Scottish Ambulance Service Job Description. Paediatric Nurse Consultant Specialist Transport & Retrieval (ScotSTAR)

Transcription

1 Scottish Ambulance Service Job Description Paediatric Nurse Consultant Specialist Transport & Retrieval (ScotSTAR) 1. DOCUMENT CONTROL Version: Author: Approved by: Approval Date: 1.0 Jason Cormack Carole Morton 26 June 2014 Review Date: 2. JOB IDENTIFICATION Job Title: Department: Directorate: Reports to: Paediatric Nurse Consultant ScotSTAR ScotSTAR (Specialist Transport & Retrieval) Operations Head of Service, ScotSTAR, Scottish Ambulance Service Job Reference: Number of Job Holders: 1 1

2 3. JOB PURPOSE Work within ScotSTAR as a Paediatric Nurse Consultant covering a full range of duties and responsibilities expected of that role. Contribute to the delivery of a proactive and responsive transport and retrieval service combining nursing, medical and paramedical duties, Coordinate and lead the retrieval team in the stabilisation and safe transfer of patients (primarily paediatric) requiring critical care, making autonomous decisions to ensure appropriate management and safe transfer, Provide expert clinical care at an advanced level to patients requiring transport and retrieval, making complex autonomous clinical and logistical decisions about patient care, utilizing advance skills and knowledge, Undertake transport and retrieval missions for high acuity, ventilated paediatric patients on an autonomous basis, Develop and implement teaching, education and information materials suitable for use within a multi-professional context to ensure optimal and consistent standards of care. Facilitate and support the learning and development of clinical practice and the implementation of standards and protocols, Develop and provide education and training in relation to the care of a sick child during transport. This will include medical and nursing staff, ambulance staff, pre-registration nursing students, medical students and senior clinicians This encompasses both ScotSTAR clinical colleagues and remote hospital units, Contribute to the development of strategic plans for Specialist Transport and Retrieval, Lead on the development of protocols and procedures for the paediatric element of ScotSTAR to provide a safe and effective service for NHS Scotland, Extend advanced skills, knowledge and experience of Critical Care to referring hospital sites, Promote, implement and evaluate effective evidence based practice within the nursing service element of ScotSTAR, Utilise advanced clinical skills, knowledge and experience for vital invasive procedures, Promote the role of the Nurse consultant as an integrated member of the multi-disciplinary team, Actively participate in the development of ScotSTAR as well as ongoing operations, Monitor compliance with national Specialist Transport and Retrieval Quality Performance Indicators and Standards, expectations and targets within own area of practice, Implement strategies, policies, plans, systems and resources as directed to maintain efficient and effective operation of paediatric Specialist Transport and Retrieval, Maintain relationships with the territorial NHS Boards, most notably PICUs, referring units and external retrieval services. 2

3 4. DIMENSIONS The ScotSTAR (Scotland s Specialist Transport and Retrieval) national service comprises the three national specialist transport teams for NHS Scotland: Scottish Neonatal Transport Service, The Transport of Critically Ill and Injured Children Service and the Emergency Medical Retrieval Service. Between them, the clinical teams undertake approximately 2,200 missions a year, transporting high acuity patients for NHS Scotland. Hosted by the Scottish Ambulance Service (SAS), ScotSTAR will provide world class transport and retrieval in a geographically challenging country. This post is accountable to the Head of Service for ScotSTAR with a professional line to the Director of Health Professions and Nursing Care, and will operate as the lead paediatric nurse for the team. This includes providing clinical leadership, governance and clinical management/supervision. 5. ORGANISATIONAL POSITION 3

