Pre-Assessment Nurse

Chelsea and Westminster Hospital NHS Foundation Trust; Greater London; On-site; GBP 32,000 - 42,000; Full time

Job summary

Chelsea and Westminster Hospital NHS Foundation Trust is seeking a dynamic nurse to lead and develop the Preoperative Assessment (POA) clinic. You will assess adults awaiting elective surgery, develop protocols, and coordinate care with the multidisciplinary team.

The role requires leadership, evidence-based practice, and the ability to deputise for the lead POA nurse. Working days are Monday to Friday with weekend shifts at times.

Qualifications

• Experience in Pre Assessment Clinic and perioperative pathways.
• Strong knowledge of pre-operative assessment principles and processes.
• Ability to deputise and lead a nursing team in clinical settings.
• Effective communication with patients, families and multidisciplinary teams.

Responsibilities

• Assess the health status of adult elective surgical patients and obtain comprehensive history.
• Undertake clinical interventions when necessary and develop patient care plans.
• Lead and develop the POA clinic, maintaining evidence-based practice.
• Coordinate with the multidisciplinary team and senior staff to optimise preoperative status.
• Ensure documentation adheres to professional standards and lead on education for staff and students.

Skills

Preoperative assessment experience

Nurse leadership

Communication skills

Education

Nursing degree or equivalent

Teaching and assessing qualification or evidence of competency

Post-registration study

Extensive post-registration experience in perioperative areas

Evidence of continuing professional development

Experience working in a multidisciplinary team

Excellent communication and interpersonal skills

Ability to deputise and lead a team

Knowledge of resource management

Ability to supervise clinical and non-clinical staff

Self-motivation and autonomy

Job description

We are an award winning organisation providing care at two main hospital sites—Chelsea and Westminster Hospital and West Middlesex University Hospital—and a number of community-based services across London, such as sexual health and HIV clinics.

With 6,700 members of staff, we are proud to care for a diverse population of one million people. We are committed to ensuring that our workforce is just as diverse with a strong mix of skills and abilities.

Our staff are at the very heart of our organisation and we recognise the valuable contribution that each and every person working at the Trust makes. One of our Trust priorities is to be an employer of choice—a place where people want to start their career and to grow with us through continued education, professional development and support .

Work collaboratively with the Lead Nurse for POA to continually develop and implement the nurse led clinic.
To undertake pre assessment of pre-operative patients according to agreed protocols.
To work with the pre assessment team to promote a high standard of professional practice and clinical care
To help maintain a creative learning environment for both students and permanent staff incorporating evidence based and best practice models.
To provide dynamic leadership for the pre assessment team in partnership with the clinical coordinator and deputise for the lead nurse, as appropriate – coordinating clinical, managerial and educational requirements of the clinical area.

Main duties of the job

Assessment of patients' health prior to having elective surgery. Please see detailed job description. Working days are Monday- Friday.

Working for our organisation

Our Trust is one of England's top-performing and safest trusts. We operate two main acute hospital sites—Chelsea and Westminster Hospital and West Middlesex University Hospital—along with award-winning clinics across North West London.

Our nearly 7,500 staff care for a diverse population of 1.5m, providing full clinical services including maternity, A&E and children’s services, plus specialist HIV and sexual health care. The CQC rates us Good in safety, effectiveness, care and responsiveness, and Outstanding in leadership and resource use.

We continually invest in our facilities, including a £30m expansion of critical care at Chelsea and an £80m Ambulatory Diagnostic Centre at West Mid.

We are delivering sustainable healthcare through our Green Plan. In line with Greener NHS ambitions, we aim for net zero carbon emissions by 2045. Achieving this requires collective effort. We encourage staff to reduce their impact on carbon, waste and pollution wherever possible. Every action counts to create a healthier, more sustainable future.

We are committed to equal opportunities and believe diversity drives innovation and excellence. We welcome applications from the global majority, veterans and underrepresented communities, valuing the perspectives they bring.

