1. JOB PURPOSE. 2. ORGANISATIONAL POSITION Professor Nancy Fontaine. Job advertised. Deputy Chief Executive Chief Nurse
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- Gervase Barber
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1 Job Title: Vascular Nurse Practitioner/ Vascular Diabetic Foot Nurse Practitioner ( VNP) Band: 7 Reporting To: Head of Surgical Nursing and Vascular Consultants Department(s)/Location: Vascular Unit PAH Job Reference number (coded): 1. JOB PURPOSE The post is an excellent opportunity to join a well-established Vascular Unit and assist to develop the new Vascular Diabetic Foot Nurse Practitioner role. The post will include a rotation (Alternate weeks) to work as the Vascular Nurse Practitioner role and the developing service of the Vascular Diabetes Foot Nurse Practitioner role. The successful applicant will be given the opportunity to lead and support junior members of the nursing team, within the outpatient and inpatient environment. 2. ORGANISATIONAL POSITION Professor Nancy Fontaine Deputy Chief Executive Chief Nurse Sharon Cullen Deputy Chief Nurse Mr Refson and Mr Abidia Vascular Consultants Winnie Furlong Clinical Nurse Specialist for Leg Ulcers Jacqui Featherstone Associate Director of Nursing and Surgery and Critical Care Suzanne Arbuthnott Head of Nursing Surgical Healthcare Group Job advertised Hannah Rayner Vascular Nurse Practitioner/ Lead Vascular Diabetic Nurse Practitioner
2 3. SCOPE & RANGE The job role has a wide scope and range as it is ever adapting to service the growing Vascular patient population. There is inter-department interaction with the MDT, x-ray team, theatre, Critical care team, Outpatient staff and the ward based nursing teams. Also becoming a member of the Essex Vascular Nurses Group, providing opportunity to have contact with external colleagues Participation in the national diabetes footcare audit. 4. MAIN DUTIES/RESPONSIBILITIES The Vascular Nurse Practitioner/ Vascular Diabetic Foot Practitioner will work with current VNP.. The types of Vascular patients include:- Aneurysm patients (Aorta, iliac, femoral, popliteal), Surveillance, planning for surgery, co-ordination of EVAR/Open surgery, post-surgical follow up. Amputation patients, this role included being the Amputation Champion for PAH, including assessment, implementation and evaluation of prescribed care. - Joint Led for the Amputation support group for patients and family members to attend. Bypass patients, including claudication surveillance, planning for surgery, post-surgery follow up Carotid Endarterectomy patients, Surveillance planning for surgery, postsurgery follow up Diabetic Foot patients, including assessment, implementation and evaluation of prescribed care The VNP duties include:- Development of the Vascular Diabetic Service with current VNP. This is a brand new service and can be tailored to suit the patient base at PAH. Nurse Led Vasoflow Clinic (Advanced Doppler producing wave formats and exercise tolerance test). Actively acting on the results- adding patients to the Vascular MDT, referral for CPET clinic, CT Angiogram, x-ray s, urgent clinic OPA rather than the OPA they have been given or Admission/discharge. Have an active role within the co-ordination of the Vascular MDT- Including booking appropriate referrals and scans for the patients. Liaising with the Critical care team for HDU/ITU bed booking and CPET clinic.