4 6. MAIN TASKS, DUTIES AND RESPONSIBILITIES LEADERSHIP Provide effective clinical leadership to nursing staff to provide world class patient care, Participate in the development of strategic plans for the organisation, taking cognisance of SAS strategic plans as well as those of territorial Health Boards (for example around service redesign) and Scottish Government aspirations, Liaise where appropriate with territorial Board clinical colleagues (for example in PICU) to ensure ScotSTAR is fully engaged with the Boards. Have responsibility for the development of strategies for and undertaking of research and development within Paediatric Retrieval to an expert level. Contribute to the development and improvement of ScotSTAR through this research and development. Deliver quality improvement changes to the operational context which are derived from this research. OPERATIONAL Undertake research and audit cycles to enhance clinical practice. Actively promotes and demonstrates evidence based clinical practice, Initiate and maintain good communication with colleagues in the team and external stakeholders, Participate in the clinical and practical education, support and development of the multidisciplinary team. Provide clinical advice to nursing and medical staff and other members of the multidisciplinary team, Ensure fair and consistent application of all service policies and procedures at all times, Undertake ScotSTAR operations throughout Scotland in conformity with the priorities, policies and values of the team, NHS Scotland and the SAS and that their spirit, Where appropriate, develop ScotSTAR staff to deliver excellence in all areas of operation through effective clinical leadership, innovation, communication and motivation, Assist with the development and review of strategic and business plans for ScotSTAR including business issues and service delivery model where these affect area of expertise, Providing recommendations to the ScotSTAR Management Group and ScotSTAR Advisory Group to achieve improvements in service delivery capabilities and where appropriate deliver their implementation, Represent ScotSTAR in national and international forums, Assist with the planning, developing and coordinating of risk management strategies that are integrated with ScotSTAR objectives and clinical care, Takes a lead role in the systematic development and review of all guidelines, policies and protocols for practice, Plans, reviews and coordinates extremely high acuity transfers, Considers access, cost, efficacy and quality when making care decisions, Demonstrates an understanding of child protection including legislation and procedures, Dissemination of knowledge through report writing, and reviewing, taking full responsibility and being sensitive to the wider implications of that knowledge, adhering to Nursing and.midwifery Council and Professional guidelines on record keeping, and Recognises ethical and legal issues, which have implications for nursing practice, taking action as appropriate. CLINICAL Maintains high level of competence and confidence with all practical/technical skills, Works autonomously as a member of the multidisciplinary team sharing responsibility for 4

5 clinical aspects of ScotSTAR, Undertake transport and retrieval missions for high acuity, ventilated paediatric patients on an autonomous basis, Works within agreed Nurse consultant/medical protocols to support and enhance the responsibilities of Middle Grade roles, Interprets clinical investigations, results, x-rays, scans and manage patient per own diagnostic decision, Initiates, prescribes and administers intravenous therapy, blood transfusions, volume expanders and intravenous medicines as indicated clinically based on a sound knowledge of pharmacology and haematology, Initiates and manages appropriate respiratory support as required, ie NCPAP, invasive and non invasive ventilation and adjusts appropriately based on clinical judgement and blood gas analysis, Participates in palliative care for patients when appropriate, leading to a pain free dignified ending to life, Practice within the legal and ethical framework as established by Nursing Midwifery Council and National Legislation, Ensures clinical practice reflects all current legislation and guidance regarding advanced clinical practice, Functions in a variety of role dimensions: health care provider, coordinator, educator, coach, advocate, administrator, researcher, role model, change agent and leader. Uses evidence and research to implement the role, Takes a lead role in directing nursing practice. Acts as a role model in practicing evidence based nursing care. Maintain and continually develop in depth specialist knowledge of nursing practice relevant to aspects of paediatric care, Responds to emergency situations, utilising clinical judgement and decision making to initiate appropriate interventions and treatments for patients, Uses information systems to support decision-making and to improve care, Ensures patients' needs are met by acting as advocate and liaising with members of the multidisciplinary team. Always act in the best interest of the patient, carer's and family to safeguard and protect the patient at all times, Participates in legislative and policy-making activities that influence an advanced level of nursing practice, Develops appropriate advanced clinical and technological skills in response to the changing needs of care and the dynamic state of healthcare services, Evaluates the patients' response to the health care provided and the effectiveness of the care. Uses the outcomes of care to revise care delivery strategies and improve the quality of care, Carrying out adverse event reviews, investigations of complaints and grievances, potentially of a complex and highly sensitive nature which could include instigating and carrying out learning opportunities/plans, Monitor compliance with national Quality Performance Indicators (QPIs) and standards, expectations and targets, and where appropriate contribute to the development of systems and processes for the reporting of these QPIs, Regular requirement to conduct and participate in reviews and debriefings with clinical teams, discussing highly distressing clinical/retrieval issues, Regular requirement to review Datix reports from clinical incidents/near misses across the country, often including highly distressing information. HUMAN RESOURCES Promote and demonstrate a culture within ScotSTAR that values continuing professional development and strives for excellence in the delivery of patient care, acting as a role model 5

