Bladder & Bowel Clinical Nurse Specialist

Job overview

Calderdale and Huddersfield NHS Trust are seeking an enthusiastic nurse to join our specialist bladder and bowel service.

The nurse will provide specialist clinical knowledge and will undertake the clinical assessment, diagnosis, planning, implementation, treatment and management of patients with bladder and bowel dysfunction in a range of community settings including patient's homes, care homes and clinics.

They will support and guide patients, carers, relatives and other health care professionals with fundamental components of bladder and bowel dysfunction treatment and management and will be confident and competent in providing information, advice and psychological support.

Main duties of the job

• Undertake holistic assessments of patients with Bladder and Bowel dysfunction using up to date knowledge and skills- including physical examination and bladder ultrasound and interpretation of results in planning care.
• Promote continence and management of incontinence through education and training programmes.
• Assess the degree and extent of bladder and bowel dysfunction and plan appropriate care in line with NICE approved pathways.
• Identify any complex factors which may predispose the patient to bladder and bowel problems or affect treatment outcomes.

Detailed job description and main responsibilities

Professional

• Work in accordance with the NMC code of professional conduct or similar professional body.
• Support the community teams in achieving clinical competency development in the management of patients with bladder and bowel dysfunction.
• To participate in professional development to aid fulfilment of the role in pelvic floor assessment and management; bowel assessment and management; catheterisation and problem solving in these areas.
• Support the Bladder and Bowel Team in all aspects of service design and development.

Responsibilities

• The Bladder and Bowel Specialist Nurse will be responsible and accountable for the direct delivery of a clinical caseload.
• Undertake holistic assessments of patients with Bladder and Bowel dysfunction using up to date knowledge and skills- including physical examination and bladder ultrasound and interpretation of results in planning care.
• Actively link with the wider MDT.
• Ensure patient/carers are provided with relevant written information regarding their plan of care.
• Work flexibly with other team members to provide co-ordinated holistic care.
• Provide clinical care that is evidence-based and appropriate to the needs of the patient.
• Refer to other professionals for any specialist support that the patient may clinically require
• Act as the support and contact for individual patient care management between other agencies.
• Communicate effectively and support patients and their carers when dealing with psychological aspects of care relating to their bladder and / or bowel dysfunction. Demonstrate empathic interpersonal and communication skills in dealing with patients and carers through the patient pathway.
• Adhere to the trust’s medicines management guidelines when independently prescribing medication and appliances.
• Advise and support in the instruction in intermittent self-catheterisation.
• Actively take part in or lead on clinical audits relating to the service or other CHFT services.
• Promote continence and management of incontinence through education and training programmes.
• Assist the Lead Specialist Nurse for the service in the investigation of complaints and incidents related to continence and to develop action plans for improving practice.
• To assist in the development and review of formularies of products, policies, procedures, strategies and guidelines to provide value for money therefore reducing wastage.
• To act as a role model in quality improvement by developing services to address the health and social needs of clients.
• Take part in training for the current supplier of the Home Delivery Service and use the IT system to enhance patient care.

Clinical Duties

• Triage patients with undiagnosed cause for their bladder or bowel dysfunction onto the caseload.
• Assess, treat and evaluate a variety of Bladder and Bowel dysfunctions with holistic care plans.
• Assess the impact of dysfunction on patients and or carers.
• Set appropriate treatment goals in collaboration with the patient.
• Set appropriate treatment goals with due regard to NICE guidelines.
• Assess the condition of skin and refer to tissue viability team as appropriate.
• Accurately measure bladder volume and nature of dysfunction using recognised bladder diaries.
• Assess the degree and extent of bowel dysfunction using recognised tools.
• Assess the symptom profile to accurately identify the type of bladder dysfunction as described by International Society for Incontinence.
• Assess the degree and extent of bladder and bowel dysfunction and plan appropriate care in line with NICE approved pathways.
• Identify any complex factors which may predispose the patient to bladder and bowel problems or affect treatment outcomes.
• Assess the level of patient quality of life and symptom severity score using recognised tools i.e. global outcomes, ICIQ symptom specific scores.
• Perform vaginal examination and teaching of pelvic floor exercises.
• Teach self-catheterisation to patients and carers if required.
• Teach and support patients and carers with rectal irrigation and bowel management regimes. Prescribe appropriate medication to patients requiring treatment with anticholinergic therapies, antibiotic treatment.
• Carry out female, male and suprapubic catheterisation when patient condition requires this. Assess patients for continence aids working alongside occupational health and physiotherapy services.
• Where treatment is not appropriate assess patients for containment products to ensure patients dignity and quality of life. Identify, timely review and reassessment.

Management

• Manage own workload, ensuring high standard of patient care delivery.
• Maintain accurate records in accordance with Trust and NMC guidelines or similar professional body. Ensure correct implementation and adherence to Trust policies and procedures.
• Ensure resources are used effectively and efficiently and contribute to maintaining levels.
• Contribute to clinical audits and suggest areas for evaluation/monitoring.
• Develop own management skills and identify gaps.
• Maintain an effective working relationship with other members of the patient care team.
• Develop and lead on any aspect of Bladder and Bowel dysfunction management in agreement and collaboration with Bladder and Bowel dysfunction Clinical Lead.
• Contribute to research as requested.
• Be confident and competent to actively participate with and fulfil all data collection requirements.