INFORMATION FOR CANDIDATES POST OF: Cardiac Specialist Nurse BASE: University Hospital Crosshouse REF NO: N/809/13 Thank you for applying for the above post with NHS Ayrshire & Arran. This information sheet summarises the terms and conditions related to the post. Please note if you provide us with an email address on your application form any future correspondence regarding this post will be emailed to you. If you do not wish to receive this correspondence by email then please contact us as soon as possible. A job description and person specification for the post are attached. This post is a Secondment/ Fixed Term until 31st December 2014 The salary for the post is based on the Band 6 salary scale which is currently £25,783 to £34,530 per annum (pro rata for part time posts). The hours for the post are 37.5 per week although part-time or job share will also be considered. DISCLOSURE SCOTLAND PROTECTION OF VULNERABLE GROUPS (PVG) SCHEME The following provides information relevant to the post you have applied for and requires your attention and completion. PVG MEMBERSHIP The post you have applied for is considered to be in the category of “Regulated Work” as defined by the above scheme and successful candidate(s) will be required to be a member of the scheme prior to commencing employment. Membership currently costs £59.00. The cost of membership, if you are successful in your application, will be paid by NHS Ayrshire and Arran. EXISTING PVG MEMBER Applicants who are already a PVG member will require to confirm their membership and the regulated workforce this covers, eg, Adults, Children or both. Prior to employment, NHS Ayrshire and Arran will determine whether the current level of membership is appropriate for the post offered. If further membership to cover another regulated workforce is required, the conditions of membership as stated above will be applied. If however the level of current membership is appropriate, NHS Ayrshire and Arran will seek a Scheme Record Update (SRU) and will both pay and incur the costs associated with obtaining the update. Further information on the scheme can be found on the Disclosure Scotland website at www.disclosurescotland.co.uk PVG SCHEME MEMBERSHIP MANDATE (Please complete Sections 1+2 and return with your application) Section 1. Personal details (* circle as applicable) Name ____________________________ Post Reference Number: Post Applied for: ___________________ ___________ Are you currently a member of the PVG Scheme *YES/NO If YES, please provide Membership Number _________________ Date of Membership _______________ Date of last Scheme Record Update (if applicable) Member of which Regulated Workforce: *Adult __________________________ *Children *Both Section 2. Declaration I understand if my application for this position is successful, I will require to become a member of the scheme covering the appropriate regulated workforce. Signed: Name: ______________________________ ______________________________ Section 3 - For office use only Full membership required Yes/No Update only: Yes/No SPN: Date: _______________________ Post Ref no: _________________ Regulated workforce: Adult / Children / Both _____________________________ GENERAL CONDITIONS: Conditions of Service - The conditions of service are those laid down and amended from time to time by the appropriate negotiating bodies e.g. NHS Staff Council/NHS Pay Negotiating Council. Annual Leave – The leave year runs from 1 April to 31 March. Annual leave entitlement for full time staff on appointment is 202.5 hours (27 days), with 217.5 hours (29 days) upon completion of 5 years NHS service and 247.50 hours (33 days) after 10 years NHS service. Entitlements for part time will be pro rata. Public Holidays – Public holiday entitlement for full time staff is 60 hours based on the 8 designated Public Holidays per annum, and on a 5 day week working 7.5 hours per day. The 60 hours entitlement is due to all whole time staff irrespective of work pattern. For part time staff, this will be applied on a pro rata basis and also allocated in hours. KSF - The NHS Knowledge and Skills Framework is essentially a development tool but will also contribute to decisions about pay progression. It will promote equality for and diversity of all staff, having the same opportunities for learning, development and review. It will promote effectiveness at work – with managers and staff being clear about what is required within a post. It will support effective learning and development of individuals – with all members of staff being supported to learn throughout their careers. Pensions - Employees are automatically opted into the NHS (Scotland) Superannuation Scheme. Contributions are at the rate of 6.8% up until £26,557 then will rise up to 9% thereafter. Employees may opt out by obtaining and completing the relevant Opt Out form from the Scottish Public Pensions Agency website. Disabled Applicants - A disability or health problem does not preclude full consideration for the job and applications from people with disabilities are welcome. All information will be treated as confidential. NHS Ayrshire & Arran has been approved, by the Employment Services Department, as an Equal Opportunities employer