Guy's and St Thomas' NHS Foundation Trust

Band 7 CNS in Critical Care Outreach Harefield Hospital

Information:

This job is now closed

Job summary

We are looking for a highly motivated individual who has excellent core values, a strong sense of team spirit and advanced assessment skills, therefore being able to deliver high quality patient centred care in this exciting area. This exciting opportunity will allow you to develop your skills and knowledge in critical care within our specialist environment. As a member of the Outreach team, the successful candidate will support and guide the management of patients with critical care needs outside of our ITU. He/she will also be involved with the coordinating of the satellite hemofiltration service. He/she will also be involved with organizing Outreach education programs and maintaining the clinical database. He/she will also play an active part in the development of a 24/7 Outreach Service.

We are seeking an enthusiastic and motivated Band 7 RGN, with evidence of advanced critical care skills. Applicants must also have successfully completed a relevant post-basic course as well as hold a teaching/assessing qualification. Applicants must have previous experience in a level 3 setting and proven clinical skills relevant to critical care.

Main duties of the job

The Outreach Clinical Nurse Specialist will work within the multidisciplinary Outreach team and deliver a high standard of patient care to the identified outreach patients. The aim of the Outreach team is to:

  1. to avert admissions to Level 3
  2. to facilitate discharge
  3. to share critical care skills
  4. provide a senior nursing presence out of hours ensuring clinical and managerial support 24/7

The post holder will assist with management requirements to ensure that both the quality of the service, and patient flows, are maintained. She/he will actively participate in Clinical Education programme and contribute to Research and audit projects

She/He will also provide delivery and management of direct patient care within the Adult Intensive Care Unit on a regular basis

All work will be in accordance with the NMC Code of Conduct and legislation affecting nursing practice

To contribute to innovative practice within Level 1-3 areas

To practice independently and within the Critical Care Outreach team to ensure optimal quality of care is delivered on the Harefield Hospital site

To be committed to the hospital's mission and the Department of Nursing Philosophy

About us

Working as a clinical nurse specialist you will be part of a strong team of Band 7s and 6s assessing patients in all areas of the hospitals. You will actively care for patients following Cardiac surgery, heart and lung transplantation and following myocardial infarction following admission as part of our Primary PCI service.

You will also care for patients with mechanical circulatory life support and has access to the world renowned training provided by the MCLS team.

Details

Date posted

28 June 2023

Pay scheme

Agenda for change

Band

Band 7

Salary

£49,178 to £55,492 a year per annum Inc HCAS

Contract

Permanent

Working pattern

Full-time, Part-time, Job share, Flexible working

Reference number

196-HH-NR-0087

Job locations

Harefield Hospital

Hillend road

Harefield

UB9 6JH


Job description

Job responsibilities

PATIENT/CUSTOMER CARE

To perform physical examination and assessment of the patient to formulate an appropriate care management plan

To accept referral of patients, following Critical Care Outreach Referral Criteria

To participate in the admission and discharge of patients, liaising with theatres, ward areas, other hospitals and patient families

To provide daily review of all patients meeting the Outreach inclusion criteria

To provide daily review of all referred patients until discharge from Outreach management

To provide specific patient management related to the following for all patients outside Level 3:

  • patients with a tracheostomy insitu [including mini-tracheostomy]
  • patients requiring intermittent Continuous Positive Airway Pressure [CPAP] or Bilevel Positive Airway Pressure [BiPAP]
  • patients requiring inotropic support
  • patients requiring mechanical support i.e. IABP, VAD
  • patients who are pacing dependent

To provide advice and support for the management of all patients requiring Renal Replacement Therapy outside the Level 3 area

To provide assessment and follow up all long-term Level 3 patients

To manage all Critical Care Outreach patients in collaboration with the multidisciplinary colleague

To actively support the development of critical care skills for staff in L2 L0 areas

To provide direct patient care within the Intensive Therapy Unit to maintain critical care skills (1/3 of contracted hours)

To provide a high standard of patient care following Trust / departmental clinical guidelines/policies/protocols

To participate as an active member of the Critical Care team to ensure optimal patient care and enhance patient outcomes

To act as part of the Hospital Resuscitation team, carrying the Cardiac Arrest bleep and actively contributing to patient management in arrest scenarios

