Practice Nurse

Job responsibilities

The post holder is an experienced nurse who, acting within their professional boundaries, will provide care for the presenting patient from initial history taking, clinical assessment, diagnosis, treatment and evaluation of care. They will demonstrate safe, clinical decision-making and expert care, including assessment and diagnostic skills, for patients within the general practice. The post holder will demonstrate critical thinking in the clinical decision-making process. They will work collaboratively with the general practice team to meet the needs of patients, supporting the delivery of policy and procedures, and providing nurse leadership as required. In order to work at this level NMC requirements for advanced practice must be met.

Key responsibilities

Clinical practice

Assess, diagnose, plan, implement and evaluate treatment/interventions and care for patients presenting with an undifferentiated diagnosis

Clinically examine and assess patient needs from a physiological and psychological perspective, and plan clinical care accordingly

Assess, diagnose, plan, implement and evaluate interventions/treatments for patients with complex needs. Proactively identify, diagnose and manage treatment plans for patients at risk of developing a long-term condition (as appropriate)

Diagnose and manage both acute and chronic conditions, integrating both drug and non-drug-based treatment methods into a management plan

Prescribe and review medication for therapeutic effectiveness, appropriate to patient needs and in accordance with evidence-based practice and national and practice protocols, and within scope of practice

Work with patients in order to support compliance with and adherence to prescribed treatments. Provide information and advice on prescribed or over-the-counter medication on medication regimens, side-effects and interactions

Prioritise health problems and intervene appropriately to assist the patient in complex, urgent or emergency situations, including initiation of effective emergency care

Support patients to adopt health promotion strategies that promote healthy lifestyles, and apply principles of self-care

Communication

Utilise and demonstrate sensitive communication styles, to ensure patients are fully informed and consent to treatment

Communicate with and support patients who are receiving bad news

Communicate effectively with patients and carers, recognising the need for alternative methods of communication to overcome different levels of understanding, cultural background and preferred ways of communicating

Anticipate barriers to communication and take action to improve communication

Maintain effective communication within the practice environment and with external stakeholders

Act as an advocate for patients and colleagues

Ensure awareness of sources of support and guidance (eg PALS) and provide information in an acceptable format to all patients, recognising any difficulties and referring where appropriate

Delivering a quality service

Recognise and work within own competence and professional code of conduct as regulated by the NMC. Produce accurate, contemporaneous and complete records of patient consultation, consistent with legislation, policies and procedures

Prioritise, organise and manage own workload in a manner that maintains and promotes quality

Deliver care according to NICE guidelines and evidence-based care

Assess effectiveness of care delivery through self and peer review, benchmarking and formal evaluation

Initiate and participate in the maintenance of quality governance systems and processes across the organisation and its activities

Utilise the audit cycle as a means of evaluating the quality of the work of self and the team, implementing improvements where required

In partnership with other clinical teams, collaborate on improving the quality of health care responding to local and national policies and initiatives as appropriate

Evaluate patients response to health care provision and the effectiveness of care

Support and participate in shared learning across the practice and wider organisation

Use a structured framework (eg root-cause analysis) to manage, review and identify learning from patient complaints, clinical incidents and near-miss events

Assess the impact of policy implementation on care delivery

Understand and apply legal issues that support the identification of vulnerable and abused children and adults, and be aware of statutory child/vulnerable patients health procedures and local guidance

Professional Role

Promote evidence based practice through the use of the latest research based guidelines and the development of Practice based research.

Monitor the effectiveness of their own clinical practice through the quality assurance strategies such as the use of audit and peer review.

Maintain their professional registration.

Participate in continuing professional development opportunities to ensure that up to date evidence-based knowledge and competence in all aspects of the role is maintained.

Work within the latest NMC Code of Professional Conduct.

Record accurate consultation data in patients records in accordance with the latest NMC guidance and other pertinent standards.

Keep up to date with pertinent health related policy and work with the Practice Team to consider the impact and strategies for implementation.

Work collaboratively with colleagues within and external to the Practice.

Pro-actively promote the role of the NP within the Practice, and externally to key stakeholders and agencies.