with a positive policy towards employment of disabled people. NHS Ayrshire & Arran guarantees to interview all applicants with disabilities who meet the minimum criteria for the post. You will note on our application form we ask for relevant information with regards to your disability. This is simply to ensure that we can assist you, if you are called for interview, to have every opportunity to present your application in full. We may call you to discuss your needs in more detail if you are selected for interview. Asylum and Immigration Act 1996 and 2004 (Section 8) - The Asylum and Immigration Act 1996 and 2004 requires employment checks to ensure that all employees are legally employed in the United Kingdom. Candidates will be asked to provide relevant original documents prior to an offer of employment being made. Any offer of employment will only be made when the organisation is satisfied that the candidate is the rightful holder of the documents and is legally eligible for employment within the United Kingdom. Relocation Expenses - Relocation expenses may be payable to the successful candidate, in accordance with the Policy. This is available on request from the Department of O&HR Development. Candidates who require to relocate to take up post, should discuss this with the interview panel. Medical Examination - Any offer of employment is conditional upon a satisfactory medical report from our Occupational Health Services. You may be offered employment conditional on confirmation that you are medically fit for employment. A commencement date for employment will only be agreed following this confirmation. Policy Relating to Staff with Bloodborne Virus Infection - Candidates for posts which involve exposure prone procedures will not be allowed to commence employment until they have been assessed as fit to perform EPPs by Occupational Health. The preemployment screening must be completed prior to any job offer being made. Where a candidate is not able to perform EPPs, Occupational Health will notify the appropriate manager that the candidate is ‘fit with restrictions’ and is unable to perform EPPs. The health status of the individual will not normally be notified to management. Where the restrictions recommended by Occupational Health are unable to be accommodated due to the clinical duties of any of the posts within the staff groups specified in the policy, an offer of employment to the post will not be made. Candidates who are not offered employment due to being deemed unfit to undertake EPPs as an essential requirement for a post, may be offered the opportunity to apply for another advertised vacant post and be considered with other applicants. The preemployment screening for EPP posts above do not apply to staff undertaking non-EPP posts who could have direct contact with blood, bloodstained body fluids or patients’ tissue in the course of their work activities. These staff will be offered and strongly advised to be immunised against Hepatitis B in line with the Immunisation Policy including recall for boosters and further antibody checks. References - Two satisfactory written references must be obtained prior to any offer of employment being made. These should include current and previous employers as requested in the job application form. This is in line with the Recruitment and Selection Policy. YOUR APPLICATION: Informal Enquiries - Informal enquiries are welcomed by Janet Mckay, Consultant Nurse Cardiac who can be contacted on 01563827175. Closing Date - Your completed application form should be submitted by 20 December 2013 via the online application form on the SHOW website. Alternatively your completed application form can be returned to the address below or can be e-mailed to Leena.Alnaib@aapct.scot.nhs.uk Department of O&HR Development 63A Lister Street University Hospital Crosshouse KILMARNOCK Ayrshire KA2 0BE ADDITIONAL INFORMATION: LOCATION - AYRSHIRE Situated in attractive south-west Scotland on the Firth of Clyde coastline is the glorious countryside of Ayrshire which you’ll soon discover is a very special corner of Scotland. Ayrshire roads are quiet, the countryside peaceful but even so its easy to get here by road, rail, or air. Local attractions include country parks, museums - there’s Robert Burns and 1000’s of years of history and heritage to enjoy, sports - sailing, watersports, swimming, riding, golf to mention but a few. Starting in the North at the family resort of Largs the coastal route runs south through the seaports of Ardrossan and Saltcoats to Irvine - Scotland’s only New Town by the sea. From Irvine you can take in the breathtaking beauty of the Ayrshire countryside - visit Kilmarnock with its famous Dean Castle and Country Park then inland through the lace making towns of Galston, Newmilns and Darvel. Further south and you are in Doon Valley - the heart of Ayrshire’s industrial heritage. Back on the coastal route south of Irvine is Troon, another popular resort and the start of Ayrshire’s famous Golf Coast. On this stretch of Ayrshire Coast Ayr is the premier resort and is also the ideal base for exploring the Burns Heritage Trail and visiting Burn’s birthplace in Alloway. From Ayr the coastal route to Girvan includes the