Job Description: Specialist Addictions NursePrescriber OVERVIEW: As Specialist Addictions Prescriber and a member of a multi-professional team the post holder is responsible for the assessment of clinical care needs and will provide high quality care to patients, families and carers in relation to drug/alcohol services. At Abbeycare Newmarket the post holder will be expected to work in partnership with other team members to provide and contribute to the development of a service to respond to the needs of all substance misuse patients who have complex health and social care needs. MAIN DUTIES & RESPONSIBILITIES ADMISSIONS: 1 Abbeycare Admissions team will provide you as Addictions Nurse with a medical summary report in an agreed format for all prospective admissions to our substance misuse detoxification rehabilitation service subject to patient and GP consent. Should the patient decline to provide a medical report or the clinic be unable to access the report you will decide on the basis of the assessments needs and complexity whether to approve admission. 2 You will provide Abbeycare with an assessment of patient s health physical/mental and assess their level/history of substance misuse at point of admission to Abbeycare. 3 You will be responsible for assessing the suitability of patients from a health perspective to be admitted to the Service. Should you feel that referral to our Consultant Psychiatrist be required you will coordinate the appropriate further medical input. In the event that alternative external arrangements are required, you will advise on appropriate onward referral. PRESCRIBING: 1 As prescribing Addictions Nurse you will design a detoxification protocol for each patient and will agree that with the patient. You will spend sufficient time with the patient to ensure that they understand the detoxification regime and agree to it. 2 You will provide a prescription for detoxification and any other medication required by the patient during their residence at Abbeycare. 3 Any PRN medication will be prescribed by you with clear, written guidance to the Abbeycare recovery support team regarding the administration of that medication including dosage and frequency. 07/02/2017 Page 1 of 6 Abbeycare Newmarket
CLINICAL/TREATMENT PLANNING: 1 You will provide Abbeycare with a written assessment report, in the agreed format, upon completion of the initial patient consultation. This will include an ongoing management plan identifying all supporting or additional medical input required for each patient through the detoxification and rehabilitation process such as nursing and dietician input. 2 Undertake the ongoing assessment of care needs including developing, implementing and evaluating action plans whilst involving the patient and family to promote the recovery process empowering the client to take responsibility for their health and wellbeing. 3 Use clinical judgement in the provision of care to enable people to improve, maintain, or recover health, to cope with health problems, and to achieve the best possible quality of life, whatever their disease or disability. 4 Collect, analyse and record results of urine/oral fluid samples, following specified protocols. You will coordinate sample collection and processing using the Abbeycare account with medichecks.com. Abbeycare will be invoiced for all blood testing. 5 Provide patients with a range of harm minimisation information and signposting for, advice and support such as safer injecting (needle exchange locations), safer drug use, safer sex and other appropriate health and social care issues. 6 Provide nursing support to BBV clinic including testing, vaccinations and data. 7 Assess patient s need for services and refer to other agencies where appropriate. 8 Promote shared care and partnership working. 9 Ensure clear and concise reports and accurate nursing records are maintained in accordance with the Policies and Procedures and NMC record keeping. 10 You will carry out any blood testing required following patient assessment or review. 11 You will assess and provide written consent for patients to receive house medication during their stay at Abbeycare Newmarket. 12 You will provide written consent for patients to receive holistic therapies and attend the gym or swimming during their residence at Abbeycare provided such activities are considered by you to be appropriate and safe for the patient. It is however agreed that our holistic therapist will conduct their own specific assessment prior to holistic treatment. 13 You will carry out admission baseline alcohol and drug testing and record weight, height and BMI of all new admissions to the service. 14 You will provide and review PRN assessment tools. 07/02/2017 Page 2 of 6 Abbeycare Newmarket
15 It will be the responsibility of Abbeycare to ensure the PRN assessment tools are implemented at all times to assess PRN detoxification requirements. 16 You will have responsibility for carrying out medication audits 17 You will have responsibility for the reporting of medication notifications to CQC in line with best practice. 18 Provide a clinical summary report for each patient as part of their discharge from the service. 19 Initiate and contribute to the development and realisation of clinical/research audit projects. 20 Understand and adhere to current legislation e.g. Supporting & Protecting Adults at risk. 21 Keep senior staff informed of all relevant circumstances and report complaints relating to the service to the Team Manager TRAINING: 1 You will provide updated detoxification protocol training to the Abbeycare recovery support team annually. 2 You will have responsibility to ensure that clinical supervision is provided regularly to meet CQC & NMC requirements and provide Abbeycare documented details. 3 Assist in the induction of new staff. 4 Act as a role model and assist colleagues to develop their professional role and skills. 5 Prepare and deliver formal and informal teaching sessions, and support others in providing education for patients, relatives, colleagues and others. 6 Maintaining and updating skills and knowledge. ON CALL: 1 You will coordinate and provide on call telephone support to Abbeycare regarding detoxification and healthcare issues. 2 In emergencies should the on call team who provide 24/7 on call support be unable to provide 24/7 on call support for whatever reason at any time the Management team at Abbeycare will utilise the services of NHS24. 3 It should however be the responsibility of the Addictions Nurse to ensure that when he is 07/02/2017 Page 3 of 6 Abbeycare Newmarket
