Duties and Responsibilities
Communication and Key Working Relationship
Communicate with patients, colleagues, and stakeholders, across acute and primary care services, internal and external contacts in a courteous, professional, and timely manner at all times, by various methods, i.e., telephone, written, face to face or virtual consultation.
Provide specialist, tailored diabetes nursing advice and support to patients, their families and carers initially, and throughout their diagnosis.
Provide and receive complex, sensitive, and possibly contentious information using highly developed interpersonal and communication skills.
To provide and receive complex, sensitive and possibly contentious information where highly developed interpersonal and communication skills are essential.
To communicate/receive highly complex and sensitive verbal information in an open and sensitive manner and involve in the decision-making process.
Develop and maintain effective working relationships with other relevant HCPs and agencies for best patient care and development of services.
Develop, maintain and improve links with primary, intermediate and secondary care staff, providing expert clinical advice and support with regards to Diabetes, making referrals as appropriate
Participate in and / or lead MDT complex case meetings as required.
Participate in or lead on education forums locally.
Plan and provide education and training to Nursing homes / Residential Homes
Plan and provide education and training to District Nursing teams.
Plan and provide education and training to General Practice teams working with them to achieve their national targets for the diabetes health of the population of Somerset.
Provide education to our patient population when responding to urgent hypoglycaemic and hyperglycaemic calls to prevent admissions to acute services.
Planning and Organisation
To prioritise and manage own workload acting as an independent practitioner within scope of competency.
Provide cross cover for colleagues during periods of absence, supporting other DSN colleagues if clinically indicated.
Works with others to review the values, strategic plans, and directions of the service to take account and plan for changing circumstances.
Works with others to review the strategic plans for Somerset to ensure integrated working with other services using technology where possible.
Analytics
Autonomously provide and deliver complex care advice on duty days, triaging referrals and monitoring urgent care needs from GPs/community hospitals/district nursing services to prevent hospital admission
Autonomously provide and deliver a duty service to receive hospital discharge referrals to help prevent hospital re-admission.
Autonomously assess, diagnose, plan, implement and evaluate treatment/interventions and care for patients presenting with an undifferentiated diagnosis and those with long term conditions.
Use analytical and judgemental skills for assessing, interpreting highly complex acting upon results.
To carry out clinically autonomous specialist assessments
Assesses, plan, implement and evaluate specialist clinical care of patients; highly complex conditions by given specialist advice to patients or carers.
The post holder will also be an independent prescriber, and the role will include writing prescriptions.
To write concise and accurate assessment reports to referrer/GP collating the information gathered, systematically demonstrating the evidence for diagnostic conclusion, and providing clear, evidence based and comprehensive treatment recommendations.
To identify the training and development needs of non-specialist staff with SFT and engage in meeting these needs.
Act as a positive role model for nurses within the community through the demonstration of strong leadership skills.
Analysis and interpretation of diagnostic results, glucose monitoring and CGM/flash uploads.
Collaboratively analyse primary care search results to plan direction of support and education.
Report any incidents by way of the Trust Incident Reporting system.
Responsibility for Patient Care, Treatment and Therapy
Awareness of unconscious bias towards individuals with diabetes and ensuring equity of service to all patient groups
Ensure patients and their families are aware of all treatment options and promote patient decision making.
Expert knowledge of all types of diabetes treatments and therapies and appropriate use, dependent on acute, longer-term setting and therapeutic goals.
Lead, develop, implement, and maintain a minimum of six-monthly virtual clinics within primary care. These could be face-to-face or virtually for best patient care and development of services across Somerset.
Lead, develop, implement, and maintain patient group education for diabetes medication starts to support locally based patient centred care and development of services.
Prescribe medication for therapeutic effectiveness, appropriate to patient needs and in accordance with evidence-based practice and national and practice protocols, and within scope of practice.
Initiation of technology to improve Diabetes care such as continuous glucose monitoring/flash monitoring and the ongoing education and support for effective use.
Policy, Service, Research & Developmental Responsibility
To work within policy, professional and legal frameworks at all times. This requires knowledge of NMC Code of Professional Conduct, Non-Medical Prescribing Framework,
Working closely with the clinical service manager to clinically support the operational plan and priorities, taking an active role in service redesign where appropriate to continue delivering a high-quality service.
To work as part of the Diabetes MDT towards a shared goal of service improvement and best practice.
Represent diabetes service at a senior level as required supported by consultants and senior management.
Undertakes staff surveys or audits necessary to own work.
Participates in research and development as and when work stream requires.
Ensure relevant research findings are translated into clinical practice
Promote a culture of evidence-based practice within the community and be involved with health promotion related to the speciality
Follows Trust policies in own role and may propose changes and implement local policies and procedures.
Responsibility for Finance, Equipment and Other Resources
Support the clinical environment in meeting cost savings targets by driving efficiency in the service and making best and most appropriate use of resources.
Responsibility for Supervision, Leadership & Management
Provide supervision and training to pre and post graduate individuals.
Support with mentoring and training new staff into the team and with mentoring Band 6 DSNs.
Participate in appraisal and clinical supervision as required.
Information Resources & Administrative Duties
Have a comprehensive understanding of Trust information systems/speciality systems.
IT Skills; including the use of Microsoft Office and Outlook, entering data onto electronic patient records.
Ensure accurate and timely recording of all workload activity via patient information systems to inform analysis of service delivery and continued service development.
Maintain specialised databases including input, updating and retrieval of statistics.
Contribute to the compilation of reports with regard to the service reports if required.
Assist primary care with identifying patient focused searches to help them identify future training requirements to attain health targets in diabetes care.
Any Other Specific Tasks Required
Ability to work flexibly and to be able to travel to other areas as and when required.
Ability to work under pressure and flexibly according to clinical challenges or unexpected changes in workload.
Willingness to develop further leadership skills including Trust management essential learning.
