Important Job Application Information Thank you for your interest in NHS Tayside vacancies Please see below Job Description/Specification and General Conditions of Service Your Application Form must be completed in full. Please note copies of Curriculum Vitae, Qualifications and Course Certificates will not be accepted at this stage. Please return your completed Application Form to recruitment.tayside@nhs.net (quoting the vacancy reference number in the subject box) or to the postal address given on the General Conditions of Service. All completed applications are held in Workforce Services until the closing date. After the closing date a panel will meet to prepare an interview shortlist. Once this decision has been made, all shortlisted applicants will be emailed to invite them to attend for interview. It is important that you check your emails regularly. This process takes approximately 6 weeks. Therefore, if you have not been contacted regarding interview within 6 weeks of the closing date, your application has been unsuccessful and you will receive no further correspondence from Workforce Services ADDITIONAL INFORMATION:Find out more about living and working in Tayside at: www.dundeecity.gov.uk www.angus.gov.uk www.pkc.gov.uk JOB DESCRIPTION 1.JOB IDENTIFICATION Job Title Department(s)/Location Trainee Advanced Neonatal Practitioner Band 7 Neonatal Intensive Care Unit Job Title: Trainee Advanced Neonatal Nurse Practitioner (ANNP) (This job description maybe be used as a contract at beginning of training and /or consolidation period) Responsible to: Senior Nurse Neonatal Services (Managerially and Professionally) Consultant Neonatologist (Clinical Supervisor) Department(s): Neonatal Services Directorate: Medical Division, Women and Child Health Clinical Group Last Update: November 2009 JOB PURPOSE This ANNP role is distinct from nursing but arises from extended nursing practice. The role incorporates the traditionally medical role enabling a holistic approach to neonatal care providing advanced clinical skills to babies and supporting their families within the neonatal service. The ANNP works in collaboration with the Senior Nurse Neonatal services (or equivalent) and Consultant Neonatologist/Paediatricians: The trainee ANNP will be undertaking a period of Masters level academic study whilst simultaneously gaining clinical experience under direct supervision of experienced ANNPs or senior medical staff. This will facilitate working towards: o Provide specialised clinical care at an advanced level to neonates and families, making complex autonomous diagnosis and management decisions, about patient care, utilising advanced skills and knowledge o Act as an educator, highly specialised clinician, consultant, auditor and researcher o Provide specialised advice and support within the neonatal sphere. o Participate in the formulation and updating of Neonatal guidelines o Demonstrate and maintain advanced newborn life support resuscitation skills by acting as a member of the neonatal resuscitation team, taking lead role as required o Advise junior medical staff, midwifery/nursing staff, medical, nursing and midwifery students acting as an educational resource ensuring that evidence based practice is promoted o Establish interchanging roles with junior medical staff on a regular, planned basis by working in partnership to ensure neonates receive the most appropriate specialist care, regardless of the unpredictability of the workload o Where applicable participate in the safe transfer of Neonates o Participate at meetings at Unit, Directorate and Senior Management Level at the request and on behalf of the Directorate Management o Provide specialist advice to the multidisciplinary team 3. DIMENSIONS (this is about key components of role) The postholder will be mentored and initially shadowed by an experienced ANNP and/or senior medical staff, progressively working towards becoming an autonomous practitioner, prioritising own workload and being accountable for the direct delivery of care. The post holder works across professional boundaries, undertaking duties of an advanced practitioner under the direction of the ANNP or Consultant Neonatologist/Paediatrician. This includes participating in medical rotas under supervision. Teach and deliver core specialist neonatal training and education to nursing / midwifery staff and students to ensure safe, evidence based practise is delivered. Attends neonatal clinical emergencies in all areas, delivering advanced resuscitation skills and stabilisation of the infant prior to transfer to the neonatal unit while being supported by an experienced practitioner until competence is achieved. The postholder will use high levels of judgement, problem solving and clinical decision making in the assessment, investigation, diagnosis, prescription and evaluation of highly specialised treatment plans. 