Community Registered Nurse

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.

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