3 Nurse led Vascular clinic twice weekly- To assess, implement and evaluate patient s care plans, including all the above patients. Nurse Led Vascular Pre assessment clinic- To pre assess all major vascular patients ensuring that the patients can make an informed decision about surgical intervention. National Vascular Registry to ensure that the data is completed and entered into the database by the MDT co-ordinator with the assistance of the Vascular team. AAA Surveillance- To ensure that the database is up to date A&E Red folder- To ensure that all patient s deemed unfit for surgical intervention have been entered in the book. Illoprost patient to assist the complex booking officers to book these patients into the appropriate TCI Meet with the Complex Booking Officers to ensure that the vascular cases are dated in an appropriate TCI in accordance with the clinical urgency of the patient. Chair the Amputation Emergency Pathway meetings if any additional changes are to be made Chair the Amputation support group meetings both patient and staff meetings. Assess appropriate Vascular Wounds including the Diabetic foot, Amputation wounds and other Vascular surgical surgery patients within the outpatient and inpatient setting, prescribing the correct care for the individual patient. Link nurse for EVAR booking with the X- ray staff Become a member of the Essex Vascular Nurse Group- including the Academic Vascular Study day Key link for a Vascular patients to the service Validate the Vascular notes for all major Vascular surgical cases. Virtual clinics for AAA patients, including reviewing scan results, implementation of appropriate scan for surveillance, writing to the patient and GP to inform them of the results
4 5. SYSTEMS & EQUIPMENT Cosmic- Outcomes from clinic and ward based patient ORMIS- Check theatre lists Outlook- s Pacs- Review scans Cris- Reports for scans Pathweb- Ordering scans and checking Bloods and MRSA results Notes Management- Letters review AAA- Database National Vascular Registry- Database Huntleigh Doppler- Vasoflow clinic and ABPI on wards and in outpatients Bighand- Dictation of clinic letters Trolley- Transport notes and clinic equipment Laptop- Vasoflow Blood pressure monitor- Vasoflow 6. DECISIONS & JUDGEMENTS The VNP is expected to make decisions on patient s care, which should be implemented and evaluated. Using the correct knowledge base and judgement to implement the care. Any abnormality within a certain criteria should be escalated to the correct member of the team in a timely fashion. It is expected that any service recommendations should be addressed by the VNP and implement an adapted form to suit the service and the team, to improve patient care. 7. COMMUNICATIONS & RELATIONSHIPS The VNP needs to have effective communication skills within the multidisciplinary team including the theatre staff, ITU/HDU staff, X-ray department, Outpatient department, Ward based staff and the complex booking officer. It is essential that the VNP works within the team to provide a smooth patient journey. There will also be external communication with the Essex Vascular Nurse. The VNP will be expected to have good written and verbal communication skills. Including following the correct escalation process within the Trust.
5 8. PHYSICAL DEMANDS OF THE JOB The VNP has to be able to walk to the different areas around the hospital to assess the patients. The VNP will be expected to transport the equipment used within the Nurse led clinics with the trolley provided. The VNP will be expected to complete the individual assessment for the patient whilst standing without any restrictions. The VNP will be expected to assist patients with their manual handling in accordance with Trust Policy. 9. MOST CHALLENGING/DIFFICULT PARTS OF THE JOB The VNP is the point of contact for all Vascular patients and is expected to build a professional relationship with the patient and their family or carers. This entails the patients confiding in the VNP, this can cause over issues to arise including SOVA issues. As the Amputation Champion and Vascular Diabetic Nurse Practitioner for the Trust, it can be very challenging to console the patient for the loss of their limb or toes both pre and post amputation. It can also be emotionally challenging to counsel the AAA patients as these are normally asymptomatic and can be a shock to patients that they will need major surgical intervention or their lives maybe at risk, especially as there are generally no symptoms. It is important also to understand and recognise that some patients are not appropriate for surgical intervention and the best treatment is conservative. This knowledge needs to be understood and the VNP needs to be able to explain to the patient and their families/ carers why this decision has been made and the consequences of not having intervention are, this may include end of life care. The VNP must be able to assist in the complaints process as this can assist in the development of the service and help to improve the patient journey. 10. KNOWLEDGE, TRAINING & EXPERIENCE REQUIRED TO DO THE JOB (Person Specification) Essential NMC Pin number Diploma in adult Nursing Desirable Degree in Adult nursing Recognised academic course about management of Vascular patients Knowledge of the Vascular Diabetic foot patient- including relevant dressing therapies Attended and competent in application of leg Ulcer dressings Attended a course in pain management Understands the essential signs of limb ischemia
6 Completed non-medical prescribing course 11. TRUST VALUES The Princess Alexandra Promise to our patients as identified by our 4 values which will contribute to improving our patient experiences: Respectful Be welcoming, Be polite and Maintain patients dignity Caring Be kind and compassionate, Show empathy and Listen and Respond Responsible Deliver Cleanliness, Be professional and Work as a team Committed Speak up, Treat others as individuals and strive for excellence The Trust believes in investing in all our staff and rewarding high standards of care whilst building for excellence and in return we expect our staff to uphold the Trust values to the highest level. 12. DUTY OF CANDOUR The Princess Alexandra Hospital NHS Trust fully endorses the principles of being open and embraces the Duty of Candour. The Trust is committed to an open and fair culture and the overall approach expected within the organisation is one of help and support rather than blame and recrimination. All staff are expected to follow this approach. 13. JOB DESCRIPTION AGREEMENT A separate job description will need to be signed off by each jobholder to whom the job description applies. Job Holder s Signature: Head of Department Signature: Date: Date:
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