Responsibility for People Management
To support and participate in the induction and supervision of new staff and other team members. Be responsible for providing and maintaining a learning environment and maximise opportunities for educational and development in the clinical area to enhance individual development and performance in the delivery of high standards. Acting as a specialist cardiac resource and assist in teaching knowledge and clinical skills for other health care professionals. Providing advice, support and completing caseload reviews for the development of specialist knowledge of other team members.
Support and Advice
Support and give advice on the management of cardiac patients to the exercise specialists within the cardiac team and support and supervise the work of exercise instructors employed by the leisure industry within the phase 3 exercise program for the heart failure and cardiac rehab patients. To manage and prioritise a specialist caseload and delegate where appropriate to the skill mix of the team. Take individual responsibility for your personal and professional development, maintain competencies, knowledge and skills commensurate with the role and NMC code. Provide and maintain a learning environment and maximise opportunities for education and development in the clinical area to support and enhance individual development and performance in the delivery of high standards of care.
Role Model and Mentorship
Act as a role model for other staff and students demonstrating high standards of specialist practice and professional conduct according to the NMC code. To act as a mentor for nursing and medical students and fulfil requirements of a practice placement.
Responsibility for Financial and Physical Resources
Responsible for identifying when stock is low and making requests for ordering. Identifying when equipment is not fit for use or new equipment is required.
Responsibility for Administration
Ensure effective and timely information exchange is maintained, verbally, written or electronically. To be responsible for maintaining accurate and comprehensive patient records in line with the nursing and midwifery Council and Livewell data protection guidelines.
Responsibility for People Who Use Our Services
Work as a lone practitioner with the support from senior colleagues and MDT as required within the community setting.
Comprehensive Specialist Assessment
To undertake the comprehensive specialist assessment of cardiac patients, including those with a complex presentation, using investigative and analytical skills, and to formulate individualised management and treatment plans, using clinical reasoning, and utilising a wide range of treatment skills and options to formulate a specialised programme of care and patient goals. Work within the framework of patient group directives for the administration of emergency drugs. Working within professional guidelines (local and national) to make specialist nurse clinical decisions without direct supervision. Seeking advice as necessary from the patients GP, consultant, GPSI in using evidence-based research or peer support from another trust.
Patient Education and Advocacy
To provide spontaneous and planned advice, teaching and instruction to patients, relatives, carers and other professionals, to promote understanding of their cardiac condition, drugs, self-management and the aims of rehabilitation, to ensure a consistent and individualised approach to patient care. Support in reducing unnecessary hospital admissions and enable the patient to be managed in the community by making clinical decisions with the supervision and support from the MDT as part of the patient management plan which may involve optimising and de-prescribing of cardiac specialist drugs.
Clinical Support and Guidance
To provide specialist clinical assessment, support and tailored education to patients, and their carers, to enable them to make informed decisions about their treatment, management and self-monitoring of their condition, that may precipitate symptoms of acute exacerbation of their underlying conditions or illness and how to manage them and when to ask for help. Evaluate the impact of education programmes and clinical interventions, for patients and carers, to ensure that they provide the necessary knowledge and skills to gain independence, safely manage changing circumstances and plan for unavoidable progression of conditions with the aim of optimising their quality/quantity of life. Act as a patient advocate as required ensuring individual needs, preferences and choices are delivered by the Service.
Clinical Issues and Emergency Situations
Deal effectively with arising clinical issues and emergency situations. Ability to perform and interpret 12 lead ECG and act accordingly with the support from the MDT and senior colleagues. To request and interpret blood results and start /adjust /stop medications as required with the support from MDT and senior colleagues by liaising with the patients GP or consultant as appropriate. Providing clinical support and guidance to the exercise physiotherapist / physiologist within the BACPR guidelines ensuring the appropriate referral and assessment of patients to the phase 3 cardiac rehab programme.
Weekly Exercise Group Attendance
To attend the exercise group on a weekly basis to provide clinical support to the rest of the team. To ensure that the patient is informed regarding cardiac medications including the benefits and potential side effects that the patient has been started on and working in partnership with the patient, GP, MDT and consultant in recommending the commencement and up-titration of cardiac medications, this also includes potentially down-titration and stopping medications according to patients clinical presentation.
Professional and Legal Accountability
To be professionally and legally accountable for all aspects of your work including management of patient care within NMC guidelines. To discuss advanced care planning as appropriate with the patient and their carers, which may include a discussion on EOL planning and to discuss with the GP regarding the writing of the TEP form. As part of your role there is an opportunity to undertake training to complete a Treatment Escalation Plan (TEP) document, to achieve this you will be required to complete training in advanced communication, care planning and TEP form writing. Liaise closely with community teams and acute cardiology team to ensure palliative care needs are addressed utilising existing services following local and national guidelines.
Knowledge of Guidelines
Work within Livewell guidelines and have a good working knowledge of national standards, such as the National service framework for CHD and guidelines by BACPR, NICE and ESC, QOS framework and CQC standards. Use a high level of empathy, sensitivity and communication skills daily with patients and their carers / family members. Establish the dynamic process of understanding, reflecting, active listening and checking understanding, thus developing a therapeutic relationship with patients and carers.
Patient Advocacy
To act as the advocate for patients and their carers liaising at a local level using specialist knowledge and communication skills with other allied health professionals and the MDT. Demonstrate excellent communication skills required to enable case discussions in case discussions/case conferences concerning service users in their caseload.
Specialist Information Exchange
Provide and receive specialist, complex, sensitive or contentious information where motivational, 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 have barriers to understanding eg. Language, learning difficulties, sensory loss. Able to provide the interface between hospital, primary, community and social care settings.
Case Manager Responsibility
Maintain case manager responsibility in liaising with inpatient teams to facilitate discharge to community (inreach HF team, AAU, arrhythmia team).
Policy Implementation and Service Development
Responsibility for implementation of policy and/or service developments. Support clinical governance including satisfaction questionnaire, patient notes audit, clinical audits as deemed necessary. Propose recommendations to changes within clinical practice and community cardiac rehabilitation and heart failure. Alongside team manager, assist in the development and updating of standards and protocols for community cardiac rehabilitation and heart failure service in line with national guidelines. Act as an expert specialist resource to advise and assist in teaching knowledge and clinical skills for other health care professionals.
Other Responsibilities
Support the team manager in the planning, development and day-to-day running of the community cardiac rehabilitation and heart failure service in their locality. Take responsibility for your own personal and professional development; maintain competence, knowledge and skills commensurate with role using the heart failure and cardiac rehab competencies. Take part in the process of clinical supervision and support clinical supervision for team members. To develop, plan, implement and evaluate educational programmes for service users.
Training and Development
To undertake all required training to develop competencies required for the role. Integrate theory into practice by bringing new knowledge around Cardiac Nursing into the practice environment. Maintain attendance at mandatory and statutory training as per organisation guidelines. Work within the NMC Code. Remain updated and ensure that clinical practice is evidence-based.
Personal Development Plan
Have a personal development plan and professional portfolio. Please see the job description for further details.
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