Job summary
Due to service expansion and the implementation of a new and exciting 24/7 service, we are looking for highly motivated, dynamic and enthusiastic practitioners to join our Critical Care Outreach Team, due to rebrand in the near future as the Deteriorating Adult Response Team (DART).
You will be joining a highly skilled, professional, dedicated and approachable team who pride themselves on delivering high standards of care to deteriorating patients across the hospital.
This role will involve a rotational working pattern, incorporating day and night shifts, with training and support from a dedicated nursing and clinical leadership team.
Main duties of the job
- Responding to acute referrals from medical and nursing staff based on track & trigger and staff concern.
- Perform an extensive assessment using a systematic approach, formulation and implementation of plan, continual evaluation of patient response and act accordingly to patient condition whilst performing interventions and escalating as required.
- Support nursing and medical staff with additional skills and knowledge when caring for the deteriorating patient.
- Developing additional skills and maintaining these within Critical Care.
- Respond to cardiac arrest calls and be an active member of the cardiac arrest team.
- Assist with timely transfers to Critical Care and facilitate intra and inter hospital transfers of critically ill patients.
- Supporting patients following their stay on Critical Care, ensuring appropriate rehabilitation is maintained throughout this transition and their remaining hospital stay.
- Provide individualised and bespoke teaching to wards and departments, as well as delivering teaching alongside the Trust PDEU (Practice Development and Education Unit) and the WYCCN (West Yorkshire Critical Care Network).
About us
We are a small, dedicated team of practitioners who work closely with Critical Care, within the division of Surgery, based at Pinderfields Hospital.
As a Trust, we provide care and support to over half a million people in Wakefield and Kirklees in their homes, in community settings and across our three hospital sites at Pontefract, Dewsbury and Pinderfields (in Wakefield).
Always striving for excellence, we are at the forefront of innovation and research and we invest in teaching and the development of our workforce.
We live by our values of caring, improving, being respectful and maintaining high standards. We listen and learn because we aim to make Mid Yorkshire the best place to work and the best place to receive care.
We have a clear vision, and you could be part of this! If you share our values and you want to make a difference to the lives of our patients and their families and carers, we would love to hear from you.
Job description
Job responsibilities
Clinical
- Ensure a prompt and timely approach to accepting referrals of patients with high NEWS or staff concern. Provide any care that they may need, document, communicate safe and efficient time management plans that include criteria for medical or critical care review.
- Be able to work rotational shift patterns to enable the service to be available 24/7, with the likelihood of working equal night to day working. Work independently, managing own workload, taking referrals and providing advice to medical, nursing and allied health professionals (AHPs).
- Provide specialist advice and undertake complex assessment of acutely unwell patients. Undertake and interpret appropriate diagnostic tests, initiate simple measures and deliver a supportive critical care nursing plan to optimise the patient, involving the MDT in discussions relating to the management and identifying risks versus benefit
- Safely and efficiently assess patients condition and treatment requirements utilising the National Early Warning Scoring (NEWS 2) assessment. Use clinical expertise in diagnosis and planning of care requirements and administer appropriate treatments, as required following approved Patient Group Directives (e.g. oxygen therapy, intravenous fluids).
- Manage, and provide enhanced supervision to support the nursing care of patients with haemodynamic instability and other appropriate respiratory and vital organ support, such as ventilated patients that are unable to be admitted to critical care.
- Demonstrate clinical competence and confidence in combination with critical thinking, problem solving and decision making skills in a variety of clinical settings.
- Assist with, or perform, emergency and resuscitative procedures associated with critically ill patients. Attend crash calls as an ILS provider and provide support to staff when managing clinical emergencies.
- Expedite, where necessary, the transfer of critically unwell patients to critical care and support ongoing care of patients discharged from critical care. Ensuring timely transfers in line with national policies.
- Support the psychological and physiological recovery of patients within the ward environment following an extended period of critical illness.
- Organise and participate in the critical care follow up clinic
- Provide professional leadership and clinical expertise across all wards and departments, providing specialist advice and developing practice in line with scope of practice and Trust policies and guidelines. Act as a role model to nursing staff and all members of the multi-disciplinary team.
- Maintain concise, precise written records about clinical work undertaken.
- Work proactively as part of the wider MDT, ensuring prompt referrals to promote seamless patient care delivery.
- Use available equipment within scope of practice and be able to train others in its use e.g. invasive pressure monitoring; intravenous infusion devices; near patient testing; respiratory support systems.
- Undertake regular clinical shifts on ICU to maintain critical care (level 2 & 3) skills and relationships with the critical care team.
- Sensitively care for dying patients and their families. Facilitate and participate in end of life discussions.
Education
- Maintain, update and promote evidence-based knowledge and skills
- Ensure mandatory training is up to date
- Undertake and complete relevant competencies relating to the role
- Assist in promoting and maintaining an effective learning environment for staff, acting as a facilitator in the supervision and teaching of staff.
- Provide a positive learning environment in response to audit and use educational strategies to motivate and retain staff.
- Establish links with educational providers to maximise learning opportunities / needs that have been identified.
