Alcohol Nurse Specialist

Job summary
If you have an interest in supporting patients who experience problematic alcohol and/or drug use, and meet the requirements of the person specification, then the team at Southmead would love to hear from you.

The Addictions team at Southmead, which includes the Alcohol Care Team, the Drug Care Team and the Treating Tobacco Dependency Team, are a passionate and committed team who support and encourage our patients to consider lifestyle changes to improve health outcomes. We are committed to addressing health inequalities, making every contact count and to having a positive contribution to the NHS Prevention agenda. You will need to have a positive, can do attitude, unwavering belief in the possibility of change and a very flexible and positive approach. If you like a Crunchie, a jacket potato and a team breakfast then you may well fit right into our team and we would love to hear from you and consider your application.

Main duties of the job
The post holder will work within the Inpatient Alcohol Care Team (ACT), providing specialist assessment, intervention and care coordination for patients experiencing alcohol and substance misuse issues across the acute hospital setting. They will undertake comprehensive assessments, develop and implement care plans, deliver evidence-based interventions and support safe discharge planning through effective partnership working with community treatment providers and recovery services.

The role involves supporting patients in the Emergency Department and inpatient wards, participating in multidisciplinary working, safeguarding processes and clinical reviews, and contributing to the management of patients with complex needs. The post holder will provide specialist advice and education to healthcare professionals, promote evidence-based practice, and support the development of staff knowledge and skills across the Trust.

As part of the wider Drug and Alcohol Recovery Care Team (DARCT), the post holder will contribute to service development, quality improvement, audit and clinical governance activities. They will support the delivery of specialist clinics and recovery-focused interventions, including Fibro Scan and SMART Recovery programmes following appropriate training, while helping to ensure the provision of high-quality, patient-centred care for people affected by alcohol and substance misuse.

About us
Bristol NHS Foundation Trust brings together more than 28,000 staff to deliver over 160 clinical services across thirteen hospital locations,operatingfrom three main sites at Southmead, Bristol citycentreand Weston.

With an annual turnover of £2.3 billion, we are now one of the largest NHS trusts in the United Kingdom. Our hospitals are spread across Bristol and Weston, join us and you can enjoy the very best of both worlds; city living within a stone's throw of the countryside or beside the seaside, both with easy access to all that theSouth Westhas to offer.

Bristol NHS Foundation Trust values all people as individuals. As an equal opportunities employer actively working towards a diverse workforce we aim to recruit and retaina workforce whichrepresentsthe rich diversity of the local population at all levels and are committed to designing our services around the needs of individual patients and those around them. Anonymous information will be used from your applicationin order toensurewe'remeeting our pledge.

Job responsibilities
Interpersonal and communication skills

• Develop and maintain effective communication with patients, carers, families and multidisciplinary teams regarding alcohol and substance misuse issues. This may include situations where you need to manage family and patient expectations in relation to accessing alcohol detox and the need to engage with community alcohol services rather than using acute hospital beds.
• Provide brief interventions, health education, advice and information to patients regarding alcohol and drug use and available treatment options. This may include patients who present to the Emergency Department and are not admitted, clinic patients or patients who have been admitted and problematic alcohol use has been identified through screening.
• Act as a specialist resource and adviser for hospital staff, patients and carers. This will include offering signposting and guidelines and supporting ward staff to develop their skills and knowledge.

Professional knowledge and expertise

• Maintain specialist knowledge of alcohol and substance misuse, including assessment, treatment and harm reduction approaches.
• Provide specialist advice and support to medical, nursing and allied health professionals regarding the management of patients with alcohol and drug-related problems.
• Practice in accordance with the NMC Code, Trust policies and relevant national guidance.
• Maintain professional competence through continuing professional development.

Problem-solving and decision-making

• Undertake comprehensive assessments of patients referred from the Emergency Department and inpatient wards. This will involve meeting patients where they are in terms of the Cycle of Change and offering a solution focused approach.
• Assess psychological, emotional, social and treatment needs, taking account of family, carer and community factors. This will involve working sensitively and empathetically using a trauma-based approach in order to develop therapeutic relationships with our patients.
• Identify levels of risk and implement appropriate risk assessment and management plans. This will include working closely with internal and external safeguarding teams where appropriate, IDVAs and the ED child safeguarding practitioner.

Planning and coordination

• Manage and coordinate care for patients with complex needs or high levels of risk until transfer to specialist community services. This may include discussing complex patients or frequent attenders with the DHI Hospital worker to find solutions to support patients with complex needs.
• Facilitate referrals to statutory and voluntary sector services, including detoxification, counselling, psychology and family support services.
• Coordinate care with multidisciplinary teams to ensure safe and effective patient management. This may include attending MDTs and supervision opportunities where appropriate.

