JOB TITLE: Deputy Sister/Charge Nurse GRADE: Band 6 HOURS: 37.5 BASE: Basingstoke or Winchester with the expectation of cross site working RESPONSIBLE TO: Sister ACCOUNTABLE TO: Clinical Services Manager Anaesthetics & Critical Care RESPONSIBLE FOR: Staff nurses, ward clerks students when shift leading Organisational Values: The post holder will: Put patients first - consider the patient’s needs and wishes in all that they do Take pride in what they do – strive for highest standards on own work and challenge colleagues to do the same Strive to be the best – in terms of patient care & teamwork Act with integrity - maintain the privacy & dignity of patients, work with integrity and be trustworthy, be accountable for own work Respect others – patients, visitors and colleagues. Actively give and receive feedback. JOB PURPOSE The Deputy Sister / Deputy Charge Nurse will undertake the management of the unit on a dayto-day basis in the absence of or in conjunction with the Sister/Charge nurse. To provide clinical leadership and support colleagues to plan, monitor and evaluate skilled and appropriate care for the critically ill patient and ensure the provision of evidence based care. The post holder must act as a role model in providing specialist knowledge within critical care. You will work as part of a team supporting and developing colleagues by mentoring and assessing their skills. The post holder is required to be registered with the Nursing and Midwifery Council Organisational Position Director of Ops, Surgical Division Clinical Services Manager Anaesthetics & Critical Care Sister / Charge Nurse Deputy Sister / Deputy Charge Nurse THIS POST FINANCIAL RESPONSIBILITY: Responsibility for safekeeping of patient property on a shift-by-shift basis. Shared responsibility on a shift-by-shift basis for the efficient use of resources and safe use of highly complex, expensive equipment (up to the value of £70,000.00) reports faults to nurse in charge. SUPERVISORY RESPONSIBILITIES: Responsible on a shift-by-shift basis for professional/clinical supervision of new/ junior staff members and pre-registration students, or learners from other areas such as radiographers, physiotherapists. RELATIONSHIPS Internal Relationships Support Staff All Clinical staff Trust Managers Transplant Coordinator External Relationships Patient’s relatives Members of the public Visitors both formal and informal to the Trust Ambulance personnel Social Workers _____________________________________________________________________________ CLINICAL/ OPERSATIONAL RESPONSIBILITES Managerial Responsibilities To provide leadership, support and guidance to staff in monitoring the planning delivery and evaluation of individualised care. Responsible for monitoring the workload/patient acuity within the ward/unit on a daily basis to ensure that nursing manpower is adequate to provide a safe standard of nursing care. Ensure the cost-effective and appropriate use of manpower and materials with consideration and due regard to budgetary control. Liaise with other wards/units within the Directorate regarding staffing issues, offering support if necessary. Exercise leadership to motivate members of staff, achieve high morale and promote effective communication within the ward/unit. Investigate all accidents, incidents and complaints as delegated by the Clinical Services Manager or Sister/ Charge Nurse, reporting them to the appropriate personnel, along with the relevant documentation, in a timely manner. Ensure that all members of staff are aware of their legal responsibilities with regard to the prescription, administration and custody of drugs. Inform Sister/ Charge Nurse or Clinical Services manager when changes in circumstances occur which may affect safe and competent practice. Act up or deputise for the Sister/ Charge Nurse when required taking charge of the Critical Care Unit as required Encourage new ideas and facilitate their implementation following discussion with the clinical leader. In conjunction with Sister / Charge Nurse and Clinical Services Manager facilitate the process of change within the ward/unit. In conjunction with Sister / Charge Nurse performs appraisals and facilitates in the development of Professional Development Plans for staff within team. Assist the Sister / Charge Nurse in any grievance, disciplinary, performance or sickness issues as appropriate and in accordance with Trust procedures. Ensuring that any Bank/Agency timesheets you sign are an accurate representation of the time worked. The post holder will need to maintain a personal duty of care when handling patient valuables/property. Clinical Skills Provide direct, holistic, specialist care for critically ill adults and children within ITU/HDU competently on a frequent daily basis; Level 2 and 3 patients with minimal supervision. Utilising advanced specialist knowledge and skill in assessing, planning, implementing and evaluating programmes of care for adult / paediatric patients within ITU/HDU from admission to discharge on a frequent daily basis, with minimal supervision. Skilled in the process, interpretation and manipulation of complex clinical data, thus facilitating early medical intervention