To deliver care consistent with the values associated with the 6Cs of nursing

COMMUNICATION

To work autonomously and liaise directly with the Intensive Care Consultant in regard to management of critically ill patients outside the Level 3 area

To act as a triage for calls made overnight to the senior nurse on call. To liaise with the senior nurse on call out of hours to ensure that appropriate senior input is available for clinical and managerial issues

To liaise with the bed manager in order to ensure that patient flows are optimized and patient pathways adhered to

To act as shift leader on ITU / Recovery / HDU when required

To actively participate in the orientation of new critical care staff

To act as a resource in critical care nursing for other professionals and patients

To actively participate in informal and formal teaching sessions in the ward areas

To actively participate in departmental seminars, conferences and educational programs

To monitor, promote and participate in patient and family education including participation in long-term patient case conferences

RESOURCE MANAGEMENT

To monitor resource needs/demands to ensure appropriate skill mix of staff to deliver patient care across the Harefield site

To ensure the effective use of Bank/Agency resources in all wards

To actively promote a cost effective culture within critical care and beyond

To anticipate requirements when clinical activity increases/decreases

To actively contribute to forward planning of nursing resources

To provide overall management of the Critical Care Outreach service when required

PEOPLE MANAGEMENT

To enable and support the clinical development of nurses within critical care , including intensive care and ward areas

To perform appraisals for band 5 and 6 nursing colleagues

To seek expert advice and assistance when required

To demonstrate effective time management skills

To take responsibility for their own continued academic and professional development

To co-ordinate Critical Care Academic day programmes for senior nursing staff

To deliver formal and informal teaching sessions to a variety of disciplines/grades

To participate in their own performance review with Service Manager

To actively encourage and support a learning environment

To act as mentor to students undertaking post-registration specialist courses

To mentor newly appointed Outreach staff, and disseminate progress with senior members of staff

To ensure that designated team members have objectives set within 3 months of commencing employment, objectives reviewed every 6 months, and have annual appraisals completed

POLICY DEVELOPMENT

To have knowledge of, and to work within, the nursing policies and objectives.

To play a lead role in the implementation of relevant guidelines (eg NICE 50)

To ensure that Outreach related policies and practices are responsive to changes within the associated services

To use best evidence to support clinical guidelines and integrate research into their clinical practice

To participate in presentations of related research/audit

To contribute to publication of related research/audit

To encourage other staff to recognise the need for nurse-led research and to encourage participation in audit and research projects

SERVICE DEVELOPMENT

To identify potential areas of nursing research and actively participate in clinical research projects

To contribute to the development of long-term critical care patient clinic

To support the safe delivery of seven day services on the Harefield site

To actively contribute to service development and future directives of the Critical Care Outreach Service ensuring that the service is responsive and tailored to the needs of Harefields patients

To develop selection and interview skills through active participation in the recruitment process of new staff

To actively contribute to the on-going development of critical care education through the Critical Care Outreach study day program, critical care skills labs and ALERT courses

To conduct route cause analysis and adverse incident investigations in a timely and thorough manner

To actively contribute to development of 24/7 Outreach service

To support and contribute to the development of nursing competencies and related training packages

To actively participate in the ongoing development and objectives of the Critical Care Outreach Service and the Adult Intensive Care Unit

INFORMATION MANAGEMENT

To contribute to the ongoing Critical Care Outreach clinical audit and research program

To contribute to and present Outreach quality / activity metrics at the Harefield Quality and Safety group meeting

To participate in the Trusts Clinical Governance Program.

To contribute to the Critical Care Outreach Report and present at Critical Care Management Meeting

To identify appropriate responses to data trends thereby ensuring that the service is responsive to quantitative sources of information

To ensure that full documentation is made of all patient reviews/assessments and that relevant data is entered into the Outreach database

To continually review Outreach database content to ensure that all data entered is useful and relevant

To act as a role model with regard to the use of the intranet/email and other IT systems

Job description

Job responsibilities

PATIENT/CUSTOMER CARE

To perform physical examination and assessment of the patient to formulate an appropriate care management plan

To accept referral of patients, following Critical Care Outreach Referral Criteria

To participate in the admission and discharge of patients, liaising with theatres, ward areas, other hospitals and patient families

To provide daily review of all patients meeting the Outreach inclusion criteria

To provide daily review of all referred patients until discharge from Outreach management

