1. JOB IDENTIFICATION
Job Title:
British Heart Foundation Cardiac Specialist Nurse
Department(s):
Nursing
Location:
Lewis & Harris Uist & Barra
Grade/Level:
Band 6
No of Job Holders: 4
2. PURPOSE
This post will provide specialist cardiac nursing care for patients with, and those at risk of
developing, cardiac disease in both primary and secondary care settings. This will include the
care of a caseload of chronic heart failure patients, the co-ordination and delivery of a
comprehensive cardiac rehabilitation programme, assessment and management of patients
referred to the Rapid Access Chest Pain service, patients with cardiac arrhythmia, and
provide specialist nursing support in primary and secondary prevention and rehabilitation to
patients and their families with vascular disease or risk equivalent’s, and provide specialist
support including education and training for other health professionals involved with the care
of patients with heart disease across primary and secondary care. The post will also assist
the Lead Nurse for the Cardiac Specialist Nursing Services with the development and
evaluation of the cardiac nursing service.
Some flexibility in working will be required across the whole of the Western Isles area to
facilitate equitable provision of Cardiac Specialist Nursing Services.
Regular professional development support in form of clinical placement with cardiology teams
at Glasgow Hospitals and formal education will be required to develop and maintain
competence and ensure close multidisciplinary team working with Glasgow cardiology teams.
The post is supported by the British Heart Foundation in terms of professional development
and CPD.
Job Summary
1. Providing expert care and advice, and manage their own caseload of patients with heart
failure, valvular heart disease, ischaemic heart disease, cardiac arrhythmia, cardiac
rehabilitation, and any other aspects of cardiac care requiring specialist input to a wide
range of people including patients, carers primary and secondary health care
teams/palliative care teams/ Social Services/ residential home care staff.
2. Work collaboratively with the multidisciplinary cardiology teams in secondary/tertiary care
to facilitate local management or onwards referral of patients with heart disease as
required.
3. The co-ordination and facilitation of a comprehensive cardiac rehabilitation and preventive
cardiology programme that addresses all aspects of lifestyle, management of risk factors
and the correct use if cardioprotective drug therapies, acting as an expert practitioner and
also providing advice/support to other members of the primary and secondary care teams.
4. Working within the Rapid Access Chest Pain service, and Cardiac Arrhythmia service to
assess, diagnose and manage patients presenting with cardiac chest pain, including
referral to tertiary care services or for onward investigation as appropriate, and providing
advice/support to primary and secondary care teams.
5. Facilitate discussion of outcome of cardiac investigations (ie Echocardiography,
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Ambulatory ECG monitoring,) along agreed pathways with cardiology services in
secondary/tertiary care , and ensure subsequent onwards referral or delivery of local
management plan, liaising with local multidisciplinary team.
6. Work collaboratively with NHSWI Consultant Physicians, GPs, palliative care services,
primary and secondary care teams to ensure a seamless service between primary,
secondary and tertiary care, promoting local implementation of managed clinical
networks/Integrated Care Pathways ensuring local and national targets for cardiac care
are being met.
7. Participate in policy and service development within own specialist area.
8. Being aware of British Heart Foundation requirements for this post.
3. Organisation chart
Senior Nurse
CHaSCP
Consultant Physician
NHSWI
Specialist
Rehabilitation
Services
GPSI
Cardiology
Network
Lead Nurse, Cardiac
Specialist Nursing Team
NHSWI
Tertiary Care
Cardiology Teams
This Post
British Heart Foundation
cardiac Specialist Nurse
NHSWI
4. MAIN DUTIES AND RESPONSIBILITIES
Clinical
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To assess, plan, provide and evaluate care to meet the care needs and to case manage
individuals with heart failure and valvular disease, ischaemic heart disease, and referrals to
rapid access chest pain service and arrhythmia service, in the Western Isles.
Provide cardiac specialist nurse input into local primary and secondary prevention and
rehabilitation programmes of care for patients with cardiac, vascular disease and vascular
disease equivalents and their families.
To ensure and facilitate liaison along agreed pathways with secondary/tertiary cardiology
services of all relevant patients with cardiac disease or requiring cardiac investigation, and
ensure that subsequent management plan/onwards referral is implemented and monitored.
To work as an integral part of the multi disciplinary cardiac nursing team, and an integral part
of the wider multidisciplinary team across primary, secondary and tertiary care.
Assess clinical status; using clinical examination and history taking skills to formulate and
implement individualised management plans.
Facilitate/implement the safe and appropriate use of drug therapy, advising multidisciplinary
team and patients on initiation and titration of cardiac drugs.
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Facilitate and advise multidisciplinary team on safe and appropriate investigations and clinical
management plan, within local and national guidelines, and advise on appropriate referral and
transfer to tertiary care cardiac services.
Monitor patient’s clinical status and blood chemistry following medication changes or other
intervention.