picturesque harbour village of Dunure and the National Trust’s major attraction - Culzean Castle. Inland is the ancient capital of Carrick Maybole with its castle and tollbooth. Here in South Ayrshire the nearby Carrick forests and hills offer superb walking country. The popular seaside town of Girvan would be your last port of call or you could continue southwards to Ballantrae along a spectacular rugged coastline notorious in the past as a haven for smugglers. From North to South the countryside is very varied with something to suit everyone - we like living and working here - and think you will too! WITHIN EASY ACCESS TO GLASGOW Most locations within Ayrshire are also within easy access of Glasgow by rail or road with all the benefits and attractions found in a major city. TOBACCO POLICY Fresh Air Policy - Please note that, in line with the national Tobacco Control Strategy (20132018), NHS Ayrshire and Arran are working towards smoke free grounds by March 2015 (with the exception of mental health facilities). ALCOHOL AND DRUG POLICY NHS Ayrshire & Arran operates an Alcohol and Drug Policy to protect the safety of all patients, visitors and staff with the aim of promoting well being and reducing harm. STAFF BENEFITS: STAFF LOTTERY The Board has set up a staff lottery and the cost of a chance in each monthly draw is deducted directly from your wage/salary if you decide to enter the scheme. Half the proceeds of the lottery are paid out as prizes and the remaining half is used to provide amenities, facilities and services for both patients and staff. During the year bumper prizes can be won and in the past these have included large cash prizes, luxury holidays and cars. STAFF DISCOUNTS Information on Discounts given to staff by several local businesses will be available on taking up employment. JOB DESCRIPTION 1. JOB IDENTIFICATION Job Title: Cardiac Specialist nurse Responsible to Consultant Nurse Department(s): Cardiac Liaison department Directorate: Medical Operating Division: ICES Job Reference: N/809/13 No of Job Holders: 7 Last Update:01/08/2012 2. JOB PURPOSE To contribute to specialist nursing care, education, counselling, support, and exercise to patients with a wide range of cardiac problems and their families. The post holder will facilitate high quality patient care within the caseload, identifying and monitoring high-risk patients to detect clinical deterioration. The post-holder will work closely with colleagues across NHS Ayrshire and Arran and all local authorities to ensure seamless care for the patient is provided. 2. DIMENSIONS The post-holder will be one of a team of Clinical nurse specialists providing specialist nursing care to patients with a wide range of cardiac problems, The team is led by the Consultant Nurse for the Cardiac MCN, and serves the population of NHS Ayrshire and Arran, a population of 377,000. Staff are based on two main sites at Crosshouse and Ayr hospitals, and a community hospital on Arran. The department has a caseload of: 1000 myocardial infarctions 250 pre and post cardiac intervention i.e. surgery 450 heart failure patients 450 patients attending exercise classes on 8 different sites 4. ORGANISATIONAL POSITION Lead Clinician Cardiac MCN Associate Nursing Director Consultant Nurse Advanced Cardiac specialist Nurses Advanced Cardiac specialist nurses Ayr Hospital Crosshouse hospital Cardiac Specialist nurses Heart Failure nurses community Cardiac Specialist Nurses 5. ROLE OF DEPARTMENT There are currently over 25,000 individuals affected by Coronary Heart Disease in Ayrshire and Arran. The cardiac liaison department works in partnership with the Coronary Heart Disease managed clinical network to improve the level of care provided to this population by: Providing a specialist nursing service to patients admitted to hospital with a wide range of cardiac conditions, this can take place both in hospitals and in community. Ensuring ongoing assessment of patients and early detection of complications, both physical and psychological and social, through nurse-led heart failure, pre and post cardiac surgery and myocardial infarction clinics, and through cardiac rehabilitation classes for suitable patients. Providing specialist education for all staff involved in the care of patients with cardiac disease. Providing a cardiac rehabilitation service in partnership with the physiotherapy department and other allied health professionals in locations close to the patients home to ensure equity of access. Referring patients to health care providers or other agencies as appropriate to ensure seamless care for the client Ensuring appropriate and effective communication between primary and secondary care, thus reducing the potential requirement for hospital admission 6. KEY RESULT AREAS To provide patients, families and carer with appropriate education, support and advice on Coronary Heart Disease and its risk factors, and impact, which empowers patients to be actively involved in managing, and monitoring their physical and psychological health. To co-ordinate appropriate and effective communication between the cardiac liaison service, patients, carers, general practitioners, hospital consultants, nursing staff, social services, and all