Bank Registered Nurses Midwives by liaoqinmei

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									Bank Registered Nurses

Grade:          Staff Nurse – Band 5.


Salary:         Band 5 - £21176- £27534 (pro rata).

Type:           As and when required

Hours:          Various

Location:       NHS Lothian

Contract:       Permanent

Duration:

Closing Date:   30/10/2010

Description:    The NHS Lothian Staff Bank provides a supplementary staffing service to clinical areas. We
                would like to recruit registered nurses to work within CCU./HDU, Theatres, Mental Health and
                Learning Disabilities Services across Edinburgh and the Lothian‟s. Hours will be variable on an
                as and when required basis and by mutual agreement. You must be a team player with a
                flexible approach to work as you will be required to work, often at short notice, in a range of
                clinical areas/locations, often at times of increased activity or staff shortage.

                In return, you will gain extensive experience of working in a multi disciplinary environment.

                Interested? If you are a Staff Nurse with CCU/HDU, Theatre, Mental Health or Learning
                Disabilities experience and would like to join our Bank then contact us for an application pack.

                Telephone:      0131 536 2020 (internal 62020) If it goes to voicemail, leave your name,
                                address, contact number and the post you are interested in
                Email:          staffbank.admin@nhslothian.scot.nhs.uk
                Post:           Staffbank Admin. Office, 5 Mill Lane, Edinburgh EH6 6TJ
1. JOB IDENTIFICATION

Job Title:        Registered Nurse

Responsible to:   Bank Staff Manager

Department(s):    Staff Bank

Directorate: Staff Bank

Operating Division: NHS Lothian

Job Reference: L-BANK-NUR2

No of Job Holders:

Last Update: 1 October 2004




2. JOB PURPOSE


As part of a multidisciplinary team the post holder will have responsibility to ensure the delivery of high quality care
to patients by the assessment of care needs, the development of programmes of care, the implementation and the
evaluation of these programmes. According to agreed competencies the bank nurse may carry out this work in
hospital and / or community settings.

In hospital environment in the absence of the ward charge nurse the post holder may be required to provide cover
to ensure effective operation of the ward. In community settings the post holder will be expected to deliver care to
a delegated caseload.




3. DIMENSIONS



       Would be a member of the multidisplinary team, in the role of a bank nurse supporting the team.
       In a hospital setting may lead team of other registered and non-registered nursing staff.
       Has day-to-day responsibility for managing patients‟ funds held at ward level or the safekeeping of patients
        house keys kept in the community.
       Uses NHS supplies cost-effectively.
       Has responsibility for the development of care packages for a group of patients.
4. ORGANISATIONAL POSITION


   Senior Manager



   Bank Staff Managers                               Ward / Community Staff



   Bank Nurses


The post holder is responsible to the Ward or Community staff whilst on duty. The post holder is line managed by
the Bank Staff Manager and professionally accountable to the Senior Manager.


5. ROLE OF DEPARTMENT

To provide a supplementary staffing service to clinical areas across NHS Lothian.




6. KEY RESULT AREAS

1. To fully assess patients, plan their care, implement and evaluate programmes of care and consult / involve
   patient / carers at all stages of the rehabilitation process so patients receive a high standard and correct care.

2. To organise own workload within the team to ensure the patients care needs are met and systems of teamwork
   are maintained.

3. To lead the nursing team, in the absence of the charge nurse / District Nurse, and act as a source of advice to
   ensure smooth organisation so patients and their relatives receive a high standard of prescribed care.

4. a) To contribute to the arrangements for patient admissions and discharges so that patients are admitted
   according to the ward procedures and discharges are fully planned.

    b) To carry out an initial visit of a new patient as delegated by the District Nurse and to deliver immediate care

5. To implement and maintain, as part of the multidisciplinary team, policies, procedures, standards and protocols
   of the clinical area, directorate / CHP and division to ensure adherence to, and delivery of the highest level of
   patient care at all times.

6. To participate in audit systems to monitor the delivery and standards of care given to patients and their families.

7. To have direct involvement in the provision of clinical practice for pre-registration and appropriate post-
   registration students to ensure that appropriate learning opportunities are provided and students feel supported.

8. To appropriately and efficiently use NHS supplies so resources are used economically.

9. a) To deputise for the ward charge nurse in the operational management of the ward so staffing resources are
   utilised appropriately .
   b) To deputise in absence of caseload holder completing risk assessment of visits and ensuring the
   appropriate allocation of work.


10. To maintain effective written and verbal communications with patients, relatives and other members of the
    multidisciplinary team to ensure patient needs are met and appropriate information is shared and documented.
    In community settings establish and maintain effective communications and relationships with statutory and
    voluntary agencies, which promotes collaborative working and effective co-ordination of services for individuals
    and groups.

11. To develop within the post by expanding knowledge and skills to ensure continuous professional development
    and the delivery of evidence-based practice.




7a. EQUIPMENT AND MACHINERY

The registered nurse is expected to have a knowledge of all equipment used in the area however may not have
daily clinical involvement. Examples of equipment and machinery used:

Specialised:
Syringe drivers.
Enteral feeding tubes and pumps.
Defibrillator.
Suctioning equipment.
ECG monitors.
Bladder scanner.
Tracheostomies.

Generic:
Range of hoist and other manual handling equipment.
Pressure reducing / relieving mattresses, static and electrical.
Wheelchairs and specialist seating.
Syringes / needles / intravenous infusions
Thermometers / sphygmomanometer.
Urinary catheters, continence products.
Wound dressings.
Medical gas delivery systems and oxygen saturation monitors.
Blood glucose monitors.
Weighing scales.
IT equipment.



