Directorate of Human Resources                                            Recruitment Team                                ...
TERMS AND CONDITIONS OF SERVICEPost: Clinical Nurse Specialist in Gastroenterology/Nurse EndoscopistReference Number: HH69...
Rehabilitation of Offenders Act 1974Under the terms of the Rehabilitation of Offenders Act 1974, many people need not refe...
Guidance for completing the NHSScotlandapplication formIf you need this, or any of the attached forms in large print or ot...
•   When you have completed all of the form, please send it to:       Recruitment Section       NHS Fife       Flat 3     ...
Present (or most recent) post section   •   If you are currently out of work, please write this in the ‘job title’ space  ...
•   Please note that all details on this section (Part D) will remain totally anonymous. It will    be detached from the r...
Support into Work          •   Have you experience of a mental health problem?          •   Want help with the application...
PROCEDURE FOR THE DISCLOSURE OF CRIMINAL RECORDS1.     IntroductionNHS Fife complies fully with the Code of Practice, issu...
The aim of the Disclosure Scotland Service is to enhance public safety and to help employersnd voluntary organisations in ...
JOB DESCRIPTION1. JOB IDENTIFICATIONJob Title:                Clinical Nurse Specialist In Gastroenterology/Nurse Endoscop...
4. ORGANISATIONAL POSITION                                                                                           Direc...
evidence based practice protocols of care and supervision of practice criteria.      7. Utilise Endoscopy Unisoft reportin...
Working practices can vary on a daily basis to meet the needs of the patients and organisational             requirements,...
•   Oxygen systems   •   Manual handling equipment   •   Fire equipment   •   Standard/electric beds   •   Urinary cathete...
•   Unisoft Endoscopy reporting system    •   Oasis    •   Master labs    •   Datix intranet    •   Internet and intranet ...
10. MOST CHALLENGING/DIFFICULT PARTS OF THE JOB    •   Carrying out technically difficult and physical and mentally demand...
Student Nurses – teaching and education in Gastroenterology Care.External:G.P. – Liaise with to provide effective ongoing ...
tumour and PEG insertion.   6. Concentration required during passing of oesophageal Manometry and pH catheters for correct...
•   First level registered nurse on part one/twelve of the NMC register   •   At least five years post registration experi...
Post Title/Grade: Clinical Nurse specialist in Gastroenterology/Nurse                  Endoscopist Band 7Department/Ward: ...
ESSENTIAL             DESIRABLE        MEASURE    Aptitude         •   Innovative                          Interview      ...
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  1. 1. Directorate of Human Resources Recruitment Team Flat 3 Willow Drive Kirkcaldy Fife, KY1 2LS Tel 01592 643355 Fax 01592 204611 Date As per postmark Your Ref Our Ref Please see below Enquiries to Recruitment Extension 7906 Direct Line Email: Sir/MadamPOST REFERENCE: HH694/01/10CLOSING DATE: 12 NOON ON 22ND JANUARY 2010Thank you very much for your interest in the above post. I have pleasure in enclosing an applicationpack which includes, a job description, application form, terms and conditions, person specification andprocedure for the disclosures of criminal records. Please be advised that the application form must becompleted in full as unfortunately we cannot accept a CV enclosure.When providing referees on the application form please be aware we require references to cover aminimum of a three year period. If the period of time both referees have known you is less than threeyears you will be required to provide additional referees. This can be indicated on an additional sheet ofpaper and where possible please give us email addresses for contact.Should you wish to make an enquiry to the Recruitment Team regarding a vacancy please ensure thatyou quote the reference number.Please be advised that if you do not hear from us within 4 weeks of the closing date then you havebeen unsuccessful in your application.May I take this opportunity to thank you for the interest that you have shown in NHS Fife.Yours faithfullyRecruitment TeamRecruitment TeamEnc.