Leadership personal and people development

Take responsibility for own learning and performance including participating in clinical supervision and acting as a positive role mode

Utilising personal development reviews for self and nurses in order to improve performance

Support staff development in order to maximise potential

Critically evaluate and review innovations and developments that are relevant to the area of work

Enlist support and influence stakeholders and decision-makers in order to bring about new developments in the provision of services

Take a lead role in planning and implementing changes within the area of care and responsibility

Contribute to the development of local guidelines, protocols and standards

Market the role of the advanced nurse practitioner in general practice

Team working

Understand own role and scope and identify how this may develop over time

Work as an effective and responsible team member, supporting others and exploring the mechanisms to develop new ways of working

Delegate clearly and appropriately, adopting the principles of safe practice and assessment of competence

Create clear referral mechanisms to meet patient need

Prioritise own workload and ensure effective time-management strategies are embedded within the culture of the team

Work effectively with others to clearly define values, direction and policies impacting upon care delivery

Discuss, highlight and work with the team to create opportunities to improve patient care

Manage and lead on the delivery of specifically identified services or projects as agreed with the practice management team

Agree plans and outcomes by which to measure success

Management of risk

Manage and assess risk within the areas of responsibility, ensuring adequate measures are in place to protect staff and patients

Monitor work areas and practices to ensure they are safe and free from hazards and conform to health, safety and security legislation, policies, procedures and guidelines

Apply infection-control measures within the practice according to local and national guidelines

Advocate for policies that reduce environmental health risks, are culturally sensitive and increase access to health care for all

Interpret national strategies and policies into local implementation strategies that are aligned to the values and culture of general practice

Managing information

Use technology and appropriate software as an aid to management in planning, implementation and monitoring of care, presenting and communicating information

Review and process data using accurate Read codes in order to ensure easy and accurate information retrieval for monitoring and audit processes

Manage information searches using the internet and local library databases

Understand responsibility of self and others to the practice and primary care trust regarding the Freedom and Information Act

Learning and development

Undertake mentorship for more junior staff, assessing competence against set standards

Disseminate learning and information gained to other team members in order to share good practice and inform others about current and future developments (eg courses and conferences)

Assess own learning needs and undertake learning as appropriate

Provide an educational role to patients, carers, families and colleagues in an environment that facilitates learning

Equality and diversity

Identify patterns of discrimination and take action to overcome this and promote diversity and equality of opportunity

Enable others to promote equality and diversity in a non-discriminatory culture

Support people who need assistance in exercising their rights

Monitor and evaluate adherence to local chaperoning policies

Act as a role model in the observance of equality and diversity good practice

Accept the rights of individuals to choose their care providers, participate in care and refuse care

Assist patients from marginalised groups to access quality care

Undertake any training required in order to meet the needs of the practice

Qualifications

Essential

• Nursing degree or equivalent experience
• Registered Nurse (NMC)
• Evidence of immunisation training and assessment of competence in last 2 years
• 6 months relevant experience working in a primary care environment in the last 2 years
• Immunisations (flu, routine, childhood, B12, travel)
• Wound Care / Treatment of small injuries / Removal of sutures & staples
• Womens health (Cervical cytology, contraception, etc.)
• Dressings
• Diabetes review
• Hypertension
• Cardiovascular disease primary prevention
• Coronary Heart Disease
• Ability to record accurate clinical notes
• Ability to work within own scope of practice and understanding when to refer to GPs
• Understanding of Extended brief interventions (NICE guidelines)

Desirable

• Cytology certificates
• Travel medicine
• Mental Health
• ECGs
• Venepuncture
• New patient medicals
• Chaperone procedure
• Requesting pathology tests and processing the results, advising patients accordingly
• Asthma
• Spirometry
• Understands the importance of evidence-based practice
• Broad knowledge of clinical governance
• Knowledge of public health issues in the local area
• Awareness of issues within the wider health arena
• Knowledge of health promotion strategies
• Understands the requirement for PGDs and associated policy

Experience

Essential

• Experience of working within a nursing team

Desirable

• Experience of working in a GP practice
• Experience of working in primary care

Disclosure and Barring Service Check

This post is subject to the Rehabilitation of Offenders Act (Exceptions Order) 1975 and as such it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service (formerly known as CRB) to check for any previous criminal convictions.

UK Registration

Applicants must have current UK professional registration. For further information please see NHS Careers website (opens in a new window).