Community Registered Nurse

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 e.g. 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 e.g. treatment of anaphylaxis (using Patient Group Directions PGD) and cardiac/respiratory arrest/Sepsis

Undertake and interpret acute observations using an appropriate tool e.g. News 2, ABCDE

Blood tests for monitoring

Management of Lines e.g. 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 e.g. 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 e.g. 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.

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 provided. 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

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.

Certificate of Sponsorship

Applications from job seekers who require current Skilled worker sponsorship to work in the UK are welcome and will be considered alongside all other applications. For further information visit the UK Visas and Immigration website (Opens in a new tab).

From 6 April 2017, skilled worker applicants, applying for entry clearance into the UK, have had to present a criminal record certificate from each country they have resided continuously or cumulatively for 12 months or more in the past 10 years. Adult dependants (over 18 years old) are also subject to this requirement. Guidance can be found here Criminal records checks for overseas applicants (Opens in a new tab).

UK Registration

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