Advanced Specialist Nurse for Stroke Rehabilitation

Job summary

Norfolk and Waveney Integrated Care System is working with NHS England to deliver transformation and strategic changes in community stroke rehabilitation and life after stroke services as described by the NHS Integrated Community Stroke Service (ICSS) model.

This is an exciting opportunity to develop the role of stroke nurses with ECCH. This role, fixed term for 9 months, is part of the ICSs NHS East of England Catalyst Project to improve outcomes for stroke survivors in line with the ICSS model. Alongside the delivery of patient care the post holder will be involved in the development and integration of the stroke nurse role within the community and subsequent evaluation activities feeding back to the NHS England.

Main duties of the job

To lead a community stroke nursing team within the East Coast Community Healthcare community stroke service, providing high quality specialist rehabilitation to patients following a stroke in order to allow patients to achieve their optimal level of independence and maximum rehabilitation potential.

To support post stroke reviews provided by other services for all stroke survivors within the Great Yarmouth and Waveney locality to identify difficulties and needs, provide information, advice and support for patients and their family and/or carers.

About us

ECCH is well established health care provider and has been successfully delivering NHS care within the community since 2011. We provide a range of NHS, community health and social care services predominantly across the easterly region of the Norfolk/Suffolk borders.

We are aligned to NHS terms and conditions, and offer many employee benefits, to find out more about us visit our website - We are a social enterprise and staff owned organisation which means staff can opt to be shareholders and have a real say in how ECCH is run and evolves to deliver healthcare for the future.

At the heart of our ambition, we work in partnership with and for the community to become the provider and employer of choice for community healthcare.

We encourage you to apply as early as possible as this job may close earlier than the advertised closing date once enough applications have been received.

Job description

Job responsibilities

Professional / Clinical Responsibilities

Working within a multi-disciplinary team the role includes;

Providing clinical and professional leadership support to own professional group and linked services within stroke services as required. Assessing, prescribing and developing highly specialist nursing for patients with complex stroke needs, using investigative, analytical and clinical reasoning skills. This must be in line with clinical guidelines, evidence based research and national stroke specific frameworks ( Integrated Community Stroke Service Model). To provide specialist nursing within the stroke survivor pathway including; medication reviews, clinical observations, prescribing of pressure care equipment, continence advice and mood screen assessments. Demonstrate dexterity and co-ordination when using specialist equipment and fine tools, advanced sensory skills, manual and mobilising skills. Demonstrate skills in dealing with complex biopsychosocial issues to generate appropriate strategies for caseload management. Developing and maintaining effective working relationships and communication with other healthcare professionals and statutory/non statutory agencies to provide a seamless, integrated pathway and service to our patient where their needs are well met. Provide clinical expertise and advice to others, including community therapy teams, Social Services, Primary Care and other agencies. Communicating complex and sensitive information to patients and carers as to their assessment, prognosis and treatment plan. To work frequently with patients and families in complex situations that are emotionally distressing and may cause hostility. This may include completing suicide risk assessments and providing and receiving contentious information. Making suitable adjustments to explanations in order to gain understanding, consent and concordance where there are barriers to understanding, such as hearing impairment, mental capacity impairment and other difficulties in comprehension. Ensure informed consent is obtained prior to initiating assessment and interventions. To sensitively negotiate patient led goals with the patient, family, carers and multi-disciplinary teams in situations where there is potential for conflict, in order to enable the patient to engage in treatment and ensure that patients are involved in the planning and prioritisation of their care plans wherever possible. To act as a key-worker for selected patients, leading multi-disciplinary and review meetings, and fulfilling a clinical co-ordinating role for these patients. Actively participate in multi-disciplinary/multi-agency meetings as appropriate. Being responsible for ensuring workload for self and others, within nursing and the wider team, is planned and prioritised according to service targets and needs. Actively contribute to supervising the workload of the wider team. Providing advice and education to patients, relatives and carers to promote and create ownership to ensure a continued consistent approach to patient care. Contributing to the requisitioning of supplies and equipment through electronic ordering systems. Pro-actively taking part in clinical supervision as per organisation policy. To work as an autonomous practitioner in the community to travel between sites for home visits desirable. A virtual post will be considered for this role to provide stroke specialist nurse intervention via telehealth. Remaining accountable for own professional actions as determined by the professional body. Providing nursing care which is evidence-based practice, using research methodology.

Management and Leadership

Be required to undertake risk assessments, liaise with Occupational Health and act upon the assessments appropriately. Planning of leave to ensure adequate staffing levels are maintained across the service. To be responsible for ensuring that there are adequate staffing levels and appropriate skill mix of staff to meet the needs of the service on a daily basis. Anticipate and identify staff shortages and relocate staff as appropriate. Lead / chair meetings where appropriate. Lead and/or participate in recruitment processes, using the opportunity to skill mix to meet the demands of the service. Undertake Personal Development Reviews for other staff members. Ensure absence reporting is undertaken as determined by organisation policy. Complete absence management meetings with Human Resources representative. Represent and promote the specialist nursing profession at clinical leads / operational meetings. To deal with initial complaints sensitively, avoiding escalation where possible and contribute to the formal complaints process, as requested by the operational lead and Specialist Services. To use advanced clinical reasoning to provide guidance to other staff in order to assist with case management. Ensure all clinicians provide comprehensive holistic assessment of patients and re-evaluation of their needs, to determine priorities of care and provide effective management of emotional, psychological and spiritual support. To demonstrate expert clinical leadership based on current advances in evidence-based outcomes/research and knowledge. To assist professional leads in their development of clinical teams. Act as a positive role model and leader to provide supervision and support (formal and informal) to members of the Nursing team.

