NHS WESTERN ISLES
JOB DESCRIPTION
1. JOB IDENTIFICATION
Job Title: Haemodialysis Nurse
Department(s): Renal
Job Holder Reference: 535
No of Job Holders: 2
2. PURPOSE
 To work within the nursing and multi disciplinary team to ensure a high standard of care to
defined patient group. Competently perform the necessary technical/ invasive/physical aspects of
care for this defined patient group.
 Take charge of unit on rostered basis.
JOB SUMMARY
 Provide and deliver a high standard of specialist skills by performing comprehensive assessment
of patient individual clinical needs, within Haemodialysis area.
 Autonomously use clinical judgement and experience to make decisions on dialysis treatment
parameters
 Utilise highly complex specialist renal equipment to provide renal replacement therapy.
 Provide clinical expertise and work as part of multidisciplinary team.
 Oversee and contribute, to the audit of standards, in line with National Standards.
3. 0RGANISATIONAL CHART
Clinical Nurse Manager
Haemodialysis Nurse
Haemodialysis Nurse
4. MAIN DUTIES AND RESPONSIBILITIES OF THE POST
Clinical
In the absence of unit manager make decisions, on all aspects of Unit management Analysing and acting
on information using comprehensive knowledge, skills and experience of the service, taking into account
the guidance of local policies procedures and protocols.
Is expected to anticipate potential problems/ needs and take steps to resolve them in the absence of Unit
manager, involving appropriate colleagues i.e. Nurse Manager / General Manager
Makes autonomous clinical nursing decisions in planning and prioritising patient care to defined patient
group.
To carry out clinical observations on patients recognising, recording and reporting all changes in patient
condition to include early recognition and intervention of acute dialysis symptoms.
Administration of intravenous fluids to treat dialysis related hypovolaemia / hypotensive episodes as per
protocol.
Administration and dosing of Heparin requirements for Dialysis as per protocol.
Initiate blood sampling as indicated by patient condition.
Demonstrate sound judgement in assessing the emotional and physical needs of the patient in holistic
manner.
Frequently assesses patient condition and plans, implements and evaluates programmes of care, involving
the multidisciplinary team as required.
Recognises own limitations in the provision of care and urgency of patients needs referring to other
healthcare professionals accordingly.
Interpreting biochemical and haematological blood results and taking appropriate action.
Care and maintenance of percutaneous access
Regular monitoring of vascular access and treatment adequacy.
Responsible for independently prescribing dialysis parameters including sodium and ultra filtration
profiles, dialysate solution, and dialyser choice; following clinical assessment of patient.
Active involvement in clinical audit within specialist area to meet requirements of QIS and Scottish Renal
Registry.
Implementing and sharing good infection control practice. In conjunction with Infection
Control team minimise infection rates.
Provide support and advice to patient and there family/ carers giving the knowledge required to help them
understand and cope with condition.
Act as patient advocate in accordance with NMC Code of professional practice
Act as named nurse to group of patients within specialist area.
Participate in renal outpatient clinics providing expert advice, providing education and support for pre
dialysis /haemodialysis and peritoneal dialysis patients.
Professional
Practice in accordance with NMC Code of Professional Conduct and other appropriate NMC guidelines.
To keep up to-date with current developments in nursing and ensure evidence based practice.
Education and Research
Supervising / mentoring health care assistants/ students with the initiation of patient care
delivery
Promoting and delivering health education within the specialised clinical area, and advise patient, family,
and or significant others in health promotion issues.
Demonstrating and undertaking evidence based practice playing active part in the introduction of this
evidence to improve patient centre care.
Active involvement in Research & Clinical Audit within clinical area to improve local practice.
Contribute to in-house training events, presentations, talks.
Actively participate in educational programme of staff and students
Participate in performance appraisal in line with policy.
Demonstrate own professional development.
Responsible for fostering a learning environment within clinical area.
Organisational
Organise own time and support junior staff and learners to practice time management.
Prioritise and manage patient case load in specialist area
Assist unit manager in the monitoring of incidents, accidents and complaints and participating in
corrective action, monitoring of outcomes.
Ensuring all specialists dialysis equipment is available and maintained.
