Job responsibilities
Clinical
1.To be responsible for the nursing assessment and generic core assessment of all new patients into the service.
2.To take the clinical lead on the referral triage process.
3.To complete telephone / virtual patient reviews on receipt of referral and co-ordinate ongoing care with PRS.
4.To take lead role in the selection and presentation of patients to be discussed at the weekly MDT meeting.
5.To undertake visits to hospitals, nursing homes and any other domestic residences, as required by the service.
6.To take a comprehensive history and establish a base line data.
7.To undertake the nursing assessment of newly referred amputee patients in partnership with other members of the multi-disciplinary clinical team and to holistically assess those attending for their first primary appointment.
8.To manage the nurse clinic as part of the evaluation of patients suitability for relevant prosthetic service intervention.
9.To complete clinic letters following MDT assessments.
10.To organise and participate in the delivery of high standards of evidence based nursing care to meet individual patient needs, e.g. wound management.
11.To work autonomously to make effective clinical decisions without direct access to senior nursing staff.
12.To be a source of knowledge regarding nursing aspects of prosthetic rehabilitation for all healthcare professionals within the department and service catchments area e.g. advise re shrinker compression socks and wound care.
13.To work closely with Prosthetic colleagues to obtain optimum outcomes for patients with their prostheses especially in areas of health promotion.
14.To work as an integral part of the multidisciplinary team, communicating verbally and in writing on a daily basis with all members of the team, providing specialist nursing advice and information about amputee rehabilitation.
15.To ensure confidentiality, privacy, dignity, choice and human rights are respected for all patients and carers.
16.To perform wound assessments, document findings, dress wounds appropriately and plan future management of wounds as required. This requires specialist knowledge and experience of prosthetic fitting techniques as wounds are often in areas within the prosthetic socket.
17.To ensure the well-being of patients using the Prosthetics Services, checking immediate health problems and taking action as appropriate
18.To liaise with nurses within the Acute Trust (such as vascular, plastics, renal and orthopaedics) regarding new and existing amputee patients prior to them visiting the prosthetic department, providing support and advice.
19.To liaise with other healthcare professionals e.g. G.P.s, treatment room nurses, practice nurses, diabetic nurses, community physiotherapists, rehabilitation centre nurses etc when establishing care plans for specific patients
20.To take bacteriology samples and basic observations on primary assessments and to interpret the results
21.Able to provide the interface between hospital and primary community and social care settings.
22.Act as an advocate at all times for both patients and the service.
23.Use a high level of communications skills to communicate effectively with patients and carers, including the communication of sensitive and complex information.
24.Establish the dynamic process of understanding, reflecting, active listening and checking understanding thus developing a therapeutic relationship with patients and carers.
25.Act as resource for the District Nursing Teams and ward teams providing teaching and education to them as required.
26.To check and maintain the department resuscitation equipment
27.To maintain close links with Tissue Viability Services in PRS catchment area
28.To participate in clinical team meetings.
29.To provide a drop- in service / triage for prosthetic patients, to review and assess for appropriate onward referrals.
30.To take the lead in relevant audits for the department and to ensure resulting action plans are implemented e.g. infection control.
31.To report and record all incidents and near misses relating to health, safety and security, physical violence, aggression and verbal abuse, following local recording policies.
32.To support and have awareness of diversity and disability issues.
33.To maintain accurate records, which are confidential, up to date, legible and complete. The records may be paper or electronic and must be maintained following local policy, NMC guidelines and government directives.
34.The post holder will be expected to oversee the standard of patient records by audit or peer review and by having open discussions with team members.
35.The post holder will be expected to offer nursing support, oversee infection control policies and offer advice to the Orthotics service as required by the service manager and orthotics clinical lead.
36.The post holder will maintain close links with Podiatry Service, especially the Diabetic specialist podiatrist.
37.To undertake telephone and virtual patient reviews.
Human Resource / Management
1.To take responsibility for prescribing dressings in line with Nurse prescribing formulary and Plymouth Area Joint Formulary. To be aware of the formularies in use in other areas covered by the PRS.
2.To attend external events, i.e. nursing conferences, workshops and seminars on behalf of the PRS, updating staff on new policies and practice developments e.g. NICE guidelines.
3.To line manage the prosthetic assistant team in conjunction with the administrative lead.
4.To act as a role model for other staff and students, demonstrating high standards of practice and professional conduct.
5.To be responsible for organising own time management on a daily basis in line with caseload demands, balancing patient needs with the non clinical aspect of the role.
6.To take the lead in the provision of evidence for CQC compliance for Prosthetics Rehabilitation Services.
7.To be aware of budgetary constraints when planning and carrying out care.
8.To adhere to the guidelines set by the NMC Code.
9.To be aware of local and national guidelines and policies.
10.Communicate effectively and work collaboratively with medical, therapy and nursing colleagues to ensure delivery of a coordinated multidisciplinary service. This will include case conferences, team meetings, correspondence and telephone calls.
11.To take an active role in writing and formulating policies, guidelines and safe standards of practice.
12.Take an active role in risk assessment / PRS risk management process.
Education and Training
1.To be responsible for maintaining own competency to practice through continuing professional development and to show evidence of competencies.
2.To assist in the organisation of and to participate in departmental and In Service Training Programmes.
3.To implement, participate and facilitate Clinical Supervision following the organisations policies.
4.To participate in annual appraisal in line with the knowledge and skills framework, 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 appropriate training and development to fulfil their role.
5.To be a member of the national Nurses Amputee Network.
6.To be a member of the Tissue Viability Link Nurse group and other relevant groups within the organisation, attending the meetings and feeding back to all relevant staff at the PRS
7.To act as the resuscitation link person for the department, and to be trained in AED automated electronic defibrillation.
8.To participate in supervising, mentoring and teaching staff and students visiting the department.
9.To act as a health educator to the patient, their family and carers.
10.To be aware of current advances in clinical care and to develop research awareness by attendance at relevant national forums and courses and to provide feedback to the team in to improve the clinical environment.
11.To comply with all infection control policies and guidance, to attend relevant updates and report issues of concern to immediate line manager. (If no action or explanation received, then it is the individuals responsibility to escalate to Locality Manager or Chief Executives office).
Working conditions / effort
1.Daily repetitive manual handling of patients and equipment.
2.Daily working in awkward spaces, typically parallel bars and toilet areas.
3.Requirement to speak in person to verbally aggressive patients and relatives.
4.To impart unwelcome and distressing news relating to patients condition and outcomes of treatment.
5.Working with patients with progressive vascular disease and poor prognosis.
6.Working with patients with severe physical disability and often with some cognitive impairment.
7.Daily exposure to amputation wounds, leg ulcers and bodily fluids.
8.Regular verbal communication with emotionally distressed patients and carers.
9.Requirement to use VDU equipment on a daily basis.
