AGENDA FOR CHANGE
NHS JOB EVALUATION SCHEME
JOB DESCRIPTION
1. JOB IDENTIFICATION
Job Title: Endoscopy Clinical Nurse Specialist
Reports to: DCU Manager and Colorectal Consultants
Department: Endoscopy Suite within Day Case Unit
Directorate: Surgical & Anaesthetic Directorate
Job Reference: SSSARAIGDCUN01
No of Job Holders:
Last Update:
2. JOB PURPOSE
The Endoscopy CNS is responsible in collaboration with all members of the multidisciplinary Team
(MDT) for providing a clinical, education and supportive role in the investigation and treatment of
patients with GI Disease.
Using specialist knowledge participates in teaching and developing Health care Professionals by
enhancing their knowledge and skills in the care of GI patients.
3. DIMENSIONS
The Endoscopy Unit is located within Raigmore Hospital and has 3 Endoscopy Rooms.
It is anticipated that the CNS will expand the service, performing up to a maximum of 5 colorectal
lists/week.
The CNS is involved in the delivery of the Bowel Cancer Screening programme undertaking Preassessment and performing colonoscopies.
Has no direct budgetary responsibilities but influences the use and spend on supplies relating to specialist
work.
4. ORGANISATIONAL POSITION
General Manager Surgical& Anaesthetic Div
GI/ Colorectal
Consultants
Nurse
Endoscopists
CNS
Pathology
Dept
Divisional Nurse Manager
Service Manager
Endoscopy CNS
Other Consultants
&
Nursing Colleagues.
Charge Nurse
and Staff DCU
X-ray
Dept
5. ROLE OF DEPARTMENT
In conjunction with the Colorectal and GI Consultants the CNS provides a nurse led service in the
investigation, diagnosis, treatment, further management, discharge or follow up of patients with GI
Disease and the delivery of the bowel cancer screening programme.
6. KEY RESULT AREAS
Clinical
1.
Works within the Statutes & Guidelines laid down by the Nursing & Midwifery Council.
2.
Works as an autonomous practitioner, manages a defined caseload of patients including patients
with rectal bleeding and other GI conditions including IBD. Demonstrating highly developed
specialist skills and knowledge acquired through experience and training.
3.
Completes and maintains accurate patient records to meet the requirements of Nursing &
Midwifery Council Standards for Record Keeping.
4.
Report abnormal findings and physical signs to relevant consultant.
5.
Monitors and interprets laboratory investigations and acts on results as per guidelines.
6.
Provides information and acts as a resource to asymptomatic clients referred for bowel screening.
7.
Works to clearly defined clinical protocols to underpin practice and, working collaboratively with
other relevant practitioners evaluates these regularly.
8.
Demonstrates highly developed skills in dealing with patients and relatives where situations and
information can be highly sensitive and using knowledge and skills to impart that information
where there could be barriers of understanding or acceptance.
9.
Explains fully to patients, details of planned investigations, procedures and treatment, including
pre-op care.
10. Participates in Bowel Screening Programme.
ENDOSCOPY
1. Assesses, plans, implements and evaluates protocols for patients referred for endoscopy,
using highly developed skills to assess and interpret findings and ensure appropriate action
is taken..
2. Obtains informed consent for all procedures performed by nurse practitioner in accordance
with NHS Highland policy on Consent to Examination or Treatment.
3. Performs Diagnostic and Therapeutic Endoscopic procedures e.g dilatiation, polypectomy
etc.
4. Performs abdominal and rectal examinations, in line with agreed protocols.
5. Administers sedation and other appropriate drugs to patients undergoing colonoscopy/ flex
sigmoidoscopy in line with agreed Patient Group Directives (PGD’s). This is under
intravenous injection.
7. Responds to emergency situations during procedures, and initiates appropriate management
and knows when it is appropriate to call for Consultant assistance.
