Senior Community Nurse - Virtual Ward/Urgent Community Response

Job overview

This is an exciting opportunity to join our Urgent Community Response Service in West Norfolk as a Senior Community Nurse. The role primarily focuses on the Virtual Ward, with additional support provided to the Urgent Community Response Care Team

The Virtual Ward within the Urgent Community Response Service provides hospital-level care to patients in their own homes, helping to prevent unnecessary hospital admissions and support early discharge. Using a multidisciplinary approach, the service delivers rapid assessment, monitoring, and treatment for patients with acute conditions, enabled by remote monitoring technology and regular clinical review. Patients receive personalised care from a team of healthcare professionals, including nurses, therapists, and medical staff, ensuring timely intervention while maintaining comfort and independence at home. This approach not only improves patient experience but also helps reduce pressure on acute hospital services.

This is a 7 day a week service and weekend working will be expected. Hours of service delivery are  8am - 8pm 365 days per year.

Main duties of the job

To work within the Urgent Community Response Team to prevent unnecessary admission to hospital.

• To assess and prescribe care pathways for patients in a crisis situation with long term conditions, the frail & elderly, palliative and end of life care and/or rehabilitation needs, to achieve quality of life and independence plus prevent avoidable admission where possible.
• To act as the patients advocate, facilitating choice and patient empowerment.
• To provide evidence based clinical/therapeutic interventions based on “best practice”.
• To work within the Urgent Community Response Team to support early discharge from hospital.
• To work with all health care professionals, and statutory/non statutory agencies to provide a seamless, integrated service to our service users.
• To support in the service delivery of Virtual Ward.

Detailed job description and main responsibilities

Clinical

The post holder will:

• Assess, plan, implement and evaluate all aspects of patient care, and develop treatment/care pathways that may need to be delivered from a range of options.
• Follow a holistic assessment, devise an individualised care pathway for each patient, modifying it as required.
• Be aware of Assistive Technology and utilise where required.
• Assess patients’ holistic needs, communicating complex and sensitive information to patients and carers as to their assessment, diagnosis, prognosis and treatment plan.
• Where there are barriers to understanding, such as hearing impairment, mental capacity impairment and other difficulties in comprehension, explanations require adjustments in order to gain understanding, consent and concordance.
• Establish and maintain therapeutic relationships with patients and carers, incorporating motivation, encouragement and confidence building to enable patients to engage in their treatment/care/management plan.
• Liaise with GPs, Social Services, inpatient teams, other allied health care professionals and the voluntary sector to ensure identified needs are met and care co-ordinated appropriately.
• Be required to undertake risk assessments and act upon them appropriately.
• Participate in multi-disciplinary/multi-agency meetings as appropriate, e.g. Gold Standard Framework.
• Plan and organise specialist services within the Urgent Community Response Team.
• Ensure activity data and clinical information is recorded on SystmOne and completed on a daily basis.
• Demonstrate dexterity and co-ordination when using specialist equipment and fine tools, advanced sensory skills, manual and mobilising skills.
• Order equipment and supplies via the electronic ordering systems used within the team.
• Ensure informed consent is obtained prior to initiating interventions.
• Be exposed to bodily fluids, infected material, blood products on a daily basis, therefore must utilise universal precautions and adhere to infection control policies.
• For those staff with a non-medical prescribing qualification, the member of staff may be required to prescribe according to service need.

Professional

The post holder will:

• Be responsible for ensuring workload for self and others is planned and prioritised according to service targets and needs.
• Be accountable for work delegated to others.
• Ensure own records are maintained, and those maintained by the team.
• Contribute to the staff rota on a monthly basis.
• Be required to undertake risk assessments and act upon them appropriately.
• Contribute to the supervision of workload within the integrated team.
• Be aware of budget and ensure all effort is made to work within this.
• Actively contribute to multidisciplinary team meetings and other meetings where appropriate.
• Support all team members within the Urgent Community Response Team, respecting them, their roles and contributions.
• Actively participate in and attend in-house training as required to develop current job role.
• Will be able to make own travel arrangements to patients’ homes, clinics, base and meetings etc, as required.
• Be responsible for safe use and maintenance of equipment and supplies.
• Remain accountable for own professional actions as determined by the professional bodies.
• Be required to demonstrate own duties to students, new starters and/or less experienced staff.
• Provide mentorship for students undertaking pre/post registration course.
• Provide advice/training to less experienced staff and supervise and support band 3 and 4  staff and students where appropriate.
• Mentor existing staff and provide training in specialist area as appropriate.
• Contribute to the induction process for new staff/students.
• Demonstrate good IT/standard keyboard skills.
• Demonstrate leadership skills within own competence.
• Maintain own continuous professional development.

Organisational

The post holder will:

• Undertake mandatory training as required.
• Participate in an annual Personal Development Review.
• Undertake Personal Development Plans for more junior staff members.
• Take part in clinical supervision as per Trust Policy.
• Follow Trust policies, and local procedures, and use discretion in interpreting them according to the setting and circumstances.
• Comment on draft policies.
• Ensure absence reporting is undertaken as determined by Team Leader and Trust Policy.
• Contribute to clinical audit as required.
• Complete the staff survey as required.
• Complete risk assessments and incident forms as required.