  2. 2. TERMS AND CONDITIONS OF SERVICEPost: Clinical Nurse Specialist in Gastroenterology/Nurse EndoscopistReference Number: HH694/01/10Pay Banding: BAND 7 - £29,789 - £39,273Hours of Duty : 37.5Contract Type: PermanentAnnual Leave: 27 days on commencement 29 days after 5 years service 33 days after 10 years servicePublic Holidays: 8 fixed public holidays.The leave year extends from 1 April to 31 March.Part time staff will receive a pro-rata entitlement for annual leave and public holidays combinedas per the Agenda For Change agreement.Reckonable service may be credited for annual leave purposes in accordance with the Agendafor Change Agreement.Sick PayEntitlements to Statutory Sick Pay and Occupational Sick Pay will be determined in accordancewith the Agenda for Change Agreement. Reckonable service may be credited for Sick Paypurposes providing there has been no break in service of 12 months or more at time ofappointment in accordance with Agenda for Change Agreement.SuperannuationOn commencement with the organisation staff will be asked if they wish to join the schemealthough they may choose to join or leave the scheme at any time. Contribution rates will varyfrom 5% to 8.5% depending on pensionable earnings.If an employee opts not to join the scheme they will automatically contribute to the StateEarnings Related Pension Scheme (SERPS) unless excluded from doing so or have arrangeda Personal Pension.Occupational Health ClearanceAny offer of employment is subject to satisfactory Occupational Health clearance. Should yoube invited to interview you will be asked to complete a Pre-Employment Health Questionnairewhich you should bring to interview. The Occupational Health Service (OHSAS) will make anassessment on your fitness to carry out the post based on the information contained within thequestionnaire. In certain circumstances further information is required before clearance can begiven and OHSAS may contact you by telephone or request that you attend for an appointment.Clearance must be obtained before any new employee commences employment within NHSFife. Clearance may be subject to you attending for a Post-Employment appointment and it is.vital that you attend this appointment if required to do so
  3. 3. Rehabilitation of Offenders Act 1974Under the terms of the Rehabilitation of Offenders Act 1974, many people need not refer toprevious convictions which, after a certain period of time, are regarded as spent. Certain postswithin the National Health Service, however, are excluded from the provisions of this Act. Allpotential employees must disclose on the application form any unspent convictions and certainpotential employees are required to inform us of any previous convictions which, for otherpurposes, are “spent” under the provisions of this Act. Failure to disclose such informationcould result in dismissal or disciplinary action by the organisation. Any information given willbe treated in the strictest confidence. Please refer to the NHS Fife Procedure for theDeclaration of Criminal Convictions for further information.No Smoking PolicyNHS Fife operates a No Smoking Policy and it is the case that staff are not permitted to smokeon the premises or during working hours. It is a condition of employment that you comply withthese requirements.Agenda for Change Implementation and Variations to Contract of EmploymentAgenda for Change is a nationally agreed remuneration, job evaluation, personal developmentand terms and conditions framework which will apply to all NHS Scotland staff (except verysenior managers and staff within the remit of the Doctors’ and Dentists’ Review Body). Thismeans that you will be subject to the terms and conditions contained within this agreement andalso any subsequent national or local agreements or variations made in respect of Agenda forChange. Such changes will automatically be applied to you and your contract of employmentwill be deemed to have been amended on this basis.Work PermitsIf a candidate who requires a work permit is appointed to a post a work permit application willbe made by NHS Fife. However, current Home Office regulations dictate that employers arenot in a position to offer employment to candidates requiring a work permit where it can bedemonstrated that EEA candidates meet the minimum requirements for the post.Job ShareUnless otherwise stated within the job advert applications for this post may be considered on ajob share basis. Should you wish to apply on a job share basis please indicate this on acovering letter attached to the application form.
  4. 4. Guidance for completing the NHSScotlandapplication formIf you need this, or any of the attached forms in large print or otherformats please call our recruitment office on 01592 643355 ext 8706or 7906.An electronic version is available at guidance • If you have any questions or need some help with completing the form, please call 01592 643355 ext 8706 or 7906 or email recruitment Please have the job reference number handy if possible • If you are using the ‘hard copy’ version of our application form, please use black ink and write clearly in BLOCK CAPITALS. This makes the form much easier to read and clearer when we photocopy it • The job reference number can be copied from the job advert or the application pack • The job location will be on the job advert • The candidate number will be written in by us once you have returned the form to our office • The people who look through your completed form (short listing or short leeting team) to see if you have the skills and abilities needed for the job, will only see ‘Part C’ of the form. They will only see your candidate number and all personal details will be anonymous • Please do not send in a CV instead of, or as well as, the application form. We do not consider CVs during the selection process • Please fill in all sections of the application form. If some parts are not relevant, write ‘not applicable’ or ‘N/A’ in that space • If you need more space to complete any section, please use extra sheets of paper. Do not put your name or any identifying information on it as it needs to remain anonymous. Secure it to the relevant section, and we will add a candidate number to it when we receive it
  5. 5. • When you have completed all of the form, please send it to: Recruitment Section NHS Fife Flat 3 Willow Drive Kirkcaldy Fife KY1 2LSPersonal Details section • This gives us your contact details such as name and address. Under ‘title’ you would put either Mr, Mrs, Ms, Dr or just leave blank if you prefer • We may need to contact you at some time throughout the recruitment process. Please let us know the most suitable method of contacting you, for example email or phone call and the most convenient timeSickness • Please list in this section the number of occasions you were off work in the past year because of illness. If you would like to discuss this for further clarification please call our recruitment office.Declarations • Please refer to the enclosed Procedure for the Disclosure of Criminal Convictions. For certain posts you must tell us about all convictions and cautions regardless of how long ago the offence may have occurred. Convictions from other countries must also be notified. If in doubt please call our office at the help line number on page one of this guidance • Please note that having a conviction will not automatically disqualify you from getting a job with us. Careful consideration will be given to the relevance of the offence to the particular post in question. However, if you are appointed, and it is found that you did not reveal a previous conviction your employment may be terminated • Remember to read, consider and sign the declaration at the bottom of page 2Qualifications section • Please tell us of any qualifications you have. This can include school standard grades, GCSEs highers, or work based qualifications such as SVQs or NVQs • Remember to write down any ‘non formal’ qualifications or certificates that you think are relevant to the job you are applying for