to avert potential complications/optimise patient clinical condition within ITU/HDU on a frequent daily basis and with minimal supervision. One Nurse per patient, nursing care of level 3 patient, providing continuous attendance, visual observation and appropriate intervention on a frequent daily basis, with minimal supervision using: Advanced forms of respiratory support (i.e. CPAP, BiPAP, Mechanical Ventilation, Tracheostomies, Bronchial Suctioning.) Advanced forms of invasive monitoring (i.e. CVP, Arterial lines, PICCO), Visual monitoring and analysis (i.e. Cardiac dysrythmias, Glasgow Coma Scale, ECG, Sao2, ETCO2, 12 lead ECGs, sedation level, pain assessment.) Advanced forms of Renal support (i.e. Haemofiltration, Dialysis.) on a frequent basis and with minimal supervision. Nutritional support (i.e. Enteral and Parenteral feeding.) on a frequent basis and with minimal supervision. Frequent blood sampling, including analysis and interpretation i.e. Arterial blood gases, capillary blood glucose measurement, cardiac output studies, using complex equipment on the Intensive Care Unit with minimal supervision. Take Laboratory blood and other specimens as required - +/- 6 per shift and access results from the Hospital computer system. Safe calculation, administration and titration of multiple and complex IV infusions (as many as fifteen) working within prescribed parameters to achieve precise aims (i.e. Inotropes, Sedation, Epidurals, PCAs etc) including a working knowledge of the drug effects, and action in the event of an adverse response, on a frequent basis and with minimal supervision. Advanced life support skills including defibrillation. Tight glycaemic control, according to ITU protocol and exclusive to ITU, on a frequent daily basis and with minimal supervision. Able to recognise and assess emergencies within ITU/HDU and take immediate appropriate action. Observation and safe management of intravascular devices, on a frequent daily basis, with minimal supervision. Observation and safe management of airway devices delivering assisted or mechanical ventilation, on a frequent daily basis, with minimal supervision. Ensure that clinical practices accurately reflect unit and trust policies and philosophies of care whilst respecting the patients’ needs and dignity on a frequent daily basis, with minimal supervision. Co-ordinate and conduct safe, timely, complex patient transfers for investigations such as CT scan, MRI scan, or relocation to other hospitals. Responsible for equipment to the value of £30,000.00 during this time. Provide advice and support to patients and relatives in unpredictable, highly emotive situations whilst respecting their cultural and spiritual values on a frequent daily basis. Plan a timely, organised, discharge of complex patients ensuring good communication with patient, relatives, receiving ward and medical team to enable a smooth, uneventful transfer for the patient, on a frequent basis with minimal supervision. As per Trust Drug Policy follow the safe ordering, storage and administration of medicines. Act in the patients best interests working to protect values and rights of the patient with integrity and insight on a frequent daily basis, with minimal supervision. Able to recognise physiological and psychological responses to intervention. on a frequent daily basis, with minimal supervision. Nurse led weaning of respiratory support according to current guidelines. Weaning of sedation, pain relief, inotropes etc as directed by clinician, on a frequent daily basis and with minimal supervision. Responsible for infection control and cleanliness standards on a shift-by-shift basis by ensuring that self and staff follow national and trust policy. May act as link nurse for nutrition, diabetes or control of infection by attending meetings held by the appropriate specialist nurse and bringing back and communicating to ward staff through the regular monthly meetings any changes in practice. To administer last offices for the deceased patient and complete documentation as per Trust policy. Adheres to the NMC Code of conduct and acts as the patient advocates at all times. Participate in multidisciplinary team discussions which affect patient care directly. To ensure patients and others safety is maintained and report to senior staff all accidents / incidents or potential risks which may result in harm to all. To transfer critically ill patients in and out of hospital safely and competently. To ensure standards of documentation are maintained in accordance with NMC Guidelines for records and record keeping as per HHFT Policy. Demonstrates an awareness of audit and participates in the collection of data for ICNARC. Demonstrates effective communication skills systems with patients, their relatives and friends and other visitors. Ensure the safety and care of patients property and valuables following HHFT Policy. Be aware of limitation of knowledge working in this specialised area. Emotional Effort Care of the dying adult, including those patients for whom the Intensive Care Consultant decides that no further treatment is appropriate, meaning the withdrawal of medications and mechanical ventilatory support to allow