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Community Registered Nurse
4 months ago
Job summary
Do you need a shift pattern that fits with your childcare responsibilities. Would you consider out of hours working within a Urgent Care Service .
Up to hours per week, working on our day service. Start time 08:00 or 09:00 whichever suits successful candidate.
This is an exciting opportunity for an experienced and self-motivated nurse to be part of a developing Urgent Care Nursing service working across Plymouth, South Hams and West Devon.
The key part of our service is providing high quality nursing care, to meet the need of the individual in the home, supporting the individual to remain at home, safe and warm, to stay independent maximising wellbeing and improving health outcome through to End of Life care.
The post holder will deliver a range of clinical skills and expertise providing care in the community. The role will involve working within the Intravenous therapy day service.
You will need the ability to working autonomously and as part of a forward thinking team demonstrating initiative and passion with sound clinical knowledge and judgement.
Livewell is dedicated to produce a competent workforce; by offering career progression and in return we expect commitment from all our staff. If you feel you have ambition, courage and energy to meet the health and social care challenges ahead.
This rolemay not be eligible for sponsorship under the Skilled Worker route, pleaserefer to the Direct Gov website for more information with regards toeligibility.
Main duties of the job
The post holder is responsible for the delivery of high quality evidence based care for acutely ill patients within their homes, with the aim of preventing hospital admission or facilitating rapid discharge.
The post holder will liaise with the referring clinician when accepting patients for treatment and be supported by senior clinicians and clinical manager.
The post holder will delivery intravenous therapies for patients within our service.
Responsible for effectively assessing, planning, implementing, monitoring and evaluating patient care this will include admitting and discharging patients form the caseload.
To prevent and reduce hospital admissions and minimise hospital lengths of stay by providing intensive and advanced nursing input, and involving appropriate members of the multi-disciplinary team.
Responsible for coordinating a shift in the absence of a senior clinician.
The Urgent Care Nursing team work on a flexible rota shift system. The service covers 24 hours per day over seven days a week. However the Intravenous therapy service runs from 08:00 - 20:30
To undertake and to develop all nursing skills and competencies as required for their role to enhance the skill mix of the nursing team ensuring that the ever changing health needs of patients are met.
Able to provide the interface between hospital, primary care, community and social care settings.
About us
Livewell Southwest is an independent, award-winning social enterprise providing integrated health & social care services for people across Plymouth, South Hams & West Devon, as well as some specialist services for people living in parts of Devon & Cornwall. With teams in community hospitals, GP practices, sports centres, health & wellbeing hubs.
As an organisation with a strong social conscience, we always value being kind, respectful, inclusive, ambitious, responsible and collaborative. Transforming services to make them sustainable, ensuring that we value, support & empower each other.
We are committed to involving the people we care for, families & carers in everything that we do, working towards co-production where we can. Helping us to deliver the right care for people, in the right place & at the right time. By putting people at the centre of what we do, we ensure to support people to lead, healthy independent lives & be the very best at helping people to live well.
Valuing our employees making an investment in their development a priority. We offer:
Protected CPD time for registered staff
Various development pathways and ongoing regular training packages for all staff
Leadership & mentoring programmes
A Robust Preceptorship
A bespoke induction programme
Existing members of the NHS Pension Scheme can continue their membership when they join the organisation.
Job description
Job responsibilities
1. Clinical
Provide holistic evidence based / best practice care to patients in accordance with National and Organisational approved policies/procedures and individual care plans.
Be responsible for the assessing, planning, implementation and evaluation of care on a day-to-day basis. The work may be unpredictable and complex and often of a sensitive nature.
Work autonomously and unsupervised in the community setting, recognising the risks associated with lone working, both clinically and socially and work proactively to reduce those risks.
Work as an autonomous practitioner, managing and prioritising delegated workload according to local guidelines and identified need. Working in a variety of community settings, exercising a high level of judgement, discretion and decision making in clinical care.
Work within challenging and unpredictable environments patients homes, which may have constraints and require adaptability
Responsibility for the specialist assessment and co-ordination of planned care to individual patients in conjunction with patients and carers.
Supporting other members of the team in their planning of patient care.
Provides support and advice to patients carers and relatives (on patients conditions and prognosis) where appropriate.
Responsibility for reviewing care delivery and maintaining records in accordance with local and with NMC guidelines.