  6. 6. Present (or most recent) post section • If you are currently out of work, please write this in the ‘job title’ space • Please write your start date in month/year format MM/YYYY • Please tell us briefly about your duties (what you do or did in your job). You could tell us your role, the main tasks, and any responsibility for supervising others. There is not a lot of space here so continue on a separate sheet if you need toEmployment History section • This is where you write down all the jobs you have done previously • Remember that if a job you have done in the past supports or is similar to the job you are applying for, please tell us more about it in your ‘support of application’ statement on page 6 of the application form – use a separate sheet if you need more spaceReferences section • Referees are people who know you at work. Please give the full names and addresses of 2 referees, one of whom must be your present or most recent employer and can confirm your job details • You should check that the people you have put on your form are happy to be referees • Your referees will not be contacted unless you are a ‘preferred candidate’ after interview. A preferred candidate is someone who is the preferred choice for the job, subject to satisfactory checks where appropriateDriving Licence • You only need to complete this if the job requires you to drive. Please check the job description or person specification. For example, some jobs with the Ambulance Service require you to be able to drive class C1 and D1 vehiclesStatement in support of your application • This is one of the most important parts of the form. In here you say why it is you want this job, and can list all your skills and abilities that you think help to match up you against the ‘person specification’. In here you could describe how something you have done in a non work setting (for example, planning and leading a group outing) shows planning skill and some leadership qualitiesWhere did you see the advert section • Please try to remember where you heard about this job, and tick the relevant box. The information you give will help us find out how good our advertising isEqual opportunities monitoring
  7. 7. • Please note that all details on this section (Part D) will remain totally anonymous. It will be detached from the rest of the form as soon as we get it and remain anonymous• We want to ensure that there are no barriers to joining our workforce. As an employer, NHSScotland is as fully inclusive as possible. One way we can ensure this is to analyse all the data provided in this section and ensure that job opportunities are being accessed by as wide a community as possible. Please send the completed form to the following address: or post your hard copy to: Recruitment Section NHS Fife Flat 3 Willow Drive Kirkcaldy Fife KY1 2LS
  8. 8. Support into Work • Have you experience of a mental health problem? • Want help with the application process for a post with NHS Fife or Fife Council? • Would you benefit from some support even after you start work? • Are you unemployed and live in Fife?Then Support into Work can provide free, independent and confidential support through thewhole process of applying for a job with either NHS Fife or Fife Council and, if successful, forthe first few weeks after starting work.Support into Work is a two-year pilot funded by the Scottish Executive to increase access toemployment for unemployed people experiencing mental health difficulties who live within Fife.The service is provided by Fife Employment Access Trust (FEAT) a well-respected voluntaryorganisation with 10years experience or supporting people with mental health problems intoemployment.FEAT is independent of both NHS Fife and Fife Council and the fact that someone hasreceived support will not adversely affect the recruitment outcome.For more information on the support available or if you would like to take advantage of theservice contact: Fife Employment Access Trust Collydean Cottage Pitmedden Loan Glenrothes KY7 6UG Tel: 01592 749880 Email: Please do not send completed application form to this address
  9. 9. PROCEDURE FOR THE DISCLOSURE OF CRIMINAL RECORDS1. IntroductionNHS Fife complies fully with the Code of Practice, issued by Scottish Ministers, in connectionwith the use of information provided to the registered person and other recipients of informationby Disclosure Scotland Part V of the Police Act 1997, for the purposes of assessing applicants’suitability for positions of trust.We undertake to treat all applicants for positions fairly and not to discriminate unfairly againstthe subject of a disclosure on the basis of conviction or other information revealed.2. Spent ConvictionsThe Rehabilitation of Offenders Act 1974 enables some criminal convictions to become ‘spent’after a rehabilitation period. The length of the rehabilitation period depends on the sentencegiven and not the offence committed. For custodial sentences the rehabilitation period isdecided by the original sentence and the length of time actually served is irrelevant. Custodialsentences of more than 2.5 years can never become spent.3. Disclosing Spent and Unspent ConvictionsIn line with the Rehabilitation of Offenders Act 1974 for any post within NHS Fife you arerequired to disclose any “unspent” convictions.If you are applying for any posts listed below you are also required to provide us with anyinformation in relation to all “spent” convictions. • Clinical Posts (including Nursing, Medical, Dental and AHP posts) • Director of Finance & Heads of Finance Department • Ward Clerks • Public Health Posts • Health Promotion Posts • Porters • Volunteers • Hairdressers • Catering & Domestic Posts within Inpatient Areas4. Disclosure Scotland (SCRO)
  10. 10. The aim of the Disclosure Scotland Service is to enhance public safety and to help employersnd voluntary organisations in Scotland to make safer recruitment decisions. Any offer ofemployment to a post identified as requiring “spent” convictions to be disclosed will be subjectto a satisfactory Disclosure Scotland check.5. Procedure for Disclosing ConvictionsIf you have an unspent or spent conviction and you are required to disclose this to NHS Fifeyou should do this by completing the section “Convictions” within Part B of the application formgiving details of the following:-• The Nature of the offence• The Sentence given• The Date of the Offence6. InterviewIf you are selected for interview, members of the interview panel will not be aware of anydeclaration you have made. Should you be selected as the preferred candidate followinginterview we will undertake to ensure an open and measured discussion on the subject of anyoffences or other matters that might be considered relevant for the position concerned. Weguarantee that only those who need to see it as part of the recruitment process will only seethis information.7. Failure to reveal informationFailure to reveal information that is directly relevant to the position sought could lead towithdrawal of an offer of employment. If you are offered employment such a failure may resultin dismissal or disciplinary action.Having a criminal record will not necessarily debar you from working with NHS Fife. This willdepend on the nature of the position, together with the circumstances and background of youroffences.8. QueriesIf you have any queries on this matter then please contact our recruitment office who will beable to assist you.