To provide specific patient management related to the following for all patients outside Level 3:

  • patients with a tracheostomy insitu [including mini-tracheostomy]
  • patients requiring intermittent Continuous Positive Airway Pressure [CPAP] or Bilevel Positive Airway Pressure [BiPAP]
  • patients requiring inotropic support
  • patients requiring mechanical support i.e. IABP, VAD
  • patients who are pacing dependent

To provide advice and support for the management of all patients requiring Renal Replacement Therapy outside the Level 3 area

To provide assessment and follow up all long-term Level 3 patients

To manage all Critical Care Outreach patients in collaboration with the multidisciplinary colleague

To actively support the development of critical care skills for staff in L2 L0 areas

To provide direct patient care within the Intensive Therapy Unit to maintain critical care skills (1/3 of contracted hours)

To provide a high standard of patient care following Trust / departmental clinical guidelines/policies/protocols

To participate as an active member of the Critical Care team to ensure optimal patient care and enhance patient outcomes

To act as part of the Hospital Resuscitation team, carrying the Cardiac Arrest bleep and actively contributing to patient management in arrest scenarios

To deliver care consistent with the values associated with the 6Cs of nursing

COMMUNICATION

To work autonomously and liaise directly with the Intensive Care Consultant in regard to management of critically ill patients outside the Level 3 area

To act as a triage for calls made overnight to the senior nurse on call. To liaise with the senior nurse on call out of hours to ensure that appropriate senior input is available for clinical and managerial issues

To liaise with the bed manager in order to ensure that patient flows are optimized and patient pathways adhered to

To act as shift leader on ITU / Recovery / HDU when required

To actively participate in the orientation of new critical care staff

To act as a resource in critical care nursing for other professionals and patients

To actively participate in informal and formal teaching sessions in the ward areas

To actively participate in departmental seminars, conferences and educational programs

To monitor, promote and participate in patient and family education including participation in long-term patient case conferences

RESOURCE MANAGEMENT

To monitor resource needs/demands to ensure appropriate skill mix of staff to deliver patient care across the Harefield site

To ensure the effective use of Bank/Agency resources in all wards

To actively promote a cost effective culture within critical care and beyond

To anticipate requirements when clinical activity increases/decreases

To actively contribute to forward planning of nursing resources

To provide overall management of the Critical Care Outreach service when required

PEOPLE MANAGEMENT

To enable and support the clinical development of nurses within critical care , including intensive care and ward areas

To perform appraisals for band 5 and 6 nursing colleagues

To seek expert advice and assistance when required

To demonstrate effective time management skills

To take responsibility for their own continued academic and professional development

To co-ordinate Critical Care Academic day programmes for senior nursing staff

To deliver formal and informal teaching sessions to a variety of disciplines/grades

To participate in their own performance review with Service Manager

To actively encourage and support a learning environment

To act as mentor to students undertaking post-registration specialist courses

To mentor newly appointed Outreach staff, and disseminate progress with senior members of staff

To ensure that designated team members have objectives set within 3 months of commencing employment, objectives reviewed every 6 months, and have annual appraisals completed

POLICY DEVELOPMENT

To have knowledge of, and to work within, the nursing policies and objectives.

To play a lead role in the implementation of relevant guidelines (eg NICE 50)

To ensure that Outreach related policies and practices are responsive to changes within the associated services

To use best evidence to support clinical guidelines and integrate research into their clinical practice

To participate in presentations of related research/audit

To contribute to publication of related research/audit

To encourage other staff to recognise the need for nurse-led research and to encourage participation in audit and research projects

SERVICE DEVELOPMENT

To identify potential areas of nursing research and actively participate in clinical research projects

To contribute to the development of long-term critical care patient clinic

To support the safe delivery of seven day services on the Harefield site

To actively contribute to service development and future directives of the Critical Care Outreach Service ensuring that the service is responsive and tailored to the needs of Harefields patients

To develop selection and interview skills through active participation in the recruitment process of new staff

To actively contribute to the on-going development of critical care education through the Critical Care Outreach study day program, critical care skills labs and ALERT courses

To conduct route cause analysis and adverse incident investigations in a timely and thorough manner

To actively contribute to development of 24/7 Outreach service

To support and contribute to the development of nursing competencies and related training packages

To actively participate in the ongoing development and objectives of the Critical Care Outreach Service and the Adult Intensive Care Unit

INFORMATION MANAGEMENT

To contribute to the ongoing Critical Care Outreach clinical audit and research program

To contribute to and present Outreach quality / activity metrics at the Harefield Quality and Safety group meeting

To participate in the Trusts Clinical Governance Program.

