Date : July 2007 Job Title Department Location Reporting to : Critical Care Outreach : Intensive Care / High Dependency Unit : North Shore and Waitakere Hospital : Charge Nurse Manager () for meeting performance objectives. Functional Relationships : Internal External Committees/Groups Unit Manager. Consumers & their families Clinical Director Nursing staff supporting the unit functioning e.g. Clinical Nurse Specialists, Clinical Nurse Educators, RN colleagues, Clinical Coach Director of Nursing & Midwifery Medical teams Allied Health team Support Services: pharmacy, nutrition, laboratory, clinical engineering, facilities Colleagues in other DHB s Unit Meetings M & M Meetings Purpose : Daily co-ordination of the Critical Care Outreach Service to ensure delivery is efficient, effective and of a high standard. Assisting and supporting ongoing learning Critical Care Outreach Team (CCOT) initiatives that support patient safety and develop competence and capability of WDHB nurses. Outreach RN, July 2007 1
Key Responsibilities Accountability 1 A. Assessment 1. Diagnostic and patient/client monitoring function 2. Monitoring response to therapeutic intervention B. Planning Care 1. Patient/client needs identified 2. Discharge planning 3. Patient/client education C. Clinical Practice 1. Helping role (supports, informs, advises, coaches) 2. Administers therapeutic interventions 3. Teaching and learning 4. Managing rapidly changing situations Expected Outcomes Provide skilled nursing care Demonstrate skill in clinical health assessment in the clinical setting Identify changes in patient/client condition Take appropriate actions and acts to prevent deterioration Effectively identify changing needs Demonstrate technical competence in undertaking relevant treatments and practices Assess patients with multiple problems to provide immediate care and assess when other team members need to be called / referred to Practice nursing in a manner that respects the boundaries of a professional relationship Provide an environment of trust and respect Identify patient s readiness to learn and implements teaching appropriately Co-ordinate and prioritise the care for a number of patients Participate in the multi-disciplinary meetings / clinical rounds Work to understand the patient/family/ whanau s interpretation of the illness to consider the options and goals Seek guidance from more experienced nurses / medical colleagues when a new situation arises Care is adapted to respond to multiple priorities Care is managed to adapt to input from the multidisciplinary team Help the patient/client understand the treatment and care plan Assist patient/family/whanau to participate in care as desired Assist patient/family/whanau cope with the implications of the situation and adapts the care plans accordingly Respond to patient/client inquiries with complete, accurate and timely information Acts appropriately to protect self and others when faced with unexpected client responses, confrontation, personal threat and other crisis situations Use informal and formal methods of teaching appropriate to the individual or group abilities D. Evaluation of care Client progress is reviewed and appropriate referral or adjustment of the care plan made in consultation with the client and health care team Integrate knowledge of bio-science and patho-physiology when evaluating patient response to intervention/therapy Accountability 2 Collaborate with the health care team to promote the best patient/client outcomes Contribute as an effective team member in service planning and quality improvement Contribute to team building activities Is courteous, diplomatic and positive in working relationships especially in stressful situations Provide feedback in a constructive, assertive manner Assist with student learning and orientation of new team members Appropriately challenge health care practice which could compromise client safety, privacy or dignity Participate in multidisciplinary clinical decision making Outreach RN, July 2007 2
Accountability 3 Accountability 4 Accountability 5 Contribute to continuous quality improvement in work practices Ensure that action is taken where problems and safety issues are identified Make suggestions of ways to improve the quality and reduce the cost of services Participate in peer review and case review to ensure that the client receives the best care possible Seek feedback from colleagues about the consistency and standards of own practice Is involved in quality improvement activities/auditing including applying the Health & Safety policies to own work activities, identifying hazards and reporting self management of hazards Demonstrate professional accountability and leadership Is a role model by continuing to work on personal and professional development Develops critical thinking and managerial skills under instruction, mentoring and educational guidance To work progressively and constructively towards clinical levelling and to take on adjunctive responsbilities. Develop the ethos of team work and collegial support Provide thoughtful, constructive evaluation in peer review Consistently exhibits fair, dependable and ethical conduct Assist with preceptoring and support of new staff and helps them become an effective team member Is self-directed and shows initiative in care delivery and teamwork Involves an advocate when the client requests support or has limited abilities in decision making Promote individual responsibility for workplace health and safety, following the guidelines of the Health and Safety in Employment Act (1992) 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 VERIFICATION: Employee: Department Head: Date: Outreach RN, July 2007 3
PERSON SPECIFICATION Minimum Preferred Qualifications RCpN, RGON, BA Nursing Continued development through post-registration education and learning opportunities Experience with 4 years experience with demonstrated appropriate clinical experience at this level. Critical care experience is essential in order to provide expert physical assessment and give advice on the correct course of action. Post graduate tertiary education in HDU/ICU is highly desirable. Advanced resuscitation training. Ability to interpret results (blood results, ECG s etc). Competence in management of patient s requiring both invasive and non invasive respiratory support, so as to provide advice and support (IPPV, CPAP, non-invasive ventilation, care of tracheostomy). Knowledge of nutritional needs of critically ill patients and those recovering from critical illness. Excellent communication skills to facilitate liaison between CCOT, service personnel, wards and other specialists. Understanding of physical, cognitive and psychological problems following critical illness. Accountability, legal and ethical awareness. Basic audit skills to ensure evaluation, development and reporting for the Critical Care Outreach service. Strong communication skills to effectively share clinical knowledge with others, teaching and guiding staff effectively Use of information and computer support systems Strong team work reputation Personal attributes Contemporary view of nursing practice as evidenced by an innovative and dynamic approach to patient care in the acute care setting. Excellent communication and interpersonal skills Understanding of and commitment to the principles of the Treaty of Waitangi. Ability to work with minimal direction, knowing when to seek medical advice A positive nursing identity and ability to act as role model for other nursing staff Able to lead and manage change Able to handle stress effectively in self and others Positive manner, able to influence without conflict, good facilitator, provides clear direction Upholds confidentiality with reputation for high integrity and discretion Sensitive and constructive in responding to the needs of individuals and groups, recognising cultural difference. An active listener, has a way of valuing everyone s opinions Reputation for excellent nursing practice and ability to coach and guide Skills / Knowledge / staff to meet patient needs. A credible role model Behaviour Demonstrated expertise in guiding care planning for complex patients and working with families Detailed knowledge and understanding of the legislation surrounding privacy and informed consent Outreach RN, July 2007 4
Excellent communicator, highly articulate and excellent listening skills Self-directed/use of initiative, confident skill in negotiation and consultation Manages personal stress effectively Upholds confidentiality with a reputation for integrity and discretion Ability to work well in a team, enhancing the capability and contribution of the team Ability to effectively share clinical knowledge with others and help transform practice Works effectively using a sense of humour Seeks guidance and supervision Has experience in maintaining good relationships to ensure continuity of care and integration, hospital and community care Outreach RN, July 2007 5