  11. 11. JOB DESCRIPTION1. JOB IDENTIFICATIONJob Title: Clinical Nurse Specialist In Gastroenterology/Nurse Endoscopist.Responsible to: Directorate Nurse Manager for Medicine.Department(s): Endoscopy Unit, Victoria Hospital, Kirkcaldy and Queen Margaret Hospital DunfermlineDirectorate: Medical Directorate.Operating Division: Job Reference:No of Job Holders: 2Last Update (insert date): 17.02.052. JOB PURPOSE • To develop and provide a high quality, patient centred, evidence based specialist nurse service for Gastroenterology patients. This would include ward and outpatient care and also community based care on occasion. • To provide professional and clinical leadership in the speciality of gastroenterology management and act as a resource for education and clinical expertise. • To be familiar with current research in the field of Gastroenterology. • To further develop the nursing service in partnership with relevant health care professionals to benefit patient care.3. DIMENSIONS Fife Acute Hospitals Trust provides care to a population of approximately 350,000 in Fife. This post is hospital based, working within the Endoscopy Unit, Out-patients department and the wards – at times working across the three sites of Victoria Hospital, Queen Margaret Hospital and St Andrews Memorial Hospital in response to service demand to promote cross cover across the Trust and to provide cover for colleagues as required.
  12. 12. 4. ORGANISATIONAL POSITION Directorate Nurse Manager (Professionally accountable) Clinical Director Directorate ManagerAccountant/Business Manager Endoscopy Services ManagerColleague (VHK) Clinical Nurse Specialist in Gastroenterology Colleague (QMH)5. ROLE OF DEPARTMENTTo have a strategic role in delivering improved outcomes for Gastroenterology patients and provide a co-ordinated servicewhich optimises patient focused, quality health care within Fife Acute Trust.6. KEY RESULT AREASProfessional 1. Practice autonomously within NMC guidelines using professional knowledge, experience and acknowledging limitations. 2. Be accountable for own practice in accordance with NMC Code of Professional Conduct. 3. To have professional self-regulation with a positive approach to professional development and life-long learning. 4. Identify and maintain supportive networks for self and colleagues.Clinical Role 1. Working autonomously, assess, plan, implement and evaluate patient care on attendance for endoscopic procedures via a direct access GP referral system, responsible for and managing the patients’ pathway from admission to discharge. 2. Development of nurse-led assessment of direct access GP referrals for endoscopy procedures. 3. Provide accurate and appropriate information to obtain written informed consent from the patient to perform endoscopic procedures. 4. Holistic assessment of patient’s suitability to undergo endoscopic procedure on the day of the appointment, taking into account current medication and physical well-being i.e. anti-coagulant therapy and potential need for biopsy. 5. Administer intravenous sedation independently to patients having endoscopic procedures within agreed local policy and also administer intravenous reversal agents if required based on clinical judgement. 6. Perform independently diagnostic/therapeutic endoscopic procedures and interpret endoscopic findings using specialist endoscopy knowledge acquired through in depth experience in a broad range of techniques relating to knowledge area. Recommend medications and further investigations or treatment following discussion with the Consultant Gastroenterologist, while working within agreed
  13. 13. evidence based practice protocols of care and supervision of practice criteria. 7. Utilise Endoscopy Unisoft reporting system effectively to produce accurate endoscopy reports to disseminate results to appropriate medical staff. 8. Provide endoscopic results and follow up information to patients on discharge, using effective verbal explanation and written information if appropriate. 9. Effective interpretation of biopsy/radiological results and initiating further investigations or treatment recommendations following discussion with Consultant Gastroenterologist. 10. Development of a nurse-led colonoscopy service, performing supervised colonoscopy procedures following the Joint Advisory Group national guidelines for endoscopic training. 11. Development of guidelines and protocol for independent administration of intravenous opiates for colonoscopy. 12. Effectively pre-assess patients referred for Percutaneous Endoscopic Gastrostomy (PEG) in the community and within the Trust. 13. Act as first assistant for insertion of PEG tubes working within agreed Trust protocols – administration of local anaesthetic and abdominal incision and pull through of PEG tube. 14. Act as an expert clinical resource to other health care professionals, patients and carers by providing advice regarding insertion and removal, usage, care of and problems with all Gastrostomy Tubes. 15. Demonstrate the ability to make clinical decisions regarding insertion of replacement PEG and removal of PEG. 16. Adhere to Infection Control Policies pertinent to manual cleaning and decontamination of endoscopes and the Oesophageal Manometry Catheter. 