Practice Nurse

Job responsibilities

Job Summary

The post holder is responsible for the delivery of practice nursing services care to the practice population. Supported by senior nurses within the practice, they will deliver care within the boundaries of their role, focusing upon supporting patients to be healthy, monitoring of long term conditions, health prevention and screening activities. They will work collaboratively with the primary healthcare team to meet the needs of patients and support the delivery of policy and procedures.

Main Duties and Responsibilities

Clinical Practice Development

Monitor and maintain the consistency of professional standards set;

Actively promote accurate record keeping in accordance with the Guidelines for Records and Record Keeping (NMC 2009);

Work within the team towards achieving common objectives;

Support practice development plans;

Support other members of the team;

Participate in educational activities within the practice, eg sharing knowledge in the form of teaching sessions for colleagues, student nurses or medical students;

Attend practice nurse meetings and practice meetings as requested;

Be aware of current evidence based approaches to patient care and demonstrate this in practice;

Co-operate with and contribute to practice research projects/audits;

Maintain continuous professional development in line with PREP and practice objectives (ie, by attending courses/study days as required and by self-directed learning);

Attendance at practice meetings/training sessions;

Liaise with external agencies and other health care professionals;

Promote practice services;

Participate in practice appraisal scheme and clinical supervision.

Clinical Nursing Practice

Wound Management

Devise and follow appropriate wound management plans for individuals;

Perform wound care using aseptic technique;

Suture and clip removal.

Refer to ulcer clinic (If required)

Screening/Diagnostic Tests (if trained in the skills required)

Undertake routine and opportunistic screening BP checks, height, weight, BMI, urinalysis, smoking status;

Undertake venepuncture;

Peak flow measurements/spirometry;

Standard and 24 hour ECG monitoring;

24 hour BP monitoring;

Doppler assessment.

Health Promotion

Recognise patients readiness to change in supporting their attempts to change unhealthy behaviour;

Provide healthy eating advice to individuals

Provide smoking cessation advice individually in opportunistic consultations and refer to Smoking Cessation Advisor as appropriate;

Provide individual advice to patients about increasing activity or exercise;

Offer advice on recommended safe limits for alcohol consumption and safe drinking practice;

Contribute towards the maintenance of health promotion material within the practice and waiting room notice boards;

Refer as appropriate.

Vaccinations and Immunisations

Administer medications and vaccinations under an individualised prescription or Patient Group Direction and in accordance with the Standards for Medicines Management (NMC 2008);

After a period of training and supervision, deliver the national Childhood Vaccination Programme;

Ensure safe storage, rotation and disposal of vaccines and drugs.

Ear Care

Provide a safe, evidence based service for patients requiring ear irrigation;

Advise patients about safe ear care.

Minor Surgery

To assist clinicians undertaking minor surgical procedures.

Infection Control

Support patients and colleagues in adopting sound infection control measures;

Apply infection control measures within the practice according to national and local guidelines. This includes:

o Universal hygiene precautions;

o The collection and handling of laboratory specimens;

o Segregation and disposal of waste materials;

o Use of single-use instruments for all procedures;

o Reporting and treatment of sharps injuries in accordance with the Practice Needlestick injury policy;

o Dealing with blood and body fluid spillage;

o Educate colleagues in adopting sound infection control measures.

Emergency Management

Maintain competency in basic anaphylaxis and resuscitation techniques;

Attend two yearly update re managing anaphylaxis;

Attend regular resuscitation training sessions (at least annually).

Child Health/Child Protection

Recognise the signs, symptoms and categories of child abuse;

Understand the importance of recognition, observation, documentation and communication;

Awareness of child health procedures, statutory local procedures and points of referral;

Knowledge of other practitioners and agencies roles;

Understand basic legal issues around child abuse.

Mental Health

Recognise and have awareness of appropriate referral mechanisms for family violence, vulnerable adults, substance abuse and addictive behaviours;

Recognise psychological needs of patient presenting with depression or suicidal tendency.

Mens Health

Initiate opportunistic consultations with patients to cover issues of mens health;

Raise awareness and give basic advice on issues covering:

o Testicular self examination;

o Incontinence and prostatic disease;

o Family planning;

o Sexual health;

Participate in screening programmes as appropriate;

Make appropriate referrals.

Contraception and Sexual Health Advice

All nurses should have a basic understanding of contraception and sexual health advice. If further training has been undertaken, the following will apply:

Advise patients on available methods of contraception and refer patients as appropriate;

Support patients attending for emergency contraception and refer as appropriate;

Perform interval checks for patients using hormonal contraception;

Teach patients correct condom use;

Offer health promotion/lifestyle advice to patients on reducing risk of sexually transmitted infection and refer as appropriate in line with practice policy;

Undertake appropriate diagnostic and/or screening tests for sexual infection as clinically indicated following a period of training and supervision.