4. Organisational Position Women & Child Health Directorate Management Professionally responsible to Senior Nurse Neonatal Services (Band 8A) Case Manager (Band 7) Senior Charge Nurse (Band 7) ANNP Clinically responsible to Consultant Neonatologist Trainee ANNP Clinical Nurse Specialist (Band 7) Neonatal Unit Nursing Staff 5. Role of Department This part should reflect local details of the unit and broader neonatal service. Should include things like cots numbers and status of unit, types of patients, admission rates, CMUs covered, P/N arrangements, transport, out patients, labour suite, telephone support For transport this will include 6. Main Duties - Under direct or indirect supervision whilst in Trainee ANNP role PROFESSIONAL Works as an trainee ANNP within the statutes and guidelines governed by the Nursing and Midwifery Council (NMC) Comply with local and national guidelines and policies The trainee ANNP will be an accountable and responsible professional, managing self, his/her own practice and that of others within an ethical and legal framework that ensures the primacy of the interest of neonates and their families Act as an ambassador for the NNU, ANNP and the neonatal specialty Ensure that written nursing and medical documentation is clear, concise, contemporaneous and chronological, and complies with NMC Standards of Record and Record Keeping Act as an advocate on behalf of babies and families Conveys the role of the ANNP to staff and parents Liaise with ANNPs throughout Scotland ensuring advanced practice and national guidelines are comparative and research based across Regions and Networks CLINICAL: Utilise highly specialised clinical and theoretical knowledge to undertake a comprehensive health history and examination of any neonate in order to diagnose and treat the neonate (including the prescription of drugs as necessary) Working in partnership with the Consultant Neonatologist, develop medical and nursing patient management plans for a case load of babies, that deliver a holistic approach to the care of neonates throughout the patient pathway from admission to discharge Regularly weigh up differential diagnosis and the potential range of treatment options, selecting from variable options some of which may be contentious. Use specialised clinical and theoretical knowledge to assess the immediate health status of the neonate Review identified/perceived problems, analyse complex information and take responsibility for decisions made ensuring that the care provided to all neonates is safe and effective Attend high risk deliveries and other emergencies as an autonomous practitioner, ensuring that neonates receive safe and effective advanced resuscitation Carry the emergency neonatal bleep/pager during consolidation period. On completion of relevant academic programme, undertake Non medical prescribing – including calculating, prescribing, administering and evaluating the effects of drug and fluid therapies in accordance with local policies Initiate and authorise blood transfusions and volume expanders as clinically indicated, in accordance with local policies Order and interpret x-rays and diagnostic investigations to ensure accurate diagnosis and treatment of the neonate. Act on results and develop management plans Participate in and perform the following advanced procedures for ill and premature neonates: o Venepuncture and capillary blood sampling o Insertion / withdrawal of umbilical catheters, which require suturing o Insertion of percutaneous catheters o o o o o o o o o o o o Insertion of intra-osseous needle Connection and calibration of invasive blood pressure transducer Sampling from indwelling umbilical catheters Perform direct arterial sample aspiration Blood gas analysis Endotracheal intubation / extubation (emergency and elective) Implementing / managing respiratory support, including ventilation Cold light transillumination of the chest Insertion of chest drain, and its removal Insertion and removal of urinary catheters Supra-pubic aspiration of urine Lumbar puncture o Examination of the newborn (This list is neither exclusive or exhaustive) Participate in the stabilisation, transfer and admission of the extremely ill neonate to or from the neonatal unit, including complex life support therapies Ensure that parents are aware of their baby’s condition and provide complex communications and support to parents Participate in palliative care for neonates, leading to a pain free, dignified ending to life. Provide intensive support, advice and care for families of neonates who are receiving terminal care Co-ordinate referral to other services, e.g. physiotherapist, occupational therapist, dietician, surgeon, cardiologist or any other service which is vital to the appropriate care of the neonate Contribute to health promotion activity, raising awareness of health and wellbeing to promote healthy lifestyle choices for the benefit of neonates and their families MANAGERIAL AND LEADERSHIP: Prioritise own workload and delegate work to others Act as a role model and provide specialist advice