other health professionals involved with the patients care to ensure integrated seamless care across primary and secondary care. To contribute to the provision of community outreach cardiac rehabilitation classes, including risk stratification, assessment, treatment and the provision of advanced life support when necessary, to ensure patient safety. To contribute to the provision of specialised education packages, across a range of cardiac conditions, for interagency services within Ayrshire and Arran, and all staff involved in the care of the client group, to ensure the improvement of clinical care outcomes for all cardiac patients. To contribute to monitoring, evaluation, audit and research activities related to the service, to ensure the quality of service provision. To facilitate improvements in services for individuals with coronary heart disease in partnership with local authorities and voluntary organisations. To assist in the implementation and evaluation of national and local guidelines in relation to cardiac disorders to ensure the delivery of high quality evidenced based patient care. To identify and meet training and development needs through personal development planning and objective setting process. To comply with all statutory policies and procedures of NHS Ayrshire and Arran. To participate in health promotion development activities to promote health and well-being within the wider Ayrshire community 7a. EQUIPMENT AND MACHINERY Computers for data entry, letter and report writing Pagers for quick contact from staff Telephones and fax for contacting patients and staff Photocopiers for copying documentation and training programmes Syringes for blood samples Blood pressure monitors for measurement Glucometers for glucose measurement Cardiac monitors for heart rate and rhythm monitoring Defibrillators for checking and for use in the event in a cardiac arrest Cardiac arrest trolley including oxygen and suction for checking and stocking Exercise equipment for providing the cardiac rehabilitation classes (i.e bikes, oximeters, pulse monitors ) 7b. SYSTEMS The post-holder is responsible for maintaining patient records and for the inputting of data into the cardiac database. This is shared with the other members of the team. They are responsible for ensuring that the appointment system for clinics and cardiac rehabilitation classes is kept up to date and is accurate and for ordering investigations. They are responsible for ensuring the ordering and supply of office supplies and health promotion materials using a paper based stock control system. 8. ASSIGNMENT AND REVIEW OF WORK Referrals will come from Consultant Cardiologist, Consultant physicians and Consultant Cardiothoracic surgeons and general practitioners. Work will be supervised by the Advanced Cardiac Nurse specialist. The post-holder works within a designated caseload and is required to make clinical decisions regarding patient management, and to use own initiative in ordering or advising on specific investigations. The post-holder will have objectives set and a personal development plan in line with the model of Performance and Appraisal and Objective setting by the Consultant Nurse. Advice and clinical supervision will be provided by the Consultant Nurse for the Managed Clinical Network. Consultants can be contacted if a patient needs medical review. The department meets monthly with physiotherapy colleagues and community heart failure nurses to discuss services and developments and for peer support. 9. DECISIONS AND JUDGEMENTS Post-holder has autonomy and independence regarding the delivery of specialised nursing care to meet the needs of the service and patient. Post-holder has the autonomy to pro-actively identify and resolve operational and clinical issues that impinge on service needs and patients safety. A Typical judgement would be clinical assessments, such as what action to take if a patient presents with symptoms during an exercise session. The actions might involve assessing cardiac rhythm, giving treatment i.e. GTN spray, sending the patient home or deciding to admit to hospital. There will usually be no medical personnel on site. This situation can also be replicated on home visits or in clinics Other typical judgements would be, the need for referral to expert agencies, advising about individuals abilities to perform certain activities, how to explain complex facts in a manner the individual would understand 10. MOST CHALLENGING/DIFFICULT PARTS OF THE JOB To convey complex concepts in language that is easily understood, and to negotiate long term behaviour change, at a time of great anxiety and distress for the individual and their family To be responsible for provision of care, while balancing competing demands, and ensuring early detection of deterioration in the condition of an individual. To provide educational support using the principles of adult learning, and health behaviour change to a wide range of individuals, both patients and staff, to promote a high standards of care for patients with Coronary Heart Disease 11. COMMUNICATIONS AND RELATIONSHIPS The post holder will be also required to communicate in a wide range of ways to ensure seamless care for the patient and