GOLDEN JUBILEE NATIONAL HOSPITAL
JOB DESCRIPTION –
1. JOB IDENTIFICATION
Job Title:
Pre-operative Practitioner
Department(s):
Outpatient department
Responsible to:
Senior Charge Nurse, Outpatient Department
Job Holder Reference:
No of Job Holders:
2. JOB PURPOSE
The post holder has acquired specialised knowledge and advanced clinical practice experience
in pre-operative assessment. (S)he will be responsible for providing a high quality holistic
service to patients undergoing surgical procedures, particularly within Thoracic and Orthopaedic
specialities, preparing the patient for the journey from preoperative assessment, post operative
phase to discharge by promoting codes of practice and NHS policies. The post holder will be
directly responsible for the assessment, planning and implementing of patient care packages
and will be able to act autonomously in the making of complex, clinical decisions. (S)he will
continually pursue their own personal/professional development to provide an expert knowledge
base on which clinical excellence can be supported. The post holder will establish and maintain
communication links with other multidisciplinary teams internally and with other external
agencies.
3. ORGANISATIONAL POSITION
Clinical Nurse Manager
Senior Charge Nurse
OPD staff
(Band 2,3,5 and 6
Pre-operative Practitioner
4. SCOPE AND RANGE
The post holder will use specialised knowledge and continually develop clinical
expertise in the pursuit of clinical excellence and to provide a seamless high quality holistic
service to both patients and their families.
The post holder will be directly responsible for assessing, planning, implementing and
evaluating individual patients within the OPD area and will be able to act autonomously in the
making of highly complex, clinical decisions.
The postholder will have responsibility for arranging specific investigations i.e. blood and x-ray
requests in line with local policy and clinical management plans.
The post holder will facilitate collaborative practice between all members of the multidisciplinary
team within the Outpatient department whilst ensuring excellent communication links with
primary care and other multi-centred external agencies.
The post holder will actively pursue his or her own personal/professional development to
provide an expert knowledge base for the education of patients and fellow colleagues including
junior medical staff.
The post holder will work autonomously, assessing up to 24 patients per week, with work being
managed and not supervised. The postholder will be responsible to the Senior Charge Nurse
for Outpatients.
Required to supervise qualified and unqualified staff as required.
To organise and prioritise care in conjunction with the multi-disciplinary team, delivering high
quality care to specific patient groups
Resource consciousness and awareness of the department budget – no direct budgetary
control.
MAIN DUTIES/RESPONSIBILITIES
Clinical
To be responsible for the clinical assessment of patients by completing a full medical clerking of
patient history and completing an in depth multi-system physical examination.
Act as a clinical expert and role model providing specialist knowledge and advice to nurses,
junior medical staff and other health care professionals within the unit
To practice advanced nursing skills e.g. clinical history taking, Physical examination,
diagnostic reasoning, venepuncture, ECG’s, order and understand investigative tests, utilise
patient group directives as indicated.
To run multidisciplinary preoperative assessment clinics on a weekly basis to ensure
optimisation of patient condition prior to major surgery.
To devise specific protocols, utilising all available resources, in relation to nursing and medical
practice in line with local and nationally agreed policies and guidelines to provide the highest
quality of care based on up to date evidence based practice.
To review the prescribed medication regime to ensure that patients receive appropriate
pharmacotherapy in effective doses- this will be carried out by those who have completed the
non-medical prescribing course.
To act within the guidelines laid down by the NMC Code of Professional Conduct.
Provide specialised extended clinical skills beyond the scope of routine nursing practice
working across professional boundaries to maximise patient care and education.
Ensure the quality of patient care is continually reviewed and assessed, with any necessary
changes implemented and monitored to maintain and improve standards of care given to
patients and their families.
Provide accurate and timely correspondence to General Practitioner and other relevant health
professionals regarding the outcome of consultations and any necessary follow-up required.
Interpreting clinical findings and investigation results – X-rays, blood tests, in order that the
consultant / medical staff are fully appraised of findings to allow relevant intervention if required.
Planning further management of a patient i.e. timing of next clinical review / investigations/
referral.
Ensure good communication and documentation in patient records: dictate clinical notes /
letters to General Practitioner / referral letters.