Womens Health

All nurses should have a basic understanding of womens health. If further training has been undertaken, the following will apply:

Advise patients on national and local cervical cytology and mammography screening programmes, along with the HPV vaccination campaign;

Undertake routine and opportunistic cervical cytology sampling in accordance with the NHS Cervical Screening Programme following a period of accredited training and supervision;

Audit a minimum of twenty consecutive smears each year to demonstrate an adequate sampling rate (benchmark for inadequate smears currently 4%);

Promote breast self-awareness, demonstrate breast self examination and provide supporting literature;

Diabetes

All nurses should have a basic understanding of diabetes and the health implications associated with the disease. If further training has been undertaken, the following will apply:

Initiate the process of diagnosis for patients with suspected diabetes and refer to GP as appropriate;

Assist in the management of patients with newly diagnosed diabetes following practice guidelines, protocols and policies;

Support patients in the management of their diabetes (type I and type II);

Undertake opportunistic screening for the diagnosis of diabetes;

Support and provide education for patients with diabetes;

Provide emergency treatment for hypo/hyperglycaemic emergencies;

Make appropriate referrals (dietician, chiropodist etc);

Respiratory Disease Management

All nurses should have a basic understanding of asthma care, its diagnosis, asthma treatments and the principles of self management. If further training has been undertaken, the following will apply:

Contribute to the care of patients with asthma and COPD;

Work within agreed local/BTS guidelines and patient group directions to manage patients with asthma, aiding diagnosis, reviewing inhaler technique and advising on treatment changes;

Manage emergency treatment of asthma attacks;

Teach and advise patients how to use various inhalers and peak flow meters;

Advise patients on their asthma control including the use of self-management plans;

Contribute to the maintenance of the practice respiratory register;

Aware of factors which contribute to development of COPD;

Make appropriate referrals.

Management of Coronary Heart Disease

All nurses should have an understanding of CHD.

Contribute to the care of patients with CHD;

Work within agreed protocols when managing risk factors to enable patients to manage their own disease;

Provide psychological support by discussing interventions and treatments;

Work with patients to set action plans for changes of lifestyle;

Advise patients on lifestyle management and drug compliance for reducing the CHD risk factors, eg:

o Hypertension

o Angina

o Myocardial infarction

o Cerebrovascular accident

Quality and Outcomes Framework and Enhanced Services

To fully participate in the practices achievement in the Quality and Outcomes Framework, utilising Population Manager in all consultations;

To assist in the provision of enhanced services that the practice has commissioned from NHS England or Somerset CCG.

General

To advise patients on general health care and treatment of minor ailments, both face to face and on the telephone;

To undertake care and maintenance of clinical equipment, as required;

To undertake stock control and ordering of Treatment Room supplies and equipment, as required;

To be flexible to provide illness/annual leave cover for other members of the nursing team;

To undertake any other Treatment Room duties not specified above.

Knowledge and Skills

Essential

• Excellent interpersonal skills verbal and written
• Ability to use initiative, work alone and within a team
• Good time management and ability to prioritise workload
• Able to work under pressure
• Flexibility, adaptable to the changing needs within the practice and ability to provide cover for other members of the nursing team
• Ability to demonstrate at least basic clinical skills
• Change management skills and ability to support patients to change lifestyle

Desirable

• Ability to evaluate the safety and effectiveness of own clinical practice
• Knowledge of health promotion strategies
• Awareness of clinical governance issues in primary care
• Knowledge of patient group directions and associated policy
• Experience of teaching and mentorship in a clinical setting
• Information Management and knowledge of clinical system (EMIS Web)
• An appreciation of the GMS (General Medical Services) contract and its application to practice

Experience

Essential

• Two years post registration experience

Desirable

• One year recent Practice Nurse experience
• Management of long term conditions
• Involvement in implementing and using protocols and clinical guidelines.
• Experience of audit

Qualifications

Essential

• Registered (first level) Nurse
• Membership of a professional body eg RCN

Desirable

• Evidence of specific/continued training and development up to Diploma level (Level 2) relevant to Practice Nursing, particularly in asthma and COPD
• Family Planning and Cervical Cytology qualifications

Qualities and Attributes

Essential

• Self directed
• Highly motivated
• Dedicated
• Flexible
• Enthusiastic
• Team worker
• Sense of humour

Disclosure and Barring Service Check

This post is subject to the Rehabilitation of Offenders Act (Exceptions Order) 1975 and as such it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service (formerly known as CRB) to check for any previous criminal convictions.

UK Registration

Applicants must have current UK professional registration. For further information please see NHS Careers website (opens in a new window).