Practical and technical skills

• Apply clinical risk assessment and management protocols. This will include case discussion with band 7s and 8 in the team and using the wider case-based discussions within the team to ensure and develop safe, effective practice.
• Deliver brief interventions and motivational approaches to support behavior change and use case discussion opportunities to reflect on the effectiveness of interventions.
• Utilise Trust electronic systems and clinical documentation processes effectively. This will involve daily use of Trust systems such as ICE, care flow workspace, care flow and ICCA

Patient care and support

• Promote the screening of Emergency Department and ward patients for alcohol and substance misuse using harm reduction principles. You will be expected to provide opportunistic support and encouragement in clinical areas to complete AUDIT screening.
• Deliver patient-centred care that addresses physical, psychological and social needs. This will involve having a sensitive and caring approach to patients.
• Provide ongoing assessment, care planning, intervention and support to patients experiencing alcohol and drug-related problems. This will involve discussing complex issues with more senior members of the team where appropriate.
• Support patients and carers to access appropriate services and resources. This will involve current knowledge of services and group offers so you can talk from a point of knowledge to encourage patient engagement.
• Evaluate the effectiveness of interventions and adjust care plans accordingly using opportunities for reflection, case discussion and patient feedback.

Service development and improvement.

• Contribute to the development, implementation and review of clinical guidelines, protocols and care pathways relevant to alcohol and substance misuse services when supported by senior team members or when requested by the service manager.
• Participate in clinical governance and quality improvement activities where appropriate. This may involve review and collation of the results and feedback from our ongoing patient survey data.
• Identify opportunities to improve patient experience and clinical outcomes and escalate suggestions to senior staff through your regular 1-1s, appraisal process, team meetings and supervision.
• Support the implementation of service improvements within the team. It is an expected part of the role that the postholder with enthusiastically embrace change.
• Promote equality, diversity and inclusion in all aspects of care delivery. This will involve respecting all members of the team, wider Trust family and patients and family.

Finance and resource management.

• Support the efficient and cost-effective use of resources, equipment and treatment interventions. This may involve using innovative ways to deliver patient information such as via text, QR codes and email.
• Work collaboratively with budget holders and service managers to ensure value for money in service delivery. This involves taking responsibility for careful use of team and Trust resources and respecting equipment to improve life span such as laptops and scanners.
• Use resources responsibly in accordance with Trust policies and procedures.

Leadership and team management

• Act as a positive role model for professional practice. This will involve positive attitudes towards our, often marginalised, patient group. Setting expectation of respect and a display of Trust values in the care of our patients by ward staff

Information and data management

• Maintain accurate, timely and comprehensive clinical records in accordance with professional standards, Trust policies and data protection legislation. This may involve duplication of records in both paper notes and electronic systems.
• Monitor and record referral activity, outcomes and service performance indicators. This will involve insuring responses are contemporary and accurate.
• Protect confidential patient information and ensure appropriate information sharing practices this is particularly complex in terms of sharing information and risks to tertiary colleagues.

Innovation and continuous improvement

• Participate in audit, service evaluation and quality improvement activities. The ACT is a progressive team which is always looking to learn, expand and develop practice. The postholder will have an attitude which openly embraces improvement and change.
• Support the collection and presentation of audit data to improve practice.
• Apply findings from research, audits and national guidance to improve clinical practice with the support of the wider team.
• Reflect on practice and identify personal learning and development needs using individual reflection, 1-1s, safe team spaces and monthly team reflection.
• Share learning from audits, incidents and training activities with colleagues and attend team meetings that reflect and learn through case discussion and RADAR reporting.

Autonomy and decision authority

• Work independently within professional competency and agreed clinical protocols discussing complex patients and discussing any identified risks or concerns that may come to light during your independent assessments with patients.
• Undertake specialist assessments and formulate care plans for patients with alcohol and drug-related needs with the guidance and support of specialist practitioners within both teams.
• Prioritise workload and manage referrals effectively using the task system on triage This will involve dynamic management of an ever dynamic patient workload.
• Escalate complex, high-risk or safeguarding concerns appropriately to senior clinicians and the multidisciplinary team in a timely and safe fashion.

Cognitive demands

• Maintain high levels of concentration when undertaking complex specialist assessments, risk evaluations and care planning. This will involve you preserving emotional energy by ensuring you take breaks and use colleagues for reflection when needed.

Person Specification
Essential and Desirable
Essential

• Significant post registration experince
• Knowledge of substance Misuse
• Brief Interventions/motivational approach - awareness/experience
• Continued professional development
• Passion for the specialty
• Assessing and working with complex needs
• Trauma based approach/awareness
• Management of patients experiencing alcohol withdrawal

Desirable

• Fibroscan training
• Qualification in specialty
• Knowledge of local services
• Acute Hospital Experience

This post is subject to the Rehabilitation of Offenders Act (Exceptions Order) 1975 and as such it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service (formerly known as CRB) to check for any previous criminal convictions.
Applications from job seekers who require current Skilled worker sponsorship to work in the UK are welcome and will be considered alongside all other applications. For further information visit the UK Visas and Immigration website (Opens in a new tab).
From 6 April 2017, skilled worker applicants, applying for entry clearance into the UK, have had to present a criminal record certificate from each country they have resided continuously or cumulatively for 12 months or more in the past 10 years. Adult dependants (over 18 years old) are also subject to this requirement. Guidance can be found here Criminal records checks for overseas applicants (Opens in a new tab).
Applicants must have current UK professional registration. For further information please see NHS Careers website (opens in a new window).