and clinical support when required to Neonatal Staff and the multidisciplinary team. Comply with policies relating to child protection and protection of vulnerable adults instigating actions and developing management plans Share responsibility with senior clinicians and managers for clinical governance issues including, clinical risk management and staff governance Attend internal and organisational meetings to promote development of neonatal services, disseminate information and action plans to colleagues Liaise with colleagues and managers to ensure that sufficient resources are available to meet clinical need Promote equality and diversity EDUCATIONAL/CONTINUING PROFESSIONAL DEVELOPMENT: Identify own educational and training support needs Maintain professional development portfolio Teach and deliver core specialist neonatal training and participate in the supervision of medical trainees, midwives and nurses. Provide a supportive learning environment, which promotes continuous professional development and lifelong learning Teach specialist neonatal skills to staff and parents / carers e.g. neonatal resuscitation, home oxygen, nasogastric feeding, stoma care and suction QUALITY, RESEARCH AND DEVELOPMENT: Create an environment conducive to research and evidence based neonatal care and encourage its implementation Initiate audit and participate in research within the NNU, and encourage others to do so. Use the results to facilitate changes to practice where indicated Evaluate newly generated research findings. As part of the neonatal team, disseminate findings and incorporate them into practice using advanced knowledge and skills to influence best practice Initiate, develop implement and review specific guidelines and clinical management plans. Ensure standards maintained, monitored, and reviewed in adherence with local, national and NMC guidelines Support initiatives in clinical practice which deliver advanced levels of neonatal care Contribute to and take an active role in key clinical research and audit projects 7a. EQUIPMENT AND MACHINERY o Staff must ensure their competence in the safe and appropriate use of all equipment and machinery within the clinical practice. This will require the post holder to undertake recognised training for the use of specific equipment. o This equipment may cost in excess of £30,000 and be in excess of 25Kg o They must also be cognisant with correct decontamination procedures and with local devise management policies, including reporting defects, faults or harm caused by pieces of equipment. o The postholder will participate in trials, training and clinical evaluation of all equipment o Ensure all equipment is stocked, functioning and ready for use This list is neither exclusive nor exhaustive. Generic Telephone Fax Fridge Freezer Ice machine Visitor intercom Water boiler Fire equipment Pneumatic tube system Wheelchair Pram Computer Scales Emergency call bell Washing machine Tumble Dryer Procedure lighting Door release system Mobile phones Pager system Specialised Digital Thermometer Cot Incubator Open care cot Infant resuscitaire Bag & Mask (infant resuscitator) Laryngoscope ET Tubes T-piece/Neopuff Oxygen analyser Oxygen flow meter Humidifier Phototherapy unit Pulse oximeter Volumetric Infusion device Syringe driver Non invasive blood pressure monitor Apnoea monitor Kanmed bed / heated cot Humilactor Glucometer Oxygen/Air cylinders & regulators Adult resuscitation equipment Suction equipment Stethoscope Ophthalmoscope Very Specialised Blood gas machine Transcutaneous PO2/CO2 monitor Gas calibrator Multiparameter monitor Invasive blood pressure monitor CPAP driver Ventilator HFO ventilator Florian monitor Inovent (Nitric Oxide) Transport Incubator Blood warmer Insight monitor Ultrasound scanner Infant Resuscitaire with ventilator and blender CFAM brain monitor Total Body Cooling system PICC lines and central catheters Chest drainage equipment Transport ANNPs Air Transport Incubator Life jackets and survival suits Securing clamps Nitric oxide Equipment Specialist vehicles and aircraft 7b. SYSTEMS Maintenance of patient records – paper & electronic Local Patient Administration System Input data on computer, including patient monitoring systems Generating patient referral, discharge letters and documentation Tele-medicine e-KSF NHS mail PACS Incident reporting and management system Laboratory System (specimen requesting & obtaining results). Internet and Intranet. Electronic workforce planning systems 8. ASSIGNMENT AND REVIEW OF WORK Work will be generated by clinical activity within the neonatal unit and wider women’s and children’s directorate(s) Local experienced ANNP and senior medical staff will supervise clinical placement. A Neonatal/Paediatric Consultant will be identified to clinically supervise, review and provide formal assessment, throughout and at the end of training/consolidation period. The trainee ANNP will be professionally accountable to (professional line manager –local title) Short and long term objectives for the trainee ANNP. Will be set in consultation with the line manager, clinical supervisor and consultant neonatologist. Achievement of these is measured against set objectives and evaluation of clinical performance. 