17. Adhere to Infection Control Policies regarding all endoscopic procedures. 18. Provide an Oesophageal Manometry and 24 hour pH study service across Fife. Working autonomously to perform insertion and removal of Manometry and pH catheters, utilising specialised equipment, skills, knowledge and understanding of software to carry out investigation. Effectively detail patients’ symptoms pre-procedure and obtain informed consent for patients undergoing this investigation. 19. Provide a nurse led out patient service for patients with gastroenterological disorders in conjunction with the medical Gastroenterology clinics. Ensure accurate clinical history taking, providing information, education and emotional support as required and ensure appropriate investigations are requested, also ensure appropriate referral to other members of the multi-disciplinary team, working within agreed protocols of practice. 20. Effectively dictate the clinic visit of each patient to appropriate medical staff. 21. Review results of outpatient investigations i.e. blood results, DEXA scan reports and discuss any abnormalities with consultant Gastroenterologist. 22. Monitor, review and act upon Gastroenterology patients blood results who are on Immuno-suppresant drug therapy either on a weekly, two weekly or monthly basis. 23. Referral to other disciplines e.g. dieticians, Surgeons, Radiology. 24. Supportive role for all patients with GI cancer at initial diagnosis, providing information and emotional support as necessary. 25. Co-ordination of staging investigations and referral to other members of the Multi-disciplinary team as and when required. 26. Frequently required to make clinical judgements involving a range of facts that require analysis and a comparison of a range of options. 27. Daily planning and organisation of workload that frequently requires adjustment due to service demands. 28. Frequently provide sensitive information in a highly emotive atmosphere when providing patients with results and diagnosis. 29. Routinely provide highly specialised clinical technical services (Endoscopy and Oesophageal Manometry and pH Studies.) 30. Routinely provide specialised advice in relation to patient care. 31. Accountable for direct delivery of a clinical technical service as agreed within local Trust policy. 32. Involved in the development of policies and protocols for service changes within our own area, but which also may impact beyond our own department. 33. Responsible for personal duty of care in relation to equipment and resources used in the endoscopy department.Management and Leadership 1. Promote and develop good working relationships with other health care professionals. 2. The GI Specialist Nurse will be a recognised expert in the field of Gastroenterological nursing and will provide professional leadership which will support and inspire colleagues and enhance the development of clinical practice. 3. Responsible for organisation and management of own workload/caseload and clinic commitments.
  14. 14. Working practices can vary on a daily basis to meet the needs of the patients and organisational requirements, therefore the ability to prioritise and adapt is required. 4. Identify requirements to carry out this specialist role, to implement and to develop the role according to patient’s needs within the resources available. 5. Establish effective working relationships with hospital, multidisciplinary and community professionals to facilitate optimum, continuing care for patients and to maintain a recognised source of expertise for these groups. 6. To provide leadership, act as a role model and demonstrate expert knowledge and high standard of specialist clinical practice. 7. Monitor the provision of the service advising the Consultant Gastroenterologist of any developments or deficiencies. 8. Provide an annual report of the service to the Directorate Manager. 9. Participate and attend relevant Trust meetings, Specialist Nurse Forum, Multidisciplinary Team Meeting and Specialist Gastroenterology Meeting, Endoscopy Users Meeting. 10. Membership and participation with local and national Clinical Nurse Specialists e.g. Scottish Nurse Endoscopy Group and GI nurses – Fife and Tayside Group to develop professionally, enhance knowledge and ensure “best practice” methods are made available to the Trust as appropriate. 11. Maintain accurate documentation and ensure confidentiality of patient information. Provide audit records and written reports as necessary. 12. Membership of professional bodies e.g. British Society of Gastroenterology (BSG), Scottish Society of Gastroenterology, National Association of Crohns and Colitis, Coeliac UK, British Liver Trust and Association of GI Physiologists (sub group of BSG.) 13. Adhere to all Trust Operational policies and procedures. 14. Develop local policies/guidelines in relation to all aspects of Gastroenterology and adapt regional and national guidelines for local use. 15. Contribute to Directorate and Trust issues including policy and guidelines development and identify opportunities whereby the post may be enhanced.Education 1. Leads, plans, develops and participates in and evaluates Multidisciplinary Education Programmes for health care staff based on evidence based practice in relation to Gastroenterology. 