6 for the behaviours and high professional standards expected, Lead the professional development, education and training of both internal and external multidisciplinary staff within area of expertise, Supports team members to deliver on their objectives through offering advice, guidance and support as necessary, Teaches and assesses advanced nursing and clinical skills as part of the ongoing programme of expanded nursing and clinical practice within ScotSTAR, Actively engages in continuous professional development and maintains a suitable record of this development. Provide line management for up to ten nursing and administrative staff FINANCIAL RESOURCES Ensure that relevant capital equipment is checked regularly and maintenance ordered if required. Ensure that clinical consumable resources are ordered for area of responsibility. Personal duty of care and responsibility for ensuring efficient use of specialist equipment. 7. EQUIPMENT AND MACHINERY Responsible and knowledgeable in the safe use of the highly specialised equipment, checking, maintaining, trouble shooting and identifying problems related to this, Be required to undertake transport missions by road as well as fixed and rotary wing aircraft Participate in any trials, training and clinical evaluation of all new equipment, Responsible for maintaining appropriate levels of stock in own area of practice and for ensuring appropriate equipment or supplies are purchased, Development of appropriate training guidelines on equipment, Undertake relevant training and supervision of nurses and medical staff in the use of equipment in use, Competent in use of computer and various software packages including Microsoft Word/Excel/Power Point/Project/Visio, Competent use of , internet and intranet, Laptop computers, projectors, printers, photocopiers, fax, telephone system and videoconferencing facilities, Competent in the use of current SAS communications equipment. 8. SYSTEMS Authorisation of payroll data (e.g. overtime, expenses) where required, The post holder receives highly complex or highly sensitive information and acts accordingly and generating information or, for example, updating systems using restricted password access, Responsible for ensuring that staff are aware of the responsibilities placed upon them under the Health and Safety at Work Act 1974, to ensure that the agreed safety procedures are carried out to maintain safe working environment for patients, visitors and employees, Responsible for inputting information into electronic patient record where applicable and also into patients written records, Develop and implement policies and protocols for own area of work, 6

7 Communicating via Tele-medicine link in the assessment and diagnosis of specific conditions. 9. DECISIONS AND JUDGEMENTS Limits of autonomy are agreed in advance with the Head of Service and Associate Medical Director, Make highly complex clinical decisions including analysis, diagnosis and clinical management based on an in depth broad expert knowledge and interpretation of clinical and other findings such as diagnostics, with support from a consultant, Have a high degree of professional autonomy and be expected to provide authoritative expert expertise, advice and consultancy within the national strategies and modern clinical practice. The post will involve giving advice both within and out with the Health Service as to what constitutes best practice Decisions include use of advanced skills such as resuscitation, Uses own initiative and acts independently within the bounds of own existing knowledge and skills, as well as policies and protocols and the interpretation of policies, Responsible for assignment of and prioritising of own workload, Ability to use own initiative and act independently with a high level of discretion, Post holder is expected to initiate action and seek advice and support as necessary, Carry out investigations, which could have many components, which require analysis and judgement of a highly complex nature. Decisions may have to be justified in subsequent forums e.g. at disciplinary hearings, Provide professional advice, guidance and support in area of responsibility to internal and external stakeholders, Requires the ability to make clear and precise judgements and decisions on a wide range of intricate issues inherent in a developing service. 10. COMMUNICATIONS AND WORKING RELATIONSHIPS This position relates to: Internal All staff within ScotSTAR ScotSTAR Head of Service ScotSTAR Associate Medical Director (AMD) ScotSTAR Clinical & Nursing/Paramedic Leads SAS Director of Health Professions and Nursing Care SAS Control Centres External All NHS Health Boards, particularly those employing ScotSTAR staff Patients, parents, carers and users of the service PICUs Academic Institutions Strategic and Working Relationships Liaising with a range of national and international organisations and external stakeholders to 7

