The post holder is required to deliver an advanced level of clinical practice within the field of neonatal care working on the tier 2 level of the medical rota.

Working within agreed protocols and guidelines the Senior ANNP exercises independent judgement to assess, investigate, diagnose, plan, implement and evaluate the clinical care and management of premature and sick babies and their families in conjunction with the neonatal MDT. Also supervising those on the tier 1 rota and new to tier 2 rota medics.

They work alongside and support the education and development of both nursing and medical colleagues.

The post holder will be allocated dedicated time to pursue and enhance an area of special interest within the scope of the role. This is not prescriptive and is dependent on the needs of both the service and the individual.

This role will help the neonatal service maintain continuity and consistency in delivering high quality care throughout the medical staff rotation programme.

The post holder will lead in reviewing cases following the PSIRF process and completion of investigations using the inPhase system.

The post holder will work closely with the medical and nursing teams to ensure that learning following incidents is disseminated to the entire team.

The post holder will support weekly multidisciplinary risk meetings to ensure incidents are reviewed and information is disseminated in a timely manne

OPERATIONAL

Provide specialised clinical care at an advanced level to neonates and families, making autonomous diagnosis and management decisions, about patient care, utilising advanced skills, and knowledge

Act as an educator, specialised clinician and auditor.

Provide specialised advice and support within the neonatal sphere by supervising and coaching resident doctors and nursing staff.

Participate in the formulation and updating of Neonatal guidelines

Demonstrate and maintain advanced new-born life support resuscitation skills by acting as a member of the neonatal resuscitation team, taking lead role as required

Advise resident medical staff, midwifery/nursing staff, medical, nursing and midwifery students acting as an educational resource ensuring that evidence based practice is promoted

Establish interchanging roles with resident medical staff on a regular, planned basis by working in partnership to ensure neonates receive the most appropriate specialist care, regardless of the unpredictability of the workload

Where applicable participate in the safe transfer of Neonates

Participate in meetings at Unit, Directorate and Senior Management Level at the request and on behalf of the Neonatal Management team

Provide specialist advice to the multidisciplinary team

Support mother/families with complex health or social issues which may impact on the neonate’s care and make appropriate safeguarding referrals as appropriate.

Clinical Responsibilities

Utilise highly specialised clinical and theoretical knowledge to undertake a comprehensive health history and examination of any neonate in order to diagnose and treat the neonate (including the prescription of drugs as necessary).

Attend high risk deliveries and perform resuscitation/advanced resuscitation of the new-born infant

Participate and lead in the management and continuity of care for babies requiring intensive care, high dependency, special care, transitional care and postnatal care.

Manage ventilator support for babies requiring intensive care.

Participate on/or lead ward rounds, evaluating the setting in which the care is given, liaising with medical and nursing staff and making recommendations plans of care to facilitate a family centred patient focus concept.

As an autonomous practitioner using specialist skills, perform diagnostic and therapeutic procedures such as:

Respond to emergency situations and initiate appropriate management within agreed protocols, utilising clinical judgement, decision making and analytical skills to initiate and lead appropriate care for sick neonates

Working under the guidance/ supervision of Consultant Neonatologist/ Paediatrician, develop patient management plans for a case load of babies, that deliver a holistic approach to the care of neonates throughout the patient pathway from admission to discharge

Participate/lead on wards rounds, evaluating the setting in which the care is given, liaising with the medical and nursing staff, making recommendations for change and evaluating outcomes to improve infant and family care.

Regularly weigh up differential diagnosis and the potential range of treatment options, selecting from variable options some of which may be contentious. Use specialised clinical and theoretical knowledge to assess the immediate health status of the neonate

Review identified/perceived problems, analyse complex information and take responsibility for decisions made ensuring that the care provided to all neonates is safe and effective

Plan medical treatment for babies including calculating, prescribing, administering and evaluating the effects of drug and fluid therapies in accordance with local policies 

Undertake daily assessment of the neonates admitted to the unit with other colleagues, including nursing and medical. This will include evaluation of progress and revision of care management where appropriate 

Lead discharge planning; produce discharge summaries and liaise with general practitioners and other members of the multidisciplinary team when appropriate. Perform discharge examinations and request follow-up appointments as required

Initiate and authorise blood transfusions and volume expanders as clinically indicated, in accordance with local policies

Order and interpret x-rays and diagnostic investigations to ensure accurate diagnosis and treatment of the neonate. Act on results and develop management plans

Participate in the stabilisation, transfer and admission of the extremely ill neonate to or from the neonatal unit, including complex life support therapies using agreed policies and protocols

Ensure that parents are aware of their baby’s condition and provide complex communications and support to parents

Participate in palliative care for neonates, leading to a pain free, dignified ending to life. Provide intensive support, advice and care for families of neonates who are receiving terminal care

Co-ordinate referral to other services, e.g. physiotherapist, occupational therapist, dietician, surgeon, cardiologist or any other service which is vital to the appropriate care of the neonate

Contribute to health promotion activity, raising awareness of health and well-being to promote healthy lifestyle choices for the benefit of neonates and their families. 

Undertake parental counselling of families facing possible preterm birth.

Non-Medical Prescribing

 As an independent nurse prescriber, initiate drug therapy and intravenous fluids, including parenteral nutrition and blood and/or volume expanders