Advanced Clinical Practitioner - Surgical Receiving Unit
Torbay and South Devon NHS Foundation Trust
As a clinical expert, you are required to have a high clinical profile ensuring the provision of effective and efficient care. You are expected to work as a highly skilled practitioner and to have expert knowledge, providing clinical expertise, leadership, and guidance within the designated service.
The primary focus of the role is to work as an advanced, autonomous practitioner providing patient-centred clinical care, encompassing the skills of assessment, examination, diagnosis, and treatment of patients. The post aims to improve outcomes for patients by enhancing timeliness and consistency of care, driving innovation through new models of care, and actively participating in research and development.
You will be expected to exercise a high degree of personal professional autonomy and make critical judgments to satisfy the expectations and demands of the role, within a defined framework. You will work at an advanced level within your competence and flexibly across all areas of the team. Key responsibilities include providing effective leadership by leading by example, empowering nurses/AHPs to improve care, and participating in strategic planning alongside the wider MDT, as well as undertaking research within the specialist area.
Consideration will be given to applicants who have not yet completed full ACP training if already on the pathway towards it.
Main Duties of the Job
* Offer a high level of Emergency General Surgery (EGS) expertise, providing individualised patient-centred care for EGS patients presenting to the Surgical Receiving Unit (SRU) in line with the Trust's values.
* Perform patient assessments, arrange/perform investigations as required, formulate and instigate management plans, and escalate to senior clinicians as appropriate, with particular emphasis on patients identified as potentially suitable for Same Day Emergency Care (SDEC).
* Investigate/monitor/review/treat appropriate patients in an ambulatory fashion on the same day or following days, avoiding unnecessary admissions. Engage with the assessment and management of non-ambulatory patients admitted to SRU as caseload allows.
* Perform simple procedures under local anaesthetic on SRU, including straightforward abscess drainage, within a structured pathway. In-post training and senior support/supervision will be provided depending on the post holder's experience and existing skillset.
About Us
The Surgical Receiving Unit (SRU) is a unit within Torbay Hospital that takes patients directly referred from GPs, patients from the Emergency Department, and patients referred directly from clinics. SRU also has a number of patients planned to return for review following procedures to prevent admission. Specialties include General Surgery, Urology, Orthopaedics, Ophthalmology, Gynaecology, ENT, and Max Fax. It is a fast-paced environment where each member of the MDT supports each other and is valued.
The team consists of an ADNPP, Consultants, Matron, Senior Sister, Unit Coordinators, Nurses, and Healthcare Support Workers.
Job Responsibilities
Communication and Working Relationships
* Communicate highly complex information on managing urological conditions, including risks and benefits, and provide details of alternative options where appropriate.
* Provide highly specialist advice to GPs and primary health care teams, especially in situations of conflicting views on the best course of action or care.
* Support patients, carers, and family members to ensure that advice and information is accessible and promote empowerment, informed choice, and self-management.
* Conduct family meetings with patients, families, and carers to facilitate open communication and forward planning of care options.
* Act as a clinical/professional practice leader, managing your own workload and working across professional, organisational, and system boundaries to improve services and develop practice.
* Participate in recruitment and selection processes where appropriate.
* Support patients and relatives through emotional and distressing circumstances, including working with terminally ill patients.
* Coordinate care for patients and relatives by communicating closely with different care centres to ensure a smooth transition of care.
Planning and Organisation
* Implement systems to identify the contribution and demonstration of the impact of advanced level nursing to the healthcare team and the wider health and social care sector.
* Provide support services to other nurses and professional groups on therapeutic interventions, practice, and service development.
* Demonstrate leadership in clinical situations which are unfamiliar, complex, and unpredictable.
* Plan and organise complex activities and programmes requiring formulation adjustment.
* Engage stakeholders both internal to the Trust and key external partners, using high-level negotiating and influencing skills.
* Generate and implement new solutions that best suit the needs of patients and carers.
* Act as a positive role model and provide highly specialist advice and consultancy for multidisciplinary colleagues.
* Review and monitor standards for best practice contributing towards performance evaluations.
* Provide clinical supervision to clinicians within the trust.
* Overcome barriers to understanding using negotiation and persuasion skills.