8. Plans follow up management of patients following endoscopic procedures i.e. surveillance
for Colonic polyps, dilations, Barratts, scans, and informs patients and GP’s as required.
Managerial
1.
To drive forward initiatives in clinical practice which deliver advanced levels of patient care and
client satisfaction.
2.
Organises workload to take account of priorities of care in meeting the needs of a defined caseload
within agreed targets and timescales.
3.
Is responsible for effective channels of communication and liaison between Outpatient Department,
Endoscopy, Ward Managers, Consultants Surgeons/Gastroenterologists, Nursing Staff, Pathology,
Radiology Services, and all relevant areas related to practice.
4.
Attends monthly multidisciplinary team meetings actively contributing and participating in agreed
outcomes.
5.
The ability to accept responsibility, to work with initiative, and yet to work within guidelines and to
co-ordinate with other team members.
Education
1.
Acts as a resource to provide education and health promotion to patients and carers in relation to the
specific GI conditions.
2.
Acts as a resource for health care professionals (medical, nursing and allied health professionals) in
all aspects of care of GIl patients throughout the patient journey.
3.
Plans, develops, implements and evaluates information for medical/nursing staff, supervising and
teaching endoscopic procedures to junior doctors and trainee nurse endoscopists.
4.
Maintains a good understanding of NHS Highland management and staffing structures and
procurement procedures.
5.
In conjunction with Clinical Supervisor and Endoscopy Manager identifies own training needs, has
active Personal Development Plan in which objectives are set, ensuring practice is updated through
developing theoretic knowledge and supervised practice.
Audit & Research
1.
Ensures professional practice is research based, evidencing best practice.
2.
Maintains awareness and reviews literature relevant to specialist practice.
3.
Participates in research studies with appropriate ethical approval as part of the multidisciplinary
team.
4.
Participates in regular audits of practice, reviewing findings and improving/changing practice
accordingly. Knowledge of use of audit databases, data entry and report generation.
7a. EQUIPMENT AND MACHINERY
Equipment
Colonoscope, Gastroscope
Proctoscope, Sigmoidoscope
Use
Investigation of Upper & Lower Gastrointestinal
Tract
Emergency equipment
Diathermy Equipment
Biopsy Forceps, Dilators snares etc
ECG Monitor
Oxygen System
Removal / Cautery to Bowel
Mucosal abnormalities i.e. Polyps
Monitor patients vital signs during procedure
Needles, syringes, cannulas, airways
Computer, video, overheads, PowerPoint
7b. SYSTEMS
1.
Maintains patient records in accordance with NMC Guidelines and NHS Highland standards.
2.
Ensures correct use of computerised systems, eg Unisoft, interprets Clinical results, e-mail
communication and training needs.
3.
Produces PowerPoint presentations for teaching purposes.
4.
Completes own Training Needs Analysis and Personal Development Plan.
8. ASSIGNMENT AND REVIEW OF WORK
1.
2.
The post is self- directed to achieve Key Result Areas.
Networks with Scottish Nurse Endoscopy Practitioners to ensure ongoing professional development.
3.
Objectives, work performance and professional development will be reviewed by Consultants and
Manager.
4.
The post holder is professionally accountable to Endoscopy Manager, Nurse Manager and GI
Consultants.
9. DECISIONS AND JUDGEMENTS
1.
Clinical workload is patient driven and influenced by clinical workload and by local, regional and
national agendas relating to GI Disease.
2.
Organises own workload according to available time / resources.
3.
The post holder is expected to anticipate problems/needs and resolve these in a proactive,
independent manner and is responsible for autonomous clinical decisions such as the need to review
a patient/ bring them back to clinic/repeat endoscopy.
4.
Whilst not holding a budget, the post holder will influence how resources are used to meet identified
need.
5.
The post holder is expected to exercise their own discretion on how to conduct the vast majority of
the job within guidelines and timescales and to seek line management support as required.