7b. SYSTEMS

Nursing staff duty rotas.
Maintenance of patient records and reports.
Patient dependency monitoring.
Audit / questionnaire completion.
In community setting;
Responsible for recording all activity on the Community Information System or appropriate local system.
Responsible for inputting, updating and maintaining a range of information databases e.g. local GP system, e-
Assess. EAssess involves sharing information with colleagues both internal and external to the organisation.
Completing timesheets/mileage.



8. ASSIGNMENT AND REVIEW OF WORK

Workload is determined by the needs of the service, and allocated by the Staff Bank according to the skills and
competencies of the post holder.

Direct supervision and allocation of workload for the duration of the shift will be by the Charge Nurse/District
Nurse/Health Visitor. However, the post holder will have responsibility for managing a defined workload, such as
taking charge of the ward in the absence of the charge nurse and acting as a named nurse for a group of patients.
The post holder will delegate / allocate work to the nursing team in the absence of Charge Nurse / District Nurse /
Health Visitor .


The post holder will be responsible to the Charge Nurse/District Nurse/Health Visitor for the duration of the shift and
should expect clinical guidance and on the job professional management. However the post holder is line
managed by the Staff Bank Managers. Ongoing issues of professional management / capability, and formal review
and appraisal of performance will be conducted by the Bank Staff Managers. The post holder is professionally
accountable to the Staff Bank Senior Manager.



9. DECISIONS AND JUDGEMENTS

The post holder is expected to clinically assess patients to establish any changes, inform other members of the
multidisciplinary team as necessary and plan subsequent care.

The post holder is expected to anticipate problems in meeting patients‟ care needs and resolve them
autonomously / within the nursing team or seek advice from a more senior nurse.

The post holder, once they have completed symptomatic relief training, makes clinical judgements about the
administration of medicines covered by a symptomatic relief prescription.

In the absence of the charge nurse / District Nurse allocates work and deployment of staff.



10. MOST CHALLENGING/DIFFICULT PARTS OF THE JOB

Being required to work, often at short notice, in a range of clinical areas / locations / community bases, often at
times of increased activity or staff shortage and integrating and establishing professional credibility within the team.

Managing the demands of direct and indirect patient care within available resources. To consistently negotiate and
balance the different and unpredictable priorities (including in community incorporating allocated additional
unplanned visits into workload) and demands from a wide range of professionals and agencies to ensure optimal
care is delivered.

Seeking local resolution to complaints from patients and relatives and advising on the formal complaint procedure
if required.

In the absence of the charge nurse / District Nurse, providing leadership to ensure the effective operation of the
area.
Managing patients who are displaying behavioural problems.



11. COMMUNICATIONS AND RELATIONSHIPS

Internal:
The postholder will be expected to communicate and liaise with the patient, their relatives and the multidisciplinary
team involved in the provision of care.
Other nursing staff – patient care, allocation of work, workload issues.
Other relevant departments within the Division e.g. Facilities, Estates, Supplies, Human Resources, Fire Officer,
Infection Control, Tissue Viability and other Specialist Nurses.
Staff Organisations.

External:
Staff in referring / receiving wards / hospitals.
Community services including Social work, education, housing, institutes of higher education, police, voluntary and
charitable agencies other relevant external agencies – regarding patient care.

Practice Education Facilitators regarding pre-registration nursing students.



12. PHYSICAL, MENTAL, EMOTIONAL AND ENVIRONMENTAL DEMANDS OF THE JOB

Physical Skills:
Administer medicines, injections, syringe drivers, intravenous infusions and blood transfusions.
Administer enteral tube feeding.
Insert urinary catheters.
Apply wound dressings.
Manual handling techniques.
Keyboard skills.

Physical Demands:
Physical manual handling of patient, patient movement with use of mechanical aides
Push wheelchairs and other mobile equipment.
Stand/walk for the majority of shift.
In community –
Personal safety - ongoing
Kneeling and bending frequently and repeatedly
Carrying equipment daily
Standing for long periods
Working in cramped and restricted conditions
Manoeuvring patients with or without the assistance of equipment as required
Stairs
Travelling in community, may be during hours of darkness

Mental Demands:
Retention and communication of knowledge and information.
Concentration required when checking documents including prescriptions; writing patient records; and dispensing,
calculating doses and administering medication. In the patient‟s home there is little opportunity to control the level
of background distraction. Single nurse administration of drugs in certain locations / community settings.
Frequent interruptions from patients / relatives / team members.
Concentration required when observing patient behaviours which may be unpredictable.
Additional time and effort required encouraging and educating patients to increase independence, including
frequent repetition of instructions.

Emotional Demands:
Communicating with distressed / anxious / worried patients and relatives.
Caring for patients and supporting relatives following receipt of bad news.

Emotional Demands (cont’d):
Supporting junior staff / colleagues in the work environment.
Communicating with and caring for patients who have reduced understanding and insight due to cognitive
impairments.
Caring for the terminally ill.

Working Conditions:
Exposure to body fluids, faeces, emptying bed pans/urinals, catheter bags (several times each shift)
Exposure to verbal and physical aggression from patients and relatives / other visitors.
Exposure to infections and temperature variations.
Exposure to tobacco smoke in areas within the ward where patients are permitted to smoke.



13. KNOWLEDGE, TRAINING AND EXPERIENCE REQUIRED TO DO THE JOB

Registered Nurse
Team-working skills and the ability to work using own initiative.
Effective communication and time management skills.


14. JOB DESCRIPTION AGREEMENT – As this is a bank staff job description signature is not
relevant
    1. JOB IDENTIFICATION L-BANK-NUR5

Job Title:                       Midwife (Newly qualified)

Responsible to:                  Bank Staff Manager

Department(s):                   Staff Bank

Directorate:                      Staff Bank

Operating Division:              NHS Lothian

Job Reference:

No of Job Holders:

Last Update



2. JOB PURPOSE

The post holder will plan and implement midwifery care to high and low risk women within a integrated service and will
liaise with the nominated preceptor for the shift or placement or the charge midwife.

