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. You will provide 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 is intended to provide improved outcomes for patients by improving 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 be expected to work at an advanced level within your level of competence and to work 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 they are 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. Emphasis is placed on patients that are 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. The post holder will work autonomously and will be experienced in identifying suitable patients and managing their ongoing care in line with SDEC/ambulatory care principles.
* 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 to the unit for review following procedures to prevent admission. Specialities include General Surgery, Urology, Orthopaedics, Ophthalmology, Gynaecology, ENT, and Max Fax. It is a fast-paced environment where each and every member of the MDT supports each other and is valued.
The team consists of an ADNPP, Consultants, Matron, Senior Sister, Unit Coordinators, Nurses, and Health care support workers.
Job description
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. The ACP will communicate highly sensitive and contentious information supporting patients and their carers to make informed decisions about their care and treatment.
* Provide highly specialist advice to GPs and primary health care teams, especially in situations where there are conflicting views or opinions on the best course of action or care.
* Support patients, carers, and family members to ensure that advice and information is accessible to them and to 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, giving full regard to patient confidentiality.
* 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, working with terminally ill patients and patients undergoing transplant assessment.
* Coordinate care for patients and relatives by communicating closely with different care centres to ensure smooth transitions 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 also key external partners, using high-level negotiating and influencing skills to develop and improve practice.
* Generate and implement new solutions that will 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 preparation for 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 judgements 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, consulting and seeking advice from 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 within the scope of this job description.
* 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, via the ordering/undertaking and interpretation of diagnostic tests.
* Assess patients as an expert clinician and facilitate stepped-up care provision where required.
* Provide direct care to patients including using practical nursing skills and procedures, whilst maintaining privacy and dignity.
* 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.
* Have competence in the clinical skills required for the role e.g. prescribing, interpretation of blood results.
* Facilitate discharge planning including effective communication with primary care teams and out-of-hours services.
* Be competent at undertaking clinical procedures relevant to the role and be responsible for developing competency frameworks and training.
* Exhibit highly developed physical skills with a great degree of accuracy and precision.
Policy and service responsibility
* Proactively lead strategic developments and other activities that monitor and improve the quality of healthcare.
* Improve clinical practice within the general Surgery services areas.
* Propose policy or service changes, including those that impact beyond your own area.
* Stay informed about developments in practice at a national and international level and implement changes that reflect benchmarked best practice.
* Engage in appropriate audit programmes within the service at both individual and systems levels.
* 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 practice improvements.
* Promote a culture of excellence and support the senior leadership team in delivering responsive care.
Responsibility for finance, equipment and other resources
* Ensure systems are in place for teams to maximise use of clinical capacity.
* Act as an authorised signatory/designated budget holder for the urology unit and specialist nurses services.
* Assist in formulating business cases to ensure adequate equipment and staffing.
* Collaborate in redesigning services to meet service user needs.
* Maintain personal duty of care regarding equipment and resources.
* Be aware of cost implications and NICE guidance when prescribing.
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 evidence-based protocols and clinical 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 their prescribing confidence and skills development.
* Support staff in providing care appropriate to patient needs.
Information technology and administrative duties
* Maintain clinical records in line with Trust policy and NMC standards.
* Implement communication systems ensuring clinical teams have access to specialist advice.
* Provide timely and accurate information to teams and coach them to use it effectively.
Person Specification
criteria
Essential
* First level Registered Nurse
* Education at Masters Level (Advanced Practice or equivalent)
* Non-medical independent prescriber
Desirable
* Leadership course/Qualification
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