to cardiac rehabilitation. Adhere to all local standard operating procedures and policies. Take responsibility for Policy and Service development, as delegated by Senior Management or as required, in line with changing legal, professional or clinical issues.. Critically analyse methodology and results of research and apply to future clinical practice where appropriate. In collaboration with UHSussex research department, develop, participate in and encourage research pertaining to cardiac rehabilitation, and assist in changing practice related to evidence based research findings. Collect audit data in line with local and national requirements (eg NACR, PATS registry). Independently undertake service audit or local protocol audits according to service need. Promote dissemination of audit results through presentation and publication. Maintain certification with NACR demonstrating a service meeting key standards. Benchmark audit data against local and national data, making changes where required. Develop strategies to increase engagement in Cardiac Rehabilitation across the socio economic groups. Evaluate the effectiveness of the cardiac rehabilitation service in relation to patient outcomes. Actively encourage patient involvement in service development. Review national policy documents with reference to cardiac rehabilitation, eg The NHS Long Term Plan, and provide recommendations and actions to achieve the targets set. Develop a business case if required. Implement NICE guidance and quality standards, contributing to gap analyses where required. Participate in local clinical governance programmes, presenting an annual cardiac rehabilitation audit. Manage the cardiac rehabilitation budget. Work with the Integrated Care Board (ICB) regarding short term funding opportunities and evaluation of their use. Develop non medical prescribing within the team to support medicines optimisation during the programme, and to make changes that could prevent a hospital admission.

People Management and Development

Deal sensitively with staff with performance or HR issues adhering to Trust policy. Undertake annual appraisal of staff, identifying learning needs. Maintain an effective roster and manage staff absence on Healthroster. Lead on recruitment to the team with onward staff orientation and development. As a senior nursing role model provide guidance and training to junior doctors and nurses working with cardiac patients on the wards. Develop a programme of education and training to upskill other professional groups in holistic Cardiac Rehabilitation. Provide a structured education programme to nurses on cardiac wards, and as a visiting lecturer at the University on post graduate cardiac modules. Establish links with educational providers and Primary care providers in line with UHS regulations, providing maximum learning opportunities in this field. Provide training and education for GPs as required. Acts as a mentor and assessor to nurses undergoing cardiac modules.

Patient Care Delivery

Provide clinical advise in the specialist field of Cardiac Rehabilitation to patients, carers and members of the MDT. Provide clinical leadership to the cardiac rehabilitation team, acting as a resource for the most complex patients. Identify patients on the cardiac wards on a daily basis who have had a recent cardiac event and provide an individual assessment and plan. Receive referrals from Consultants Cardiologists, Consultant Surgeons, Heart Failure team, Arrhythmia team, General Practitioners, non-local hospitals. Triage referrals into the service ensuring patient safety. Provide phase 1-3 cardiac rehabilitation, and support onward referral to phase 4. Deliver individualised patient education to inpatients after a cardiac event, in the short window they are in hospital. Undertake a holistic assessment of the patient and develop an individual plan with the patient to address risk factor modification including lipid counselling, stress management, smoking cessation counselling (including pharmacological and behavioural support), diabetes education, nutrition education and counselling, psychosocial support and exercise management. Work with patients on behavioural goals. Provide a timely response to patients telephone calls, assessing symptoms and providing specialist advise with safety netting. Recognise life threatening changes and escalate appropriately. Develop pathways to prevent readmissions. Use non medical prescribing skills to optimise patient medication during the cardiac rehabilitation programme and to manage an unstable patient. Provide education and advise regarding complex medication regimes, promoting compliance, and identify adverse reactions with an action plan to resolve. Manage own clinical caseload and provide support and supervision to team members in the management of theirs. Be aware of expected clinical pathways and where deviation has occurred taking the necessary steps using specialist nursing skills. Perform psychological assessment using the Hospital Anxiety and Depression Score, acting upon findings and making referrals as required. Recognise the impact of psychological challenges on behavioural change. Provide support to patients with other psychological and emotional challenges, referring them to the clinical psychologist as necessary. Work closely and network with other nurse specialists to share practice and provide a uniformly high standard of care. Make clinical judgements about patients and adjust treatment plans accordingly in order to achieve treatment targets. Person Specification

clinical experience

Essential

masters level education evidence of specialist studies in cardiac nursing established experience in cardiac nursing strong cardiac rehabilitation experience Teaching and assessing qualification experience of managing own caseload of patients

Desirable

Independant prescriber BACR exercise training course management or leadership qualification physical assessment module health promotion course Psychology / counselling training

Equality, Diversity, and Inclusion

Essential

Evidence of having undertaken own development to improve understanding of equalities issues Evidence of having championed diversity in previous roles (as appropriate to role).

---