The post-holder will work to uphold the philosophy of care within the unit to ensure that the woman and her family are
the central focus of a high quality services and that care provided is individualised.




3. DIMENSIONS


The post holder will be required to provide a full range of midwifery care across all care settings within the maternity
services in NHS Lothian. They will be responsible for providing support to ancillary staff.
4. ORGANISATIONAL POSITION



                                                    Senior Manager



                                                     Bank Staff                         Supervisor of
                                                     Managers                            Midwives


                                                 Newly qualified Bank               Midwifery Team
                                                       midwife



The post holder is responsible to the Midwifery team leader whilst on duty. The bank midwife will be allocated to a
Supervisor of Midwives. The post holder is line managed by the Bank Staff Manager and professionally accountable to
the Senior Manager of the Staff Bank.


5. ROLE OF DEPARTMENT

To provide a supplementary staffing service to clinical areas across NHS Lothian.



6. KEY RESULT AREAS


    1. Work in accordance with the NMC Midwives rules and Professional Code of conduct ensuring all care is
       evidence based.
    2. Keep up to date with current developments in midwifery, as well as, the broader healthcare agenda that may
       impact on maternity services.
    3.   Will be required to meet on at least an annually basis with identified Supervisor of Midwives

    4. Be fully aware and work within local, divisional and national policies, standards and guidance relating to all
       aspects of clinical practice.
    5. Promote a culture of women centred care, ensuring informed choice and that the packages of care are tailored
       to each woman‟s individual needs.
    6. Work within established practice frameworks utilizing the full range of midwifery skills to women
    7. Consolidate clinical skills/competencies and clinical decision-making processes as part of a mutually agreed
       preceptorship programme.
    8. Plan, implement and evaluate individualised care packages and liase with other professionals as required in
       accordance with the NMC midwives rules and locally agreed risk assessment pathways.
    9. Adhere to local policy and NMC statutory guidance for administration and storage of medicines.
    10. Supervise midwifery support staff.
    11. Have a clear understanding of clinical governance and as part of a team participate in the achievement of
         identified priorities and clinical/national audit.
12. Have an understanding of the child protection guidelines and appropriate referral pathways.

13. As part of a team be aware of the importance of ensuring sufficient supplies on a day/to day basis to meet the
    needs of the service.
14. Prioritise own workload allocated by Charge Midwife or deputy.
15. Report complaints, incidents and accidents via the appropriately identified channels and be involved in their
    investigation and resolution.

16. Participate in midwifery and multi-professional training programmes.
17. Participate in education programmes for parents on an individual or group basis.
      7a. EQUIPMENT AND MACHINERY

      1. The midwife is expected to have competence in the safe and appropriate use of all equipment used within the
         clinical area. This may require the post holder to undertake recognised training for the use of specific equipment.
      2. Examples of equipment and machinery used include blood gas analyser, neonatal resuscitaire, cardiotocograph,
           pulse oximeter, infusion pumps, ventouse machine, incubators, entonox apparatus, specialist delivery beds,
           neonatal monitoring equipment. (This is not an exhaustive list).


      7b. SYSTEMS


      The post holder must be competent in the appropriate use of all IT and manual systems relevant to the practice area
      and has responsibility to ensure that all data is recorded accurately. These include
      1. Patient administration system
      2. Results reporting
      3. Maintenance of patient records
      4. Incident reporting system



8. ASSIGNMENT AND REVIEW OF WORK
Workload is determined by the needs of the service, and allocated by the Staff Bank in response to demand and in
accordance with the skills and competencies of the post holder.
Within maternity services work is generated from various sources within the primary and acute sector. It may also be
self-generated by the midwife and/or the woman recipient of care. Work is determined on shift-to-shift or day-to-day
basis. Midwives are expected to work autonomously with low risk women and liaise or refer to another professional as
appropriate, in accordance with NMC midwives rules and agreed risk assessment pathways. The post holder is also
expected to prioritise their workload appropriately.
 The post holder will be responsible to the Charge Midwife / Team Leader for the duration of the shift / placement, and
should expect clinical guidance and on the job professional management. However, the post holder is line managed
by the Staff Bank Managers. Ongoing issues of professional management / capability, and formal review and
appraisal will be conducted by the Staff Bank Managers. The post holder is professionally accountable to the Senior
Manager.



9. DECISIONS AND JUDGEMENTS


As an autonomous practitioner supported by preceptorship, clinical decision-making is an integral part of the midwives role
when providing all aspects of maternity care to both “high” and “low” risk women during the antenatal, intrapartum and
postnatal periods.
The post holder will refer and/or liaise with other appropriate practitioners when further support or expertise is required.
The post holder will be required to support and participate in peer review and multi professional educational programs to
help inform clinical decision-making processes.



10. MOST CHALLENGING/DIFFICULT PARTS OF THE JOB
Being required to work, often at short notice, in a range of locations often at times of increased activity or staff shortage
and integrating and establishing professional credibility within the team.

Maintaining midwifery standards and philosophy of care, prioritisation and delegation of workload and time
management.



11. COMMUNICATIONS AND RELATIONSHIPS

In addition to regular communication with the woman and their relatives to devise care plans, supporting informed decision-
making in relation to all aspects of care other contacts falls into the following main categories.


