Duties and Responsibilities To undertake the delivery of evidence based nursing care as delegated by the Advanced Nurse Practitioners and Senior team in CRT. To undertake skilled clinical nursing procedures and provide clinical advice. To provide nursing care and support for patients with complex and continuing health care needs. To plan, implement, evaluate and re-assess packages of care. To assess, plan, implement and evaluate programmes of care. To inform the Senior clinical team of changes in the patients condition. To ensure appropriate delivery of care via referrals to other agencies. To identify and access sources of expert, professional knowledge to positively influence patient care. To support the ANPs and senior team in ensuring that the CRT works collaboratively and co-operatively with clinical colleagues. To participate in research and audit activity as a requirement of practice Key results from the job holder To work without direct supervision, delivering skilled nursing care to patients within the community. To assess, plan, implement and evaluate programmes of care according to assessment criteria. To support CRT in creating an environment conducive to learning and act as a coach, mentor and assessor to all learners and as a health educator to the wider community in opportunistic and planned situations. Planning and Organisational Duties To maintain own development and clinical competencies via on-going Continuing Professional Development (CPD) linked to the Knowledge and Skills Framework (KSF). To maintain a personal, professional portfolio by collecting evidence of personal development through reflective practice. To attend mandatory training in accordance with Trust policies. To work within Nursing and Midwifery Council (NMC) guidelines and abide by the NMC Code of Professional Conduct To adhere to Trust Policies and Procedures, NICE Guidelines and NSF initiatives. To comply with Health and Safety Policies. To ensure prompt recording and reporting of accidents/incidents. To maintain accurate, comprehensive and up-to-date documentation in line with the NMC Guidelines for Records and Record-keeping. To share best practice and undertake all activity within the framework of Clinical Governance.To participate in the staff appraisal scheme. To report sickness and absence in accordance with Trust Policy. To provide clinical information to Senior Nurses to inform the Strategic Development Plan.To bring professional practice issues to the attention of the Community Matron and Clinical Facilitator. To advise on changes required to policy/procedure due to changes in practice and be actively involved in any working parties, as requested. To develop partnerships via pro-actively networking with other professionals and agencies to enhance service delivery. To accept responsibility for own professional practice as a reflective, accountable practitioner. Communications and Key Working Relationships To provide and receive sensitive or contentious information. To use effective interpersonal skills when communicating with patients, in particular when the atmosphere is hostile, antagonistic or highly emotive. To interpret verbal and written information, from a variety of sources. To communicate with members of the Primary Health Care Team and multi-agencies to provide quality holistic care to meet patient need. To facilitate communication within the organisation by accessing own emails in a timely manner. Responsibility for Health & Safety Compliance with the Health & Safety at Work Act 1974 the post holder is required to fulfil a proactive role towards the management of risk in all of their actions. This entails the risk assessment of all situations, the taking of appropriate actions and reporting of all incidents, near misses and hazards, and a statutory duty of care for their own personal safety and that of others who may be affected by their acts or omissions. Responsibility for Teaching (A learner can be defined as the patient, relative, carer, student nurse, qualified nurse, home care or any individual or group who can demonstrate a change of behaviour following learning). To act as a mentor, coach, assessor and health educator both formally and informally to all learners. To facilitate effective learning within community practice and nurture reflective practice. To support the ANPs and senior clinical team in creating an environment for continuing professional development to facilitate learning and to ensure fitness to practice. To identify the needs of the learner in terms of their individual learning requirements and set aims and objectives with the learner to ensure that their needs are met. To attend mentor updates annually, if applicable. To develop teaching packs, as required, to disseminate evidence-based information to patients, carers, nurses and multi-agency professionals. To deliver in-service training, as required, via various teaching methods. To acknowledge the public health role and actively seek out opportunities for improvement and protection of the health and well-being of the wider community.