Maintain accurate records, which are confidential, up to date, legible and that all care given has to be documented. These records may be paper or IT based system and must be maintained as specified in the Organisation Policies, NMC guidelines and Government directives. The post holder will be expected to oversee the standard of patients records by audit or peer review and have regular open discussions with team members.
Works as part of a multi-disciplinary team
Acts as patient representative to facilitate appropriate care pathways which involves effective communication to peers, other specialist practitioners, GPs and Consultants.
Delivery of Direct Care
To assess, plan and evaluate care provided for patients.
Participates in monitoring of evidence-based standards through research, clinical trials, audits and staff initiatives.
Initiates prescribed care in conjunction with Team Manager/Consultant/GP and other clinicians.
Without direct supervision and reporting directly to Consultant Physician or GP will work towards undertaking care delivery involving an extensive range of activities including:
Subcutaneous/intramuscular therapy and diabetic injections
Administration of medication
Acute and chronic disease management
Assisting the multi-disciplinary team in palliative care (EOL)
Acute/chronic pain management
Facilitating appropriate care for elimination needs (Bowel and catheter management)
Wound assessments and management
Management of surgical drainage systems
Blood glucose monitoring
Health promotion
Acting as a formal mentor to pre-registration nursing students
Adopting link roles
Intravenous drug and fluid therapy
Administration of Nebulised drugs
Administration of oxygen therapy
Undertaking investigative procedures to support diagnosis, including ECG
Computer skills
Liaising with and referring on to other agencies and professionals
Pulse oximetry and interpretation
Recognising and managing emergency situations treatment of anaphylaxis (using Patient Group Directions PGD) and cardiac/respiratory arrest/Sepsis
Undertake and interpret acute observations using an appropriate tool News 2, ABCDE
Blood tests for monitoring
Management of Lines TIVAD, PICC and Midline
Continence management
Bowel care
Falls assessment
2. Management and Leadership:
Have on-going responsibility and duty of care for patients, staff, self and others in all aspects of Health, Safety and Risk.
Act as a role model, promoting good performance and practice.
Participate in team activities to develop and consolidate a cohesive and supportive team ensuring openness within the team.
Participate in recruitment and selection of new staff
Reporting of all incidents and near misses. Supporting team manager in investigations of incidents. Report to line manager any untoward incidents complaints, accidents, defective equipment and take appropriate action to ensure safety of patients, relatives, self and colleagues and follow up with appropriate documentation.
Inform Band 6 or 7 of any on-going nursing/management issues affecting patient care or working capacity.
Be aware of pressures facing your work colleagues and offer support and ensure they are aware of additional support that may be available to them
To be responsible for the procurement and monitoring of equipment for patients on caseload.
The post holder will be required to use a computer, being responsible for timely recording patient activities for IT data collection, dealing with e-mail queries, stock and equipment ordering.
To preserve confidentiality and comply with of the Data Protection Act, Access to Health Records and Consent for Treatment
To have a flexible approach to the working day to meet the needs of the patient/service.
3. Professional
To work within the NMC code and fulfil revalidation requirements
Act as a role model for all staff and students demonstrating clinical skills and high standards of practice and professional conduct.
To remain updated and competent and ensure that clinical practice is evidence based.
To have an up to date personal development plan and professional portfolio.
To participate in an annual appraisal of their work in line with the Knowledge and Skills Framework (KSF) where the job description will be reviewed and objectives set. In line with the annual development plan the post holder will be expected to undertake any training or development required to fulfil their role.
Undertake regular clinical supervision.
4. Education and Training
Support the team manager in providing and maintaining a learning environment and maximise opportunities for education and development in the clinical are to enhance individual development and performance in the delivery of high standards of care.
Take part in the process of clinical supervision and support clinical supervision for junior team members.
Take responsibility for your own personal and professional development; maintain competence, knowledge and skills commensurate with role.
To undertake all required training and competencies required for the role.
Maintain attendance at mandatory and statutory training as per organisation guidelines.
Integrate theory into practice by bringing new knowledge around acute care from training into the practice environment.
Act as a mentor for students and fulfil requirements of a practice placement.
To facilitate induction for new members of the team.
Act as a link nurse for speciality to enhance team education.
5. Research
Actively participate in audit as directed by the Team Manager.
