Community Mental Health Nurse Primary Care Liaison

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1 Date: March 2013 Job Title : Community Mental Health Nurse - Department : Mental Health Services Location : North Shore One Community Mental Health Team Reporting To : Team Manager Functional Relationships with : Internal Community Mental Health Team members Clinical Coordinator Lead Clinician, North Adult Services Associate Director of Nursing Consumer Advisor(s) Quality, Risk and Training coordinators. Waitemata District Mental Health Services and teams (e.g. acute inpatient units; residential rehab; Maternal Mental Health) Moko and Isa Lei Waitemata Mental Health Services Group (e.g. CADS, RCS and Forensic Services) External NGOs, i.e. accommodation, rehabilitation and programme providers GP s and PHO s Consumer organizations Family members and caregivers Community organizations Government agencies Purpose To promote effective team work and collaborative relationships between primary and secondary services To contribute to the development of an integrated service delivery across the continuum of mental healthcare To provide triage, assessment and planned short term interventions, based on recovery principles to ensure clinical needs of service users are met To provide specialist nursing interventions, as part of the overall care plan. Waitemata District Health Board -JOB DESCRIPTION - Page 1

2 KEY TASKS To practice as a Registered Nurse in the Community Mental health team with a particular focus on EXPECTED OUTCOMES Clinical practice is carried out to professional standards and legal requirements, and is in line with Waitemata District Health Board policies and procedures Triage,Comprehensive Assessment and Brief focused intervention provided for non-urgent referrals Care co-ordination is provided to the designated consumer group, in accordance with the role expectation for care co-ordination. Cultural aspects are recognised, acknowledged and incorporated into all assessments and interventions. Assessments and care plans (including risk assessment and risk management plans) are well documented, safe, and in accordance with the designated standards of Nursing practice and Service policies and protocols. Referrals are promptly followed up with phone calls and face to face appointments Referral source is informed of actions taken or delays in following up clients Up to date, valid interview and assessments processes/tools are used There is regular review of effectiveness of input and service user satisfaction Areas of specialization are developed and delivered e.g. group work, Solution focused therapy. Appropriate crisis management and action is taken as required All appropriate clinical tests are completed All clients have appropriate documentation at entry to the service, e.g. HoNOS, Smoke free assessment, Adult assessment forms These are re-evaluated as appropriate Waitemata District Health Board -JOB DESCRIPTION - Page 2

3 To provide a service user sensitive service To interact with internal and external customers in a positive and constructive way To work in a way that always puts service user needs first To work from a recovery base. The nurse will receive feedback regarding their customer effectiveness on a regular basis To promote effective liaison with Primary Health Care providers Services are delivered in accordance with the Mental Health Service and the Team s philosophies, priorities and objectives To be responsible and accountable for all actions undertaken in the course of duties. Contribute to the development of effective communication between CMHC and primary health care providers Facilitate discharge planning and referral processes to health care providers and support agencies to meet identified health needs of service users Negotiate with GP s to assess people referred at GP practices as appropriate and space available Completes orientations and mandatory training as stipulated in the Training and Development and team policies. Philosophies and values are known and supported. Consumer rights and responsibilities are actively supported. All conduct is ethical and confidential. Safety standards are known and met. Works in accordance with relevant Waitemata Health policies, professional codes of conduct and relevant legislation All documentation is legible, dated and signed with name and designation clearly written All clinical contact statistics and outcome measures are completed within the required timeframes Demonstrates understanding of ethical implications of practice All documentation is in line with the New Zealand Mental Health Standards To provide a therapeutic and physically safe environment for clients, ensuring that confidentiality is maintained Uses principles of quality of service in all interactions Anticipates potential incidents, hazards and initiates preventative action That all actions by the nurse will meet standards set down by the Registered Nurses Act Waitemata District Health Board -JOB DESCRIPTION - Page 3

4 Demonstrates effective workload management skills Demonstrate flexibility and adaptability in response to workload demands, and urgency Assist Recovery colleagues in the discharge of service users to primary health care Assist crisis colleagues when necessary Demonstrate a commitment to personal and professional development. Regular professional supervision occurs to review quality of practice. Professional development is actively pursued by active participation in appropriate in-service or outsourced education, reading relevant literature or seeking other resources. Professional advisor is liaised with regarding professional issues as required. To work as an effective team member Observe and identify roles, functions and philosophies of the multidisciplinary team. Contribute to all clinical activities of the multidisciplinary team Maintain active communication within the team and relevant agencies. Progressively make contributions to the multidisciplinary team by taking on responsibilities, roles and functions within the team. Exchange and share resources and expertise. Provide individualized plans and interventions Client-centered approaches are used Plans include targeted outcomes and goals negotiated with the client and caregivers All service users have a current written comprehensive plan which includes clinical needs, and in which service user has collaborated All plans include appropriate cultural input All documentation is completed in accordance with best practice guidelines All interventions are documented Specific clinical interventions are implemented in accordance with the Management/Risk Plan Record and communicate nursing processes and outcomes with/or for the service user Collaborative note writing is completed with the client where possible Formal documentation is routinely completed in clinical files within the duty All clinical interventions are documented in a timely and accurate manner, and in accordance with best practice guidelines Data is provided and referrals made to other services and agencies as relevant for addressing clients social, occupational and other needs as appropriate Waitemata District Health Board -JOB DESCRIPTION - Page 4