If you haven’t heard from us within 3 weeks of the closing date, your application was likely unsuccessful. Employment is subject to a six-month probation. Some roles may require weekend shifts at multiple sites.

Detailed job description and main responsibilities

Roles and responsibilities
Clinical
Assess the health status of adult elective surgical patients obtaining a comprehensive history involving carers/relatives as appropriate.
Undertake clinical interventions, such as phlebotomy and ECG recording, in accordance with Trust policies when necessary
Develop and maintain competence to perform an assessment of the patients’ physical health status in preparation for anaesthetic and surgery. Be able to analyse findings to guide patient care. Make autonomous decisions regarding suitability to proceed to surgery.
Request and perform investigations as per guidelines/protocols and with reference to multidisciplinary team.
Demonstrate sound analytical and judgemental skills using a range of information and facts to establish the rationale for investigation and plan of care.
Discuss plans for discharge with patient and carer with particular reference to setting patient expectations for day case surgery.
Discuss the implications of surgery involving the risks and benefits helping the patient to make an informed choice regarding consent to treatment/surgery and provide accurate and concise information.
Have an understanding of and share responsibility for developing protocols and guidelines within POA.
Review and evaluate results of investigation/care promptly to ensure patient’s condition and safety is optimised preoperatively to avoid inappropriate admissions and delays in surgery being performed.
Directly refer patients to health care professionals to ensure appropriate assessment and evaluation prior to admission in collaboration with the multidisciplinary team.
Maintain up to date standard documentation in accordance with the NMC Standards for Records and Record Keeping.
Act in accordance to the NMC Code of Professional conduct and guide others to do the same.
Practice in accordance with the core PROUD values of the Trust.
Contribute to improving patient care via inter-disciplinary decision making.
Communication
Demonstrate skills in dealing with conflict and assist the Lead POA nurse in resolving issues.
Assess the knowledge base of the patient and family/carer and provide appropriate information regarding condition, surgery, pre and post-operative care, recovery and return to daily life.
Review and develop patient literature and information to reflect current practice, risks and benefits, seeking knowledge from established information sources.
Act as a primary contact prior to admission ensuring patient has point of contact details.
Communicate with patients and relatives in a sensitive manner appropriate to the situation providing information and reassurance.
Demonstrate competence in negotiation skills both verbal and written.
Act as chair for meetings and act as a recorder for meetings when requested to do so.
Management of People/Time/Resources
In the absence of the Lead POA nurse take responsibility for the management of the POA clinic.
Demonstrate effective leadership and promote positive team working to ensure a high level of patient care is delivered utilising members of the multidisciplinary team.
Have an understanding of the wider surgical patient pathway and the role of POA within it.
Understand basic budgetary matters and contribute to cost effective and efficient use of resources under the direction of the lead POA nurse.
Act as an authorised signatory for the hire of temporary staff, in the absence of the lead POA nurse.
Participate in the recruitment and retention of staff and be competent in carrying out the Trust interviewing/recruitment policy.
Have an understanding of the staff appraisal system and carry out appraisal on junior staff.
Take shared responsibility for the health and safety aspects in the clinical area to ensure a safe working and patient environment.
Make judgements regarding patient’s condition and suitability for admission. Where appropriate suspend/defer patients to optimise preoperative status. Communicate such decisions promptly to the wider multidisciplinary team.
Participate in change management and service improvement plans.
Manage a case load of patients whilst supporting/advising junior colleagues.
Contribute, participate and where appropriate act as a lead on groups, meetings and working parties to facilitate the integration of POA within the tryst and to ensure collaborative working practices are adhered to.
Quality Improvement/Clinical Governance
Share responsibility for implementing evidence based practice; participate in auditing clinical outcomes and standard setting.
Identify adverse incidents/situations and discuss/investigate with the Preoperative Assessment nurse manager and initiate a plan of action to minimise/eliminate risk.
Take all action within the scope of responsibility to ensure minimal patient cancellations on admissions.
Participate in auditing of clinical outcomes and standard setting to improve quality of service.
In conjunction with the preoperative assessment nurse manager assist in the accurate and immediate investigation of all incidents and accidents to patients and/or staff, and instigate appropriate action.
Investigate patient complaints in accordance with the Trust complaints procedure.
Appreciate other methods of service delivery and participate in their implementation. Assist in the implementation of statutory guidelines e.g. NICE guidelines, National Service Frameworks.
Assist or participate in departmental and Trust initiatives or audits, related to service improvement/clinical governance.
Perform risk assessments regarding working practice and the environment and adhere to safe systems of work.
Demonstrate awareness and follow principles of the Clinical Governance Framework.
Education and Training
Share responsibility for and participate in organisation of preceptorship/mentorship/supervision and assessment of student nurses in clinical area.
In collaboration with Preoperative Assessment Nurse Manager coordinate the evaluation of education initiatives in the clinical area.
Act as a clinical role model for junior team members.
Assist with the development and implementation of an education and training programme for junior/new staff.
Develop competence in clinical supervision and the ability to act as a clinical supervisor.
Consolidate POA skills using personal development planning/KSF tools to progress.
Facilitate others to develop informal teaching skills.
Physical, Mental and Emotional Effort
This post operates within a team structure. Potholders are expected to deliver pre-operative assessment care autonomously with regards to surgery and anaesthetic risk. More complex cases are dealt with independently initially with reference to anaesthetic colleagues as required. The role cares for patients at a vulnerable stage in the patient journey. This requires considerable decision making skills and an advanced level of mental and emotional maturity. The organisation of the clinics can be very busy and challenging.