2. Educate patients, their families/carers (when appropriate), regarding their disease, including advice on treatments, outcomes and preventative measures to help them adapt and manage their condition. 3. Act as an expert clinical resource to other healthcare professionals. Advise colleagues and other healthcare staff of relevant research findings and ‘best practice’ methods. 4. Maintain a high level of awareness and up to date knowledge of all relevant research and other evidence based findings: recommending and processing change where considered necessary. 5. Demonstrate a commitment to further learning opportunities and professional development in Gastroenterology, ensuring PREP requirements are met. 6. Promote and advise on health and life style activities for patients, carers, health care professionals and the general public. 7. Develop training and development strategies to meet the needs of professionals within the organisation and across organisational and professional boundaries. 8. Develop and improve own competence in structured ways, including accessing clinical supervision. 9. Teaching of student nurses in relation to basis Gastroenterology nursing care. 10. Frequently provide teaching and education to staff in nursing homes and specialised care homes in relation to the care of for PEG tube.Research and Audit 1. Leads, plans, develops and implements audit activity related to Gastroenterology, including training and supervising staff. 2. Critically evaluates research and audit finding and disseminates these findings to healthcare professionals and senior management as appropriate. Identifying and initiating change across the Trust as requires. 3. Participation in clinical trials as initiated by Consultant Gastroenterologists and Drug Companies.7a. EQUIPMENT AND MACHINERYGeneric • Personal computer • Photocopier & Fax • Bed trolleys
  15. 15. • Oxygen systems • Manual handling equipment • Fire equipment • Standard/electric beds • Urinary catheter equipment • Patient hoists • Laboratory specimen equipment • Vacutainer/Cannulation systems • Intravenous infusion fluids, giving sets & stands • Suction equipment • Resuscitation equipment • Pressure relieving equipment • Syringes/needles & scalpels • Sharps boxes • Clinimatic • Wheelchairs & Walking aids • Fridge • Cordless telephone • Dictaphone • Dynamap & Thermometer • Sphygmomanometer • Resuscitation Trolley & equipment • Infection control equipment • X-rays boxesSpecialised • Pulse oximeter • Enteral feeding equipment • PEG/Buttons feeding tubes • Naso-gastric tubes • Defibrillator • Infusion devicesVery Specialised • Gastroscope, flexible and rigid sigmoidoscope, colonoscope • Light source • Processor • Television monitor • Diathermy equipment • Hot biopsy forceps and polypectomy snares and graspers • Cold biopsy forceps • Video and photographic equipment • Needle injectors • Oesophageal banding equipment • Dilatation equipment and balloons • Oesophageal and rectal stents • Clipping device • Sengstaken tube7b. SYSTEMS • Computer literate using Microsoft PowerPoint, Excel, Access, E-mail. • Completion of timesheets/annual leave/study leave request forms. • Use of Microsoft Excel spreadsheet for off-duty.
  16. 16. • Unisoft Endoscopy reporting system • Oasis • Master labs • Datix intranet • Internet and intranet • Gastroenterology – Microsoft Excel GI cancer database • Microsoft GI Nurse database8. ASSIGNMENT AND REVIEW OF WORKWorkload is determined by needs of the service. The post holder acts as an autonomous practitioner who plans,manages and prioritises own caseload without supervision.Caseload can be generated from various sources such as patient telephone calls, Consultant Gastroenterologist,ward and endoscopy staff, secretarial staff, community staff and members of the Multi-disciplinary team within theTrust.Requires yearly Personal/Professional Development Plan Review by the Directorate Nurse Manager.9. DECISIONS AND JUDGEMENTS • The post holder acts as an autonomous practitioner, acting on own initiative who plans, manages and prioritises own caseload and can make judgements based on individual patient needs. This would include anticipation and resolution of potential problems or concerns involving gastroenterological disorders management. • Is consulted and consults in clinical decision making regarding treatment changes, discharge and follow up arrangements for both in-patient and out-patients. • Ensure assessment of needs and care provided is accurately and systematically documented for professional and legal reasons. • Challenges inappropriate care/interventions related to Gastroenterology. • As a Nurse Endoscopist working autonomously a Consultant Gastroenterologist is available on site during the times of the nurses’ endoscopy list and can be contacted if the Nurse Endoscopist deems this necessary. • The Nurse Endoscopic is accountable for her own actions, uses her own initiative and acts independently when carrying out endoscopic procedures e.g. dose of intravenous sedation or therapeutic procedures required during endoscopy.