Participate in the monitoring of standards of care within the defined policies, procedures and
protocols of the service, ward / department to ensure adherence to, and delivery of a high
quality service
Liaise with other healthcare professionals regarding patient treatment and progress
Organises / participates in organisational wide committee meetings as designated by Clinical
Nurse Manager and Senior Charge Nurse.
Professional
Initiate innovative patient care and delivery packages in order to lead and develop
evidence based practices.
As a clinical expert, to advise on educational opportunities which facilitate the continual
development and support of specialist knowledge and skills in relation to the development of
excellence in clinical nursing practice.
To act as a specialist in the field of pre-operative assessment, to provide advice, counselling
and support for patients, their families and members of the multidisciplinary team including
medical staff.
Practice within the Legal & Ethical framework as established by the Nursing and Midwifery
Council (NMC) and National Legislation to ensure patient interests and wellbeing is being met.
Work within the National Health Service (NHS), NHS Health & Safety Executive (HSE)
Legislation, Policy, Guidelines and Procedures. Maintain patient records in line with NMC
guidelines for records and record keeping and Caldicott data protection.
Organisational/Managerial
Responsible for the day to day management of personal time and that of staff within remit in
line with agreed job plan.
Support and develop staff from the multidisciplinary team to broaden their skills, knowledge and
experience to promote the development of a flexible skilled workforce.
Performance is monitored on an ongoing basis and is appraised annually by the senior charge
nurse.
Provide expert advice and support relating to pre-assessment .
Accountable for the effective management of resources including stores, supplies,
pharmacy and maintenance of equipment.
Act in a collaborative and advisory role to senior staff
Share service objectives with staff and lead in appraisal and setting of personal
development plans of staff where appropriate.
Participate in the recruitment and selection process within remit where appropriate.
Initiate and follow through appropriate procedures when a breach of policy occurs.
Responsible for the development of action plans to address any system failures.
Contribute to the wider Corporate agenda where appropriate.
Maintain and process accurate / up-to-date electronic or Integrated Care Pathway (ICP) clinical
records in accordance with both legal and departmental requirements
Ability to develop, implement and maintain all policies, procedures, standards and protocols of
relevant to the pre-operative assessment service
Assist in the development and maintenance of competencies within the specialty area
Shared responsibility for the induction of new staff
Responsibility as a mentor to give advice and support to designated members of staff through
regular discussion which will assist personal development and address any other workplace
issues
Support staff in establishing personal development plans
May participate in the appraisal of others
Act timeously in resolving complaints effectively by investigation before responding at either
local level or escalate as appropriate
Dealing with daily issues / problems relating to patient care
Communicate with the Senior Charge Nurse, regarding daily running of service / problems as
they arise or any changes to be considered for implementation to improve the overall service
Actively participate and have a clear understanding of clinical and staff governance as per
Departmental / Organisational policy
To comply with GJNH Health & Safety policy and professional practice, ensuring safe delivery
of healthcare to patients and maintain a safe working environment
Organise and actively participate in the In-Service Training for the Department
Prepare and deliver formal and informal teaching sessions and support others in providing
education for patients, relatives and colleagues
Organise courses to be held at GJNH and regularly attend courses to further personal and
professional development
Ensure that on-going personal development needs and professional education and research
are identified and met
Performance will be monitored by the senior charge nurse.
E- ksf will be kept up to date by the postholder.
Education and Research/Audit
Working with the Senior charge nurse develop the provision of up to date, evidence based
multidisciplinary information through continuing education, professional updating and
involvement with specialist professional groups to maintain expert professional and clinical
practice.
Develop pre-operative education to undergraduate and post graduate nurses and allied health
professionals including medical staff in association with their mentors during clinical placement,
where appropriate, in line with NES Quality Placement Standards.
Ascertain and review the specific needs of patients, relatives and staff in relation to the
speciality and identify and pursue research to enhance the provision of care to meet these
needs.
Motivate, actively promote and disseminate research based practice with the aim of
providing the most up to date evidence based information available which will lead to best
practice within the speciality.
Initiate and undertake research and audit projects where appropriate to review and enhance
service and practice needs in line with nursing research strategy.