10. MOST CHALLENGING/DIFFICULT PARTS OF THE JOB
1. The challenge is developing, managing, acting autonomously as endoscopist during patient procedure
and subsequent care, making spontaneous decisions which directly affect patient care.
The role requires a high level of technical skills and the ability to support patients physically and
psychologically through investigation, diagnosing, treatment and future management.
11. COMMUNICATIONS AND RELATIONSHIPS
1.
Establishes and maintains professional relationships with nursing colleagues, medical colleagues,
health care professionals, to provide a planned, co-ordinated seamless service for patients.
2.
There is significant contact with patients, relatives and carers requiring information, education and
support which requires post holder to be sensitive and flexible regarding the communication needs of
the individual. Communication may be complex and challenging due to new diagnosis, changing
situation, physical and mental problems.
3.
Negotiating and influencing skills are required to manage change effectively and to put forward the
nursing viewpoint to the multi professional team.
4.
Attends meetings relating to clinical guidelines i.e. Managed Clinical Network meetings.
5.
Attends monthly GI meetings and other relevant clinical and business meetings to represent CNS
viewpoint.
6.
Teaching and presentation skills are required to fulfil the role of teaching and developing staff.
12. PHYSICAL, MENTAL, EMOTIONAL AND ENVIRONMENTAL DEMANDS OF THE JOB
Physical
1.
Post holder works in the clinical environment and in an office
2.
Post holder is regarded as an expert practitioner within the specialty of GI disease. Fine motor skills
and dexterity are required in the direct clinical involvement of patients – performing flexible
sigmoidoscopy, colonoscopy, Gastroscopy
3.
Requires expert co-ordination for therapeutic/intervention or treatment, and occasionally required to
move or manoeuvre patients during examinations.
Mental
1.
The work can be taxing therefore the post holder requires physical and mental stamina. A high level
of concentration is required (often for greater than an hour) for example during direct clinical
involvement/advising/psychological care to patients with GI Disease, teaching patients and other
professionals.
2.
Post holder must be able to focus on task in hand, prioritising effectively, working to deadlines and
manage change.
3.
Post holder requires confidence to contribute/lead in clinical and managerial settings, constantly
responsible for making autonomous decisions which can occur during technically demanding
situations.
4.
The ability to prevent undue stress and its adverse effects by ensuring, with the support of colleagues,
line managers and team members, that the demands from various sources do not become unrealistic.
5.
Undertaking further study/courses to maintain professional development on an ongoing basis
requiring home study and time commitment.
Emotional
1.
During procedures requires a high level of technical ability and at same time supports the patient
physically and psychologically, this can be emotionally draining.
2.
Is involved in informing and advising patients on daily basis.
3.
Supports distressed/anxious patients and relatives in dealing with the emotional effects of potentially
life threatening illness.
Environmental
1. Exposure to body fluids / faeces.
13. KNOWLEDGE, TRAINING AND EXPERIENCE REQUIRED TO DO THE JOB
1.
R.G.N
2.
A minimum of 5 years post registration experience. 3 years of which should have been in an acute
gastroenterology / colorectal setting including the care of patients with colorectal diseases.
3.
Must be in possession of ENB DO3 course or Glasgow Caledonian Endoscopy Knowledge & Skills
degree.
4.
Must be able to demonstrate a high level of practical and theoretical knowledge in colorectal
diseases.
5.
Must have excellent highly developed communication, interpersonal and leadership skills, attained
through training and experience with managing staff at Senior nurse level.
6.
The ability to learn and the wish to develop knowledge of gastrointestinal conditions is essential.
7.
Proven organisational, and management skills are desirable.
8.
Able to demonstrate effective teaching methods.
9.
Some knowledge, skill and experience in audit methods desirable.
10. Good basic IT skills desirable.
14. JOB DESCRIPTION AGREEMENT
I agree that the above Job Description is an accurate reflection of my duties and
responsibilities at the date of signing.
Job Holder’s Signature:
Date:
Manager’s Signature:
Date: