Specialty Nurse Challenging November 2015 Job Title : Specialty Nurse - Challenging Behaviours This is a pilot role for 6 months: January to June 2016 Department : Medicine and Health of Older Location : Waitemata DHB sites Reporting To : Clinical Nurse Director, Inpatients Services, Medicine and Health of Older Direct Reports : None Functional Relationships with : Internal Infection Control team Charge Nurse Managers Inpatient Unit Manager AT&R & MHSOA Nursing and medical staff Behaviours of Concern Gerontology Nurse Specialists Committee Psych Liaison Team External Dementia Nurse Specialist Families and carers Allied Health Staff GPs NASC Hospice Daily Operations Manager Community cultural Duty Nurse Manager services Bureau Coordinators Residential Aged Care Nurse Educators facility staff Our DHB Purpose, Values and Standards At the heart of Waitemata DHB is our promise of better care for everyone. This promise statement is the articulation of our three-fold purpose to: 1. promote wellness, 2. prevent, cure and ameliorate ill health and 3. relieve the suffering of those entrusted to our care. At the heart of our values is the need for all of us to reflect on the intrinsic dignity of every single person that enters our care. It is a privilege to be able to care for patients, whānau and our community, a privilege that is sometimes overlooked in our day to day work. Our standards and behaviours serve as a reminder to us all about how we are with our patients and with each other.
Specialty Nurse Challenging Purpose of the role: To ensure appropriate, safe, timely care is received by patients who are admitted to the medical wards at North Shore Hospital and require a higher level of observation. To provide advanced nursing assessment skills and expertise for clinical management, and the co-ordination of patient care plans for patients with challenging behaviour. To liaise with the nurses and managers on the medical wards at North Shore to ensure care is appropriately evaluated every 24 hours and nursing care plans adjusted to incorporate changes in patient need. To manage and approve the requests for special care assistants (watches) and monitor the use of the HCA s in these roles on the medical wards at NSH. This is a pilot role for 6 months: January to June 2016. Specialty Clinical Nurse: Definition under DHBNZ/NZNO titles Works in a narrow field but with more in-depth knowledge and skills than RN Enhance health outcomes for clients by working directly with them to provide assessment, care and education within specific area of practice Contributes to development of pathways, protocols and guidelines in the specific area of practice Works in a defined role using clinical pathways for assessment, referring to senior medical and Nurse Specialists for ongoing care.
Clinical Care/Care Coordination Professional Leadership & Expertise Specialty Nurse Challenging KEY ACCOUNTABILITIES Domain One Professional responsibility Includes accountabilities for professional, legal, ethical and culturally safe practice. This includes being able to demonstrate advanced critical thinking, judgement and accountability for own actions and decisions Meets all registered nurse PDRP competencies at minimum of RN Level 4 requirements refer generic RN competencies and those described for AT&R or is committed to apply for recognition at this level Perceived as highly effective, progressive and knowledgeable in gerontological nursing, according to legal, ethical, cultural safety/ sensitivity and professional standards. Applies critical reasoning and professional judgement to nursing practice issues and decisions for patients at risk Provides advanced practice specialty gerontology nursing assessment to planning care Acts as a positive role model and presents a professional image Domain Two Management of nursing care at advanced practice level Includes accountability related to patient/client assessment and management of advanced nursing care that is supported by evidence Be familiar with all patients on the wards who require an increased level of observation Provides specialty nursing care and expertise to support inpatient ward staff in the care and management of patients who present with challenging behaviour and require an increased level of observation. Sees and assesses all NSH medical ward patients who require a special care assistant. Reviews and approves all medical ward requests for a special care assistant (watch) Liaises directly with the referring ward s CNM for medical review, for patients who become unwell and whose behaviour changes. Provides planned nursing assessment, care planning and recommendations for intervention based on best practice guidelines to achieve identified outcomes, through a caseload model of care, for patients who require increased level of observation for challenging behaviour. Understands and is able to explain the reasons why a patient requires assistance or is declined the request for a special care assistant. Proactively ensures patients who no longer require the need for closer observation are managed appropriately and have the appropriate care plan in place. Liaises with the CNS dementia and psych liaison service where appropriate to ensure optimum management of the patient. Daily review and discussion with the nursing staff to ensure individual care plans are implemented for patients. Demonstrates clinical and professional leadership through effective teamwork and collaborative relationships Acts as an advocate to promote patient needs and rights. Role models advanced therapeutic communication, engages patient and family in care planning for self-care, improving knowledge of disease/illness, self-management, prevention of complications and promotion of recovery Ensures best use of human resource and beds available.