Collect, collate and evaluate a range of information to support clinical and service audit. Maintain accurate and up to date patient records, data bases and specialist reporting in accordance with organisation policy and professional guidance.
Support the team manager in working towards the achievement of specific performance targets related to acute care team.
6. Communication
Use a high level of communication skills on a daily basis with patients, carers and relatives to encourage concordance with care planning and agreed outcomes.
Use a high level of communication/negotiation skills on a daily basis with other health and social care professionals. To inform each, as appropriate, of the highly complex and sensitive information related to patients condition required to achieve the best outcomes and care pathways.
Show empathy and sensitivity when dealing with life threatening illnesses or other sensitive health related problems of patients, relatives and carers.
Ensure effective and timely information exchange is maintained, verbally, written or electronically.
Will be expected to liaise with: people with acute and chronic diseases, relatives and carers, members of the public, consultants, GPs and any other medical nursing or therapy staff. Community and Acute providers, Intermediate Care Service staff, Social Services, other specialist practitioner, statutory and voluntary organisations.
Provide and receive complex, sensitive or contentious information where persuasive, motivational, negating, empathetic and reassurance skills are required verbal and non-verbal, as well as written and electronic to communicate effectively with patients, carers and GPs. This will include patients who may have difficulty understanding or communicating patients may be dysphasic, depressed, deaf and blind or may have difficulty accepting diagnoses.
Able to provide the interface between hospital and primary, community and social care settings in reaching to inpatient facilities to facilitate discharge to community.
Demonstrate highly developed communication skills required to take a lead role in case discussions/case conferences concerning service users in their caseload.
Act as patient advocate as required to ensure individual needs, preferences and choices are delivered.
Support the team manager in communication and promotion of the service.
Support the team manager in development, implementation and evaluation of protocols, guidelines, policies, integrated pathways and tools.
If the post holder is supplied with a mobile phone, laptop and lone worker device they are for work purposes and are expected to abide by organisation.
Person Specification
Knowledge
Essential
Background knowledge of nursing and health care. Government Policies relating to acute care in the community. Understanding of Clinical Governance. Understanding of clinical supervision and continued professional development Understanding of team function Overview of Acute Discharge process and community nursing Current and up to date knowledge of Code of Conduct (NMC)
Desirable
Knowledge of Secondary & Primary Care Sector Basic knowledge of Acute and Long Term Conditions
Experience
Essential
Experience in clinical assessment Experience or understanding of community working Experience of a variety of healthcare settings
Skills
Essential
To be able to respond to urgent calls in different parts of the city Strong evidence of Acute Care background and skills Working without supervision Evidence of autonomous practice Clinical Risk Management End of Life Care Emergency Care Management Infection control experience Evidence of recent study Acute care assessment skills Excellent communication skills Computer literacy Good time management Delegation skills Managing care of infections Intravenous/subcutaneous/central line management skills Excellent interpersonal skills Organisational skills Ability to discuss complex patient care with senior clinicians Non judgemental Ability to motivate others Flexible/adaptable Ability to prioritise Leadership, co-ordination and management skills
Desirable
Previous triage experience Respiratory background Cardiac background Alert, Aim/Impact etc course Wound care background Surgical background Venepuncture & cannulation skills
Behavioral Attributes & Competencies
Essential
Familiar with and committed to the principles and values of the NHS. Demonstrate commitment to and focus on quality, promotes high standards to consistently improve patient outcomes. Consistently put clinicians at the heart of decision making. Creates and fosters a culture of openness, honesty, integrity and inclusiveness. Values diversity and difference. Uses evidence to make improvements and seeks out innovation. Demonstrates commitment to partnership working. Flexible approach to working. Attention to detail. Highly motivated with ability to influence and inspire others. Outcomes focused. Ability to act as a champion for patients/carers and their interests, ensuring the patients voice has an impact on service developments.
Qualifications
Essential
NMC Registered Nurse (Adults) Relevant post registration courses/knowledge base relevant to the post. The post holder will need to travel and attend to service users based across Plymouth and other geographical areas. Full and valid driving licence and access to a car for work purposes is required. Reasonable adjustments under the Equality Act will be taken into account for the successful applicant.
Desirable
Recognised teaching or mentorship qualification at degree level or equivalent Non-medical prescribing