Practice Nurse jobs in United States

Provide specialist nursing in clients' homes for adults and/or children with complex, long-term conditions. Lead on assessment, care planning, delivery, and review; train and supervise support staff; ensure safe, person-centered care in line with NMC standards and CQC regulations.

• Complete holistic assessments, risk assessments, and person-centered care plans (including ventilation/trach, PEG/PEJ/NG, bowel/bladder, skin integrity, catheter/stoma care, suctioning, oxygen therapy, IV/SC therapies within scope).
• Deliver and evaluate evidence-based interventions; recognise and respond to deterioration (e.g., NEWS2/PEWS) and escalate per SOPs.
• Safely administer and manage medicines (including enteral and inhaled routes; IV/SC if competent and authorised).

• Competency-assess and supervise support workers; provide bedside coaching and annual refreshers for tasks such as tracheostomy care, suction, ventilation checks, enteral feeding, seizure rescue protocols.
• Lead shifts, coordinate multidisciplinary input, and act as clinical point of contact for families.

• Liaise with GPs, community teams, hospices, acute trusts and AHPs; attend/lead MDT reviews and contribute to EHCP/CHC reviews where applicable.
• Plan safe hospital discharges and step-ups/step-downs in care.

• Document care contemporaneously in EHR and maintain auditable records (MARs, fluid/nutrition charts, ventilation logs).
• Report incidents/near misses, conduct investigations and implement learning.
• Uphold Duty of Candour, infection prevention & control and safeguarding standards.

• Apply the Mental Capacity Act (incl. best-interest decisions), Deprivation of Liberty Safeguards/LPS and children's safeguarding procedures.
• Maintain robust lone-working and home-environment risk controls.

• Enhanced DBS (child/adult barred list as applicable) and right to work in the UK.
• Occupational health clearance and up-to-date immunisations (per UKHSA guidance).
• Mandatory training: Life support (ILS/PILS), Safeguarding Adults L2-3 & Children L2-3, Infection Prevention & Control, Medicines Management, Information Governance, Moving & Handling, MCA/DoLS/LPS, Lone Working.
• Evidence of continuing professional development and annual NMC revalidation.

• Rotas may include days, nights, weekends; lone working in clients’ homes; occasional shadowing/overlap shifts for training and reviews.
• Use of mobile EHR/apps and remote supervision tools.

• Care plan and risk assessment completeness and review cadence.
• Incident rates and time-to-escalation; learning actions closed on time.
• Staff competency sign-offs and refresher compliance.
• Client outcomes: ventilation hours stability, unplanned admissions, pressure-area prevalence, nutrition/hydration goals.
• Family satisfaction and MDT feedback.

• Tracheostomy tubes and suction, humidification, ventilators (set-up, troubleshooting, daily checks), sats/ETCO monitoring, oxygen delivery.
• Enteral feeding pumps/sets, catheter/stoma supplies, syringe drivers (within scope and training).
• Emergency grab-bag use; anaphylaxis/seizure rescue protocols.

• Uphold NMC Code, model compassionate, culturally competent practice.
• Maintain boundaries and confidentiality within clients’ homes.
• Contribute to service audits, policy reviews and CQC readiness.

• Registered nurse (Adult / Child / LD) with current NMC registration.
• Post-registration experience delivering complex care in the community or acute setting.
• Verified competencies in at least two of: tracheostomy care, invasive/non-invasive ventilation, enteral feeding (PEG/NG), seizure management and PRN rescue meds, central/peripheral line care and IV/SC therapies, complex moving & handling.
• Confident in clinical assessment, escalation and emergency response (BLS/ILS/PILS as appropriate).
• Strong teaching/supervision skills; able to sign off staff competencies.
• UK driving licence and ability to travel across [patch] (or clear statement if not required).

• Previous package leadership or case management experience; CHC/Personal Health Budget exposure.
• Paediatric high-dependency or ICU/HDU background (for children’s packages).
• Tissue viability, respiratory, neuro or palliative care experience.
• Non-medical prescribing (V300) or PGD/PSD experience within scope.
• Quality improvement/audit experience.