the patient to die with dignity: The nurse provides close, sensitive support to family, friends and significant others. Management of brainstem dead patients undergoing organ donation, close, sensitive support of family, friends and significant others. Liaising closely with the transplant co-ordinator. All of the above requiring extreme emotional effort. Will be in daily contact with anxious and or distressed patients and relatives and, on a frequent basis will be required to deliver bad news. Communication Within the constraints of patient confidentiality, respond to internal and external requests for information about patient conditions on a frequent daily basis, relaying information in a format easily understood, to family, friends and significant others, face to face or via the telephone. Ensure pertinent information is accurately conveyed to relevant personnel in a timely manner on a frequent daily basis. i.e. the multi-disciplinary team and all other health professionals etc; via email, telephone, written or face to face Utilise advanced skills to overcome communication difficulties with patients due to intubation, tracheostomy, sedation or brain injury on a frequent daily basis. Communicate extremely sensitive or emotive information to families or visitors on a frequent daily basis, with minimal supervision Assess and advise patients and relatives in crisis and ensure that their needs are met by the whole team on a frequent daily basis. Maintain accurate and legible documentation according to Trust and professional guidelines on a frequent daily basis Accurate charting of multiple, complex clinical data of the critically ill adult / child at least hourly. (i.e. blood pressure, heart rate. pulse, temperature, central venous pressure, individual hourly infusion rates, urine output, other bodily fluid output i.e. wound drains. Mechanical ventilation settings, sedation score, together with other data relevant to the individual patient). Provide statements in response to formal complaints or resolve with patients or relatives any verbal complaints. Inform and involve the Senior Sister / Matron Critical Care / PALS services any that cannot be resolved. Use learning from complaints to develop and change practice Assesses patients, plans, implements care, provides specialist advice and maintains associated records To provide a safe environment within the clinical setting. To transfer critically ill patients in and out of hospital safely and competently. Carries out specialist nursing procedures e.g. Haemofiltration Assist, in conjunction with the Sisters/ Charge Nurse and Clinical Services Manager in ensuring that agreed programmes and standards of care are implemented and evaluated, thus providing high standards of patient care at all times. To act as an effective role model and resource/adviser to colleagues in the delivery of nursing care. Work as an effective member of the multi disciplinary team and individually without supervision where appropriate. Ensure that nursing care and clinical practice is research and/or evidence based and accurately reflects the department’s philosophies. In conjunction with specialist staff/management, participates in research and audit projects. Will keep up to date with clinical developments relevant to the speciality and current issues relating to nurses and the Trust. Demonstrate competence in caring for critically ill patients and provision of all therapies within clinical setting. Will promote a healthy and safe environment for patients and staff. Liaise with other disciplines on issues which may affect the care and safety of patients. To lead and promote the ongoing development of the role of Audit, CCMDS where appropriate maintain audit reports, accurate records, data collection and costing. May undertake research, lead clinical audits in own specialist area Generic Competencies Will be accountable for his/her actions and act in accordance with NMC Code of Professional Conduct. Will act in accordance with Local, Hospital and Statutory Guidelines & Policies including Health and Safety initiatives. Will be familiar with the Health and Safety at Works Act, and be aware of its implications and ensure that local unit and departmental policies are followed. Will work in accordance with Corporate Objectives. Will compile a personal & professional portfolio (in conjunction with the Knowledge and Skills Framework and the compilation of a Personal Development Plan). Will maintain a high standard of care and give courteous reception to all patients and visitors. Will adopt a service-orientated approach to work. Will practice in a cost effective and cost aware manner. Establish a relationship with a Clinical Supervisor. Will act as supervisor, where appropriate to junior members of staff and unqualified members of staff. Will ensure that the hospital’s policy is understood and carried out with regard to the care and custody of drugs/medications, especially with regard to those covered by the Control of Drugs Act. Will be familiar with the unit’s fire, manual handling and Health and Safety policies and ensure that all nurses in the unit are aware of the policies. Will be fully conversant with the Trust