BHSCT Critical Care Outreach Nurse Band 7 ref:56023663
Branch: Belfast HSCT
Location: ROYAL VICTORIA HOSPITAL
Directorate: Surgery & Specialist Services
Salary: Band 7 (£47,810 - £54,710)
Contract Type: Permanent
Opening date: 11/11/26
Closes: Wed, 25 November 2026 @ 4:30 PM
Interview Dates: To Be Confirmed
Notes: We accept online applications only.

A waiting list may be created for similar posts that may arise while the waiting list is live, this may include temporary or part-time posts. This will be managed in line with the updated HSC waiting list principles effective from 1 April 2026. Where a part-time waiting list is required, one part-time waiting list will be created- regardless of any specific hours advertised, this waiting list will cover all future vacancies where part-time posts arise. A part-time post is defined as any post that has less than 37.5 hours per week. Please remember to save or print a copy of the job description before submitting your application, as it will not be accessible afterwards.

Flexible Working
We welcome flexible working requests from day one. All HSC organisations offer a range of flexible working options. The options available for this post will depend on the requirements of the role. Find out more about flexible working options on our website.

Successful applicants have the opportunity to request Flexible Working from the 1st day of their employment. A number of Flexible Working provisions are offered by all HSC Organisations, what provisions are available depends on the role being undertaken.

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POST: Critical Care Outreach Nurse
LOCATION: Belfast Trust - Royal Victoria Hospital site
BAND: 7
REPORTS TO: Lead Nurse - Critical Care Outreach Team
RESPONSIBLE TO: Co-Director of ACCTSS

Job Summary / Main Purpose
To work in collaboration with the Critical Care Team to develop and deliver Outreach services. The Critical Care Outreach service has two main functions. The first is to follow up patients following discharge from Critical Care to the wards and all patients with both tracheostomies and laryngectomies. The second is to provide a Patient at Risk Service, where an early warning system prompts referral following patient deterioration. Critical Care Outreach team members then review the patient with the aim of preventing intensive care admission.

Following induction and training, the post holder will be an experienced, highly competent and confident Critical Care Outreach Nurse who is proficient in both critical care and outreach nursing, utilising their clinical expertise and specialist knowledge to assess and stabilise the acutely deteriorating patient outside of the critical care environment.

The Critical Care Outreach Nurse will work as an autonomous practitioner, providing specialist advice and support to facilitate high quality, individualised care to the acutely deteriorating and critically ill patients in conjunction with the multidisciplinary team. The Critical Care Outreach Nurse will be responsible for a caseload of patients across a number of specialities.

The Critical Care Outreach Nurse will provide specialised clinical support, education and guidance in matters relating to critically ill patients, together with mentorship and role modelling to support clinical staff displaying excellent leadership skills and sharing best practice.

Main Duties / Responsibilities
For each of the following, the postholder will;

Clinical Expert

• Perform comprehensive patient assessments based on history taking and physical examination to arrive at a clinical diagnosis. Act independently by suggesting solutions and making recommendations for acutely unwell adult ward-based patients.
• Devise treatment plans independently, and using initiative, while acting in the patients best interests and make changes where required. Alerting the appropriate members of the patients medical team, other members of the Outreach Team and or/Critical Care medical staff, sometimes in highly emotive situations.
• Demonstrate a sound level of clinical judgement and decision making in the assessment of patients, making management recommendations and implementing measures that will enhance patient care.
• Manage a caseload of patients, who are referred via a bleep system plus Encompass, prioritising patients so as to prevent further deterioration, and avoidance of admission to intensive care or conversely a timely admission, within the constraints of the acute hospital setting.
• Act as an autonomous practitioner role modelling clinical expertise, assisting colleagues to develop advanced knowledge and skills in order to benefit the treatment and care of critically ill patients in any adult setting within the Royal Victoria Hospital.
• Provide initial psychological assessment of the acutely unwell patient and those discharged from critical care including the recognition of delirium, liaising with ward staff and at times, initiating the referral to clinical psychology, in conjunction with patients medical team.
• Request, where appropriate, further investigations e.g. 12 lead ECG, biochemistry, arterial blood gas analysis etc.
• Undertake the advanced practice and interpretation of: Arterial and venous blood gas's; Patient history taking and physical assessment; Chest X-ray request and basic interpretation; Use of Patient Group Directives (PGD's); Outreach nurse competencies (guided by NORF).
• Evaluate the effectiveness of interventions/recommendations at timely intervals making adjustments/recommendations to treatment plans as necessary.
• Demonstrate the skills required to guide the management of the dependent patient outside of the Critical Care environment to ultimately avoid a critical care admission. Or where appropriate; facilitate a timely admission to critical care.
• Competently identify level 1, 2 and 3 patients in the ward environment and ensure all are nursed in a safe manner.
• Be jointly responsible for the nursing management of Level 2 patients on the ward who have been accepted for admission to Critical Care. In addition, competently manage Critical Care therapies and supports intra-hospital transfers to Critical Care.
• Ensure adherence to the DHSS and NMC guidelines for the safe handling, administration, storage and custody of medicinal products.
• When identified prior to discharge from Critical Care, provide follow up and on-going care for patients at ward level until a time when clinically appropriate to discharge.
• Provide follow up and on-going care of patients with altered airways who are both inpatients within RVH or discharged from Critical Care including liaising with the multi-disciplinary team regarding weaning, decannulation and long term management.
• Provide leadership that facilitates professional decision making and effective team working.

