Detailed job description and main responsibilities

Professional

·        Work in accordance with the NMC code of professional conduct or similar professional body.

·        Support the community teams in achieving clinical competency development in the management of patients with bladder and bowel dysfunction.

·        To participate in professional development to aid fulfilment of the role in pelvic floor assessment and management; bowel assessment and management; catheterisation and problem solving in these areas.

·        Support the Bladder and Bowel Team in all aspects of service design and development.

Responsibilities

·        The Bladder and Bowel Specialist Nurse will be responsible and accountable for the direct delivery of a clinical caseload.

·        Undertake holistic assessments of patients with Bladder and Bowel dysfunction using up to date knowledge and skills- including physical examination and bladder ultrasound and interpretation of results in planning care.

·        Actively link with the wider MDT.

·        Ensure patient/carers are provided with relevant written information regarding their plan of care.

·        Work flexibly with other team members to provide co-ordinated holistic care.

·        Provide clinical care that is evidence-based and appropriate to the needs of the patient.

·        Refer to other professionals for any specialist support that the patient may clinically require 

·        Act as the support and contact for individual patient care management between other agencies.

·        Communicate effectively and support patients and their carers when dealing with psychological aspects of care relating to their bladder and / or bowel dysfunction. Demonstrate empathic interpersonal and communication skills in dealing with patients and carers through the patient pathway.

·        Adhere to the trust’s medicines management guidelines when independently prescribing medication and appliances.

·        Advise and support in the instruction in intermittent self-catheterisation.

·        Actively take part in or lead on clinical audits relating to the service or other CHFT services.

·        Promote continence and management of incontinence through education and training programmes.

·        Assist the Lead Specialist Nurse for the service in the investigation of complaints and incidents related to continence and to develop action plans for improving practice.

·        To assist in the development and review of formularies of products, policies, procedures, strategies and guidelines to provide value for money therefore reducing wastage.

·        To act as a role model in quality improvement by developing services to address the health and social needs of clients.

·        Take part in training for the current supplier of the Home Delivery Service and use the IT system to enhance patient care.

Clinical Duties

·        Triage patients with undiagnosed cause for their bladder or bowel dysfunction onto the caseload.

·        Assess, treat and evaluate a variety of Bladder and Bowel dysfunctions with holistic care plans.

·        Assess the impact of dysfunction on patients and or carers.

·        Set appropriate treatment goals in collaboration with the patient.

·        Set appropriate treatment goals with due regard to NICE guidelines.

·        Assess the condition of skin and refer to tissue viability team as appropriate.

·        Accurately measure bladder volume and nature of dysfunction using recognised bladder diaries. 

·        Assess the degree and extent of bowel dysfunction using recognised tools.

·        Assess the symptom profile to accurately identify the type of bladder dysfunction as described by International Society for Incontinence.

·        Assess the degree and extent of bladder and bowel dysfunction and plan appropriate care in line with NICE approved pathways.

·        Identify any complex factors which may predispose the patient to bladder and bowel problems or affect treatment outcomes.

·        Assess the level of patient quality of life and symptom severity score using recognised tools i.e. global outcomes, ICIQ symptom specific scores.

·        Perform vaginal examination and teaching of pelvic floor exercises.

·        Teach self-catheterisation to patients and carers if required.

·        Teach and support patients and carers with rectal irrigation and bowel management regimes. Prescribe appropriate medication to patients requiring treatment with anticholinergic therapies, antibiotic treatment.

·        Carry out female, male and suprapubic catheterisation when patient condition requires this. Assess patients for continence aids working alongside occupational health and physiotherapy services.

·        Where treatment is not appropriate assess patients for containment products to ensure patients dignity and quality of life. Identify, timely review and reassessment.

Management

·        Manage own workload, ensuring high standard of patient care delivery.

·        Maintain accurate records in accordance with Trust and NMC guidelines or similar professional body. Ensure correct implementation and adherence to Trust policies and procedures.

·        Ensure resources are used effectively and efficiently and contribute to maintaining levels.

·        Contribute to clinical audits and suggest areas for evaluation/monitoring.

·        Develop own management skills and identify gaps.

·        Maintain an effective working relationship with other members of the patient care team.

·        Develop and lead on any aspect of Bladder and Bowel dysfunction management in agreement and collaboration with Bladder and Bowel dysfunction Clinical Lead. 

·        Contribute to research as requested.

·        Be confident and competent to actively participate with and fulfil all data collection requirements.