9. DECISIONS AND JUDGEMENTS The trainee ANNP is accountable for his/her own practice; therefore he/she is answerable for all actions and omissions, regardless of advice or direction from other professionals. Act decisively under supervision as clinical lead in complex situations. Independently analyse, interpret and compare a range of options and differential diagnosis to resolve clinical problems The trainee ANNP has the authority, within the boundaries of their developing knowledge and skills, to order investigations and prescribe specialist treatment following analysis of the results without recourse to medical staff. The trainee ANNP will use own initiative and act independently within the boundaries of their own existing knowledge and skills. Recognise when additional supervision is required and seek advice appropriately The trainee ANNP is accountable for optimal use of resources balanced against the needs of each individual neonate Freedom to act and make clinical decisions is guided by precedent and clearly defined policies, procedures and codes of conduct in accordance with NMC regulations, Clinical and Staff Governance Framework and the EU Clinical Trials Directive 10. MOST CHALLENGING/DIFFICULT PARTS OF THE JOB Studying at masters level of education and learning new skills while accepting increased responsibility. Attending high risk deliveries and caring for critically ill neonates whilst simultaneously prioritising other work demands The unpredictability of the workload and the dynamic change from routine to emergency with no prior notice Adapting to the change in role and making complex and high level independent clinical decision Complex nature of and emotional demands within the specialty, for example when caring for critically and terminally ill neonates Supporting parents, families and colleagues in difficult and emotional circumstance Requiring an awareness of support mechanisms for women / families with complex health or social issues which impact on the management of the neonate’s care Gaining the confidence of stressed parents who are perceived as being aggressive and abusive. Dealing with stressed staff and managing conflict in the workplace. 11. COMMUNICATIONS AND RELATIONSHIPS Under direct or indirect supervision whilst in Trainee ANNP role The trainee ANNP will be required to communicate verbally, by telephone, in writing and by email to midwifery/nursing, medical staff and the larger multidisciplinary team encompassing both hospital and community settings on a number of clinical matters Overcome frequent barriers to understanding when delivering complex, difficult to understand information in stressful circumstances to service users and colleagues Liaise with specialist transport services, Scottish Ambulance Services and other units when arranging inter-hospital transfers Develop effective communication and relationships with parents and visitors which will assist in creating the optimum caring family centred environment Establishes, maintains and enhances professional relationships with medical, midwifery and nursing colleagues and other health care professionals Communicates with senior team regarding clinical, managerial and professional issues Adhere to policy on confidentiality including the requirements of the Data Protection Act and Caldicott guidelines. The ability to handle sensitive information in a manner not liable to offend or antagonise Engage in effective communication with parents and relatives, often delivering complex and highly sensitive condition-related information, including diagnosis and prognosis. Makes appropriate referrals to a wide range of other healthcare professionals and specialities Frequent requirement to receive and communicate complex information tactfully Maintains accurate records in line with NMC Guidelines Contributes to a supportive environment in the interest of staff morale Develop external professional networks that promote both the profession and organisation Aware of and disseminates relevant safety action notices and other essential communication within the nursing, medical and clinical support worker team Utilise interpreter service to overcome cultural and language difficulties Give presentations at teaching sessions 12. PHYSICAL, MENTAL, EMOTIONAL AND ENVIRONMENTAL DEMANDS OF THE JOB As the patients can be as small as 500 grammes, procedures require extreme manual dexterity, accuracy and the utilisation of highly developed skills, as well as intense concentration in an emotionally charged, hot environment. PHYSICAL : On most of the shifts worked, the post holder will be involved in: Performing complex medical procedures while standing in a restricted position over incubators and