Lead Nurse / Prescribing Nurse

We are seeking a Lead / Prescribing Nurse able to work in a role seeing both patients with undiagnosed conditions independently and routine patients with LTC's.

To work with the Practice Team in providing patient-focussed care responsive to the health needs of our patients.

To assess patients health care needs and manage a caseload of patients, for treatment and referral patients as appropriate.

To make judgements involving complex facts and/or situations, which require analysis, interpretation and comparison of a range of options, which could be complex and made up of several conflicting components and where expert opinion may differ, or not all information is available independently.

To order investigations, follow up results and arrange appropriate management including seeking advice where appropriate.

Main duties of the job We are looking for a highly experienced lead / prescribing nurse to join our practice in the Warners End area of Hemel Hempstead.

Please see job description attached for full list of responsibilities.

About us Our organisation is team based and we work as a cohesive unit. We support and respect each other.

Our nursing team consists of three Practice Nurses and two healthcare care assistants. We are part of a friendly and proactive local Primary Care Network. As part of our team we have clinical pharmacists, physiotherapist, midwife, MH worker, Paramedic, and are looking to expand our clinical team.

All eligible members of staff are in the NHS Pension Scheme or alternative. 5 weeks holiday (plus Bank Holidays), uniform provided by the practice, social outings.

Job responsibilities Job Summary

The post holder is an experienced nurse, who acting within their professional boundaries, will lead the nursing team in providing care for the presenting patient from initial history taking, clinical assessment, diagnosis, treatment and evaluation of their care. They will demonstrate safe, clinical decision-making and expert care for patients within the general practice. They will work collaboratively with the general practice team to meet the needs of patients, supporting the delivery of policy and procedures, and providing nurse leadership as required. In order to work at this level, NMC requirements for advanced practice must be met.

Personal Qualities

The ability to lead the nursing team and to work efficiently under pressure is a pre-requisite. Able to deal with and resolve problems in a positive manner.

When dealing with patients and their records to be aware of the importance of confidentiality. To be punctual at all times and to be of smart appearance, including conforming to the practice dress code.

To be polite, courteous, and have a calm, friendly and welcoming manner.

Willingness to attend relevant training courses and meetings that are of benefit to the individual and the practice.

Key responsibilities

Clinical practice

• Deliver a high standard of patient care as Lead / Prescribing in general practice, using advanced autonomous clinical skills, and a broad and in-depth theoretical knowledge base.
• Manage a clinical caseload, dealing with presenting patients needs in a primary caresetting.
• Instigate necessary invasive and non-invasive diagnostic tests or investigations and interpret findings/reports.
• Where the post holder is an independent prescriber : to prescribe safe, effective and appropriate medication as defined by current legislative framework
• Lead or Assist in developing and delivering specialist primary care services, such as long term disease management (diabetes, asthma, chronic obstructive pulmonary disease, coronary heart disease and hypertension).
• Assess, plan, develop, implement, and evaluate programmes to promote health and well-being, and prevent adverse effects on health and well-being.
• Implement and evaluate individual treatment plans for patients with long-term conditions.
• Identify, and manage as appropriate, treatment plans for patients at risk of developing a long-term condition.
• Prioritise health problems and intervene appropriately to assist the patient in complex, urgent or emergency situations, including initiation of effective emergency care.
• Support patients to adopt health promotion strategies that encourage patients to live healthily and apply principles of self-care.
• Deliver opportunistic health promotion.
• Provide information and advice on prescribed or over-the-counter medication on medication regimens, side effects and interactions.
• Assess and care for patients presenting with uncomplicated wounds.
• Support and manage health needs of women presenting for cervical cytology consultations.
• Recognise, assess, and refer patients presenting with mental health needs in accordance with the National Service Framework (NSF) for Mental Health
• Implement and participate in vaccination and immunisation programmes for both adults and children.
• Advise, support and, where appropriate, administer vaccinations for patients travelling abroad.
• Promote and deliver evidence-based care for patients presenting with aural conditions.

Communication

• Utilise and demonstrate sensitive communications styles, to ensure patients are fully informed and consent to treatment.
• Communicate with and support patients who are receiving bad news.
• Communicate effectively with patients and carers, recognising the need for alternative methods of communication to overcome different levels of understanding, cultural backgrounds, and preferred ways of communicating.
• Utilise communication skills to support patients to adhere to prescribed treatment regimens.
• Anticipate barriers to communication and take action to improve communication.
• Estimate and maintain effective communication with individuals and groups within the practice environment and with external stakeholders.
• Act as an advocate when representing the patients and colleagues viewpoints to others.
• Recognise and work within own competence and professional code of conduct as regulated by the Nursing and Midwifery Council (NMC).
• Produce accurate, contemporaneous, and complete records of patient consultation, consistent with legislation, policies and procedures.
• Prioritise, organise, and manage own workload in a manner that maintains and promotes quality.
• Deliver care according to the NSF and the NICE guidelines and evidence-based care.
• Assess effectiveness and care delivery through self and peer review, benchmarking, and formal evaluation.
• Participate in the maintenance of quality governance systems and processes across the organisation and its activities.
• Utilise the audit cycle as a means of evaluating the quality of the work of self and the team, implementing improvements where required.
• In partnership with other clinical teams, collaborate on improving the quality of health care, responding to local and national policies and initiatives as appropriate.
• Evaluate the patients response to health care provision and the effectiveness of care.
• Support and participate in the shared learning across the practice and wider organisation.
• Participate in the management, review, and identify learning from patient complaints, clinical incidents and near-miss events utilising a structured framework (e.g. root-cause analysis).
• Participate in the performance monitoring review of the team, providing feedback as appropriate.
• Understand and apply legal policy that supports the identification of vulnerable and abused children and adults, being aware of statutory child/vulnerable adult health procedure and local guidance.
• Work within the policies relating to domestic violence, vulnerable adults, substance abuse and addictive behaviour and refer as appropriate.
• Understand own role and scope in the organisation and identify how this may develop over time.
• Work as an effective and responsible team member, supporting others and exploring mechanisms to develop new ways of working.
• Delegate clearly and appropriately, adopting the principles of safe practice and assessment of competence of those taking on delegated duties.
• Ensure clear understanding and utilisation of referral mechanisms with the practice.
• Promote a learning environment for patients, nurses and other health professionals.
• Contribute to the planning and implementation of the teaching for existing staff, such as medical students, NP students, GP registrars, Health Care Assistants, within the Practice.
• Work effectively with others to clearly define values, direction and policies impacting upon care delivery.
• Participate in team activities that create opportunities to improve patient care.
• Participate in and support local projects as agreed with the practice management team.

Management of risk

• Manage and assess risk within the areas of responsibility, ensuring adequate measures are in place to protect staff and patients.
• Monitor work areas and practices to ensure they are safe and free from hazards and conform to health, safety and security legislation, policies, procedures, and guidelines.
• Ensure safe storage, rotation and disposal of vaccines and drugs is undertaken. Where appropriate, oversee the monitoring, stock control and documentation of controlled drug usage according to legal requirements.
• Undertake mandatory and statutory training.
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