JOB TITLE                           Nurse Practitioner

REPORTS TO                      Marie Jocelyn and Dr. Jullien H. C. Walkley  

                                             Managerially:  Practice Manager                                                      

JOB SUMMARY / PURPOSE

The Nurse Practitioner (NP) is a healthcare provider who operates independently in a variety of settings, making professionally autonomous decisions for which he or she is accountable.  The role is unique in combining advanced nursing skills with clinical, diagnostic, and treatment skills.  The NP provides an alternative and complementary source of primary healthcare alongside services provided by General Practitioners (GP’s).  They act as an advocate to directly increase the availability and accessibility of healthcare for patients across the age spectrum dependent on areas of identified need within the Practice.

As a key member of the primary care team, the NP functions in a variety of role dimensions: healthcare provision, management, service development, education, advocacy, administration and leadership participating actively in the planning, development and implementation of policy which influences advanced nursing practice in the Practice.

DUTIES AND RESPONSIBILITIES

Clinical:

• Assumes a clinical workload dependant on the individual general practice population in collaboration with GP colleagues or as determined by a specific patient group.

• Provides a holistic approach to healthcare, drawing from both the nursing and medical model of health and illness where appropriate in order to screen for the early signs of disease and diagnose acute problems.
• Demonstrates knowledge of the pathophysiology of acute and chronic conditions commonly seen in practice.
• Accepts referrals from other disciplines unsupervised.
• Undertakes the independent and autonomous assessment of undifferentiated and undiagnosed problems with attention to physical, emotional, social, cultural and mental health issues.
• Uses sound judgement in assessing conflicting priorities and needs.
• Formulates a diagnosis utilising medical diagnostic problem-solving skills including history taking, physical examination, invasive and non-invasive investigations which involves contact with potentially infectious biological substances on a regular basis.
• Initiates appropriate diagnostic strategies and therapeutic interventions including radiology and laboratory requests, with attention to safety, cost, invasiveness, acceptability and efficacy.
• Develops with the patient and family an on-going, evidence-based plan for health, with an emphasis on preventative measures.
• Interprets and evaluates diagnostic test results in liaison with the patient and their GP and initiates treatment accordingly.
• Evaluates the patient’s condition and response to therapeutic interventions and modifies the plan of care accordingly for optimal outcomes.

·        Prescribes as an independent, extended and supplementary nurse prescriber accordingly within the legal framework of nurse prescribing.

·        Utilises patient group directives (PGD’s), as an integral component of treatment plans in accordance with clinical guidelines based on efficacy, safety and cost-effectiveness.

• Initiates independent and collaborative patient referral to statutory and non-statutory organisations including GP’s, Secondary Care Consultants, other members of the PHCT, allied health professions and voluntary agencies.
• Makes use of computer technology using automated information systems in order to support decision making, improve the quality and co-ordination of care and services and to enable faster and more certain communication within the Practice.
• Maintains accurate records (including practice notes, computer and patient hand-held records, child protection records and records at Nurse Practitioner-led clinics) according to the Guidelines for records and record keeping (NMC, 2002).

Management:

·        Evaluates aspects of work using the audit cycle to report on services and standards of care in order to positively influence decision-making and planning.

·        Engages in clinical supervision and self-evaluation and uses this to improve care and practice.

·        Manages change in response to altered dynamics within work environment as influenced by political, social and economic factors.

Professional:

·        Demonstrates respect for the dignity of all human beings whatever their age, gender, religion, socio-economic class, sexual orientation and ethnic or cultural group.

·        Provides a high standard of care at all times in accordance with the Code of Professional Conduct (NMC, 2002) and The Scope of Professional Practice (UKCC, 1992).

·        Promotes the role and services of the Primary Care Nurse Practitioner by giving presentations and participating actively in forums relevant to the work.

·        Maintains professional competency and an awareness of organisational developments by attending relevant meetings, courses, conferences and seminars disseminating principals of best practice and relevant information to colleagues.

• Ensures patient confidentiality at all times in accordance with the Code of Professional Conduct (NMC, 2002).
• Adheres to the requirements of the Data Protection Act.

Leadership:

·        Participates in professional organisations.

·        Involved actively in the evaluation of Nurse Practitioner services.

·        Deputises as lead in absence of Lead Nurse Practitioner.

Communication:

·        Utilises highly developed communication, negotiation and interpersonal skills.

• Communicates the patient’s health status using appropriate terminology, format and technology. The course of this communication process involves the discussion of complicated issues and the sharing of delicate information on a regular basis.

·        Assesses patients’, carers’ and relatives’ on-going and changing learning needs and communicates health advice, instruction and counselling appropriately.

·        Provides health promotion and disease prevention services to patients who are healthy or have acute and/or chronic conditions by giving anticipatory guidance and counselling to promote health, reduce risk factors and prevent disease and disability.

• Communicates across language and cultural barriers within particular client groups, (e.g. Asylum Seekers and Refugees) in partnership with the available agencies and interpretation services.

Communication (cont):

·     Develops robust communication networks for the purpose of sharing relevant information in a safe and appropriate manner (which includes regular

communication with patients and their families/carers, members of the Primary Care and Acute Trust’s nursing teams, Primary and Secondary Care doctors, Social Services, Allied Health Professionals and Voluntary Agencies face-to-face, by telephone, letters/referrals and by email). 

Educational:

·        Participates in teaching Registrars and FY2 doctors and others who visit the services in which the Nurse Practitioner is involved.

·        Participates in the mentoring process of trainee nurse practitioners by coaching and supporting their clinical development.

Research:

·        Utilises an evidenced-based approach applying research findings pertinent to patient care and service development to critically evaluate outcomes, patient management and service development.

·        Initiates/participates formally and informally in nursing research in order to improve or evaluate care.

Attributes

Essential

Desirable

Education & Qualifications

·           RGN

·           Current NMC Registration

·           BSc (Hons) Nurse Practitioner (Primary Health Care)

·           Independent/extended Nurse Prescribing qualification.

·           Portfolio of evidence reflecting practice experience and professional requirements

·           MSc Nurse Practitioner (Primary Health Care).

·           Supplementary Prescribing Qualification.

.

MSc Nurse Practitioner

(Primary Health Care)

ENB 998 or equivalent

Experience

·         Experience of working within Primary Care setting for minimum of 3 years

·         This setting must offer direct access to the public in which a wide range of health and social needs are identified

·         Can demonstrate competency in autonomous practice.

·         Demonstrates underpinning knowledge and skill in profiling health and social needs within the specific practice population

·         Demonstrates ability in teaching, research, audit and management

·         Demonstrates an understanding of the wider issues of health and social needs and care within the Primary Care setting

·         Demonstrates an understanding of health education and health promotion

·         Ability to cross role boundaries

·         Experience of developing programmes to target areas of need

·         Participating in practice development

·           Published research.

·            Demonstrates evidence of developing innovative practice

Personal Characteristics

·         Demonstrates excellent communication and interpersonal skills

·         Self motivation and adaptability

·         Confident networking skills both locally and nationally in order to promote and extend the role

·         Approachable and flexible

·         Proactive and an effective change agent with critical thinking and leadership skills