Request and organise diagnostic tests for individual patients (e.g. X-rays. ECHO, ECG, ETT,
Ambulatory ECG and BP monitoring, Pathology (including venepuncture) as indicated, in line
with agreed protocols, ensuring that the results are acted upon in line with agreed pathways
and appropriate management plan formulated and monitored.
Interpret specific investigations in order to manage the patient’s clinical treatment effectively.
Provide home visits and clinical assessment for cardiac patients who are unable to attend the
out patient setting to continue their treatment plan, or ensure liaison with primary care to
ensure treatment plan implemented.
Work in partnership with patients and carers to empower them to make informed choices
about their health and their healthcare.
Provide support and advice for terminally ill patients (end-stage cardiac conditions) and their
carers and liaise with the palliative care team.
Professional
 Understand the obligations associated with professional registration and practice in
accordance with the Nursing and Midwifery Council “Code of Professional Conduct” and be
professionally accountable to the NMC.
 Realistically evaluate performance and apply knowledge/skills to meet current and emerging
demands.
 Ensure personal knowledge base is up-to-date and informed by evidence based practice
 Be a resource for all NHSWI staff
 Participating in projects where appropriate, to identify health and well being issues and the
needs of the community.
 Participate in the development of care programmes, protocols and referral pathways in
conjunction with Lead Nurse Cardiac Specialist Nursing Services and health care staff in
primary and secondary care.
 Undertaking of evaluation of own role as agreed with Line Manager and in association with
CHD MCN and other advisory agencies.
 Contribute to the research agenda and to participate in BHF research
 Contribute to undergraduate and post graduate nurse training agenda
 Provide local information for Annual Report
Education and Research
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Regular professional development in the form of clinical placements at Glasgow cardiology
departments are a requirement of this post, as agreed with Line Manager and according to
the needs of the service
To provide specialist advice, education and support for staff within the cardiac nursing service
and across primary and secondary care nursing, ensuring delivery of a high standard of
evidence based care to patients with heart disease.
Participate in the collecting, organising and collating of data in respect of the assessment of
health needs and making results available via suitable forums such as the CHD Advisory
Group, CHD/Stroke MCN, etc.
Take responsibility for own personal professional development and continuing education.
Identifying own development needs in relation to existing and future work requirements.
Making effective use of learning opportunities within and outside the workplace.
Assisting others to identify learning needs and to support good practice
Being involved in research and development activities as required (e.g. recruiting patients to
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trials, facilitating focus groups etc) by performing specific tests or tasks, obtaining data using
specific methods and collating information.
Providing training opportunities for patients, carers and health care staff as appropriate and in
association with other organisations as required
Ensure examples of good practice within the service are disseminated locally and nationally
(e.g. CHD MCN, British heart Foundation events) in order to improve care for patients with
heart disease.
Attend BHF professional development events and study days as required in BHF contract.
Organisational
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Participate in delivery of cardiac specialist nursing services in NHS Western Isles.
Participate in implementation of recommendations from the CHD/Stroke MCN.
Ensure that appropriate referrals to other health care professionals are made, ensuring
continuity of care. Working with different professional groups and agencies in the joint
assessment of health needs for patients with coronary heart disease.
Where groups do not exist, participate in establishing local community support groups and
enabling people to access them (e.g. in liaison with British Heart Foundation, Chest Heart
Stroke Scotland).
Working with Lead Nurse Cardiac Specialist Nursing services and health care teams across
NHS Western Isles and with partner agencies. For example Comhairle na Eilean Siar to
develop new and existing services as required.
Communication
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Being able to communicate effectively with patients in respect of assessing both physiological
and psychological needs.
Being part of making complex decisions (e.g. about treatments, resources etc).
Providing technical or clinical advice to non-specialists, patients, carers and the public.
Demonstrating well-developed skills in facilitation, conflict resolution, negotiation, motivation
and influencing people.
Presenting, explaining and discussing issues in formal situations (e.g. at strategic meetings,
public meetings etc) and exploring the outcomes of these discussions.
Being able to maintain confidentiality during communication consistent with legislation and
employer’s policies.
To be available as a contact point for patients, relatives and carers who experience difficulties
and require advice and support regarding their disease and treatment and to be able to pass
this advice in a manner appropriate to their needs.
Managing, interpreting, appraising and synthesising data and information appropriately to
inform health care staff and service users of performance (e.g. audit data). Accessing
appropriate sources to improve analysis and presentation.
Reporting the post progress to the British Heart Foundation through quarterly audit reports.
Management
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To plan, implement, document and evaluate programmes of care, including maintenance of
patient records.
Assist Lead Nurse Cardiac Specialist Nursing Service in identifying and appraising service
performance and playing an active role in investigating poor quality, understanding the
contributing factors and action planning accordingly.
Participate in development of mechanisms for monitoring service performance against local
and nationally defined quality indicators (e.g. National CHD & Stroke Strategy, Health
Improvement Scotland) in conjunction with personnel from the Clinical Governance
Department.
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Implement HIS Coronary Heart Disease standards and NHS Western Isles policies as
appropriate.