  17. 17. 10. MOST CHALLENGING/DIFFICULT PARTS OF THE JOB • Carrying out technically difficult and physical and mentally demanding endoscopic procedures. • Caring for patient and relatives when breaking bad news in a highly emotive atmosphere. • Working autonomously, maintaining a high degree of personal motivation. • To develop and maintain effective communications with the primary and secondary care teams to ensure the patient receives optimum continuity of care. • Balancing the needs of the patient with other demands of the service. • Prioritising the patients’ needs within the strategic needs of the service. • Making complex, informed and independent decision appropriate to Gastroenterology nursing.11. COMMUNICATIONS AND RELATIONSHIPS • The post holder must possess effective verbal and written communication skills. • Establish goods working relationships with medics, nursing staff and other agencies as appropriate across all boundaries in a specialist role. • In a specialist capacity act as the pivotal link between primary and secondary care. • Act as a resource person for information and education. • Develop and maintain a clinical network with other Gastroenterology nurses and other disciplines at local and national level.Internal:Patient and their relatives – involved in provision of their care and treatment planning.Consultant Gastroenterologist – for clinical advice and service delivery.Other Gastroenterology Specialist Nurses/Nurse Endoscopists.Nursing staff of all levels – in provision of care.Medical staff of all levels – To advise and provide information in the effective provision of Gastroenterology care.Colorectal cancer Specialist Nurse – for referral of Cancer patients and service collaboration.Upper GI Cancer Specialist Nurse (Tayside) – for referral of Cancer patients and service collaboration.Stoma Care Nurse Specialists – for referral of patients undergoing bowel surgery (Non- Cancer) and servicecollaboration.Other Nurse specialists within the Trust – for advice on provision on patient care.Dieticians – To provide effective nutritional care.Speech and Language Therapists – Referral to prior to PEG insertion.Pharmacists – advice on drugs and drug therapy.Stores – Stock and non-stock issues.Estates – Maintenance and repair of equipment.IT Department – Maintenance and advice regarding computer equipment.Health & Safety – Actioning of safety action notices.Infection Control – Issues related to endoscopic procedures and aftercare of PEG sites.Medical Records Staff – for case note requests and organisation of clinics.Departmental Areas e.g. A&E, X-Ray, outpatients, Theatre, Pathology, Labs, Medical Physics, Mortuary, MedicalPhotography.Medical Secretaries – accessing notes, appointments and organisation of patient care.Audit Department – On-going audit projects.Moving & Handling – Advice on moving and handling patients in endoscopy.Transport/Ambulance desk – arranging transport for patients for clinic review, endoscopy or admission.Complaints Officer/patient Liaison – dealing with statements and complaints.Directorate Nurse Manager – professional issues/advice.
  18. 18. Student Nurses – teaching and education in Gastroenterology Care.External:G.P. – Liaise with to provide effective ongoing care for GI patients in the community.District Nurses/Treatment Room/Practice Nurses – Liaise with to provide effective ongoing care for GI Patients inthe community.Nursing Homes – To provide information and education regarding PEG Tubes.Palliative care nurses – referral to for terminal care for GI patients.National Association for Crohns and Colitis (NACC) committee members – medical advisory capacity.Local Coeliac Group – medical advisory capacity.Upper GI Cancer Group – development of a streamline service for patients with upper GI cancer between Fife andTayside.Scottish Nurse Endoscopists – Networking and developing national links.Medical Representatives – for drug therapy advice.12. PHYSICAL, MENTAL, EMOTIONAL AND ENVIRONMENTAL DEMANDS OF THE JOBPhysical Skills/Demands: 1. Administration of intravenous sedation, reversal agents, controlled drugs and antibiotics. 2. High degree of precision and hand, eye and sensory co-ordination are essential during endoscopic procedures both diagnostic (manoeuvring of scope) and therapeutic (polypectomy) also required in role of first assistant in PEG tube placement (administration of local anaesthetic and abdominal incision in conjunction with endoscopic view) 3. Positioning of patients for endoscopic procedures. 4. Standing/walking for the majority of the shift. 5. Handling of endoscopes can put strain on arms, neck, shoulder, back, wrists, elbows and knees. 6. Manoeuvring of trolleys. 7. Use of hoists for immobile patients. 8. Traction removal of PEG tubes. 9. Driving skills to cover across Fife sites. 10. Sensory skills to assess patients. 11. Keyboard skills. 12. Ability to carry out vital signs and observations. 13. Venepuncture and cannulation and removal of cannulae. 14. To have the expertise to handle and operate highly specialised and expensive endoscopy equipment.There is a need for frequent intense effort over several long periods during the working week.Mental Demands: 1. Retention and communication of knowledge and information. 2. Concentration required when checking documents/patient notes and calculating drug dosages. 3. Concentration required when observing patient behaviours which may be unpredictable due to sedation. 4. Recognition of abnormal pathology. 5. Concentration required during therapeutic procedures e.g. hot biopsy, polypectomy, biopsy of
