DUTIES AND RESPONSIBILITIES CLINICAL AREAS To provide care for patients receiving maintenance haemodialysis as out-patients. To maintain competence in:- 2.1. Operating the dialysis machines. 2.2. Cannulation of fistulas and grafts. 2.3. Care of central venous dialysis catheters 2.4. Operation of infusion devices. To accept responsibility and be accountable for the total patient care for a named group of haemodialysis patients, monitoring health status and blood results. To adjust prescribed care in conjunction with the team leader. To develop and maintain a high level of clinical knowledge in order to assess patients who become or present unwell, in the absence of medical cover on site. To be able, on occasions, to take appropriate action in referring patients when necessary to the GP, the Oxford Kidney Unit or Wycombe Hospital medical staff. To assist in the care of patients on Peritoneal Dialysis, (PD) in the unit and at home. To learn the basic PD procedures. To take all measures to ensure the safety of the patient, relatives and other staff members, reporting all accidents and incidents and completing the relevant documentation. To help and support patients who find it difficult to adhere to their treatment regime. To liaise with members of the multidisciplinary team, in the hospital and the community, on behalf of the patient. To negotiate responsibility for different aspects of the patients care in the absence of senior nursing staff. To ensure that agreed nursing policies are implemented. To communicate effectively with the patients and their relatives both face to face and by phone. To care for the needs of patients attending renal outpatient clinics, including venepuncture, dressings, drug administration and advice where indicated. To develop and maintain a high level of knowledge of infection control issues, practising within the policies and guidelines recommended by the Trust and Unit, thus ensuring the safety of patients and staff at all times. PROFESSIONAL RESPONSIBILITIES To assist in maintaining and enhancing the safety of the Clinical area with particular emphasis on its environment, equipment and ward and unit practices, ensuring that all policies are adhered to. To practice research based nursing care, maintaining professional development by contributing to development programmes and by reading and discussing as appropriate nursing journals and research papers. To participate in a project or take on a link role within the clinical area to enhance the development of nursing practice. To maintain a professional attitude and observe the NMC Code of Conduct at all times. MANAGERIAL / ORGANISATIONAL To regularly coordinate the clinical area on a day to day basis sometimes in the absence of a more senior nursing staff member on site. To organise ward activity and communications with the Oxford Kidney Unit, Wycombe Hospital and the community. To be able to make appropriate decisions regarding problems with patients or staff and know when to refer to senior management at Oxford. Assess, prioritise and allocate workload to maintain safety at all times. To maintain accurate records of care reflecting the process of the nursing care delivered, both on paper and electronically. To abide by the Data Protection Act at all times. To be responsible for the care, control and proper administration of drugs as required by the NMC and by the Oxford University Hospitals NHS Trust. To have a broad knowledge of all Trust policies and procedures with regard to Health and Safety including manual handling policies; infection control; fire; incident reporting; care of patients property; resuscitation; transport; admission and discharge of patients; security and complaints procedure. To participate in annual updates for resuscitation, fire, health and safety, manual handling and control of infection. To be aware of and monitor the safe and economic use of all supplies and equipment and to practise effective use of resources. To be willing to cover for sickness and holiday periods when needed, providing flexibility in the clinical environment. To organise cover for sick leave in the absence of senior staff as far as possible. Facilitate communication with community nurses, GPs and ward nurses in the host hospital. To be prepared to learn new skills and implement change. EDUCATION AND TRAINING To assist in the education and development of staff in clinical skills, unit policies and management. To assist and teach patients and their families to learn the skills to become independent with renal failure at home. To develop and maintain IT skills in order to carry out patient care. To help provide a conducive learning environment by: Being involved in an active teaching programme. Use of planned teaching sessions. Use of teaching in the clinical areas. Being a mentor for more junior staff and students. Actively seeking further education by reading journals and attendance at study days.