To contribute to the Critical Care Outreach Report and present at Critical Care Management Meeting

To identify appropriate responses to data trends thereby ensuring that the service is responsive to quantitative sources of information

To ensure that full documentation is made of all patient reviews/assessments and that relevant data is entered into the Outreach database

To continually review Outreach database content to ensure that all data entered is useful and relevant

To act as a role model with regard to the use of the intranet/email and other IT systems

Person Specification

Qualifications

Essential

  • registered nurse
  • 1st degree in relevant subject
  • Teaching/Assessing qualification
  • Advanced Life Support
  • Evidence of excellent I.T skills

Desirable

  • Cardiac advanced life support
  • Advanced Assessment course
  • MSc or working towards
  • Evidence of departmental/shift managment
  • Evidence of presenting at conference
  • Demonstration of commitment to trust wide initiatives and Q I projects

Experience

Essential

  • Evidence of advanced Critical care skills (including post op cardiac and thoracic patients- level 2 and 3)

Experience

Essential

  • Evidence of involvement in staff appraisal/performance management
Person Specification

Qualifications

Essential

  • registered nurse
  • 1st degree in relevant subject
  • Teaching/Assessing qualification
  • Advanced Life Support
  • Evidence of excellent I.T skills

Desirable

  • Cardiac advanced life support
  • Advanced Assessment course
  • MSc or working towards
  • Evidence of departmental/shift managment
  • Evidence of presenting at conference
  • Demonstration of commitment to trust wide initiatives and Q I projects

Experience

Essential

  • Evidence of advanced Critical care skills (including post op cardiac and thoracic patients- level 2 and 3)

Experience

Essential

  • Evidence of involvement in staff appraisal/performance management

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.

Certificate of Sponsorship

Applications from job seekers who require current Skilled worker sponsorship to work in the UK are welcome and will be considered alongside all other applications. For further information visit the UK Visas and Immigration website (Opens in a new tab).

From 6 April 2017, skilled worker applicants, applying for entry clearance into the UK, have had to present a criminal record certificate from each country they have resided continuously or cumulatively for 12 months or more in the past 10 years. Adult dependants (over 18 years old) are also subject to this requirement. Guidance can be found here Criminal records checks for overseas applicants (Opens in a new tab).

UK Registration

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

Additional information

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.

Certificate of Sponsorship

Applications from job seekers who require current Skilled worker sponsorship to work in the UK are welcome and will be considered alongside all other applications. For further information visit the UK Visas and Immigration website (Opens in a new tab).

From 6 April 2017, skilled worker applicants, applying for entry clearance into the UK, have had to present a criminal record certificate from each country they have resided continuously or cumulatively for 12 months or more in the past 10 years. Adult dependants (over 18 years old) are also subject to this requirement. Guidance can be found here Criminal records checks for overseas applicants (Opens in a new tab).

UK Registration

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

Employer details

Employer name

Guy's and St Thomas' NHS Foundation Trust

Address

Harefield Hospital

Hillend road

Harefield

UB9 6JH


Employer's website

https://www.guysandstthomas.nhs.uk/careers/careers.aspx (Opens in a new tab)


Employer details

Employer name

Guy's and St Thomas' NHS Foundation Trust

Address

Harefield Hospital

Hillend road

Harefield

UB9 6JH


Employer's website

https://www.guysandstthomas.nhs.uk/careers/careers.aspx (Opens in a new tab)


Employer contact details

For questions about the job, contact:

Matron, Critical Care

Ellen Dunthorne

e.dunthorne@rbht.nhs.uk

03301285680

Details

Date posted

28 June 2023

Pay scheme

Agenda for change

Band

Band 7

Salary

£49,178 to £55,492 a year per annum Inc HCAS

Contract

Permanent

Working pattern

Full-time, Part-time, Job share, Flexible working

Reference number

196-HH-NR-0087

Job locations

Harefield Hospital

Hillend road

Harefield

UB9 6JH


Supporting documents

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