Produce independent data and ensure results are highlighted and acted upon by relevant
clinical staff
Prodce records on number of assessments carried out.
Responsible for evaluating outcomes by standard setting and audit to achieve maximum
recovery and expeditious discharge in a cost effective manner, implementing changes as
necessary.
SYSTEMS AND EQUIPMENT
Microsoft word
Excel
Datix
Clinical Portal
Powerpoint
Helix/ PAS system
Q-Pulse
Learn pro
Comply with the Data Protection Act, Caldicott Guidelines and local policies regarding
confidentiality and access to medical records
Complete patient records accurately
Completion of personal timesheet and patient statistics as required by the Senior Charge Nurse
Use of manual handling equipment.
Telephone system.
7.
DECISIONS AND JUDGEMENTS
Makes autonomous complex clinical decisions including diagnosis and clinical management of
pre operative patients within the outpatient department based on specialist knowledge and
interpretation of clinical and other findings such as laboratory investigations, ECG’s and X-rays.
These and other decisions such as admission discharge and transfer from hospital are made
as there are no permanent junior medical personnel attached to the clinics
Uses highly developed skills and initiative and can act autonomously (within a multidisciplinary
team) within the limitations of clearly defined policies and guidelines.
Demonstrates sound judgement in assessing the emotional and physical care of the patient, in
a holistic manner, using specialist knowledge of the grieving process.
Anticipates conflicts and difficulties arising from differences in expectations among the team
within the department and develops solutions for both intra and inter professional differences.
Post holder organises and manages own caseload/ clinic capacity and is responsible for
clinical management of own workload
Has the ability to anticipate, by using expert knowledge, changes in patient’s conditions and
implement the appropriate actions required
In conjunction with the Senior Charge Nurse, Clinical nurse manager and service manager
assists and recommends plans for the development of the service, taking account the
increasing demographic and geographical demand of the patient group.
Collate statistical information for ongoing audit purposes, which will impact on service
development and quality.
Challenges decisions made by others if they are against policy or not in the best interest of the
patient
Responds to complex / demanding patient situations, both clinically and administratively
8. COMMUNICATIONS AND RELATIONSHIPS
The post holder will be required to use a variety of advanced verbal, written and computerised
communication methods to develop internal and external networks to promote the profession,
directorate and organisation.
Proficiently acts as both patient and staff advocate through the advanced knowledge and
application of ethical, legal and professional skills whilst providing support and empathy and
reassurance to both parties in the delivery of patient care.
Responsible for communicating and interpreting sensitive, complex, clinical information in an
easy to understand way to patients and their relatives from a variety of cultural and life
circumstances where there may be barriers to understanding and resistance to behaviour
change i.e. patient undergoing major thoracic surgery.
The post holder will be required to use negotiation and motivational skills where there may be
barriers to understanding and resistance to change within the multidisciplinary team i.e.
negotiating changes to working practices with the nursing and medical staff.
9. PHYSICAL, MENTAL, EMOTIONAL AND ENVIRONMENTAL DEMANDS OF THE JOB
The job entails a combination of sitting, standing and walking and does include moving and
handling of patients on a daily basis.
Skilled technical and manual dexterity/expertise required for invasive/non-invasive
techniques such as Venepuncture, and interpretation of ECG’s.
Moving and handling of technical and clinical equipment within the outpatient department
areas.
Exposure to body fluids /therapeutic products on a daily basis.
Mental Effort/Skills
The pattern of work can be unpredictable based on the need of an individual patient i.e. if a
patient is unwell or an emergency occurs within the outpatient department, routine tasks have
to be delayed till the situation is resolved.
The post holder has to be able to respond quickly and effectively to rapidly changing
clinical situations and be able to employ specialist clinical knowledge and skills in their
management.