Person specification

• Experience in Pre Assessment Clinic
• Very good knowledge base in the pre-operative pathway

Education and Experience

• Relevant Nursing Degree or equivalent
• Teaching and assessing qualification or evidence of competency
• Evidence of post registration study
• Extensive post registration experience across the perioperative clinical areas and previous pre assessment experience
• Evidence of continuing development
• Working within a multi-disciplinary team
• Excellent communication and interpersonal skills
• Ability to deputise and lead a team
• Knowledge of resource management
• Able to supervise clinical and non-clinical staff
• Self-motivated and able to work autonomously under own initiative as well as a team member

Important

• There may be some occasions when we have to close a vacancy earlier than the advertised closing date, this will be due to a high volume of applications. You are therefore advised to submit your application as early as possible to avoid disappointment.
• Please check your emails regularly (and your junk folder) as this is how we will communicate with you throughout the recruitment process.
• In submitting an application, you authorise the Trust to confirm any previous NHS service details via the Inter Authority Transfer (IAT) process, should you be appointed to the post.
• During the recruitment process your identity documentation (ie passport, driving licence, visa etc) will be scanned using a device which recognises UV, infrared and machine-readable zone security features of the documents provided.
• Employment at the Trust is offered subject to successful completion of a six month probationary period.
• We operate a joint recruitment hub across the North West London Acute Provider Collaborative Group. As part of this, your application and personal data may be shared with partner trusts within the group for recruitment and workforce purposes, in line with General Data Protection Regulation (GDPR)

Right to work

If you need sponsorship to work in the UK, please visit the Home Office website for information on sponsorship and visa status before you fill in your application form. Due to recent changes in the UK immigration rules which affect Skilled Worker Visas, Global Business Mobility, Higher Skill Level and Increased Salary Thresholds, please ensure that you are able to meet the requirements to live and work in the UK before applying. Further information about eligibility is available on UK Visas and Immigration - GOV.UK

Employer certification / accreditation badges

You must have appropriate UK professional registration.

This post is subject to the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 (Amendment) (England and Wales) Order 2020 and it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service.

Application numbers

This vacancy may close early if it receives a high number of applications. Please complete and submit your application in good time to avoid disappointment.

The recruitment team are available to provide support from 9am–5pm, Mon–Fri. To contact the team please call the Trust switchboard and ask for ‘Recruitment team, Human Resources Department’.