major incident plan, and ensure that all nurses on the unit understand the procedure. The post holder must at all times carry out his/her responsibilities with regard to the Trust’s Equal Opportunities Policy. Communication In conjunction with the Sister / Charge Nurse, Clinical Services Manager, other senior members of the Surgical Division, Nursing and Medical Consultants maintain an efficient communication system ensuring dissemination of information to all staff. Facilitate the development of an environment which allows other members of staff to have an opportunity to put forward ideas and suggestions for improvements in patient care. Maintain effective communication links with all other disciplines, wards and departments. Provide support to the clinical leaders exercising leadership as required and achieving and maintaining high morale. Encourage the provision of feedback to colleagues at all times. Liaise with outside agencies as indicated in relation to patient care Education and Training To promote the role of the Band 6 nurse within Critical Care Provides clinical and managerial leadership to nursing and support staff Provides clinical supervision to other staff, students Ensure that all nursing staff, within the ward/unit adheres to all Hospital Policies and Procedures. Be familiar with the Health and Safety at Work Act and recognise responsibilities in following Health Policies. Participate in the orientation of new staff to their duties, ensuring that expectations of the roles are discussed and developed. Provide support for and give guidance to junior staff. Be familiar with the Major Incident procedure, Fire policy and Pandemic Flu policy and ensure that all nurses within the ward/unit are aware of these policies. Be responsible for own education and professional development and updating of critical care skills. Facilitate in the delivery of formal and informal teaching sessions for pre-registration and qualified staff. Act as a mentor and preceptor and assist in the management of preceptorship and mentorship arrangements for staff new to the ward/unit. Participate in educational audits and ensure that the ward/unit provides an appropriate learning environment at all times. Provide support to non-nursing, clerical and administrative staff. In conjunction with the Sister / Charge Nurse to undertake individual performance reviews on nursing staff within Band 5 and Band 2. Participate in the recruitment and selection of staff for the ward/unit. In conjunction with the Practice Development Team for Peri-operative, Critical Care and Pain and Sister / Charge Nurse ensure that staff within team receives annual in-service training relating to fire, lifting, health and safety and Basic Life Support. Assist in the maintenance and review of information technology systems within the ward/unit. Self Management Is wholly accountable for his/her own nursing practice and takes every reasonable opportunity to sustain "Fitness for Practice" and competence. Practices in accordance with the Trust and NMC Code of Professional Conduct and other appropriate NMC guidelines. Takes responsibility for ensuring up to date clinical competence, knowledge acquisition and the development of personal portfolio and personal development plan. General Undertakes all relevant clinical, non-clinical and managerial functions commensurate with band. Recognises the Scope of Professional Practice in the advanced clinical role within the post operative and critical care settings. Demonstrates flexibility and a willingness to work within other post operative and critical care settings, wards & departments within the Trust as required and where necessary. To accurately maintain patient records and any other appropriate records related to the unit or staff. Undertake projects as required and identified by the Sister / Charge Nurse or Clinical Services manager Be prepared to work in the Critical Care Unit across any of the Trust sites as dictated by clinical and service needs. GENERIC DUTIES FOR ALL STAFF 1. Diversity and Rights Promote people’s equality, diversity and rights, and treat others with dignity and respect. 2. Confidentiality Ensure confidentiality at all times. Employees of the Trust must not without prior permission disclose any information regarding patients or staff obtained during the course of employment, except to authorised bodies or individuals acting in an official capacity. Failure to adhere to this instruction will be regarded as serious misconduct and may lead to disciplinary action. The Data Protection Act may render an individual liable for prosecution in the event of unauthorised disclosure of information. 3. Trust Policies and Procedures including Control of Infection To be familiar with and to comply with the Trust's policies and procedures, which are available via line managers in each department and on the Trust intranet. Failure to adhere to this instruction will be regarded as serious misconduct and may lead to disciplinary action. Be aware of and adhere to the Trust’s infection control policy. Infection control is everyone's business and it is important that all members of clinical and non clinical staff observe good infection control practice at all times. Failure to adhere to this instruction will be regarded as serious misconduct and may lead to disciplinary action. 