RESPONSIBILITIES / ACCOUNTABILITIES:
Working with the Clinical Nurse Specialists to support and maintain a clinically managed network of multidisciplinary professionals, enhancing the care of people with Heart Failure at local level and promoting evidence-based practice to ensure efficient and effective use of expert resources. Work closely with all members of the multi-disciplinary team across primary, community, secondary, social care, hospices, voluntary and wellbeing sector to promote the development of a seamless service ensuring good communication at all times. Be responsible for the assessment, planning, implementation, and evaluation of individualised nursing care to patients living in the community, always maintaining patient privacy and dignity. The service is provided five days per week.
Deliver care in health centres, GP surgeries and community venues as required. Use a range of verbal and non-verbal communication tools to communicate effectively with patients and carers, ensuring an understanding of their condition so that patients are supported in the short- and long-term self-management of their condition, including gaining consent and discharge plans. Undertake clinical procedures within own scope of competency, utilising a variety of clinical instruments and equipment safely and precisely. Initiate, facilitate and participate in appropriate health enhancing activities to meet the needs of patients, promoting self-care.
Communicate with a range of people in a form that is appropriate to them and the situation, including the exchange of factual information with patients and carers, using persuasion and reassurance, effectively managing any barriers, dealing professionally, sensitively and in a non-judgemental manner whilst respecting patients' dignity, wishes and beliefs and obtaining their consent for specific activities. Participate in managing and coordinating the work of junior staff, offering support and development as appropriate. Contribute to the recruitment and selection of staff for the team and participate in induction and orientation programmes as appropriate. Participate in the onboarding and monitoring of patients receiving remote monitoring for their heart failure.
Strategic Management: Be aware of and participate in risk assessment for the benefit of self, colleagues and clients, in line with the Risk Management Policy and Health and Safety at Work Act 1974, particularly in relation to the Lone Worker Policy.
Service Development and Improvement: Maintain current registration in line with HCT Policy and follow the code of conduct of the Nursing and Midwifery Council. Attend regularly and participate actively in Clinical Supervision in line with HCT Policy, sharing the facilitation role as agreed, following appropriate training. Ensure the Policies of the Trust are implemented and adhered to at all times. Be prepared in the HCT Emergency Plan in response to a major incident. Participate in multi-agency working in relation to patient care.
Management and Leadership: Contribute to the recruitment and selection of staff for the team and participate in induction and orientation programmes as appropriate. Take responsibility for own continuous professional development, maintaining a sound level of professional knowledge and competence in line with the Personal Development Plan agreed at annual appraisal. Ensure attendance at all required (mandatory) training. Take all reasonable steps to ensure that advice and treatment given is up to date and evidence-based, bringing new ideas/evidence-based practice to the team for discussion.
Participate in managing and coordinating the work of junior staff, offering support and development as appropriate. Undertake appropriate (as agreed with the service lead) heart failure educational courses and where appropriate undertake and practice in non-medical prescribing as appropriate. Participate in the experience of pre-registered students in placement, mentoring pre-registered students and junior staff as required. Develop specialist skills and knowledge by participation in group work, committees and workshops, including Link Nurse/Facilitator roles. Maintain confidentiality and manage information sensitively. Demonstrate discretion and respect when communicating with patients, colleagues and other agencies.
Communicate effectively with all members of the MDT, supporting and promoting teamwork generally. Maintain close liaison within a multi-disciplinary Primary Health Care team and all other agencies as necessary.
Finance and Resource Management: Be aware of Health and Safety at all times, ensuring that equipment is well maintained in a safe and hygienic way. Be aware of and utilise appropriate resources in the provision of total patient care.
Information Management: Maintain a high standard of both manual and computerised documentation within agreed guidelines, ensuring a clear understanding of the related HCT Policy.
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