The NCH & C Respiratory & Oxygen Team based in West Norfolk are looking for a passionate, motivated Respiratory Nurse Specialist. We are a respiratory nursing team focused on high quality, patient-centered care and this post will provide the opportunity to utilise specialist skills, knowledge, experience and develop your career further.
As a Respiratory Nurse Specialist you will focus upon the autonomous assessment, management, review and supportive care of patients living with a respiratory diagnosis including COPD, Interstitial Lung Disease and Bronchiectasis. This will include admission avoidance, post hospital discharge visits, acute in-reach and specialist advice to virtual ward. In addition we deliver the home oxygen assessment and review service for all patients prescribed oxygen therapy.
Applicants will demonstrate extensive respiratory knowledge with appropriate post registration qualifications and excellent communication skills. Understanding of the current drivers in respiratory care to transform services is an essential requirement. Quality improvement is core to the ethos of the service.
The successful applicant will be required to travel across West Norfolk assessing patients in a variety of settings. The applicant will receive support and professional development.
Current service hours are 8-4pm Monday- Friday excluding bank holidays but may be subject to change in the future.Main duties of the job
- New community assessments for respiratory patients referred into the service
- Home oxygen assessments and review
- Admission avoidance and exacerbation management
- Management of complex respiratory patients
- Triage role (rotational day to day includes referral management, visit allocation, telephone advice and admission avoidance calls)
- Assessment of patients admitted to hospital with acute exacerbation of COPD, completion of discharge bundle, identifying patients suitable for discharge onto Virtual Ward pathway.
- Advanced care planning
- Integrated working with secondary and tertiary respiratory centres to manage patient respiratory care
- Multi-disciplinary and inter agency working to support respiratory patients at home (including Social Prescribing, Charitable organisations, Mental Health Teams, Hospice)
- Act as a source of expert advice for colleagues across primary, community and secondary care including Virtual Ward.
- Training and education to other professionals, patient groups on an adhoc.
- Supervision of Band 6 and Band 4 within the service to include clinical supervision, appraisals and role development
- Support the Clinical Lead Nurse with aspects of managerial responsibilities.
- Service development and innovation
NCH& C is proud to be the first standalone NHS community trust in the UK to achieve an 'Outstanding' rating from the Care Quality Commission (CQC). Our focus is on continually improving the quality of care we offer to local people and on improving access to that care, helping people to move seamlessly from one service to another. Praising NCH& C's compassionate, inclusive and effective leadership at all levels, the CQC observed that our staff are well supported to make positive changes and innovations.
Norfolk Community Health & Care NHS Trust is committed to continuing to create a modern and inclusive work environment. As part of this commitment we actively promote flexible working opportunities where possible, to meet the needs and wishes of our workforce to maintain and improve their wellbeing. The trust offers a range of flexibility, including flexible working patterns, and we would encourage you to discuss this with the recruiting manager before or during the application process if this would interest you.
We welcome applications from people who share our values and can help us deliver outstanding care in our local community.Job descriptionJob responsibilitiesJob Purpose
To act as a specialist practitioner in the advanced assessment, clinical diagnosis and treatment of patients with respiratory disease (COPD, Interstitial Lung Disease and Bronchiectasis). To act as an expert source for patients, their families and other healthcare professionals whilst working collaboratively with the wider multi-disciplinary team in order to provide the best care and support to patients and their families.
To provide vision and a lead role in the promotion and development of new services for patients across the primary/secondary interface, at all stages of the patients journey.
Improve the standards of care delivery to respiratory patient through Clinical Governance processes, clinical commissioning engagement and by modernising the services available to them.
The role will include planning, coordinating, delivering and evaluating respiratory care on a daily basis in an acute hospital and community setting. Main Duties & Responsibilities Professional & Clinical
Provide an advanced level of specialist care to patients with respiratory disease (COPD, ILD & Bronchiectasis) either face to face or via telephone advice.
Management & Leadership
- Instigate diagnostic testing such as CXR, lung function tests and blood tests and action results as appropriate.
- Prompt clinical triage of all referrals (electronic, written, telephone) into the Respiratory & Oxygen service.
- Accept referrals from primary, community care and patient self-referrals (already known to service), offering specialist advice, home visits and clinic appointments in order to avoid hospital admission/readmission
- Caseload management including discharge management and continuing specialist support for patients who require ongoing complex care and management of their respiratory disease.
- and arrange appropriate timely, follow up in the community.
- Proactively identify and assess patients admitted to hospital with an acute exacerbation of COPD through clinical assessment and use of appropriate tools (COPD discharge bundle).
- Facilitate the discharge of patients admitted to hospital with acute exacerbation of COPD. This includes referral to Virtual Ward where appropriate.
- Provide triage telephone advice during working hours to Virtual Ward regarding respiratory/oxygen management.
- Arrange appropriate timely follow up in the community for patients discharged from hospital with an AECOPD. This will include patients discharged from Virtual ward following AECOPD or requiring support for weaning of oxygen therapy.
- Conduct COPD assessments in the community/clinic for patients referred into service. This will include unstable disease and urgent exacerbation management (admission avoidance).
