Senior Metal Health Nurse - Enhanced Therapeutic Observations and Care

Job overview

We are seeking 3 Band 6 Registered Mental Health Nurses who will deliver outstanding specialist mental health nursing support to patients identified as requiring enhanced therapeutic observation and care following triage and assessment by the ETOC Team Leader.

This patient group will in most cases involve the care of patients with mental illness or who are presenting with risks associated with a mental health condition, but may also include

• Challenging behaviour
• Learning disability, autism or other neurodiversity
• Dementia
• Delirium
• Intoxication

Main duties of the job

The Senior ETOC Nurse will be expected to support expert assessment and review of patients triaged by the ETOC team leader.

The Senior ETOC Nurse will be required to work a 24/7 shift pattern, and will be expected to deputise for the ETOC Team Leader on occasion, completing triage assessments for all ETOC referrals across the Denmark Hill Site.

The Senior ETOC Nurse will use their experience to proactively identify and assess for causes of behavioural escalation and, using excellent skills in de-escalation, develop, deliver and contribute to care plans to manage these,  using their expertise to support junior colleagues providing ETOC to patients across site.

The Senior ETOC Nurse will be required to provide direct care, particularly to more complex patients requiring ETOC, and support activities of daily living, and together with the activity co-ordinators and wider ETOC team will formulate and deliver meaningful therapeutic engagement to support patients through their stay at King’s.

The Senior ETOC Nurse will be expected to provide and contribute to core nursing care and support with patient physical health within the scope of their own knowledge and competence.

The Senior ETOC Nurse will will on occasion, be expected to assist in restricting the movement of patients who are being cared for using:

• Mental Capacity Act (2005)
• Deprivation of Liberty Safeguards (2005)
• Mental Health Act (1983)

Detailed job description and main responsibilities

Clinical responsibilities:

• Providing hands-on care to patients including:

a. Undertaking 1-1 enhanced therapeutic observations, care and engagement with patients in an honest, open and non- judgmental way, acting as a role model not only to junior ETOC team staff but also to King’s staff in the wider clinical area.

b. Recognising and valuing patients as individuals, acknowledging the importance of maintaining patient respect and dignity at all times and ensuring that the care provided respects equality and diversity.

c. Ensuring the timely escalation of any concerns to the MDT, area nurse in charge and ETOC Team Leader.

d. Monitoring and recording patient clinical observations, such as physical observations and vital signs, and escalating as appropriate any signs or symptoms of deterioration to the ward or department nursing team).

e. Providing person-centred, holistic, relational care to patients presenting with complex mental health needs or other behaviours that challenge, supporting a detailed, rolling mental state examination of the patient where necessary, delivering psychotherapeutic interventions where indicated.

f.  If required, deputising for the ETOC Team Leader and providing a responsive triaging service to wards and departments at Denmark Hill, including risk formulation and acting as decision maker on the level and duration of ETOC.

g. If required, deputising for the ETOC Team Leader to take on the role of shift co-ordinator, allocating resource as required across site, supporting the wider team and ensuring effective handovers and risk management.

h. Implementing the principles of ‘recovery’ - encouraging and supporting patients to engage with healthy lifestyles, facilitating psychosocial activities and other activities of their interest.

i. Advocating for the patient’s needs and rights.

j. To assist patients with activities of daily living whilst encouraging independence, as appropriate.

k. To assist with patient nutritional needs – eating, drinking, menu selection, meal delivery and special diets according to the individual patient’s needs.

l. Engage with patients who may present with challenging behaviour; utilise enhanced verbal de-escalation skills to support the safe and appropriate management of patients.

m. To lead on, provide and contribute to a rolling risk assessment of patients, including an initial robust formulation – providing and recording observations, information and clinical thinking to support safety, and using tools such as DASA, DASA-YV or BVC as a method of assessing and proactively seeking to address causes of distress before they occur.

n. Escorting patients off ward where appropriate to do so.

• . Ensure relevant electronic notes and incident reports are completed in a timely manner and to a high standard.

p. Participate in multidisciplinary team handovers providing excellent holistic nursing observations including behavioural triggers and de-escalation techniques.

q. To assist in the maintenance and safekeeping of patients property in line with Trust policy

r. To ensure that all patients and relatives are welcomed and orientated to the environment; facilitate supportive contact with the patients wider support network.

s. To be a reflective practitioner; engage in de-briefs, supervision and staff support sessions, and to be mindful of own mental wellbeing, personal boundaries and self-care.

t.  Actively support the management of any mental health or behaviour emergencies involving patients under the care of the ETOC team.

Knowledge and Frameworks:

• Able to demonstrate a thorough understanding of Mental Health disorders and symptoms, assessment, risks, management and treatment and a clear understanding of the importance of mind and body care.
• A thorough understanding of the causes of behaviour that challenges – including trauma, dementia, delirium, learning disability and autism and other forms of neurodiversity, and other forms of cognitive impairment.
• A clear understanding of behavioural management approaches and techniques, including the role of psychopharmacology.
• A thorough working knowledge and detailed understanding of the MHA, MCA and DOLS and other legislation applicable to the practice area and how they are implemented in practice.

Communication:

• Contributing to an effective communication process with appropriate and accurate information to patients, carers, family, friends and colleagues. Engaging and listening carefully and actively, and responding using appropriate language and accessible communication methods and skills. Developing communication skills to enable and support difficult conversations, acknowledging cultural differences and professional boundaries.
• Contributing to and encouraging a clinical environment that fosters good communication based on respect and empathy between patients and health care profesisonals.
• Maintaining timely and accurate written and electronic patient records in line with Trust policy. Use of care plans, pathway documents and Information System progress notes appropriately and in a timely manner.
• Reporting, without delay, any safety or security concerns to maintain the safety of patients, carers, staff and others to appropriate authorities and organisations.
• Reporting safeguarding concerns in line with Trust policy and professional responsibilities.
• Responding respectfully to concerns or complaints raised by patients, families and carers and escalating in accordance with trust polices.
• Maintaining confidential information in accordance with Trust Policies.

Team working and Professional development:

• Protecting patients, self and others by maintaining a clean and healthy environment in accordance with health and safety and infection control policies. Supporting senior staff in ensuring audit and compliance activities and reports are kept up to date.
• Working in ways that support shared responsibility within the team: demonstrating support, respect and courtesy towards colleagues; working in a professional manner and with Trust values always in mind, respecting the boundaries of the relationship with patients, carers and staff.
• Attending and participating in team meetings where required.
• Providing supervision to junior colleagues as required, both on a shift by shift basis and more fomally as a named supervisor.
• Supporting any teaching commitments held by the team as required.
• Engaging in reflective practice to ensure effective patient care is based on evidence based practice, and with Trust values in mind. Attending staff training and meetings including reflective practice groups where required.
• Demonstrating own role to others and acting as role model to others at all times in accordance with Trust values.
• Undertake any other duties that are commensurate with the band and nature of the post.