8 ensure ScotSTAR services are best practice, Initiating, developing and maintaining effective working relationships with all relevant colleagues in NHS Scotland, Developing and maintaining effective relationships with service providers, key organisations and stakeholders both within and outside ScotSTAR, Promoting and advocating ScotSTAR in relevant forums, Consulting extensively and working in partnership with internal and external stakeholders to ensure that appropriate services and programmes are pursued and developed for ScotSTAR. Communication requirements Communicates very sensitive, complex information to patients, parents and carers, with empathy and sensitivity in a difficult environment Communicates highly sensitive, highly complex specialist information to colleagues Acts as a patient/staff advocate through the application of ethical, legal and professional knowledge and skills Uses a high level of interpersonal, professional and communication skills in hostile antagonistic or highly emotive situations, Demonstrates effective verbal and- written communication with all members of the multidisciplinary team within own department and relevant departments. 8

9 11. PHYSICAL, MENTAL AND EMOTIONAL DEMANDS OF THE JOB Manual dexterity and highly developed physical skills are vital for all procedures e.g. intubation, intravenous cannulation, arterial cannulation, or chest drain insertion. Passing naso-gastric tubes, urinary catheterisation, venous, capillary or arterial blood sampling, Dexterity and skill is also required when undertaking blood culture sampling, lumber puncture or supra pubic aspiration, IV cannulation, IV infusions set up and administering IV drugs either through patient group directions, extended or supplementary prescribing, Paediatric Life Support with bag and mask ventilation and cardiac massage, Advanced Life support skills including airway management intubation, drug administration via intravenous catheter or using the intra-cardiac route, Administration of drugs via the endotracheal tube e.g. adrenaline, Exposure to body fluids/ blood products/ therapeutic products, Potential exposure to toxic gasses i.e. nitric oxide, Potential expose to congenital infection/ blood born infections, Moving, lifting and manoeuvring equipment, Moving and manoeuvring cots/beds, Performing complex medical procedures over babytherms, cots and beds, Frequently bending to carry out procedures, or examination of patient, Frequent periods of moderate physical effort, Intense concentration over long periods of time, Clinical decision making, Recognising and responding to ethical issues due to the nature of the post, Dealing with an unpredictable workload, Challenging inappropriate/poor clinical practice, Delivering presentations to a variety of professional groups regularly, Manage a wide range of issues and concerns, Negotiation, persuasion and a rational approach to decision making, There will be a frequent requirement to review and debrief on clinical operations which will regularly include highly distressing circumstances, There will be a frequent requirement to review Datix incidents/near misses often on highly distressing situations, and There will be a frequent requirement for prolonged travel by air and road in challenging conditions, whilst caring for a critically ill child. This may involve extremes of temperature, moving and vibration. 12. MOST CHALLENGING/DIFFICULT PARTS OF THE JOB Managing and leading advanced paediatric retrieval missions, Making highly complex clinical decision in time critical circumstances, Communicating highly distressing information, Providing a professional advisory teaching role to a variety of colleagues, Highly unpredictable working pattern, Delivering high quality care in a developing team, and Providing high quality care in an extremely challenging high risk environment. 13. KNOWLEDGE, QUALIFICATIONS AND EXPERIENCE REQUIRED TO DO THE JOB 9

10 The post holder will have achieved a Masters qualification in Nursing or equivalent experience, The post holder will have specialist knowledge of critical care across a range of clinical issues, with significant experience in specialist transport and retrieval. This will be underpinned by theory and practice acquired through an ANP education programme at masters level. RSCN/RN Child Branch. Ability to meet the highly complex needs of the sick ventilated patient requiring full nursing and medical support. Highly developed interpersonal skills, including ability to work in effective partnership with individuals from a wide range of backgrounds, disciplines and organisations. Highly developed written and verbal communication skills. Advanced skills of persuasion, influence and negotiation when communicating with a range of internal and external stakeholders. IT skills. Organisational skills, including time management, prioritisation, delegation and managing conflicting demands. Ability to draft information, reports, articles and papers to publication standard. Ability to present highly complex/specialist information at internal and external meetings, committees and conferences. 14. JOB DESCRIPTION AGREEMENT Job Holders Signature: Date: Line Managers Signature: Date: All job descriptions are subject to review. Jobholders are expected to be flexible and prepared to carry out any similar or related duties, which do not fall within the work outlined. The line manager, in consultation with the post holder, will undertake any review. 10