Neurovascular Senior Enhanced Nurse Practitioner

Job description

Job responsibilities

To provide skilled assessment of patients including history taking, physical assessment and requesting, interpreting and acting on appropriate tests and investigations in a timely manner. Expectation to undertake Non-Medical Prescribing course. Use expert and specialised clinical and theoretical knowledge to safely and appropriately assess and diagnose patients in their care, within own professional boundaries with support from ACP

Act autonomously within evidenced based guidelines to plan and implement individualised management plans. Formulate clinical decisions and often complex treatment plans to manage illness with support from ACP.

Direct responsibility to manage own caseload of patients in the inpatient and outpatient follow-up stage of the patient pathway, including a comprehensive assessment/review of SAH patients, requesting diagnostics when compliant, reviewing results and creating and implementing management plans within the specialty and priorities workload to meet patient and service need.

Liaising with sub specialty Consultants and ACP team where necessary. Demonstrate competence, knowledge and skills in a wide range of practical procedures.

To delegate/refer to other practitioners when this will improve health outcomes or when risk and needs are beyond own competence and scope of practice. With support from ACPs manage referrals and triage from other disciplines/primary care and provide specialist advice and support to colleagues within the organisation and to the wider team outside the organisation.

Alongside ACPs, to support development and implement pathways of care, adapting to patient needs by ensuring a planned and coordinated approach to care, supporting enhanced recovery and reducing inappropriate admissions to improve patient experience and safety.

Working alongside a multi-disciplinary team meeting to support with clinical follow up patients beyond the local MDT, with support from ACP. Support the discharge planning processes.

To provide and direct emergency and elective patients to holistic support; offering telephone follow up clinics, ad hoc telephone support as required and inform patients relevant support services. Refer directly to other health care professionals, Charities and specialist services such as Neuropsychology, Endocrinology, Neurology both internal and external departments as necessary, to ensure optimal efficiency and quality of care, regionally and nationally.

Act as a patient advocate to facilitate the process of shared decision-making in respect to health, choice of treatment and care, and contribute to case conferences as required. Use interpersonal and communication skills where there may be significant barriers to build confidence. Ensure patients individual needs are expressed, valued and individual management plans are understood.

Offer specialist advice on diagnosis and symptom management for patients within the speciality. Evaluate response to treatment and interventions and advise on the adaptation of management and discharge plans.

Empower patients to self-manage their condition, undertaking risk stratification to identify where additional support or patients may require further rehabilitation. With the ACP, support provision of clinical advice and input to commissioning the sub specialty service both locally, regionally and nationally as required.

Work with the ACP in the further development and delivery of practitioner led clinics in line with local service need, to include pre-operative assessment.

Act as a resource, providing clinical expertise, specialist advice teaching and support across service boundaries to ensure optimum liaison and co-ordination of care.

Undertake clinical competencies relevant to sub-speciality service to develop specialist knowledge within role. Actively integrate theory and practice.

To act appropriately in emergency situations and to be familiar with emergency procedures including fire and resuscitation. To have the ability to lead and direct other staff appropriately in such situations. Request blood group & screen (G&S) investigations and cross-matching (XM) of red blood cells (RBCs) in accordance with the Trust maximum surgical blood ordering schedules (MSBOS).

Once completed IRMER training, ensure that you work within your scope of your approved non-medical referrer protocol regarding requesting radiography.

To participate in sub-specialty MDTs, departmental and regional meetings. With support from ACP carry out ad hoc telephone consultations to inform patients of care planned as required to request necessary diagnostic testing or imaging according to protocol. To liaise with referrers as required.

To organise urgent clinical review e.g. ward attendance whereby patient has deteriorating neurology requiring further assessment. To coordinate ward attendance as required whereby patients contact Senior Enhanced Neurovascular Nurse Practitioner with new or ongoing symptoms pre or post operatively that require further investigation.

To be able to advise appropriately using clinical and theoretical knowledge, to request the necessary diagnostic testing/imaging, review results and ascertain senior review if required. Contribute to root cause analysis and serious event review.

Be responsible for maintaining current registration with the relevant professional body (NMC) and work within the Code of Professional Conduct and relevant Guidelines for Practice and maintain a personal professional portfolio.

Keep up to date with current research and audit findings and base all clinical assessment and management decisions on credible high-quality evidence. Promote integrated working practice between clinical areas and interdisciplinary teams to ensure safe patient care.