* Provide expert advice and information to other professionals and agencies to ensure appropriate referral to the service.
Analytical and Judgement
* Make critical judgments to inform clinical decision-making, recommendations, and prescription of treatment.
* Use highly complex reasoning skills to provide diagnosis, treatment options, and health promotion advice.
* Manage conflicting views and reconcile professional differences of opinion.
* Recognise and work within the limits of your own competency and consult the Consultant when appropriate.
* Participate in the medical review of patients as required.
* Challenge practice standards and influence constructive change.
Responsibility and Accountability
* Practice autonomously and self-direct your workload, defining your own boundaries of practice.
* Have advanced leadership skills to enhance the development of patient pathways to meet national standards and guidelines.
* Represent the Trust and ISU at local, regional, and national levels, presenting at meetings and conferences as required.
Responsibility for Patients and Client Care
* Carry out thorough holistic assessments of patients with specialist care needs.
* Assess patients as an expert clinician and facilitate stepped-up care provision where required.
* Provide direct care to patients, maintaining privacy and dignity and acting as a role model for other staff.
* Develop highly specialised programmes of care and provide highly specialised advice regarding care.
* Be familiar with and use a variety of diagnostic, symptom management, and patient outcome tools.
* Facilitate discharge planning, communicating with primary care teams and out-of-hours services.
* Be competent at undertaking clinical procedures relevant to the role and develop competency frameworks and training.
* Demonstrate highly developed physical skills with a great degree of accuracy and precision.
Policy and Service Responsibility
* Proactively lead strategic developments and activities that monitor and improve the quality of healthcare.
* Improve clinical practice within the general Surgery services areas.
* Propose policy or service changes that impact beyond your area.
* Stay informed of developments in practice at national and international levels and implement changes reflecting best practice.
* Engage in appropriate audit programmes within the service.
* Continually assess and monitor risk in your own and others' practice.
* Use evidence-based practice to underpin clinical guidelines and integrate research into clinical practice.
* Develop, implement, and evaluate strategies to advance knowledge and practice.
* Identify national issues, strategies, and policies that impact service provision and initiate improvements.
* Support the senior leadership team in delivering long-term plan priorities for responsive care.
* Support the senior leadership team in delivering services that meet the needs of the whole person.
Responsibility for Finance, Equipment, and Other Resources
* Ensure systems are in place for teams to maximise clinical capacity.
* Act as an authorised signatory/designated budget holder for urology unit and specialist nurses services.
* Assist in formulating business cases for adequate equipment and staffing.
* Collaborate in redesigning services to meet service user needs.
* Maintain a personal duty of care in relation to equipment and resources.
* Be aware of cost implications and NICE guidance when prescribing as a non-medical prescriber.
Responsibility for Supervision, Leadership, and Management
* Participate in academic and clinical supervision.
* Continue your own academic development.
* Promote a culture conducive to lifelong learning.
* Contribute to developing and implementing evidence-based protocols and guidelines.
* Work alongside the Planned Care nursing education lead to develop and deliver teaching packages.
* Evaluate the impact of training on practice and service provision.
* Develop Specialist Nurses in utilizing advanced clinical reasoning skills.
* Mentor Specialist nurses undertaking advanced practice modules.
* Support other Specialist nurses in developing skills and addressing ethical dilemmas.
* Lead staff to provide care appropriate to patient needs.
Information Technology and Administrative Duties
* Maintain clinical records in line with Trust policy and NMC standards.
* Implement systems ensuring clinical teams have access to specialist advice and information.
* Introduce systems to provide timely and accurate information to teams.
Person Specification
Criteria
* First level Registered Nurse
* Education at Masters Level (Advanced Practice or equivalent)
* Non-medical independent prescriber
* Leadership course/qualification
* Working towards Master's Degree
* Evidence of working autonomously as an Advanced Nurse Practitioner within the specialty
* Advanced assessment skills
Disclosure and Barring Service Check
This post is subject to the Rehabilitation of Offenders Act (Exceptions Order) 1975, necessitating a submission for Disclosure to the Disclosure and Barring Service to check for any previous criminal convictions.
Torbay and South Devon NHS Foundation Trust
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