to improve on the knowledge and skills of staff caring for patients with cardiac disease. There is a frequent need to deal with highly complex and sensitive information, using tact, sensitivity and always being aware of the need for confidentiality. Patients can frequently have difficulties with communication due to cultural, language, physical or learning disabilities. Communication will take also place with a wide range of individuals caring for these clients. These include: Members of the Coronary Heart Disease managed clinical network Secondary care Consultant Nurse/Senior nurse Consultant Cardiologists Nursing teams A/E staff Physicians Cardiology staff Allied health professionals Clinical effectiveness department Primary care Heart failure nurses General practitioners CHP prescribing advisors Community nursing teams Practice nurses Health Improvement Officers Local Authorities Leisure services Social work services Voluntary/charity organisations 12. PHYSICAL, MENTAL, EMOTIONAL AND ENVIRONMENTAL DEMANDS OF THE JOB PHYSICAL EFFORT/SKILLS: The job requires a combination of sitting, standing and walking. There is a requirement to take part in moderate activity (exercise classes) lasting for an hour, on two occasions a shift, one to four times a week. There is a requirement to use keyboard skills There is a requirement to use driving skills on home visits and to exercise classes. This will be on at least one occasion every day. The post-holder is required to have physical skills relating to venepuncture, advanced life support and defibrillation The post-holder is required to use breakaway techniques if required when functioning as a lone worker on home visits The post-holder may come into contact with physical and verbal aggression MENTAL EFFORT/SKILLS: The post-holder is required to have high levels of concentration while : Driving During patient assessment in nurse-led clinics During patient/ bereavement counselling sessions lasting an hour or more While preparing discharges and reports During teaching sessions with staff members and other individuals While assessing appropriateness of psychological referrals The pattern of work can often be unpredictable as patients or their relatives can contact the jobholder at any time during their shift and this may require the post-holder to solve a problem or in some cases to arrange a home visit. EMOTIONAL EFFORT/SKILLS: As a clinician, the post-holder will be required to communicate sensitive, complex, clinical information to patients and their families in easy to understand language. They will be required to negotiate behaviour change with patients with different life circumstances who may be resistant to change. This communication may take place either in hospital or in the patient’s own home and the patients may be anxious, or aggressive or unhappy with areas of their care. They often are the first point of contact for asking about the impact of the disease and are called upon to make it clear to some groups of patients that they will not get better and will in fact die of their illness. This is particularly true of those with heart failure, who have an illness that will progressively deteriorate. Patients rely on the post-holder for some time during their illness and are often anxious, worried and depressed. The post holder identifies when this progresses to needing psychological help and refers as necessary. The post-holder will be involved in palliative care management and bereavement counselling with some patients (i.e. Heart Failure). Patients may die while on the caseload and the jobholder is required to deal with the distressed relatives, who often have questions they feel can be answered best by the post-holder. ENVIRONMENTAL The post-holder will be exposed to body fluids while taking blood at clinics and will be exposed to verbal aggression on occasion. In addition the post-holder will spend some time working at a keyboard while preparing reports. 13. KNOWLEDGE, TRAINING AND EXPERIENCE REQUIRED TO DO THE JOB Essential criteria: Registered Nurse Educated to degree level or equivalent experience Experience in working with patients with cardiac disorders Current driving licence Advanced life support provider desired, Evidence of professional/personal development Experience of working autonomously Excellent communication skills Working knowledge of NHS Ayrshire and Arran policies and procedures NHS Ayrshire and Arran Person Specification Post Title Cardiac Specialist nurse Post Reference Number N/809/13 Selection Factors (Person Specification) QUALIFICATIONS & TRAINING EXPERIENCE Criteria Essential Registered general nurse Educated to degree level or equivalent Desirable Advanced life support provider Essential Experience in looking after patients with a cardiac condition Desirable KNOWLEDGE Essential Broad knowledge of cardiac care Knowledge of NHS Ayrshire and Arran policies and procedures Desirable COMPETENCIES & SKILLS Essential Excellent communication skills Good organisational skills Post holder must have current driving license Evidence of professional/personal development Experience of working autonomously Desirable PERSONAL CHARACTERISTICS AND OTHER Essential Works well as part of a team Desirable