To work as part of a cohesive Advanced Practice team liaising closely with medical and nursing staff across the Division. Act as a positive role model for clinical staff. Be actively involved in teaching pre and post registration clinicians as well as an expectation to teach at a regional level on issues related to Neurovascular Subspeciality.

Facilitate and Co-ordinate the Neurovascular Research Portfolio in collaboration with Lead Neurovascular Research Consultant, Neurovascular research fellow, and Neurovascular ACP, with support from Skull-Base ACPs. Take ownership of Neurovascular research data collection, administration, in line with research governance principles and with outreach support from NBT Research and Development team.

Be involved in the bedside, classroom, and directorate teaching of North Bristol NHS Trust staff, as well as utilising additional teaching opportunities such as national teaching appropriate to the specialty, and teaching/contributing to courses run by the local university, in addition to presenting at national conferences such as BNVNG (British Neurovascular Nurses Group) of which membership is encouraged.

Mentor students and medical staff, and supervise other staff working within the clinical area, providing professional support and clinical supervision as required.

Contribute to networking with other professionals in similar roles within the specialty at Local, Regional and National level with the ACP. Be an active member of relevant trust wide professional groups such as the trust wide Advanced and specialist practice forum

Maintain own awareness of relevant research evidence relating to own work specialty and ensure that this is applied in own practice where appropriate. Contribute to where appropriate, to the development of local evidence-based standards, policies and guidelines related to the specialty.

Instigate and participate in interdisciplinary research and audit projects within the specialty and Division and contribute to the professional development of knowledge in the specialty.

To contribute to planning, developing and improving services to be responsive to patient needs as well as the Division, Trust and National Health Service needs. Participate in implementing national standards and frameworks at a local level within the speciality.

To be responsible for identifying and addressing his/her own professional, training and development needs considering developments in service in the specialty.

Ensure that handover lists are communicated well. Foster effective communication strategies with all members of the medical, nursing and surgical teams

To provide clinical, psychological, emotional and social support to all aneurysmal SAH and non-aneurysmal SAH patients. Ensure that patient pathways for SAH patients are followed, developing and improving, and update Neurovascular patient information leaflets as required.

To support discharge planning for SAH patients with neurosurgery ward teams and AHPs. Ensure that the SAH service is robust and is receptive/reactive to the changing needs of this client group and service provision

Review all SAH inpatients daily and provide clinical support and recovery/discharge advice, along with elective neurovascular inpatients with guidance from ACP.

In hours, provide telephone access for patients preoperatively and post discharge for help and support. Provide emotional and psychosocial assessment in the informal and clinical settings including accessing advice. To act as a liaison for primary care and other health care facilities who need advice

To contribute towards health promotion for all patients providing educational advice and support. To ensure the ongoing collection of patients reported outcome measurement (PROMS) and maintain audit and a database of all cases and interventions.

Ensure appropriate representation and participation in clinical/departmental meetings for example: Clinical governance, Infection control where required

Facilitate and Co-ordinate Neurovascular Research Portfolio with Neurovascular Consultant, Clinical Fellow and ACPs

Following Trust policy act in an appropriate manner when dealing with incidents and complaints.

Person Specification

Essential and Desirable

Essential

• Professional NMC Registration
• Relevant BSc Level 6 degree
• Commitment to undertake Physical Assessment, Pathophysiology and Diagnostic Reasoning and Non-Medical Prescribing modules-Level 7
• Teaching and Mentoring Recognised Qualification
• Working Knowledge of Neurovascular/Skull-Base Neurosurgery
• Evidence of Ongoing CPD
• Involvement in Research or Audit Projects
• Evidence of maintained competence of clinical skills
• Ability to organise and prioritise own workload
• Ability to act independently, resolve complex clinical situations and harbour excellent decision-making skills.
• Excellent Written Communication skills

Desirable

• Completion of Physical Assessment, Pathophysiology and Diagnostic Reasoning and Non-Medical Prescribing modules-Level 7
• Specialty Specific Post-Graduate Qualification (ie: Neurosciences course)
• Neurosciences Experience
• Excellent Leadership and Organisational Skills
• Evidence of Teaching in a variety of environments
• Evidence of contribution to quality improvement/change 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).

Employer details

Employer name

North Bristol NHS Trust

Address

Department of Neurosurgery, Southmead Hospital

Southmead Road

Bristol

BS10 5NB

Employer's website

https://www.nbt.nhs.uk (Opens in a new tab)