Internal :
All Members of multidisciplinary and Primary Health Care teams
Staff representatives
Admin staff

External :
Social work, housing, police, voluntary and charitable agencies


      12. PHYSICAL, MENTAL, EMOTIONAL AND ENVIRONMENTAL DEMANDS OF THE JOB

           EXAMPLES

           Physical Skills
            Undertake venepuncture and intra muscular injections daily
            Perform vaginal examination
            Insertion and removal of sutures
            Insertion and removal of foley catheters
            Perform normal delivery of babies

           Physical Demands
            Stand/walking for the majority of the shift
            Manual handling of patients
            Awkward positioning at times eg during vaginal delivery, assisting breast feeding mums

           Mental Demands
            Retention and communication of complex information regarding patient care
            Concentration required for all or most of the shift when caring for one women in labour
            Concentration required when assessing CTG tracings, checking documents/patients notes and calculating drug
              dosages, whilst subject to interruptions by patients/relatives/visitors

           Emotional demands
            Frequently communicating with distressed/anxious/worried clients and relatives
            Breaking bad news regarding pregnancy outcome e.g. stillbirth, congenital abnormality etc

           Working Conditions
            Exposure to body fluids several times a shift blood, liquor, faeces, urine, vomit
            Exposure to gases, entonox, anaesthetic gases
            Exposure to verbal aggression and unpredictable behaviours of patients and their families.
13. KNOWLEDGE, TRAINING AND EXPERIENCE REQUIRED TO DO THE JOB


   1. Registered Midwife




14. JOB DESCRIPTION AGREEMENT

A separate job description will need to be signed off by each jobholder to whom the job
description applies.
                                                                                          Date:
Job Holder‟s Signature:
                                                                                          Date:
Head of Department Signature:
    1. JOB IDENTIFICATION L-BANK-NUR4

Job Title:                        Health Visitor

Responsible to (insert job title): Staff Bank Manager

Department(s):                    Staff Bank

Directorate:                      Staff Bank

Operating Division:              NHS Lothian

Job Reference:

No of Job Holders:

Last Update (insert date):        1 October 2004




2. JOB PURPOSE
The HV is responsible for improving health and social well being of individuals, families, groups and communities by raising
awareness of health and social well being and working with other professionals to facilitate and empower individuals and
families to engage in healthy lifestyles.

The HV will influence the broader context which affects health and social well being, enabling people to improve their own
health and working collaboratively to tackle health inequalities. through promotion of health, assessment of needs and
engaging in anticipatory and supportive care

The HV is responsible for achieving this contribution to public health through taking account of the different dynamics and
needs of individuals, families, groups and the community as a whole.




3. DIMENSIONS


The bank Health Visitor will be responsible for the delivery of a Health Visiting service to a geographical or practice
population as determined by the CHP /LHP Clinical Nurse Manager or lead Health Visitor.


The specific population / demographic indicators, deprivation and vulnerability factors will be dependent on the
placement.
4. ORGANISATIONAL POSITION

              Senior Manager



              Bank Staff Managers                          LHP Clinical Nurse Managers/
                                                           Lead HV


              Bank Health Visitors                         Health Visiting Teams


The post holder is expected to manage and co-ordinate the delivery of care for the delegated caseload, within a
highly devolved management structure. The post holder is responsible to the Health Visiting team leader / LHP
Clinical Nurse Manager or equivalent whilst on duty. The post holder is line managed by the Bank Staff Managers
and professionally accountable to the Senior Manager (NHS Lothian Staff Bank)


5. ROLE OF DEPARTMENT

To provide a supplementary staffing service to clinical areas across NHS Lothian.



6. KEY RESULT AREAS

1. To work collaboratively as a member of the Integrated Primary Health Care team, by developing and
   maintaining strong links with agencies to tackle health equalities in partnership including receiving and acting
   on referrals for specialist services provided in conjunction with other agencies.

2. To identify the health needs of the client group and explore opportunities for the promotion of a healthy lifestyle
   through individual and group health promotion activities and public health initiatives both locally and nationally,
   enabling people to improve their own health by working collaboratively with them and all relevant agencies.

3. To develop and deliver specific programmes aimed at improving health, increasing social inclusion, preventing
   ill health and reducing inequalities. This may include involvement in areas such as

        immunisation programmes and health screening
        engaging in Health Visiting practice and duties as detailed in Lothian Child Health Surveillance Programme
        planning, facilitating and evaluating parenting programmes based on specialist training to promote
         parenting capacity, confidence and development in parenting skills in the care of their children

4.   To develop and implement specialised services to address the needs of an identified socially excluded and
     vulnerable client group in conjunction with other statutory and voluntary organisations to improve health and
     reduce health inequalities
5.   To support members of the team ensuring quality of life is maintained and appropriate referrals are made to
     other agencies to arrange continued support for independent living

6.   To undertake all aspects and responsibilities of working in the area of child protection, as detailed in the Lothian
     Child Protection Guidelines. This includes
      the ability to provide and receive highly complex sensitive information
      interpreting situations and taking appropriate action
        participating in client assessments, planning and delivering child protection services
        ensuring appropriate communications within NHS and with other agencies
        ensuring appropriate and contemporaneous records of interventions are maintained
        acting as the key health professional in Child Protection
        having an active involvement in the legal processes

7. To maintain accurate and up-to-date clinical records complying with the requirement for patient confidentiality,
   including
    Recording activity / contacts on Community Information System or local equivalent
    Updating and maintaining information databases
    Cause for concern / child protection records
    Parent Held Child Health record

8. To influence policies affecting health by acting as the client's advocate, in responding to current policies,
   programmes and services which have an impact on social well being

9.   For the duration of attachment to a specific team provide ongoing leadership and mentorship to the health
     visiting team including students acting as a mentor and engage in the supervision, assessment and
     development, teaching and delivery of relevant training programmes

10. To facilitate and enable the ongoing process of professional and personal development for self and team
    colleagues to ensure an appropriately skilled workforce and thereby promote staff retention

11. To participate in the recruitment, management and support of staff in the performance of their duties in line with
    current Human Resource policies

12. To adhere to local and National Policies and participate in the effective delivery of them whilst complying with
     statutory policies and procedures of Lothian Health and the NMC Code of Professional Conduct




7a. EQUIPMENT AND MACHINERY

I.T. equipment
Responsible for the safte use, transport and storage of all diagnostic and treatment equipment relevant to the post
e.g. weighing scales, syringes, sphygmomanometers etc


7b. SYSTEMS

Child Health Surveillance Programme
Community Information System
GP Systems
Cause for Concern/Child Protection
Parent Held Child Health Record




8. ASSIGNMENT AND REVIEW OF WORK
Workload is determined by the needs of the service, and allocated by the Staff Bank in response to demand and in
accordance with the skills and competencies of the post holder.