cots Walking/standing for majority of shift, can be in excess of 7 miles per day Adapting to changing shift patterns Use of computer keyboards and VDU screens Frequent lifting, moving of moderate weights including equipment >25kg for short periods Frequent moving of cots and incubators Frequent bending at awkward angles to assist breast feeding mothers Frequent bending at awkward angles over cots to carry out nursing procedures Transporting sick or preterm infants receiving respiratory support using a transport incubator / resuscitaire which require manipulation en route Shifts frequently in excess of 10 hours Irregular breaks Breaks not bleep / pager free MENTAL : Concentration is required on every shift while undertaking intricate clinical care to neonates, including invasive procedures with little or no margin for error. The clinical condition of babies requiring neonatal care can change very quickly and requires meticulous attention to detail to ensure that any changes in condition are acted on immediately. This can result in an unpredictability of the workload, as there may be a requirement to change from one task to another to deal with these changes in condition. Concentration to undertake complex calculation of drugs in minute doses Maintaining work/life balance Providing telephone support and advice to remote areas without direct access to patient EMOTIONAL : Dealing on a daily basis with distressing and highly emotive situations involving neonate, parents, siblings and the extended family e.g. death of an neonate, breaking bad news, supporting distressed parents, their families and staff Coping with the fluctuating anxieties of parents of unstable neonates Conveying distressing news and dealing with severely challenging behaviour Diffusing potential complaints Dealing with complaints Dealing with verbally abusive parents, relatives and visitors Coping with the erratic, unpredictable behaviour of parents involved in substance misuse ENVIRONMENTAL : Constantly working within a hot room environment (>24°) which is necessary to maintain body temperature of small neonates nursed in cots Frequent daily exposure to body fluids, hazardous and infectious materials Using complex medical equipment involving noxious gases, i.e. Nitric Oxide Exposure to phototherapy lights Holding patients for radiological investigations Working in personal protective equipment Lone working Extremes of temperature Adverse weather conditions Transport Motion sickness Travelling under hazardous conditions 13. KNOWLEDGE, TRAINING AND EXPERIENCE REQUIRED TO DO THE JOB 1st level registered nurse (child or adult) / midwife with current (NMC) registration and relevant post basic neonatal qualification Experience in a Neonatal Intensive Care Unit demonstrating the appropriate competencies and skills for the job, including technical competency for invasive procedures. Commitment to attend and work towards an Advanced Neonatal Nurse Practitioner Qualification at Master’s level or equivalent education/ clinical experience Non Medical Prescribing course – NMC recorded, or commitment to undertake Current neonatal intensive care experience with evidence of a commitment to continuing professional development Successful completion of (and update as directed) an accredited Neonatal Resuscitation course Evidence of problem solving skills Self motivated and able to manage own time and to work in complex environment Effective communication and presentation skills are essential Experience in clinical training / teaching IT skills Team building and leadership skills Presentation skills 14. 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: PERSON SPECIFICATION POST REF NO: JOB TITLE/BAND: D/RA/27/13 Trainee ANNP Band 7 LOCATION: HOURS: NICU 37.5 per week CRITERIA EXPERIENCE: ESSENTIAL Extensive post qualification in speciality experience in neonatal intensive care. QUALIFICATIONS: (Training; Research; Publications) KNOWLEDGE & SKILLS: First level registered nurse/midwife Post-basic qualification in neonatal nursing Under graduate degree or equivalent Evidence of continuous professional development in neonatal care. NLS Child protection training Breast feeding training Able to demonstrate the appropriate competencies and skills of a highly specialised neonatal nurse, caring for babies requiring all levels of care. Specialist knowledge of the clinical management of premature and sick neonates Ability to study at Master’s level Ability to function autonomously, seeking support and advice appropriately Able to manage resource Evidence of ability to effectively lead a team. Effective educator and assessor Ability to work using own initiative and as part of a DESIRABLE Previous experience at Charge Nurse orSCN/CNS level NLS or generic instructor course Nurse Independent Prescribing. Experience of undertaking research / audit project Presentation skills Ability to write academic papers PERSONAL QUALITIES: multidisciplinary team. Evidence of effective problem