Workplace Health & Safety Service Development Quality Improvement: Supports Professional Activity Education and clinical teaching Specialty Nurse Challenging Acts as a nursing resource providing expert advice and education to nursing staff and health care professionals / family-whanau to manage the care of the patients who present with challenging behaviour and support families/whanau/carers Domain Three Interpersonal relationships and enhancing the patient experience Includes accountability for interpersonal and therapeutic communication with clients/patients and members of the health care team. Attend key meetings Balancing meeting daily 1000 Patient Access meeting weekly (Tuesday 11am) Escalation meetings as required Behaviours of Concern and Occupational Violence Committee Proactively communicate with internal stakeholders All parties are informed about the cohort of patients with challenging behaviour and managers have confidence that the right care is being delivered in a safe and timely manner. A hospital wide approach to problem solving is used. Domain Four Interprofessional healthcare and quality improvement to deliver organisational objectives Includes accountability for evaluating the effectiveness of care and promotion of nursing perspective within the health care team Assists in the implementation of nursing practice and models of care appropriate to patients with challenging behaviour. Participates in interdisciplinary case review processes and clinical supervision with Clinical and Gerontology Nurse Specialists as able Self-directed in achieving own learning and development plan, including PDRP responsibilities/current portfolio Actively participates in professional nursing groups, maintain effective local, regional, national and international networks. Attends educational opportunities and conferences. Leads/contributes/collaborates in quality & care improvement processes, risk management and resource utilisation review, including trending and auditing and developing appropriate responses educational, policy, advisory at patient, nurse and system level Identifies efficiencies through new and innovative ways of working, improves quality of care and patients experience Assists with implementing the service strategy in a project or programme of work to enhance the patient experience, access to service. Includes assisting in implementation and management of initiatives to address differential access to healthcare services for Maori. Recognises Individual Responsibility for Workplace Health and Safety under the Health and Safety in Employment Act 1992. Policies are read and understood and relevant procedures applied to their own work activities. Identifying, reporting & self-managing hazards where appropriate Early and accurate reporting of incidents at work
Statutory & Treaty of Waitangi obligations Specialty Nurse Challenging Ensures the professional and political integrity of WDHB by carrying out all functions in compliance of the Treaty of Waitangi and by demonstrating a serious commitment to keeping the treaty alive. Shows sensitivity to cultural complexity in the workforce and patient population VERIFICATION: Employee: Manager: Date: Note: This job description forms part of an individual s contract of employment and must be attached to that contract.
Specialty Nurse Challenging PERSON SPECIFICATION POSITION TITLE: Specialty Nurse Challenging Behaviours Education and Qualifications Experience Skills/ Knowledge/ Behaviour Personal Attributes Will receive RCpN, RGON, BHSC Current APC as Registered Nurse in New Zealand Post graduate certificate completed in gerontology practice. Must include advanced assessment and diagnostic reasoning skills. At least five years post registration practice in acute medicine or gerontology nursing Achieved RN Level 4 or equivalent in specialty with current portfolio Reputation for excellence in specialty practice - 3 years post registration in nursing practice - 2 to 3 years minimum experience in medicine or AT&R Advanced physical assessment, history taking, diagnostic reasoning and pharmacology knowledge Demonstrated operational management/care coordination skills Clinical professional leadership Confident multidisciplinary teacher Project management and quality improvement processes Demonstrated confidence in quality improvement to improve service delivery Understands the importance of good relationships in ensuring continuity of care: hospital and community care A passion for improving patient centred nursing practice and standards of care Ability to work independently and as a team member Leadership Proactive attitude management Excellent communicator Teamwork Articulate, good presentation skills Cultural safety Self directed and motivated Self-management Strong teamwork reputation, confident Patient/client population focused collaboration Communication / interpersonal skills Resilience Innovation Positive professionally mature Flexibility Able to influence without conflict, accepts Planning and monitoring constructive feedback Culturally safe practice