Financial Responsibilities

Questioning and challenging decision-making regarding equipment and resources so that the most cost effective solutions are sought and adhered to whilst maintaining clinical integrity. Authorised signatory for team budget code which include delegated budgetary responsibility for the therapy element.

Education and professional development

Devise and deliver or attend in-house training as required to develop the current and future job roles for the service. Produce and deliver induction programmes for students and new starters. Create and promote a healthy and safe continuous learning environment for all staff in Have oversight and accountability for the programme of education for students on clinical placements. Provide advice/training and /or supervision to less experienced and staff including the mentoring of existing staff. Act as role model by offering support and work shadowing with other professionals in other services. To participate in Clinical Governance, Research and Development and Audit activities as required by line manager and MDT colleagues.

Operational Delivery

To work closely with the Operational Clinical Lead for Stroke ESD team and the integrated neurology service Neurological Rehabilitation Services within SSOCS. Work closely with other team leaders and professional leads in other elements of the integrated stroke service to ensure seamless delivery of stroke services and share best practice across the service. Be able to interpret organisational data for use within patient, staff and system management whilst adhering to contractual arrangements, local and national, ensuring targets are met. To develop and update standard operating procedures, protocols and processes based on the current best practice evidence for both the nursing team and the wider service. To create and maintain effective professional relationships with therapists across the Stroke pathway using this to help evaluate our service, implement change and promote our service on a national platform.

Risk and Governance Management

Be responsible for the safe use and maintenance of equipment and supplies, Informing the line manager of needs and opportunities identified. Complete and/or create QUEST incidents assessments as required. Support others to create and or maintain risk assessments Escalate Risks to be placed onto the Organisation risk register.

Service Development

Instigate and actively participate with the Operational Lead in the development of the operational strategy. Lead the team in continuous service improvement. Contribute to working groups within the business unit and organisation. Implement policies for the service, proposing changes to these, and advising other external agencies about these changes or developments. To actively review current specialist equipment available, keeping up-to-date with clinical and technological advances and to disseminate this specialist knowledge and information to the rest of the physiotherapy team or other appropriate staff.

All roles within East Coast Community Healthcare CIC (ECCH) require staff to demonstrate our Values and Signature Behaviours in the care and service they provide to patients, service users, stakeholders and colleagues. All members of staff should consider these as an essential part of their job role.

Our Values outline the core behaviours that we can all achieve and are summarised as an acronym within the word CARE . These stand for: Compassion, Action, Respect and Everyone .

Underpinning our Values are our Signature Behaviours which highlight by taking the right actions we continue to build a strong culture. Our four Signature Behaviours are: Compassion - We Listen, We Learn, We Lead| Action - My Accountability, My Responsibility | Respect - Respect Our Resources: People, Time and Money | Everyone - Work Together, Achieve Together .

Person Specification

Personal Attributes

Essential

Demonstrates understanding of safeguarding issues Can demonstrate an ability to contribute towards a safe environment Able to provide evidence of where you have demonstrated the ECCH Values and Behaviours Able to work reflectively, and work on personal development. Listens to personal comments without becoming defensive. Has a range of mechanisms for dealing with stress, can recognise when to use them and does so Able to meet the required IT skills for the post To work as an autonomous practitioner in the community to travel between sites for home visits desirable. A virtual post will be considered for this role to provide stroke specialist nurse intervention via telehealth.

Qualifications

Essential

Current first level NMC registration (adult) Post graduate diploma level or equivalent relevant to clinical area Teaching and assessing qualification In-depth knowledge in the management of stroke Knowledge of national requirements and directives related to speciality Knowledge of psychological response to long term condition management

Desirable

Educated to Masters level or equivalent combination of post graduate/registration, qualification, short courses and experience

Skills and Knowledge

Essential

Understanding of the management of patients with Stroke Up to date professional portfolio which will demonstrate reflective practice and evidence of on-going professional development/education Ability to take strategic view for long term service improvements Knowledge of anatomy, physiology and pathology relating to Stroke Knowledge of risk management and health and safety Microsoft packages (Word, Excel, Powerpoint) Able to perform audit and analyse findings Knowledge of accountability and ethics Presentation skills Excellent verbal and written skills Excellent interpersonal skills Empathetic when dealing with emotional situations and giving sensitive information Professional approach Report writing Able to negotiate, lobby and influence and build professional relationships and networks Able to remain calm in difficult situations Analytical skills to be able to interpret diagnostic investigations Organised/methodical Ability to manage conflicting priorities

Desirable

Knowledge of organisational structures and relationships in health and social care Knowledge of counselling/debriefing techniques Potential to lead a multidisciplinary team Can use visual and technological teaching aids Analytical skills to deal with interpreting complex clinical information

Experience

Essential

Experience of working in an NHS multi-professional setting dealing appropriately with patients with Stroke patients Participation in clinical audit and evaluating the outcomes of a service Managing and working autonomously using initiative Working across organisational boundaries Ability to demonstrate working autonomously in developing treatment plans, assessment, discharge planning for patients with complex care needs Experience of supervising others

Desirable

Extensive post registration experience with demonstrable recent experience practising to a high level of expertise in Stroke at a specialist level Evidence of influencing and implementing change Community Nursing experience

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