  19. 19. tumour and PEG insertion. 6. Concentration required during passing of oesophageal Manometry and pH catheters for correct positioning. 7. Concenetration required as frequent interruptions from telephone enquires. 8. Unpredictable day-to-day workload, ability to adapt to any situation presented from a variety of disciplines and the patient group. 9. Ability to educate and communicate sensitive, unwelcome, unpleasant information to patients and their relatives. 10. Communicate complicated information verbally and written to patients regarding individualised treatment and care plans. 11. Tact and diplomacy required when discussing ‘bowel problems’ with patient group. 12. Frequent intense concentration required for recording clinical history in medical notes. 13. Ability to direct care for patient caseload in conjunction with Gastroenterologist. 14. Exposure to verbal/physical aggression in clinic and endoscopy setting. 15. Concentration required when observing patient behaviour that may be unpredictable due to sedation and distress of endoscopic procedure. 16. Educating patient regarding informed choice. 17. Act upon and initiate tests as necessary for individualised care. 18. Working autonomously. 19. Accountability for own actions. 20. Time management skills. 21. Concentration required when completing pathology forms, X-ray referrals. 22. Identifying and managing cardio/respiratory arrests.There is a frequent requirement for intense concentration.Emotional Demands: 1. Communicating with distressed/anxious/worried patients/relatives. 2. Caring for patients following receipt of bad news i.e. diagnosis of GI cancer or incurable chronic disease. 3. Communicating complex issues within the multidisciplinary team. 4. Personal/interpersonal stressors. 5. Ethical considerations of inserting a PEG tube to provide nutrition for the patient who is unable to swallow. 6. Supporting staff in the work environment.Frequent exposure to highly distressing and emotional circumstances.Working Conditions: 1. Exposure to body fluids i.e. faeces, blood, vomit, sputum, saliva, urine, stoma site exudate. (Frequently each working day) 2. Exposure to verbal/physical aggression. (Occasionally during planned endoscopic procedures) 3. Working constantly in artificial lighting with no natural light. (Constantly) 4. Exposure to Peracetic acid (Nu-Cidex, disinfectant used for endoscopes) (Frequently)Considerable exposure to hazards.13. KNOWLEDGE, TRAINING AND EXPERIENCE REQUIRED TO DO THE JOB
  20. 20. • First level registered nurse on part one/twelve of the NMC register • At least five years post registration experience. • Senior nursing experience in Gastroenterology. • Educated to degree level. • Ability to travel. • Basic IT skills. • Completion of ENB or equivalent certificate in upper/lower GI endoscopy. • Evidence of further education or development in relation to Gastroenterology nursing. • A willingness to undertake further studies as appropriate. • Inter-personal skills, including negotiation and management skills. • Ability to assess information and make recommendations. • Ability to develop protocols which influence and change practice. • Effective written and verbal communication skills. • Technical ability to perform endoscopic GI procedures. • Effective time management skills. • The post holder will possess team-working skills and have the ability to motivate others and work using own initiative.An advanced theoretical and practical knowledge of a range of work procedures and practicesare required. The post holder requires to undergo several formal courses of study to obtain anadvanced level of theoretical and practical knowledge. Successful completion of these coursesresult in the acquisition of the necessary skills to carry out a range of endoscopic procedures.The Nurse Endoscopist is expected to undergo the same training as, and in practice iscompared to, the Medical Endoscopist as set down by the Joint Advisory Group on Gastro-Intestinal endoscopy and the British Society of Gastroenterology working party report entitled‘The Nurse Endoscopist’ 1994.14. JOB DESCRIPTION AGREEMENTA separate job description will need to be signed off by each jobholder to whomthe job description applies.Job Holder’s Signature: Date:Head of Department Signature: Date: RECRUITMENT AND SELECTION STANDARDS PERSON SPECIFICATION FORM
  21. 21. Post Title/Grade: Clinical Nurse specialist in Gastroenterology/Nurse Endoscopist Band 7Department/Ward: Endoscopy ESSENTIAL DESIRABLE MEASURE Experience • Post registration • Senior Nursing Application form and experience experience in interview Gastroenterology Qualifications/ • 1st Level Registration • Evidence of Application form and Training • Educated to degree clinical interview level or working governance. towards degree • Infection control • Evidence of ongoing champion. professional development. • Completion of ENB or equivalent certificate in upper lower GI endoscopy Knowledge • A sound knowledge • Research/Audit Application form and of acute medical interview nursing. Skills • Venepuncture Application form and • Organisational skills • Counselling skills interview • Teaching / I.T and • Male / Female presentation skills catherisation skills • Good communication and interpersonal skills • A level of English language competency and communication skills necessary to perform this role safely and effectively • Cannulation
  22. 22. ESSENTIAL DESIRABLE MEASURE Aptitude • Innovative Interview • Enthusiastic • Demonstrate leadership ability • Able to work on own initiative • Calm under pressure • Must regard the patient and family as partners in care. Other • Multidisciplinary Interviewe.g. Team Player, Team player Be able to travel • Ability to travel across sites