Promote and maintain good working relationships with the specialist area, and within WIH
Actively participating in relevant meetings pertinent to and promoting the unit and the nursing profession
generally.
Communication
Establish and maintain professional relationships and communications with nursing and
medical colleagues, health care professionals, voluntary services to provide a planned
co-ordinated service for patients.
Reporting and documenting any relevant nursing /patient needs, communicating changes with other health
care professionals in the multidisciplinary team with ongoing responsibility for patient care issues, as they
occur on daily basis.
Demonstrate skill in communicating with all levels of multidisciplinary team, within the department and
throughout NHS Western Isles.
Maintain effective communication channels with NHS Highland Dialysis unit and external
providers regarding; a wide range of clinical and technical issues
Educate patients, and relatives at appropriate level, to ensure understanding. Ensuring
patients have understanding, to make informed choice of options available.
Record and store data e.g. clinical observations, test results, patient care, personal data,
and research data.
Maintain patient records in accordance with NMC guidelines, and Western Isles NHS
Managerial
Actively participate in developing and implementing policies procedures, and
protocols for specialist area of practice. Ensuring they are available and adhered to by all
members of team.
In absence of Unit manager provide cover to ensure effective operation of the service.
Ensures effective day to day management of resources; (including stores supplies pharmacy and
maintenance of equipment.)
Be aware of the local equipment training programme for all staff, in relation to Clinical
Negligence Scheme and maintain records.
Supervising / mentoring health care assistants/ students with the initiation of patient care.
Contribute to monitoring and management of Unit budget, with senior nurse in working within the
constraints of the department budget e.g. appropriate use of consumables, handling of
equipment,
stock levels, monitoring off duty and sickness / absence.
Assist unit manager in developing initiatives which deliver enhanced levels of patient care and client
satisfaction.
Assist in the recruitment and retention of staff.
Deal with complaints in a calm and courteous manner, ensuring that wherever possible complaints
are dealt with efficiently and satisfactorily and resolved locally.
Assist unit manager in managing and driving change and development through planning,
communication and action within the multidisciplinary team to ensure objectives are met.
Assist the unit manager in ensuring good communication systems in place facilitating access
by staff to relevant documented minutes and information, and are involved and informed of
all agreed decisions.
In conjunction with unit manager, ensure safe staffing levels are maintained on daily basis to cope with
activity and service levels on set budget.
Support unit manager in creating an environment for research based nursing practice, participate
and encouraging others to undertake audit and research to improve local practice.
Contribute to supportive environment in the interest of staff moral.
Apply the service and corporate Clinical Governance strategies to clinical area.
Assist other clinical areas within Western Isles N.H.S Hospital if the clinical situation or staffing
levels demand.
5. SUPPORTING EVIDENCE
Physical Demands of the Job
Ability to prepare dialysis machine and ensure ready for function.
Commencement and termination of dialysis; using specialist dialysis equipment.
Fine motor skills and dexterity in obtaining blood samples and cannulation of vascular access (A.V.F /
Graft ),
Care of the patient undergoing dialysis treatment using specialist dialysis equipment, to include problem
solving skills and corrective action.
Undertaking manual handling assessments and ensuring identified actions are met and implemented.
in
Frequent moving and handling of patients from totally independent to, assisting from wheel chair to
weighing scales, onto dialysis chair.
Moving and handling of dialysis machines / chairs/ and consumable stock.
Exposure to body fluids therapeutic products
Frequent need to walk / stand and bend during shift to provide patient care.
Hand washing / cleansing between each patient.
Frequent checking of equipment attached to patient, IV access /dialysis machines.
Mental Effort
Concentration, decision making and organisational skills to cope with competing demands dynamic
changes in patient’s condition, personnel issues with staff, staff shortages
Concentrate as nurse in charge despite constant interruptions and demands from telephone calls, staff and
visitors.
Recognising patient urgent healthcare needs and making appropriate instant decisions to provide
appropriate clinical management-frequently.
.
Ability to identify and resolve complex problems in vital haemodialysis machinery.
Maintaining concentration required when checking documentation and calculating
drug doses dialysis prescription, whilst subject to frequent interruptions from patients / relatives/
team members.