The post holder will require high levels of concentration and application of specialised
knowledge during:
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patient assessment at nurse led pre operative assessment clinics.
patient counselling sessions re surgery, pathology or receiving bad news.
teaching sessions with staff members including medical staff.
assessment and making appropriate referrals.
planning of ongoing personal professional and academic development.
use of multidisciplinary, research/audit computer databases.
correspondence through email and writing formal reports
communication with patients and relatives in person or by telephone
Clear understanding of the effects of surgical intervention on the normal anatomy and
physiology of the patient
Keyboard skills and interpretation of data required to be applied daily
Intense concentration required when assessing and diagnosing patients – number times daily
The demand on time management working in a busy clinic, whilst ensuring effective / efficient
patient care, especially when assessing complicated patients requiring review by medical staff
Definitive diagnosis and referral for investigations – numerous times daily
Interpretation of investigation results – X-rays, bloods walking test – numerous times daily for
discussion with consultant
Workload priorities vary to meet service requirements - daily
10. MOST CHALLENGING/DIFFICULT PARTS OF THE JOB
Working within a developing infrastructure in which processes are continually evolving.
Deciding and knowing whether or when to seek advice / consultation with the Consultant in
charge of the patient
Ensuring expert clinical assessment, evaluation and making autonomous decisions based on
complex information and clinical presentation i.e. patient condition and symptoms, diagnostic
results
Evaluating complex information and implementing effective communication skills to disseminate
this to other members of the multidisciplinary team
Provide a specialised, professional advisory role to a wide variety of contacts including patients,
relatives, nursing, medical and paramedical colleagues.
Communicating complex and sensitive information to patients and relatives and also
psychologically supporting distressed, anxious relatives, patients and colleagues.
Participating actively in ongoing and innovative research and audit to and the ability to act as
an effective change agent to ensure that high quality, evidence based care is passed on to the
patient
Dealing with difficult situations and behaviours from staff, patients, relatives and other
members of the public.
Meeting the strategic priorities within the MCN for heart disease.
11. KNOWLEDGE, TRAINING AND EXPERIENCE REQUIRED TO DO THE JOB
1st level registration with extensive post registration experience
Educated to Degree Level or working towards higher education
Clinical skills assessment course – if the post holder does not have this course it must be
passed within the first 12 months in post
Evidence of developed communication and management skills.
Ability to use specialised computer skills to access and input data related to practice/research
and audit.
Evidence of involvement in the development of programmes of care, protocols and clinical
audit.
Independently conduct a comprehensive clinical patient history and perform a multisystem physical examination leading to differential diagnosis.
Experience in the development of nurse led services within the acute care setting
Experience in the performance of advanced roles such as cannulation, venepuncture, ECG,
and ordering X-rays
Awareness of health and health promotion in relation to differing specialities.
Evidence
of
further
specialist
knowledge/education
including
certification/diploma/continuing professional development in relevant area.
postgraduate
Extensive post registration experience
Ability to demonstrate competence at main duties outlined in the job description
Proven previous clinical management skills
Demonstrates behaviours in line with the GJNH Visions and Values
12. JOB DESCRIPTION AGREEMENT
A separate job description will need to be signed off by each jobholder to
whom the job description applies.
Job Holder’s Signature:
Date:
Head of Department Signature:
Date:
Recruitment Person Specification
BAND 6 Pre-op Practitioner
Essential
Desirable
Qualifications/Training
1. 1st level RN
Evidence of post registration
study to degree level or
equivalent
Clinical skills assessment
course
Experience
2.
Extensive
comprehensive
clinical experience
Experience in appraisal setting
and day to day management
skills
Experience of working within
an outpatient department and
pre-assessing patients
3.
Developed
communication
and management skills
Computer skills – ability to use
specialised
computer
packages
Ability
to
conduct
a
comprehensive patient clinical
history
Ability to perform a multisystem physical examination
Ability to carry out ecg’s,
venepuncture,
Demonstrable leadership skills
Evidence of team working
Decision making skills
Problem solving ability
Ability to prioritise competing
demands
7.
Experience working within the
Orthopaedic or cardiothoracic
setting
Additional job
requirements
Eg. car driver, unsocial hours
4. Flexibility in working hours
over Monday to Friday
(some
evenings
and
weekends may be worked)
9.
Any
other
information
5.
:Demonstrate behaviour in line
with GJNH visions and values
10.
Skills/Knowledge
additional
6. Evidence of study
within Thoracic
speciality
Non medical prescribing
course
8.