solving skills. Understanding of own development and training needs and ability to facilitate in self and others Able to deliver on all aspects of a clinical governance agenda Able to instruct, direct and support Willingness to highlight and others in the delivery of neonatal deal with sensitive or care potentially confrontational issues The ability to communicate effectively and sensitively Able to work as part of the multi disciplinary team. Willing to take responsibility for own practice and guidance of inexperienced nursing staff. Adaptable and flexible in approach to own work practice. Enthusiastic. Self-motivated. Ability to empathise and reassure. Diplomacy. Tact. Facilitator, negotiator, teacher, diplomat effective Awareness of the differing cultures and individual needs of children and families. Highly analytical Very organised prioritise OTHER: (eg travel across Tayside) and able to Able to undertake flexible working hours. OHSAS and CRB check satisfactory to the trust General Conditions of Service POST REF NO: D/RA/27/13 JOB TITLE/GRADE: Trainee Adv Neonatal Nurse Practitioner, Bd 7 LOCATION: Neonatal Services – Ninewells Hospital Conditions of Service Remuneration Hours of Duty Superannuation The terms and conditions of service for this post are those determined by the NHS Staff Council. The current salary scale for the post is £30,764 to £40,558 per annum (pro rata for part-time staff). Placing on the scale on appointment is normally at the minimum but may be higher subject to verification of previous relevant service. Salary is paid monthly by Bank Credit Transfer. The hours of the post are 37.5 per week. Start and finish times will be determined by the needs of the service. Membership of the NHS Superannuation Scheme is not compulsory but is open to all staff between the ages of 16 and 70 (65 in some instances). The contributions paid are a percentage of superannuable pay, which is essentially basic pay excluding, for example, overtime or travelling expenses. Contribution rates with effect from 01.04.12 are as follows: Annual Pensionable Pay (Full-time equivalent) Up to £15,000 £15,001 to £21,175 £21,176 to £26,557 £26,558 to £48,982 £48,983 to £69,931 £69,932 to £110,273 £110,274 to any higher amount Annual Leave Contribution 5% 5% 6.5% 8.0% 8.9% 9.9% 10.9% Contributions are subject to tax relief and reduced National Insurance contributions. NHS Tayside also makes a substantial contribution towards scheme benefits – currently around 14% of basic pay. On appointment = 27 days (pro rata for part-time Staff) or 5.4 weeks per year. After 5 years aggregated service = 29 days (pro rata for part-time staff) or 5.8 weeks per year References After 10 years aggregated service = 33 days (pro rata for part-time staff) or 6.6 weeks per year Public Holidays = 8 days (pro rata for part-time staff) or 1.6 weeks per year All offers of appointment are subject to receipt of two satisfactory references Occupational Health Clearance All offers of appointment to new entrants to the National Health Service are subject to a medical examination. Medical examinations are arranged and undertaken by the Occupational Health and Safety Advisory Service (OHSAS). Rehabilitation of Offenders Act 1974 (Exclusions and Exceptions) (Scotland) Order 2003 All current or spent criminal convictions, cautions, warnings or any case pending must be disclosed prior to commencing in employment as detailed on the application form. Disclosure Scotland Immigration, Asylum and Nationality Act 2006 Please note that having a conviction will not automatically debar you from obtaining employment with NHS Tayside. Careful consideration will be given to the relevance of the offence to the particular post in question. However, if you are appointed, and it is found that you did not reveal a previous conviction your employment may be terminated. The successful applicant will be required to become a member of the Protecting Vulnerable Groups Scheme (PVG) in respect of regulated work with protected adults and regulated work with children. It is a criminal offence for an employer to employ anyone who does not have permission to live or work in the UK. Shortlisted applicants will be asked to produce specific original documentation at interview e.g. Passport, or full birth certificate together with an official document giving the applicants permanent National Insurance Number and name issued by a Government Agency or a previous employer, as well as photocopies of these documents. Professional Registration/you should have current and continuing professional Induction Standards & Code registration with NMC and hold the appropriate of Conduct qualification(s). Smoking Policy Smoking is prohibited within NHS premises and grounds. Applications Completed forms should be returned to: recruitment.tayside@nhs.net quoting the job reference in the subject line or Workforce Services, Level 9, Ninewells Hospital, Dundee DD1 9SY By closing date of Wednesday 12June, 2013.