Participate in reviewing changes in practice and measuring the extent to which quality has
been improved across the patient pathway.
Assist Lead Nurse Cardiac Specialist Nursing Services in involving patients, carers and the
public.
Assist Lead Nurse Cardiac Specialist nursing Service in overcoming barriers to development
and constructively challenging those whose views and actions are not consistent with
development.
Maintaining stability during times of change.
Recognising the importance of people’s rights and interpreting them in a way that is
consistent with employer’s procedures, policies and legislation.
Challenging behaviour that infringes on the rights of others, identifying and taking action to
address discrimination and oppression.
Encourage partnership working with voluntary groups.
5. SUPPORTING EVIDENCE
Physical Demands of the Job
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Combination of sitting and standing throughout the day. There may be the physical
transportation of equipment.
Standard keyboard skills in Microsoft Word, Excel
Dexterity in completing tasks will be required
The ability and knowledge to demonstrate equipment safely and effectively
Collecting blood and other samples
Using monitoring equipment
Travel throughout the Islands by boat, plane or car in all weather conditions.
Mental Effort
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High levels of concentration are required to carry out tasks and diagnosis.
Observing unpredictable patient behaviours that may be a consequence of treatment.
Maintaining a balanced approach to informed consent and ensuring that the patient has fully
understood the treatment involved.
Clinical assessment and production and implementation of clinical management plan will
require long periods of concentration.
Assisting Team Leader in producing guidelines and local policies may require long periods of
concentration
Emotional Effort
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Frequent exposure to emotional and distressing situations such as imparting distressing and
upsetting information e.g. diagnosis of potential cardiac disease.
Frequently required to counsel distressed patients and relatives on coming to terms with their
diagnosis or illness.
Caring for dying or terminally ill patient.
Supporting staff who are caring for terminally ill and dying patients.
Recognising stress in self and other staff and being able to offer strategies to address stress.
Working Conditions
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Frequent exposure to sharp objects when performing venepuncture.
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Flexible working conditions to meet the needs of the service
Ability to work in various environments in Primary and Acute care.
Hazards, which are unavoidable such as road traffic accidents, spills of harmful chemicals,
aggressive behaviour of patients, relatives and carers.
6. STANDARD ELEMENTS
Comply with all approved NHS Western Isles policies and procedures.
Confidentiality
The post holder must maintain the confidentiality of information about patients, staff and other health
service business in accordance with the Data Protection Act 1984.
Health and Safety
You are required to take responsible care of the Health and Safety of yourself and other persons who
may be affected by your acts or omissions and co-operate with NHS Western Isles to ensure that
statutory and departmental regulations are adhered to.
Assist in maintaining own and others’ health, safety and security
This involves:
a) Complying with Board health and safety policies, procedures and participating in mandatory
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
Board policy to do all that us 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 this post.
Job Holder’s Signature:
Date:
Head of Department Signature:
Date: 24 April 2014
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PERSON SPECIFICATION
Job Title:
British Heart Foundation Cardiac Specialist Nurse
Department: BHF Community Cardiac Services
FACTOR
ESSENTIAL
Experience
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Experience in the management of patients with
Cardiac Disease at Specialist Nurse Level.
Qualifications,
Training
Research
Publications
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1st level RN registration.
Relevant first degree or similar qualification.
Post graduate qualification in Cardiology or
equivalent experience.
Familiar with current guidelines for CHD + CHF
Familiar with Clinical Governance
Advanced Clinical Assessment Skills Qualification or
willing to work towards.
Independent Nurse Prescriber or willing to work
towards.
Willing to undertake clinical modules within Practitioner
with Specialist interest in Cardiology Diploma including
regular clinical placements at Golden Jubilee National
hospital.
Advanced Life Support Provider, or willing to undertake.
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Knowledge and
Skills
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DESIRABLE
Post Graduate
Qualification in
Palliative Care.
Advanced
Communication
Course.
Familiar with the management of Chronic Heart Failure Knowledge of
strategic Cardiac
and Valvular disease
issues.
Familiar with the management of ischaemic heart
disease.
Familiar with management of cardiac arrhythmias
Understanding of Palliative Care Issues in cardiac
disease
Evidence of Personal professional Development
Good level of understanding of health care service
delivery and management (including national CHD and
Stroke Strategy for Scotland).
Working knowledge of audit and research in clinical
settings
Being able to communicate effectively with patients and
colleagues, including abilities in conflict resolution,
negotiation, motivating staff and influencing people.
Comprehensive IT skills
Experience of contributing to Clinical Governance
Issues.
Able to demonstrate good teaching skills
Clinical assessment & diagnostic reasoning skills
Phlebotomy
Able to work autonomously
Able to facilitate change
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Disposition
Other
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Well developed organisational and time management
skills and able to manage changing priorities
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Ability to work alone as well as part of a Multidisciplinary
Team.
Able to demonstrate ability to manage own caseload.
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Full driving licence.
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