As an autonomous practitioner the post holder will be expected to prioritise their own and the team's workload on a
daily basis and anticipate and resolve problems. The postholder will contribute to the development of specific areas
of work within the wider context. Certain aspects of this will be self generated. The post holder will be responsible
to the CHP / LHP Clinical Nurse Manager / Team Leader for the duration of the shift / placement, and should
expect clinical guidance and on the job professional management. However the post holder is line managed by the
Staff Bank Managers. Ongoing issues of professional management / capability, and formal review and appraisal
will be conducted by the Staff Bank Managers. The post holder is professionally accountable to the Senior
Manager.




9. DECISIONS AND JUDGEMENTS

As an independent practitioner the postholder is expected to work autonomously and prioritise their own and other
team members workload on a daily basis in accordance with local and National policies. Uses analytical and
judgemental skills to deal with complex facts or situations.

The post holder will be expected to make decisions in conjunction with other professionals regarding the referral,
support and management of children and families where there are child protection issues.
Anticipating guidance and appropriate referral.

Crisis intervention may be required where an immediate response is required. The post holder is
required to make decisions regarding assessment and interpretation of client need and the
appropriate level of response. Health Visitors in neighbouring teams will be able to provide guidance to
the bank Health Visitor.



10. MOST CHALLENGING/DIFFICULT PARTS OF THE JOB

Being required to work, often at short notice, in a range of locations / community bases, often at times of increased
activity or staff shortage and integrating and establishing professional credibility within the team.

Being able to deliver high quality care in a range of settingsand balance conflicting priorities in addressing the
health challenges of a local population within a multi-disciplinary framework.




11. COMMUNICATIONS AND RELATIONSHIPS

Internal
Health Visitors, CHP / LHP staff e.g. Chief Nurse, Clinical Nurse Manager, lead Health Visitor
GP‟s
Admin staff
All members of the Primary Healthcare Team

External
Social Work, Social Care & Education staff
Statutory and Voluntary agencies
Police
Housing
Communication is regular, face to face, on the telephone or in written correspondence and may be about any
aspect of service delivery. It is also often around complex, sensitive or contentious issues, this can include intra-
professional issues such as child protection, child abuse and mental and physical health issues.



12. PHYSICAL, MENTAL, EMOTIONAL AND ENVIRONMENTAL DEMANDS OF THE JOB

Physical
IT skills
Driving
Requirement to work flexibly with attention to speed, accuracy and factual record keeping

Physical Demands
Physical effort to move equipment
PC work

Mental
Unpredictable demands
Frequent interruptions by telephone, face-to-face contact with children, families and other professionals
Requires concentration and focus
Personal safety - Lone working
Working under pressure
Responding to situations requiring crisis intervention

Emotional
Dealing with loss, bereavement and post natal depression
Dealing with sensitive child care issues e.g. child protection, abuse, neglect, domestic violence
Dealing with special needs, illness of child/family member
Dealing with parents who are violent, aggressive and manipulative

Environmental
Driving in adverse weather conditions
Variable housing conditions – hygiene, pets, cigarette smoke, effects of drug and alcohol use, safety issues
Exposure to body fluids, head lice



13. KNOWLEDGE, TRAINING AND EXPERIENCE REQUIRED TO DO THE JOB

RGN & Registered Health Visitor
Experience of work with vulnerable families desirable
Experience of multi-agency work and partnership approaches desirable
Experience of group work/related activity
Basic IT skills
Driving Licence

                                                      Attributes

Interest in new developments
Innovative, flexible approach
Good interpersonal and communication skills
    1. JOB IDENTIFICATION L-BANK-NUR7

Job Title:                      Midwife

Responsible to:                 Bank Staff Manager

Department(s):                  Staff Bank

Directorate:                    Staff Bank

Operating Division:             NHS Lothian

Job Reference

No of Job Holders:

Last Update



2. JOB PURPOSE

The post holder will plan and implement maternity care to „high‟ and „low‟ risk women within a fully integrated
maternity service. She/he will be the lead practitioner for the management of low risk pregnancies and births. For
„high‟ risk pregnancies or specific needs she/he will be required to work closely with the multi-professional team
within the acute and primary setting to provide a systematic approach to care.

The post-holder will work to uphold the philosophy of care within the unit to ensure that the woman and her family
are the central focus of a high quality services and that care provided is individualised.



3. DIMENSIONS

The bank midwife will be required to provide a full range of midwifery care across all care settings within the
maternity services in NHS Lothian. They will be responsible for providing support to newly qualified midwives and
ancillary staff.
4. ORGANISATIONAL POSITION



                                                Senior Manager


                                                Bank Staff                      Supervisor of Midwives
                                                Mangers


                                                                                    Midwifery Team
                                                 Bank Midwife


The post holder is responsible to the Midwifery team leader whilst on duty. The bank midwife will be allocated to a
Supervisor of Midwives. The post holder is line managed by the Bank Staff Manager and professionally
accountable to the Senior Manager of the Staff Bank.