4. Safeguarding Children Employees of the Trust have a responsibility at all times to ensure the well being and safety of children under the care of the organisation and to comply with the Trust’s policies and procedures in this. 5. Risk Management and Health & Safety Be aware of the Trust’s risk management strategy and policies. Support the departmental manager in promoting a risk management culture within your working environment, ensuring participation and involvement when requested. Identify potential risks that may impact on the Trusts ability to achieve its objectives, and report concerns to the line manager. Health & Safety is the responsibility of all staff and the postholder is required to take due care at work, report any accidents or untoward occurrences and comply with the Trust Health & Safety Policy in order that it can fulfil its Health and Safety responsibilities. The Trust operates a “No Smoking” Policy, and smoking is forbidden throughout the Trust’s premises. 6. Training and Development Attend mandatory training updates as required. Undertake training as necessary in line with the development of the post and as agreed with the line manager as part of the personal development process. Achieve and demonstrate agreed standards of personal and professional development within agreed timescales Take responsibility for identifying what learning you need to do your job better and jointly plan with your line manager what training you require. Participate in the Trust’s appraisal process to discuss how your role will help deliver the best possible care to our patients and help to deliver any changes in service. 7. Patient and Public Involvement The Trust has a statutory duty to ensure that patients, clients and members of the public are consulted and involved in decisions about local health service developments. You should be mindful of this and do what you can, as appropriate to your role and level of responsibility, to meet this duty. 8. Data quality Ensure that accurate data is entered into all data collection systems, manual or electronic. Report non-compliance with the Data Quality Policy, erroneous production of data and any factors affecting the production of valid data to the Data Quality Manager. 9. Research Governance The Trust manages all research in accordance with the requirements of the Research Governance Framework. As an employee you must comply with all reporting requirements, systems and duties of action put in place by the Trust to deliver Research Governance. 10. Major Incident In the event of a major incident or civil unrest all Trust employees will be expected to report for duty on notification. All Trust staff are also expected to play an active part in training and preparation for a major incident or civil unrest. 11. Modernisation and Change To be aware of internal and external targets to achieve in respect of service delivery and improving and progressing patient care, and contribute and work to achieve them. This job description is an outline of the role and responsibilities. From time to time due to the needs of the service, we may ask you to flexibly undertake other duties that are consistent with your role and banding, including project work, internal job rotation and absence cover. PERSON SPECIFICATION Job Title: Deputy Sister/ Deputy Charge Nurse Grade: Band 6 Base: Critical Care Critical Care Essential Criteria Education/ Qualifications Previous experience Level 1 Registered Nurse Recognised Intensive Care Course (ICU)or equivalent Mentorship course Specific critical care clinical management competencies Intermediate Programme or equivalent management course ILS course Proven significant experience post ICU course in an adult ICU Proven ability to contribute to the development of specialist protocols and practice changes arising from audits and adhere to all Trust policies and procedures. Evidence of being able to lead in and assist others in audits, surveys, research & development, clinical trials and equipment testing as needed. Demonstrate extensive experience in caring for critically ill patients Skills/Knowledge/ Ability Ability to communicate complex and highly sensitive information to patients and relatives using empathy and reassurance, gain co-operation where required and overcome barriers to understanding. Desirable Level Degree qualification or working towards a degree. Recruitment and selection training. KSF appraisal training. Management of sickness training. Method of Assessment AF/ I AF/I Budgetary awareness Demonstrate ability and experience in the following: Leadership Team building Managing resources AF/I Demonstrates ability to influence and negotiate with others. Ability to work on own initiative Demonstrate an awareness of clinical governance and risk management and how this effects their role and the department Ability to assess, plan, implement and evaluate specialist care delivered to patients/clients and give relevant advice/information to patients and relatives. Ability to make judgements related to critically ill patients