Gizella Pal

As a Junior Sister in Intensive Care my duties are complex, and I must be very flexible. There are two main parts of my role:

1. Direct clinical: supporting my band 5 intensive care nurses at bedside: drug administration, patient transfer, resuscitation, setting up

haemodialysis machine, setting up invasive and non-invasive ventilation, tracheostomy care, proning, LIDCO

2. Non-clinical (operational):

staff management issues, supply issues, patient, staff and visitors risk and safety issues; coordinating patient flow on my unit.

A)Providing day-to-day operational and strategic intensive care management: ensuring high quality, individualised patient care,

implementing, assessing and evaluating all aspects of care: benchmarking to NMC and local guidelines, policies

B) Coordinating teamwork under the leadership of our line manager/ senior sister (band7), supervising/supporting band 5 nurses.

The team structure at our ICU: up to 20 ICU nurses and healthcare supporting workers led by a Band 7 senior sister+ 2-3 junior sisters,

therefore I am usually responsible for supervising 6-8 Band 2-5 healthcare workers.

C)Hospital at night extra role: I often hold the bleep to solve critical care staffing issues ; patient admission and discharge problems in

ICU as well as HDU.

D) Working with the Education Team, off duty and annual leave team and clinical development/ risk /infection prevention staff .

E)Supporting the continuous professional developments of my colleagues: performing appraisals, planning educational/ development

pathways

F)Liaising with the multidisciplinary team working in ICU: pharmacy, physiotherapy, dietitian, radiographers etc, coordinating the team

effort

G) Ensuring effective communication between 'shop floor workers' and a management team / matron.

H) I am a Link nurse for Infection Prevention, Health and Safety, this includes teaching and assessing healthcare workers in these

areas.

I) Mentoring trainee nurses and induction for newly qualified nurses.

J)Developing the Band 6 role according to patients' changing needs and research findings, within the resources available especially

during COVID 19.

Specific roles and responsibilities during Covid 19 Pandemic:

-admissions/ discharges of Covid 19 infected level 2 and level 3 patients

-staffing, allocations (skill mix, patient/staff needs considered), allocating non-ICU trained nurses and healthcare support workers were

particularly challenging: ensuring they got supported in their specific roles, feeling welcomed while working on Covid ICU

-dealing with sickness records: who is safe to work who is not safe to work, observing rapidly changing national covid screening

guidelines, treatment policies

-quick and adequate problem solving and decision making, delegating tasks to healthcare workers with the appropriate level of skills

- effective communication

-mastering dynamic approach of day or night-time work: being flexible for rapid situation changes

-attending Covid related meetings (MDT, family, staff member, etc)

-ensuring my team was supported and had adequate covid 19 related teaching (as required),

-staff well-being, career progress and performance support ( appraisal , formal and informal meeting)

-Motivating my team members, role modelling, being supportive flexible and approachable (being clinical expert), leading by example in

difficult times

- mental health support to my team members: spotting early signs of stress and distress and escalating mental health problems.

I worked in the General Intensive Care Unit in Southampton General Hospital. It was a 21-bed unit caring for patients from all areas of the hospital, who required varying levels of monitoring and organ support (level II and level III care). The length of patient stays varied greatly depending upon their reason for admission, from one or two days to several months. I was a skilled member of the nursing team caring for critically ill patients in a highly complex environment, able to provide independent, one to one nursing care for the most complex level 3 patients. I assessed, planned, evaluated and delivered a high standard of care to patients and provided professional support to their families, in accordance with policies and guidelines and within available resources. I supervised, mentored and taught junior nursing staff. General duties: 1. Maintaining high standards of nursing care 2. Assessing, planning, delivering and evaluating individualised patient & family centred care and providing support and advice to other staff as appropriate. 3. Liaising with all members of the multi-professional team to ensure that all treatments are correctly carried out in accordance with the given instructions and policies. 4. Responding to the critically ill patients' „fluctuating” condition and /or observe the response to treatments and alter plan of care accordingly. 5. Maintaining appropriate level of competence and being aware of personal limitations. 6. Maintaining accurate records of observation, treatment and care. 7. Adhering to NMC Code of Conduct and Trust policies and procedures. 8. Acting as an effective role model by using professional standards relating to attitudes, appearance and conduct. 9. I was involved in teaching, induction and mentorship of new/junior staff . 10. Providing support and advice to colleagues to enable development of prioritising skills. 11. I participated in Continuous Assessment of trainee nurses and assessed their competencies, provided constructive feedback. 12. Responsibility for professional development in order to achieve a minimum of NMC PREP requirements for trained nurses. 13. Updating my knowledge with the latest clinical developments and participating in innovation and change concerned with improving the standards of intensive care for our patients. Attending ITU nurse meetings, team building meetings.

UHS Trust provides services to some 1.3 million people living in Southampton and south Hampshire, plus specialist services such as neurosciences, cardiac services and children's intensive care to more than 3 million people in central southern England and the Channel Islands. Every year the Trust's 9,500 staff treat around 140,000 inpatients and day patients, including about 50,000 emergency admissions and deal with around 120,000 cases in our emergency department. The critical care facilities across Southampton General Hospital and the Princess Anne Hospital provide a variety of specialist services. These include Cardiac, Paediatric, General, Neuroscience, and Neonatal intensive Care Units. The Trust also has a number of high dependency areas that provide Level 1 and 2 care for the critically ill. The units need to find ways to cope with increasing pressures and meet the strategic goals of the Trust and to facilitate the new developments identified as priorities. The implementation of a Critical Care Clinical Information System (CIS) was helping to make the best use of resources whilst maintaining the high-quality care the units are renowned for. This was an opportunity to be involved in a large and exciting project within Critical Care at SGH. The role of the Clinical Change Lead was involved providing an expert resource to all users of the CIS. They were performed a vital role by utilising their clinical expertise to participate in the design and configuration of the system, as well as negotiating and driving change within pre-existing working practices. The applicant was a key figure in developing and delivering system training to new users in addition to providing new and revised process and procedural documentation such as SOP's. As a member of the Critical Care CIS Core Team, they will use clinical expertise to participate in the planning, implementation and ongoing support of the Critical Care CIS system to the five Critical Care Units at University Hospital Southampton (UHS). Facilitate the translation of current unit workflows across multidisciplinary units into effective system configuration by conducting workflow and process evaluation. Communicate the clinical needs of the units to the system technical team(s). Communicate system capabilities to a variety of specialist clinical teams. Manage the expectations of staff in line with system functionality. To use sound clinical knowledge, which may or may not be within own clinical area to negotiate and influence changes in practice with staff that will be affected by the implementation of the CIS, in order to enhance patient care and safety. This will include consultants and their teams, nursing staff, pharmacy staff and other health professionals.