5. ROLE OF DEPARTMENT

To provide a supplementary staffing service to clinical areas across NHS Lothian.



6. KEY RESULT AREAS


    1. Work in accordance with the NMC Midwives rules and Professional Code of conduct ensuring all care is
       evidence based.
    2. Keep up to date with current developments in midwifery, as well as, the broader healthcare agenda that
       may impact on maternity services.
    3.   Will be required to meet on at least an annually basis with identified Supervisor of Midwives
    4.   Be fully aware and work within local, divisional and national policies, standards and guidance relating to all
         aspects of clinical practice.
    5. Promote a culture of women centred care, ensuring informed choice and that the packages of care are
       tailored to each woman‟s individual needs.
    6. Work within established practice frameworks utilizing the full range of midwifery skills (both integral and
       extended) in the provision of maternity care to women in the acute/primary setting. Ensure that clinical
       competence in midwifery skills are maintained to ensure a high quality and safe delivery of service to
       women and their babies.
    7. Plan, implement and evaluate individualised care packages and liaise with other professionals as required
       in accordance with the NMC midwives rules and locally agreed risk assessment pathways.
    8. Supervise the work of Midwifery Support staff as well as midwifery, medical and nursing students and junior
       medical staff.
    9. Have a clear understanding of clinical governance and as part of a team participate in the achievement of
       identified priorities and clinical/national audit.
    10. Have an understanding of the child protection guidelines and appropriate referral pathways.
    11. In the absence of the charge midwife ensure that there are sufficient supplies on a day/to day basis to meet
        the service needs and assist the ward manager in maintaining a cost effective service and budget control
        for medical, surgical and administrative supplies.
    12. Assist with the co-ordination of the clinical activities of the work area and prioritise own work as allocated
        by charge midwife or deputy. .
    13. Assist with orientation programmes which familiarise new members of staff with the organisational and
        clinical demands of the unit and clinical area
    14. Report complaints, incidents and accidents via the appropriately identified channels and be involved in their
        investigation and resolution.
    15. Participate in both medical and midwifery education programmes, participating in the teaching/mentoring of
        all learners and new members of staff within the work area.
    17. Facilitate, participate and evaluate education programmes for prospective parents in an individual or group
        basis.



7a. EQUIPMENT AND MACHINERY

1. The midwife is expected to have competence in the safe and appropriate use of all equipment used within the
   clinical area.. This may require the post holder to undertake recognised training for the use of specific
   equipment.
2. Examples of equipment and machinery used include blood gas analyser, neonatal resuscitaire,
    cardiotocograph, pulse oximeter, infusion pumps, ventouse machine, incubators, entonox apparatus, specialist
    delivery beds, neonatal monitoring equipment. (This is not an exhaustive list).




7b. SYSTEMS

The post holder must be competent in the appropriate use of all IT and manual systems relevant to the practice
area and has responsibility to ensure that all data is recorded accurately. These include
1. Patient administration system
2. Results reporting
3. Maintenance of patient records
4. Incident reporting system



8. ASSIGNMENT AND REVIEW OF WORK
Workload is determined by the needs of the service, and allocated by the Staff Bank in response to demand and in
accordance with the skills and competencies of the post holder.

Within maternity services work is generated from various sources within the primary and acute sector. It may also be
self-generated by the midwife and/or the woman recipient of care. Work is determined on shift-to-shift or day-to-day
basis. Midwives are expected to work autonomously with low risk women and liaise or refer to another professional
as appropriate, in accordance with NMC midwives rules and agreed risk assessment pathways. The post holder is
also expected to prioritise their workload appropriately.
The post holder will be responsible to the Charge Midwife / Team Leader for the duration of the shift / placement,
and should expect clinical guidance and on the job professional management. However, the post holder is line
managed by the Staff Bank Managers. Ongoing issues of professional management / capability, and formal review
and appraisal will be conducted by the Staff Bank Managers. The post holder is professionally accountable to the
Senior Manager.




  9. DECISIONS AND JUDGEMENTS


  As an autonomous practitioner supported by preceptorship, clinical decision-making is an integral part of the midwives
  role when providing all aspects of maternity care to both “high” and “low” risk women during the antenatal, intrapartum
  and postnatal periods.
  The post holder will refer and/or liaise with other appropriate practitioners when further support or expertise is required.
  The post holder will be required to support and participate in peer review and multi professional educational programs to
  help inform clinical decision-making processes.



  10. MOST CHALLENGING/DIFFICULT PARTS OF THE JOB
  Being required to work, often at short notice, in a range of locations / community bases, often at times of increased
  activity or staff shortage and integrating and establishing professional credibility within the team.
  Maintaining midwifery standards and philosophy of care, prioritisation and delegation of workload and time
  management.




  11. COMMUNICATIONS AND RELATIONSHIPS

  In addition to regular communication with the woman and their relatives to devise care plans, supporting informed
  decision-making in relation to all aspects of care other contacts falls into the following main categories.

  Internal :
  All Members of multidisciplinary and Primary Health Care teams
  Staff representatives
  Admin staff

  External :
  Social work, housing, police, voluntary and charitable agencies
12. PHYSICAL, MENTAL, EMOTIONAL AND ENVIRONMENTAL DEMANDS OF THE JOB

   EXAMPLES

   Physical Skills:
    Undertake venepuncture and intra muscular injections daily
    Perform vaginal examination
    Insertion and removal of sutures
    Insertion and removal of foley catheters
    Perform normal delivery of babies

   Physical Demands:
    Stand/walking for the majority of the shift
    Manual handling of patients
    Awkward positioning at times e.g. during vaginal delivery, assisting breast feeding mums

   Mental Demands:
    Retention and communication of complex information regarding patient care
    Concentration required for all or most of the shift when caring for one women in labour
    Concentration required when assessing CTG tracings, checking documents/patients notes and calculating
      drug dosages, whilst subject to interruptions by patients/relatives/visitors

   Emotional demands:
    Frequently communicating with distressed/anxious/worried clients and relatives
    Breaking bad news regarding pregnancy outcome e.g. stillbirth, congenital abnormality etc

   Working Conditions:
    Exposure to body fluids several times a shift blood, liquor, faeces, urine, vomit
    Exposure to gases, entonox, anaesthetic gases
    Exposure to verbal aggression and unpredictable behaviours of patients and their families.