unavailable that he will coordinate appropriately trained and qualified medics to cover in his absence in order to meet the needs of the service. GOVERNANCE: 1 You will have responsibility to ensure Abbeycare that NMC registration is up to date. 2 You will participate in regular clinical governance meetings with the other members of the clinical and management team. 3 You will have responsibility to ensure that your clinical training is up to date and appropriate for the role with records available to Abbeycare Newmarket. SYSTEMS AND EQUIPMENT 1 You will be competent in the use of the below listed equipment: Breathalyser Sphygmomanometer Testing kits Dictaphone / voice recognition Computer Mobile phone / pager Emergency drugs and equipment BBV / vaccinations 2 You will comply with the proper operation and security of clinical, administrative and managerial systems. These include: maintenance of patient s records, safe custody of medicines, risk management, staff supervision, appraisal and PDPs Monthly statistical collection in relation to worker s client activity for Team Manager Weekly diary sheets in relation to worker s activity Planning on-going appointments Co-ordination of workload with other staff members Participation in weekly clinical meetings and others as directed by senior staff as appropriate. Inputting into Databases, spreadsheets and competent in software relevant to service Incident reporting Completion of NDTMS DECISIONS & JUDGEMENTS 07/02/2017 Page 4 of 6 Abbeycare Newmarket
Assessing clients for suitability for clinical treatment which may include complex issues requiring specialist knowledge. Assessing and implementing referral to other agencies / team where appropriate Problem solving in unique situations both in clinic and home environments Risk assessment Assist in the orientation and teaching of new staff and students. Assess and work with complex or sensitive information. Is accountable for own clinical practice. Practice within current legal, ethical and professional frameworks. These include: Local and National Child protection Guidelines, Mental Health Act, Supporting & Protecting Adults at Risk, Data protection Act, NMC Code of professional Conduct and associated guidelines, Working time Directives, SIGN Guidelines, NICE Guidelines. COMMUNICATIONS Regularly responsible for providing information/training in workplace as part of induction process Occasional in-service training on specific subjects/responsibilities Occasional training or information sessions to nursing groups out with the service The post holder communicates in various methods, written, telephone, face to face, e-mail and fax. The post Holder communicates information with different levels of sensitivity in relation to its content, from routine administrative information to sensitive and important clinical information. The post holder demonstrates reassurance, motivational and negotiating skills when communicating with clients, particularly with regard to treatment compliance and self-help. Communicate in a manner that is open, professional, polite, positive and welcoming to all. PHYSICAL DEMANDS OF THE JOB Lifting boxes of stock on delivery occasionally up to 5kgs Carrying case files and equipment in relation to clinical work several times a day not more than 5kgs. Negotiate stairs and entry to client s rooms and offices occasionally Driving undertaken in the course of their work daily using lease cars or private vehicles. Geographical area and attending clinics while accommodating for travel time Combination of walking, sitting, standing throughout the day may sit at computer for up to 3 hours 2/3 times a week. 07/02/2017 Page 5 of 6 Abbeycare Newmarket
MOST CHALLENGING/DIFFICULT PARTS OF THE JOB Working on own with a difficult patient in a variety of clinical settings. Working with patients with co-morbid issues and with pregnant clients and the attendant complications of such Emotional demands of working with clients who frequently have chaotic lifestyles Working with patients who have a forensic history of assault. Aggression and abuse Accessing and inputting database for client information Dealing with the Court preparation of written Court reports. Bodily fluids and excreta Mental Demands Working with patients who may be distressed, withdrawing from drugs/alcohol or displaying aggressive behaviour can be several times daily Listening to distressing information in relation to issues such as sexual abuse- can be daily Working with patients who are suffering from HIV and Hepatitis B and C daily Concentration is required if undertaking prescribing clinics and whilst subject to interruption during consultations. Accurate record keeping maintained post consultation if unable or inappropriate to complete at time. Constantly working with the unpredictability of drug and alcohol users. Difficulty in accessing information from other agencies to enhance patient care. Emotional Demands Working within a forensic environment and the attending stresses Working in partnership where differing service philosophies may, on occasion, cause tension. In dealing with some patients distressing and disturbing information can be disclosed Working with a patient group who often have chaotic and unstructured lifestyles. Working autonomously can, on occasion, lead to the feeling of isolation. Working Conditions Frequent exposure to verbal aggression, on a daily basis Frequent unpredictable exposure to physical aggression Exposure to body fluids several times during a shift Constant exposure to people under the influence of illicit substances and their paraphernalia 07/02/2017 Page 6 of 6 Abbeycare Newmarket