5 Contribute to the ongoing development, quality improvement and implementation of Community mental health multidisciplinary team policy and clinical processes particularly focused on Primary Care Liaison Provide nursing consultancy to team and enhance client outcomes Applies knowledge and skills from theory and research to the practice of nursing Interacts effectively with service users families and carers Undertakes teaching activities with consumers, families and colleagues Participate in regular policy, quality and clinical meetings Attend planning days Attend individual service user meetings and present data as relevant Access relevant ideas and resources related to other services and contemporary practice, and share these with the team Complete delegated tasks and projects with a focus on and report back on the progress and outcome of these Attend and make recommendations at relevant meetings Act as a resource person to the Community mental health team and other relevant primary health care providers Clarify nursing role and tasks to aid appropriate referrals Act as a safe practitioner using procedures/clinical standards of practice Use a model of nursing care delivery to work with clients and families to assess, plan, implement and evaluate quality individualised care to consumers Identify and anticipate complications, side effects from medications, emergency situations and difficulties and co-ordinate appropriate action Maintain positive interaction with service users and families, and wherever possible plan, implement and document care collaboratively Establish and maintain effective communication with relevant others Liaise and advocate with others on service users behalf. Provide data and recommendations with awareness of the Privacy Act to assist others to meet clients needs Keep informed of developments with families, others and relevant agencies Plan and undertake education sessions for consumers, family, carers and colleagues in response to identified need Ac as Preceptor for new nurses, student nurses and nursing interns as required Provide expert advice and consultation to primary health care providers regarding mental health. Models expert skills within clinical practice area Waitemata District Health Board -JOB DESCRIPTION - Page 5

6 To recognize the principles of the Treaty of Waitangi and acknowledge cultural and social difference of all groups To recognise Individual Responsibility For Workplace Health and Safety under the Health and Safety in Employment Act 1992 Provides mentoring /coaching of other health care professionals in area of primary care liaison Waitemata District Health Board s commitment to bi-culturism is honoured. Cultural advice is sought. Work co-operatively with culturally appropriate staff. Company health and safety policies are read and understood and relevant procedures applied to their own work activities Workplace hazards are identified and reported, including self management of hazards where appropriate Can identify health and safety representative for area Waitemata District Health Board -JOB DESCRIPTION - Page 6

7 Behavioural Competencies Adheres to Waitemata District Health Boards 4 Organisational Values of: Every single person matters, whether a patient / client, family member or a staff member We see our work in health as a vocation and more than a job, We are aware of the suffering of these entrusted to our care. We are driven by a desire to relieve that suffering. This philosophy drives our caring approach and means we will strive to do everything we can to relieve suffering and promote wellness. We need to be connected with our community. We need to be connected within our organisation across disciplines and teams. This is to ensure care is seamless and integrated to achieve the best possible health outcomes for our patients/clients and their families. We seek continuous improvement in everything we do. We will become the national leader in health care delivery. Behavioural Competencies Behaviour Demonstrated Communicates and Works Cooperatively improve the experience of the healthcare workforce, patients & Actively looks for ways to collaborate with and assist others to their families and the community & Iwi. Is Committed to Learning Proactively follows up development needs and learning opportunities for oneself and direct reports. Is Transparent Communicates openly and engages widely across the organisation. Enacts agreed decisions with integrity. Is Customer Focused Responds to peoples needs appropriately and with effective results Identifies opportunities for innovation and improvement Works in Partnership to Reduce Inequality in Outcomes Works in a way that: Demonstrates awareness of partnership obligations under the Treaty of Waitangi. Shows sensitivity to cultural complexity in the workforce and patient population. Ensures service provision that does not vary because of peoples personal characteristics. Improves health Work practices show a concern for the promotion of health and well-being for self and others. Prevents Harm Follows policies and guidelines designed to prevent harm. Acts to ensure the safety of themselves and others. Waitemata District Health Board -JOB DESCRIPTION - Page 7

8 VERIFICATION: Employee: Manager: Date: Review Date: Note: This job description forms part of an individual s contract of employment with WDHB and must be attached to that contract. Waitemata District Health Board -JOB DESCRIPTION - Page 8

9 PERSON SPECIFICATION Education Experience/Knowledge Skills and Attributes ESSENTIAL Registered Psychiatric or Comprehensive Nurse Minimum of 4 years postgraduate Minimum 2 years community mental health nursing experience Sound Clinical Skills Comprehensive assessment skills Ability to relate effectively with primary health care Life skills Level 3 Nurse in Community Communication skills Conflict resolution Consumer focused Self directed Time management Computer skills Self motivation Sense of humor Ability to deal with personal stress positively Clean drivers license DESIRABLE.Working towards level 4 triage /crisis experience Care coordination experience Waitemata District Health Board -JOB DESCRIPTION - Page 9

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