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Prevent avoidable hospital admissions by providing a holistic assessment, care planning, implementation, treatment and evaluation of patient care packages to meet the individual needs of the patient in accordance with Trust guidelines.
Support the aversion of hospital admission by assessing, organising and delivering specialised care packages for patients discharged into the care of the team.
Undertake core nursing assessments and procedures as required whilst attending the patient e.g. wound dressing, observations, pressure area care, risk assessments e.g. Purpose T , MUST.
Undertake highly developed physical skills e.g. delivery of intravenous therapy, cannulation, syringe driver, catheterisation.
Undertake diagnostic procedures/tests as required and to, when competent to do so, gain a full insight into patients condition, e.g. ECGs, phlebotomy, spirometry, blood glucose testing.
Undertake responsibility for prescribing medication where applicable in line with independent nurse prescribing guidelines following accredited training and competence.
If you have a non-medical prescribing qualification, you will be expected to practice as a prescriber as part of this role.
To be confident in using these skills & nursing knowledge to work autonomously to plan and implement episodes of care, referring appropriately to other services to support the plan of care as required.
Respond to urgent calls from health and social care professionals and utilise sound clinical decision making and triage processes to assess, plan and implement evidence based treatment plans in response to clinical assessment.
Assess and prioritise unscheduled requests for nursing intervention and allocation to the appropriately skilled clinician.
Ensure at all times patients are treated with care and compassion.
To be accountable for the holistic assessment, care planning, implementation and evaluation of patient care packages related to Care Interventions, treatment plans.
Assess and identify any complications surrounding patient care and to act accordingly to enable the patient to remain at home where appropriate. Assess and implement care interventions to meet identified health needs of individuals, families and communities. Maintain associated records.
Refer patients to other services / agencies as appropriate e.g. Social Services, specialist services.
Identify unpredicted crisis situations and manage accordingly i.e. staff, caseload, support network and supervision. Identify to senior managers the situation, risk, action and outcome.
Manage team members and own workload to support the delivery of care in the community and prevent inappropriate hospital admissions.
Organise and coordinate the overall care to meet clients care needs, which may be complex involving other professionals and agencies. Provide individuals and their families with specialist advice in order for them to make informed choices about their health.
Take responsibility for identifying and developing a range of clinical skills/knowledge appropriate to necessitate safe discharge or prevention of admission.
Take a lead in the setting of standards of care amongst the team members and to teach, deploy, co-ordinate and supervise the team, recognising their knowledge/skills and development potential. Plan and co-ordinate for self and others; off duty, covering annual leave, sickness and study leave in the most cost effective way when required to do so.
To be accountable and responsible for the management of work priorities for self and team members. Develop with patients personalised care plans, which use evidence-based care and ensure that the most appropriate member of the team delivers the care required.
Provide education to patients on nature of their condition, treatment, side effects and expected outcome. Enable patients and carers to participate in their care, thus encouraging independence and self-reliance.
You will enjoy working autonomously in a community environment, which puts the patient at the centre of their care. You will have experience of undertaking comprehensive nursing assessment and treatment planning preferably with community experience.
You will have passion and drive with a strong team ethic and flexible disposition, responding positively to a fast-changing environment.
You will enjoy the challenges that a changing environment brings.
You will work collaboratively as a member of the integrated team with local health and social care providers as well as GPs, and the voluntary sector to provide high quality health care within an integrated team model.
We offer a comprehensive induction period and are committed to developing our staff. You will have a Personal development plan which supports your development, identifying both formal and informal training.
Rated 'Outstanding' by the Care Quality Commission, we are proud to provide high quality innovative services across most of the east of England that enable people to receive care closer to home and live healthier lives.
There's one reason why our services are outstanding - and that's our amazing staff - who, for the seventh year running, rated us incredibly highly in the national staff survey.
If you share our passion for innovative and high-quality care delivery, then please submit your application and join us on our exciting journey as a leading-edge specialist community provider. All are welcome to apply and our promise to you is a culture which prioritises staff engagement and development.