13. KNOWLEDGE, TRAINING AND EXPERIENCE REQUIRED TO DO THE JOB


   1. Registered Midwife
   2. Successfully completed preceptorship in substantive post



14. JOB DESCRIPTION AGREEMENT

A separate job description will need to be signed off by each jobholder to whom the job
description applies.
                                                                                          Date:
Job Holder‟s Signature:
                                                                                          Date:
Head of Department Signature:
2. JOB IDENTIFICATION L-BANK-NUR3

Job Title:              District Nurse

Responsible to:         Bank Staff Manager

Department(s):          Staff Bank

Directorate:            Staff Bank

Operating Division:      NHS Lothian

Job Reference:

No of Job Holders:

Last Update (insert date):



2. JOB PURPOSE

The postholder is responsible and accountable for the assessment and delivery of quality nursing care, primarily in
the domiciliary setting, to a practice population and the wider locality and in partnership with others. This includes
monitoring and evaluating its effectiveness.

The postholder is responsible for raising awareness of health and social well being, influencing the broader context,
enabling people to improve their own health and working collaboratively to tackle health inequalities.




3. DIMENSIONS


    The bank District Nurse will be responsible for the delivery of a District Nursing service to a geographical /
    practice population as determined by the CHP / LHP Clinical Nurse Manager or Lead District Nurse.

    The specific population / demographic indicators, deprivation and vulnerability factors will be dependent on the
    placement.
4. ORGANISATIONAL POSITION




                                            Senior Manager
                                                                                CHP / LHP Clinical Nurse
                                                                                Manager / Lead DN
                                           Bank Staff
                                           Managers
                                                                              District Nursing Teams
                                          Bank District Nurse
                                                Nurse

The post holder is expected to manage and co-ordinate the delivery of care for the delegated caseload, within a
highly devolved management structure. The post holder is responsible to the District Nursing team leader or CHP
/ LHP Clinical Nurse Manager or equivalent whilst on duty. The post holder is line managed by the Bank Staff
Manager and professionally accountable to the Senior Manager of the Staff Bank.



5. ROLE OF DEPARTMENT

To provide a supplementary staffing service to clinical areas across NHS Lothian.




6. KEY RESULT AREAS

13. To be responsible and accountable for the ongoing assessment, development, implementation and monitoring
    of health and social care ensuring that the highest standards of care and service is delivered in a consistent
    and safe manner within the home and clinical setting. This includes considering the patient‟s care needs over
    the 24-hour period.

14. To initiate, establish and maintain good working relationships with patients, carers and members of the Primary
    Health Care Team to support multidisciplinary working.

15. To establish and maintain effective communications and relationships with statutory and voluntary agencies,
    which promotes collaborative working and effective co-ordination of services for individuals and groups. This
    will include effective discharge planning procedures and development and support of care packages in line with
    the Joint Future agenda, which may include commissioning of care services.

16. To be responsible for assessing and evaluating treatments either solely or in partnership with other prescribers,
    ensuring a cost effective approach.


17. To develop and deliver specific programmes of care aimed at improving health, increasing social inclusion,
    preventing ill health and reducing inequalities for individuals and the wider community.

18. Be aware of development of National and Divisional policies and protocols which have an impact on service
    delivery and physical, mental and social well being of the community.

19. To appropriately influence decisions in relation to patient care by acting as the patients and carers advocate in
    a variety of situations in order to promote the best possible outcome.

20. For the duration of attachment to a specific team, in the absence of the caseload holder be responsible for the
    day to day management of the district nursing team including allocation of work, risk management, monitoring
    standards of clinical practice and ensuring provision of evidence based/best practice through clinical audit.

21. For the duration of attachment to a specific team provide ongoing leadership and mentorship to the district
    nursing team including students acting as a mentor and engage in the supervision, assessment and
    development, teaching and delivery of relevant training programmes

22. To act as a resource and provide specialist nursing advice to other professionals and relevant agencies to
    promote best practice and ensure appropriate care.

23. To facilitate and enable the ongoing process of professional and personal development for self and team
    colleagues to ensure an appropriately skilled workforce and thereby promote staff retention.

24. To participate in the recruitment, management and support of staff in the performance of their duties in line with
    current Human Resource policies.




7a. EQUIPMENT AND MACHINERY


Responsible for the safe use, transportation, where appropriate, and storage of all diagnostic and
treatment equipment relevant to the post. This will range from basic items such as sphygmomanometers
and syringes, to more sophisticated and complex equipment such as specialist mattresses and hoists.
This may on occasion be specifically purchased for individuals.
In addition the postholder will be expected to use computers on a daily basis.
Whilst on duty the postholder is contactable by mobile telephone or pager.
7b. SYSTEMS


Responsible for the creation and maintenance of accurate and up to date clinical records complying with the
requirements for patient confidentiality and in accordance with all statutory policies and procedures of the Board,
CHP / LHP and the NMC Code of Professional Practice.
Responsible for recording all activity on the Community Information System or appropriate local system.
Responsible for inputting, updating and maintaining a range of information databases e.g. local GP system, e-
Assess. e-Assess involves sharing information with colleagues both internal and external to the organisation.
Responsible for completing timesheets/mileage forms.
Responsible for ordering supplies e.g. clinical supplies and equipment.