that involve complex facts or situations, analysing what is needed and comparing a range of options. Ability to prioritise own workload and that of others. You will be able decide how best to achieve expected results, whilst acting within clearly defined policies/procedures and codes of conduct. Able to work under pressure IT Skills Time management Role model Change management/Clinical Developments Audit and research Clinical Governance NHS and Government Strategy Ability to act on own initiative with evidence of sound decision making abilities Ability to communicate articulately (written, verbal and non-verbal) Proven organisational skills Ability to relate to and motivate others Personal Qualities Professional at all times Motivated and able to motivate others Calm and objective Good interpersonal skills Effective multi-professional working Ability to work across the Trust sites as service needs dictate Able to demonstrate an active role in AF/I teaching Positive and enthusiastic attitude Approachable Supportive Effort Flexibility Ability to work nights and weekends Ability to work 11.5hr shifts Able to work under pressure Dexterity and coordination needed for manipulation of intravenous injections, syringe drivers, infusions, endotracheal suctioning, insertion of urinary catheters and other similar procedures. Ability to deal with difficult/sensitive situations Pippa Woodcock June 2012 How identified - key AF: C: I: P: T: Application Form Pre-Employment Check Interview Presentation Test AF/I SUPPLEMENTARY JOB DESCRIPTION INFORMATION Post Title: Band 6 Deputy Sister / Deputy Charge Nurse Ward/Dept and Site: Date Completed: Multi site 20th August 2012 Please indicate in the boxes with a tick whether the post holder will be expected to work in or be directly exposed to the following factors. Please provide details including frequency (eg how many times per shift, if appropriate. (See attached job matching checklist for extra guidance for these factors). Working Conditions Inclement weather Excessive temperatures Unpleasant smells/odours Noxious fumes Excessive noise &/or vibration Use of VDU more or less continuously Unpleasant substances/nonhousehold waste Infectious Material/Foul Linen Body fluids, faeces, vomit Dust/dirt Humidity Contaminated equipment or work areas Driving/being driven in normal situations Driving/being driven in emergency situations Fleas or lice Exposure to dangerous chemicals/ substances in/not in containers Exposure to aggressive verbal behaviour where there is little/no support Exposure to aggressive physical behaviour where there is little/no support Comments: Yes No Details (including frequency, where appropriate) Weather controlled / ward environment Excrement / clinical waste MRSA, variable Very occasionally Frequently Occasionally Emotional Effort Processing (e.g. typing/transmitting) news of highly distressing events Giving unwelcome news to patients/ clients/carers/staff Caring for the terminally ill Dealing with difficult situations/ circumstances Designated to provide emotional support to front line staff Communicating life changing events Dealing with people with challenging behaviour Arriving at the scene of an accident Comments: Physical Effort Working in uncomfortable/ unpleasant physical conditions Working in physically cramped conditions Lifting weights, equipment or patients with mechanical aids Lifting or weights/ equipment without mechanical aids Moving patients without mechanical aids Making repetitive movements Climbing or crawling Manipulating objects Manual digging Running Standing/sitting with limited scope for movement for long periods Yes No Details (including frequency, where appropriate) Occasionally supported by shift leader (Band 6 or above) Yes No Details (including frequency, where appropriate) Kneeling, crouching, twisting, bending or stretching Standing/walking for substantial periods of time Heavy duty cleaning Pushing/pulling trolleys or similar Working at heights Controlled restraint i.e. jobs requiring training/certification in this Comments: Yes No Details (including frequency, where appropriate) Mental Effort Carry out formal student/ trainee assessments Carry out clinical/social care interventions Analyse statistics Operate equipment/ machinery Give evidence in a court/tribunal/ formal hearings Attend meetings (describe role): Carry out screening tests/ microscope work Prepare detailed reports Check documents Drive a vehicle Carry out calculations Carry out clinical diagnosis Carry out non-clinical fault finding Comments: Rarely Freedom to Act Yes Does the post holder generally work with the supervisor/manager close by/available Does the post holder generally work with the supervisor/manager contactable by telephone or bleep No Details (including frequency, where appropriate) Is the post holder the lead specialist in their field Daily How often on average is guidance/advice given How often is your work checked/monitored/ assessed Comments: Weekly Frequency Please attach any additional information on a separate sheet. Signed by post holder*: Date Signed by line manager: Date * in the case of new jobs this will have to be an ‘estimate’ of the demands of the role.