Leadership and managerial responsibilities
- Participate in the setting and monitoring of standards in the service, which utilises research based evidence, and is audited and improved accordingly
- Contribute to relevant audits to enable service development, establishing clear performance goals, with regular monitoring and feedback.
- Collect and electronically input data used for analysis and presentation of Critical Care Outreach service data, presenting service outcomes to MDT groups as requested
- Participate actively in relevant meetings at local, regional and national level
- Participate in the renewal, development of protocols and policies within the speciality / role.
- Have involvement with development of the service within the Trust
- Represent the service at local, regional and national forums.
Professional responsibilities
- Adhere to the NMC Code of Conduct and associated guidelines and maintain professional registration
- Act as the patients advocate where appropriate.
- Act as a role model at all times, upholding Trust values and contributing to a culture within the hospital which recognises and works in partnership with patients and their carers.
- Uphold quality initiatives that improve patient experience and enhance the interface between staff, patients and visitors.
- Be responsible for own and whole Trusts requirement to reduce hospital acquired infection and cross infection through the implementation of good practice e.g. effective hand washing; using protective clothing appropriately; rigorously applying standard (universal) precautions to minimise the transmission of infection.
- Use correct moving and handling techniques and appropriate equipment when moving or handling patients, stock and equipment which may be soiled or infected. The post-holder is responsible for taking reasonable care with regard to him/ her as well as for any colleagues, patients or visitors who might be affected by any act or failure to act by the post-holder in accordance with the Trusts policies on Health and Safety at Work.
- Report any accident, untoward incident or loss relating to staff, patients or visitors according to Trust policies
- Undertake in-service training relevant to the post.
- Comply with Trust Policies and Procedures.
Job description
Job responsibilities
Clinical
- Ensure a prompt and timely approach to accepting referrals of patients with high NEWS or staff concern. Provide any care that they may need, document, communicate safe and efficient time management plans that include criteria for medical or critical care review.
- Be able to work rotational shift patterns to enable the service to be available 24/7, with the likelihood of working equal night to day working. Work independently, managing own workload, taking referrals and providing advice to medical, nursing and allied health professionals (AHPs).
- Provide specialist advice and undertake complex assessment of acutely unwell patients. Undertake and interpret appropriate diagnostic tests, initiate simple measures and deliver a supportive critical care nursing plan to optimise the patient, involving the MDT in discussions relating to the management and identifying risks versus benefit
- Safely and efficiently assess patients condition and treatment requirements utilising the National Early Warning Scoring (NEWS 2) assessment. Use clinical expertise in diagnosis and planning of care requirements and administer appropriate treatments, as required following approved Patient Group Directives (e.g. oxygen therapy, intravenous fluids).
- Manage, and provide enhanced supervision to support the nursing care of patients with haemodynamic instability and other appropriate respiratory and vital organ support, such as ventilated patients that are unable to be admitted to critical care.
- Demonstrate clinical competence and confidence in combination with critical thinking, problem solving and decision making skills in a variety of clinical settings.
- Assist with, or perform, emergency and resuscitative procedures associated with critically ill patients. Attend crash calls as an ILS provider and provide support to staff when managing clinical emergencies.
- Expedite, where necessary, the transfer of critically unwell patients to critical care and support ongoing care of patients discharged from critical care. Ensuring timely transfers in line with national policies.
- Support the psychological and physiological recovery of patients within the ward environment following an extended period of critical illness.
- Organise and participate in the critical care follow up clinic
- Provide professional leadership and clinical expertise across all wards and departments, providing specialist advice and developing practice in line with scope of practice and Trust policies and guidelines. Act as a role model to nursing staff and all members of the multi-disciplinary team.
- Maintain concise, precise written records about clinical work undertaken.
- Work proactively as part of the wider MDT, ensuring prompt referrals to promote seamless patient care delivery.
- Use available equipment within scope of practice and be able to train others in its use e.g. invasive pressure monitoring; intravenous infusion devices; near patient testing; respiratory support systems.
- Undertake regular clinical shifts on ICU to maintain critical care (level 2 & 3) skills and relationships with the critical care team.
- Sensitively care for dying patients and their families. Facilitate and participate in end of life discussions.
Education
- Maintain, update and promote evidence-based knowledge and skills
- Ensure mandatory training is up to date
- Undertake and complete relevant competencies relating to the role
- Assist in promoting and maintaining an effective learning environment for staff, acting as a facilitator in the supervision and teaching of staff.
- Provide a positive learning environment in response to audit and use educational strategies to motivate and retain staff.
- Establish links with educational providers to maximise learning opportunities / needs that have been identified.
Leadership and managerial responsibilities
- Participate in the setting and monitoring of standards in the service, which utilises research based evidence, and is audited and improved accordingly
- Contribute to relevant audits to enable service development, establishing clear performance goals, with regular monitoring and feedback.
- Collect and electronically input data used for analysis and presentation of Critical Care Outreach service data, presenting service outcomes to MDT groups as requested
- Participate actively in relevant meetings at local, regional and national level
- Participate in the renewal, development of protocols and policies within the speciality / role.