8. ASSIGNMENT AND REVIEW OF WORK

Workload is determined by the needs of the service, and allocated by the Staff Bank in response to demand and in
accordance with the skills and competencies of the post holder.

Within District Nursing teams the workload is generated by means of an open access referral system and is self
generated. The post holder therefore is responsible for initiating and receiving patient referrals from and to a wide
range of agencies including patients and carers and out of hours services. There is no defined maximum caseload
size/dependency. The postholder is required to monitor caseload activity whilst on placement with any specific
team.
As an autonomous practitioner the post holder will be expected to prioritise their own and the team's workload on a
daily basis and anticipate and resolve problems. The postholder will contribute to the development of specific areas
of work within the wider context. Certain aspects of this will be self generated. The post holder will be responsible
to the CHP / LHP Clinical Nurse Manager / Team Leader for the duration of the shift / placement, and should
expect clinical guidance and on the job professional management. However the post holder is line managed by the
Staff Bank Managers. Ongoing issues of professional management / capability, and formal review and appraisal
will be conducted by the Staff Bank Managers. The post holder is professionally accountable to the Senior
Manager.




9. DECISIONS AND JUDGEMENTS

As an independent practitioner the postholder is expected to work autonomously and prioritise their own and other
team members workload on a daily basis in accordance with local and National policies. Uses analytical and
judgemental skills to deal with complex facts or situations.

Makes decisions regarding assessing and interpreting patient conditions and responding appropriately with regard
to risk management issues. Some decisions may be made in conjunction with patients, carers and other
professionals regarding the support and management of appropriate packages of care to maintain independent
living. This will include the need to facilitate a quality and effective delivery of care balancing conflicting priorities
on a daily basis.

Determining when to refer to other healthcare professionals and statutory and voluntary services.

Co-ordinates and supervises team members and makes judgements about their competency. Takes action to
support staff and resolve any staff problems/disputes within own team.



10. MOST CHALLENGING/DIFFICULT PARTS OF THE JOB

Being required to work, often at short notice, in a range of locations / community bases, often at times of
increased activity or staff shortage and integrating and establishing professional credibility within the team.
To consistently use highly developed assessment skills, to deliver quality holistic care in isolation, in a range of
settings and balance conflicting and unpredictable priorities in addressing the health and social care needs of the
local population.

To consistently negotiate and balance the different priorities and demands from a wide range of professionals and
agencies to ensure optimal care is delivered.


11. COMMUNICATIONS AND RELATIONSHIPS

In addition to contact with patients and carers other contacts falls into the following main categories.

Internal :
All Members of Primary Health Care Team
Out of hours nursing and medical colleagues
CHP / LHP staff e.g. Chief Nurse, Clinical Nurse Manager, Lead District Nurse
Staff representatives
Admin staff
External :
Social work, education, housing, institutes of higher education, police, voluntary and charitable agencies

Communication is regular, face to face, on the telephone or in written correspondence and may be about any
aspect of service delivery. It is also often around complex, sensitive or contentious issues.




12. PHYSICAL, MENTAL, EMOTIONAL AND ENVIRONMENTAL DEMANDS OF THE JOB

Examples may include:-
Physical Skills:
Manual dexterity and accuracy required for setting up syringe drivers, infusions, administrating IM injections,
complex wound dressings, removal of sutures, insertion of catheters
Manual handling
Keyboard skills for data entry


Physical Demands:
 Personal safety - ongoing
 Kneeling and bending for long periods to dress complex wounds
 Carrying equipment daily
 Standing for long periods
 Working in cramped and restricted conditions
 Manoeuvring patients with or without the assistance of equipment as required
 Stairs
 Travelling, may be during the hours of darkness
All of the above activities are required to be carried out on a daily basis

Mental Demands:
 Concentration required during patient assessment, information sharing, attending case conferences,
   addressing patient and staff needs and requirements, report writing.
 Increased concentration is required when completing documentation in the patient‟s home where there is little
   opportunity to control the level of background distraction.
 Intense concentration required when working with complex cases i.e. vulnerable patients and single nurse
   administration of controlled drugs.
 Working with both predictable and unpredictable workload.
 The ability to act expediently and appropriately when responding to crisis situations. This happens on a
   frequent basis.
 On-going requirement for continual updating and learning of techniques and practices, including information
   technology skills.
 Working with patients with complex and diverse needs.
 Plan and organise workload, staff meetings, rotas reflecting the unpredictability necessitated through
   unplanned staff absence.

Emotional Demands:
 Communicating with distressed/anxious/worried patients and carers on a daily basis
 Frequently care for patients and families throughout their palliative care journey. This is particularly so when
  dealing with younger age groups
 Dealing with bereaved and grieving families and carers
 Dealing with vulnerable people
 Domestic violence
 Family breakdown
   Management of aggression
   Managing conflict
   Team issues and individual staff support

Working Conditions:
 Daily exposure to bodily fluids
 Management of potentially volatile situations on a daily basis
 Occasional exposure to verbal and physical aggression
 Home environments i.e. hygiene, ergonomics, pets, passive smoking on a daily basis
 Personal safety, lone working
 Road traffic conditions daily
 Inclement weather




13. KNOWLEDGE, TRAINING AND EXPERIENCE REQUIRED TO DO THE JOB

   The post holder will be a Registered General Nurse and will hold a relevant District Nursing qualification.
   A sound knowledge of NHS environment and current policies affecting the health of the population.
   Well developed communication and interpersonal skills, particularly influencing and negotiating skills.
   Evidence of continuous professional development
   The ability to work flexibly as part of a team.
   General information and technology skills, including use of the computer to record and retrieve clinical
    information.
   Driving license desirable but not essential



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:

								
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