- Clinic or community reviews to patients newly diagnosed with bronchiectasis or ILD to enable holistic assessment and signposting to support services.
- Conduct oxygen assessments/reassessments (including performing a capillary blood gas) in various settings (community, clinic, patients home, day unit)
- Provide reassessment and monitoring (including risk identification) of patients prescribed oxygen therapy including those discharged from hospital.
- Spirometry interpretation.
- Provide a key role in delivery of the Respiratory MDT across primary, community and secondary care.
- Communicating highly complex information sensitively to patients including discussing advance care planning, end of life care with patients and families, utilising appropriate paperwork/ pathways as required.
- Provide palliative support/advice for Health Professionals and patients with respiratory disease.
- Liaise with other professionals (health, social, voluntary sector) in assessment, management and care of respiratory patients including tertiary centres, local hospice, mental health service and charitable organisations.
- Be accountable for own clinical practice by maintaining and developing own advanced levels of clinical competence including identifying any gaps in knowledge and seeking/accessing additional education/information (this includes new standards/guidelines and peer discussion).
- Actively promote, facilitate, and disseminate research and evidence-based practice relating to respiratory disease.
- Maintain a high profile in clinical areas, acting as a role model of clinical excellence to other professionals.
- Utilise Independent Prescribing to enhance quality and delivery of patient care
- Ensure prescribing practice is evidence-based in line with local and national prescribing guidance by completion of appropriate audits, awareness of changes to formularies and peer supervision.
- Educate and empower patients and carers to identify early signs of change in condition providing them with necessary knowledge and skills to gain independence and make informed choices to safely manage their condition/s. This includes providing individualised self-management plans and use of digital options/apps.
- Offer health promotion advice and support to families and patients with respiratory disease including smoking cessation.
- Provide education and specialist advice for other healthcare professionals, including students, in relation to respiratory disease, both in primary and secondary care settings.
- Lead, provide and utilise Clinical Supervision and reflective practice within whole team.
- Effective time management and prioritising of workload.
Provide day-to-day management for the delivery of the local Respiratory and Oxygen Services (including COPD/Oxygen Support Service).
- Responsible for the day-to-day management of a group of staff including work allocation, performance/attendance issues, participating in recruitment, appraisal and development.
- Provide leadership, support, Clinical Supervision and development opportunities for other team members and healthcare professionals.
- Ensure timely and effective communication with the Clinical Lead on all professional matters.
Ensure effective use of resources, both financial and human.
- Robust budget management as delegated from Clinical Lead.
- Management and presentation of data and service information reports such as performance, activity and data error reports.
Ensure clinical information/records are maintained and activity data recorded in a timely manner as per trust policy. Education & Professional Development
Develop, provide, and evaluate education and literature for patients and their families.
- Actively participate in and contribute to networking opportunities at local, regional, and national levels.
- Lead and deliver local Respiratory Meetings providing support to other health professionals involved in respiratory care.
- Facilitate and provide support/advice/education to the local Integrated Breathe Easy group.
- Prepare and deliver educational sessions as required to peers, other Health Professionals
- Be accountable for ensuring workload for self and others is prioritised, planned, and delivered according to service targets and needs including delivery of key performance indicators and collation of service data.
Risk & Governance Management
- Leading and delivering additional projects within respiratory service as required.
- Take responsibility for recording near misses and risks as per trust policy and report to Clinical Lead. This will include oxygen risk assessment and use of DATIX.
- Completion of appraisals for other team members
- Be responsible for attending mandatory training as per trust policy.
- Responsible for safe use and maintenance of equipment and supplies.
Actively lead and participate in multi-disciplinary work to develop strategies relating to the respiratory pathway.
- Collaborate with others in the development of pathways of care for the management/treatment of people with respiratory disease.
- Work effectively with multi-agency teams and other organisations to develop existing services for people with respiratory disease- providing expert opinion.
- oCurrent NMC registration as 1st Level Registered Nurse
- o1st level degree and/or professional knowledge supported by additional post registration specialist respiratory training, experience and short courses equivalent to degree level/masters level
- oPost registration mentorship
- oEvidence of continuing professional development and its application
- oMaster's degree
- oIndependent Prescriber (or willingness to undertake within first 12 months)
- oAdvanced Clinical Practice
- oPost qualification respiratory experience at a relevant level
- oExperience of multidisciplinary and partnership working
- oExperience of delivering teaching/education.
- oWorking in community or acute health care setting or both at appropriate level
Skills, Abilities and KnowledgeEssential
- oContributing to service planning/project management
- oClinical audit experience
- oLeadership experience and management of staff/team
- oGood IT skills
- oClinical assessment skills including chest auscultation.
- oAbility to carry out highly advanced range of assessments in order to make, support a clinical diagnosis and develop a treatment and management plan.
- oAbility to interpret spirometry.
- oAbility to raise concerns and improve standards as required.
Personal and People DevelopmentEssential
- oPrevious use of SystmOne
- oAbility to perform capillary or arterial blood gas
- oManagement/supervision of a team or other staff and facilitating development
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