- Have involvement with development of the service within the Trust
- Represent the service at local, regional and national forums.
Professional responsibilities
- Adhere to the NMC Code of Conduct and associated guidelines and maintain professional registration
- Act as the patients advocate where appropriate.
- Act as a role model at all times, upholding Trust values and contributing to a culture within the hospital which recognises and works in partnership with patients and their carers.
- Uphold quality initiatives that improve patient experience and enhance the interface between staff, patients and visitors.
- Be responsible for own and whole Trusts requirement to reduce hospital acquired infection and cross infection through the implementation of good practice e.g. effective hand washing; using protective clothing appropriately; rigorously applying standard (universal) precautions to minimise the transmission of infection.
- Use correct moving and handling techniques and appropriate equipment when moving or handling patients, stock and equipment which may be soiled or infected. The post-holder is responsible for taking reasonable care with regard to him/ her as well as for any colleagues, patients or visitors who might be affected by any act or failure to act by the post-holder in accordance with the Trusts policies on Health and Safety at Work.
- Report any accident, untoward incident or loss relating to staff, patients or visitors according to Trust policies
- Undertake in-service training relevant to the post.
- Comply with Trust Policies and Procedures.
Person Specification
Experience
Essential
- Significant post registration experience caring for acutely unwell patients in an enhanced care setting inclusive of ED, L1 surgical and medical environments and within Critical Care.
- Experience in undertaking assessments of patients using a recognised systematic approach
Desirable
- Critical Care level 2 and level 3 experience
- Completion of enhanced care (level 1) competencies or Steps 1/2/3 CC3N competencies
- Audit experience
- Implementation of change and evaluations
Knowledge and Awareness
Essential
- Extensive clinical knowledge in the care and management of acutely unwell adults
- Awareness of current NHS challenges including within Critical Care & Critical Care Outreach
- Awareness of external Critical Care Networks
- Knowledge of the wider hospital network
- Awareness of change management
- Knowledge of the local deteriorating patient agenda
- Knowledge of national and local NHS agendas
Desirable
- Demonstrates experience of taking charge and delegating duties
- Experience of leading change
Skills and Abilities
Essential
- Demonstrates ability to work within a small team and importance of team dynamics
- Able to prioritise own workload and that of others as appropriate
- Able to work under own initiative within boundaries of role
- Able to take charge of urgent situations and delegate duties effectively
- Recognition and management of the deteriorating adult patient
- Works well under pressure
- Enhanced problem solving and decision making skills
- Excellent written and verbal communication skills
- Effective time management skills
- Able to teach and develop others
- Supervisory skills and experience
- IT skills
Desirable
- Experience in management of invasive and non-invasive ventilation / nasal high flow / CPAP
- Involvement in clinical audit
- Venepuncture
- Cannulation
- Non-medical prescribing
- Competencies relevant to acute care environment
Qualifications
Essential
- Registered Nurse with current registration
- Teaching and assessing qualification
- Evidence of professional development in relevant acute / critical care area
Desirable
- Appropriate post registration module or working towards
- ILS/ALS certificate
- Educated to degree level or working towards
- Masters qualifications
Person Specification
Experience
Essential
- Significant post registration experience caring for acutely unwell patients in an enhanced care setting inclusive of ED, L1 surgical and medical environments and within Critical Care.
- Experience in undertaking assessments of patients using a recognised systematic approach
Desirable
- Critical Care level 2 and level 3 experience
- Completion of enhanced care (level 1) competencies or Steps 1/2/3 CC3N competencies
- Audit experience
- Implementation of change and evaluations
Knowledge and Awareness
Essential
- Extensive clinical knowledge in the care and management of acutely unwell adults
- Awareness of current NHS challenges including within Critical Care & Critical Care Outreach
- Awareness of external Critical Care Networks
- Knowledge of the wider hospital network
- Awareness of change management
- Knowledge of the local deteriorating patient agenda
- Knowledge of national and local NHS agendas
Desirable
- Demonstrates experience of taking charge and delegating duties
- Experience of leading change
Skills and Abilities
Essential
- Demonstrates ability to work within a small team and importance of team dynamics
- Able to prioritise own workload and that of others as appropriate
- Able to work under own initiative within boundaries of role
- Able to take charge of urgent situations and delegate duties effectively
- Recognition and management of the deteriorating adult patient
- Works well under pressure
- Enhanced problem solving and decision making skills
- Excellent written and verbal communication skills
- Effective time management skills
- Able to teach and develop others
- Supervisory skills and experience
- IT skills
Desirable
- Experience in management of invasive and non-invasive ventilation / nasal high flow / CPAP
- Involvement in clinical audit
- Venepuncture
- Cannulation
- Non-medical prescribing
- Competencies relevant to acute care environment
Qualifications
Essential
- Registered Nurse with current registration
- Teaching and assessing qualification
- Evidence of professional development in relevant acute / critical care area
Desirable
- Appropriate post registration module or working towards
- ILS/ALS certificate
- Educated to degree level or working towards
- Masters qualifications
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.
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).
Additional information
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.
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).
