Detailed job description and main responsibilities

The post-holder will be supported to develop skills, practices and behaviours which include:

Clinical Practice 

• Assess, differentially diagnose, plan, implement and evaluate individual treatment interventions for patients by virtue of expert clinical judgement and close liaison with members of the MDT.   
• Use expertise and decision-making skills to inform clinical reasoning approaches when dealing with differentiated and undifferentiated individual presentations and complex situations, synthesising information from multiple sources to make appropriate, evidence-based judgements and/or diagnoses. 
• Initiate, evaluate, and modify a range of interventions which may include prescribing medicines, therapies, lifestyle advice and care. 
• Exercise professional judgement to manage risk appropriately, especially where there may be complex and unpredictable events and supporting teams to do likewise to ensure safety of individuals, families and carers. 
• Ensure compliance with their respective code of professional conduct and work within their scope of practice. 
• Works in conjunction with the MDT to clearly define values, direction and policies impacting upon care. 
• Work in partnership with individuals, families and carers, using a range of assessment methods as appropriate.  
• Be able to demonstrate a critical understanding of their broadened level of responsibility and autonomy. This includes being critically aware of their limits of their own competence and professional scope of practice, including when working with complexity, risk, uncertainty, and incomplete information. 
• Be responsible and accountable for their decisions, actions and omissions at this level of practice.
• Utilise professional judgement and maturity, understanding when to seek help.
• Demonstrate critical reflection on own practice, self-awareness, emotional intelligence, and openness to change.
• Demonstrate effective communication skills, supporting people in making decisions, planning care or seeking to make positive changes, using Health Education England’s framework to promote person-centred approaches in health and care.
• Work collaboratively with an appropriate range of multi-agency and inter-professional resources, developing, maintaining, and evaluating links to manage risk and issues across organisations and settings.
• Evidence the underpinning subject-specific competencies i.e., knowledge, skills and behaviours relevant to the role setting and scope, and demonstrate application of the capabilities to these, in an approach that is appropriate to the individual role, setting and scope.
• Act as a clinical role model/advocate for developing and delivering care that is responsive to changing requirements, informed by an understanding of local population health needs, agencies and networks.
• Actively implement effective systems and processes for infection control management whilst working clinically and be a role model for other members of the clinical team.  
• Initiate drug therapy/medication within the parameters of agreed clinical guidelines and in accordance with the legal framework you work under to supply and prescribe medicines (if from professional group legally entitled to prescribe). This is desirable but not essential.
• Upon completion of training, pre-assess patients for upcoming surgery, including undertaking a clinical examination, ordering, interpreting, acting upon and documenting investigations and findings, helping to facilitate informed clinical decision making.
• With appropriate training and supervision, assess a patient’s donor sites for conduit harvest such as Long Saphenous Vein and Radial artery by clinical examination and ultrasonic vein mapping. Accurately document findings in patient notes and clinical systems, enabling appropriate clinical decision making.
• With appropriate training and supervision, clinically examine a patient in routine 6-week follow-up clinic, making the appropriate checks on their recovery, requesting and interpreting further investigations such as Blood tests, Chest X-rays, ECG’s and Echocardiograms, initialising readmission seeking appropriate medical opinion when needed. Documentation and communication of findings to Consultant Surgeon, dictation of letters to referring Cardiologist and General Practitioner.
• Communicating with the patient highly sensitive and complex information regarding risks and benefits of Surgery as part of the pre-operative consent process.
• Following training and appropriate supervision, competently establish invasive and non-invasive monitoring.
• With appropriate training and supervision contribute to the clinical management of the post–operative patient, including early recognition of common post-operative complications, requesting, interpreting further investigations and acting upon findings, seeking senior advice if required.
• Assist in the resuscitation of arrested or compromised patients, performing Advanced life support and when required emergency chest openings in CITU/HDU working in the role of Cardiac Surgical Assistant and Advanced Life Support Provider.
• With appropriate training and supervision, act as first or second assistant for all Cardiothoracic surgical procedures, within the SCPs scope of professional practice.
• With appropriate training and supervision, undertake the surgical procedure of conduit harvesting, specifically the Long Saphenous Vein, Short Saphenous Vein and Radial Artery, both Endoscopically and open, completing wound closure utilising clinical judgement and in accordance with the clinical needs of the individual patient.
• Under appropriate supervision support the Surgeon performing sternotomy, ensuring haemostasis and aseptic technique are maintained.
• With appropriate training and supervision, assist and independently undertake the closure of the sternal wound, ensuring haemostasis and asepsis.
• Following appropriate training insert endoscopic ports for the use in Robotic surgery, acting as primary or secondary bedside operating clinician for Robotic surgery.
• Following training and appropriate supervision perform the removal of central lines, pacing wires and chest drains.
• Following training and appropriate supervision undertake the removal of IABP.
• Perform both male and female catheterisation.
• With appropriate training assist and lead in emergency CALS and chest opening situations.

For further details please see the attached JD & PS