Educate staff whilst maintaining patient safety and ensuring high standards.
Emotional Effort
Dealing with emotional effects of caring for patients and their families’ who maybe distressed/ anxious/
worried.
Supporting patients and carers through the decision to withdraw dialysis treatments
Dealing with the emotional effects on patient / family and self, when having to break bad news.
Unique aspects of working in rural community caring for patients who may be family relations, friends,
neighbours.
Working Conditions
Direct exposure on daily basis to body fluids: blood /blood products/vomit /urine
.
May be in direct contact with patients with blood borne viruses. Protective clothing and policies are in
place.
Work environment being warmer than regular wards due to the nature of renal failure, and heat generated
by dialysis machine during heat disinfection phase.
Handling and exposure to chemicals used for internally cleaning dialysis machines.
Working in area with artificial light
6. STANDARD ELEMENTS
These are sections that will be generic and included in every job description and will include
confidentiality, health and safety and avoiding discrimination. Example sections are noted below:
Confidentiality
This involves taking the necessary precautions when transmitting information only disclosing it to
those who have the right and the need to know it.
All personal health information is held under strict legal and ethical obligations of confidentiality.
NHS Staff must follow guidance (NHS Code of Practice on Protecting Patient Confidentiality)
before disclosing any patient information. All staff must respect confidentiality of all matters that
they may learn relating to their employment, other members of staff, patients and their families.
Health and Safety:
Assist in maintaining own and others’ health, safety and security.
This involves:
a) Complying with Board health and safety policies, procedures and participating in
madatory training.
b) Maintaining a safe working environment and reporting any issues of concern as
appropriate.
NHS Western Isles attaches the greatest importance to the health and safety of its employees. It is
the Board policy to do all that is reasonable to prevent personal injury and hazard to health by
protecting staff and others including the public from foreseeable hazards compatible with the
provision of proper services to patients. The Board expects its entire staff to take reasonable care of
their own health and safety and that of others who may be affected by their acts or omissions at
work. More detailed information is given in departmental safety policies where appropriate.
Ensure own actions support equality, diversity and rights.
This involves:
(a) Acting in ways consistent with the Board’s policies and procedures.
(b) Treating those you come into contact with equitably and with respect.
(c) Recognising the need for aids or adaptations.
JOB DESCRIPTION AGREEMENT
I, (Print Name)…………………………………………………….. confirm that
the job description(s) /person specification(s) attached have been
discussed with me and are an accurate and up-to-date account of the
duties and responsibilities and skills/qualifications required to undertake the
post.
Job Holder’s Signature:
Date:
Head of Department Signature:
Date:
WESTERN ISLES NHS BOARD
PERSON SPECIFICATION
Job Title:
Department:
Location:
Hospital and community
FACTOR
EXPERIENCE
QUALIFICATIONS, TRAINING,
RESEARCH PUBLICATIONS
KNOWLEDGE AND SKILLS
ESSENTIAL
 Sound experience in relevant
speciality, or ability to demonstrate
skills and experience at this level
DESIRABLE
 First level Registered nurse (RN).
.
 Relevant speciality qualification or
equivalent level of education to
support clinical experience.
 Evidence of continuing
professional development in
relevant speciality
 Mentorship course (or ability to
demonstrate skills and experience.)
 Teaching course, (or ability to
demonstrate skills and experience.)
 Good communication skills
I.T. Skills
 Able to work autonomously and
within team
 Manual dexterity to use equipment.
 Ability to plan staff rota and
understand resource management.
 Ability to undertake audits /
research if required.
 Sound experience in relevant
speciality, or ability to demonstrate
skills and experience at this level.
 Basic computer skills
 Training in immediate Life
Support.
 Training in Moving and Handling.
 Training in Infection Control
Training in Health and Safety.
 Good analytical and
judgement skills in relation
patient care, with appropriate
actions.
 Ability to teach others and
formulate teaching programmes.
 Cannulation / venepuncture skills
DISPOSITION
 Pleasant outgoing personality
 Strong motivation to work within
area.
.
OTHER
Flexibility for shift work or working in
other areas