Education, Research and Practice Development

• Develop, deliver and evaluate specialist core training related to tracheostomies and laryngectomies adhering to trust policy in a multi-disciplinary format to all members of the multi-disciplinary team.
• Develop, deliver and evaluate a variety of specialist training, on request, including induction programmes, acute care skills development programmes etc.
• Regularly participate in, support and encourage research and evidence based practice for the enhancement of patient care.
• Support the training and education of ward staff in the management of the acutely and critically unwell patient, and in addition provide education in the provision of additional treatments, e.g. the initiation of oxygen treatments including HFNO, EPAP and NIV.
• Take responsibility for the development of clinical guidelines, standards and integrated care pathways.
• Take responsibility for data collection, the interpretation and dissemination of findings.
• Identify areas for future research and contribute to both local and national research projects as appropriate.
• Participate in the development and expansion of nursing practice to ensure ward based nurses acquire the skills required to provide the continuity of care of patients who are acutely unwell or who are transferred from ICU/HDU.
• Act as a role model and teacher, working alongside staff, promoting high standards of quality care and supporting and empowering them through clinical decision-making processes.
• Disseminate knowledge to the Trust-wide multi-disciplinary team related to Critical Care Outreach clinical guidelines and integrated care pathways.
• Develop educational programmes and courses applicable to the critically ill, acutely unwell patients or those with an altered airway in conjunction with trust policy.
• Be prepared to learn from others, concerning the care and management of multi-speciality patients.
• Identify key learning opportunities either independently, within a team or multidisciplinary setting, facilitating and developing independent and team learning. Incorporating supervision and reflection into practice.
• Liaise with and assist with the delivery of multi-professional and inter-professional learning.
• Demonstrate self-direction in facilitating continuing personal and professional development in accordance with NMC code of professional conduct and within the scope of professional practice.
• Act as a mentor and resource for student nurses, qualified members, and other members of the multi-disciplinary team, providing specialist education and teaching, by incorporating work-shadowing, role-modelling and bedside teaching.
• Contribute to the development of a learning culture within the Trust, encouraging all staff to participate in reflective practice strategies and lifelong learning initiatives.
• Actively support and participate in the Trust's Knowledge and Skills Framework [KSF] programme.

Leadership and Management

• Contribute to clinical decision-making and effectiveness, through involvement in clinical audit, risk management and clinical governance, to include reporting and investigating incidents as per Trust policy, investigating complaints and writing reports if required.
• Demonstrate leadership abilities to support and inspire all members of the multi professional team, through appropriate delegation, supervision and role modelling in the provision of safe quality critical care to patients Trust wide.
• Freedom to initiate action within broad clinical/professional policies seeking guidance from others as necessary.
• Alert appropriate members of the patient's admitting team, the Outreach Team and/or Critical Care medical staff if unable to make a confident assessment of the patient's condition.
• Following a period of induction, works independently and without direct supervision in a variety of clinical settings Trust wide, liaising with nursing staff, specialist nurses and medical staff as required.
• Exhibits effective decision-making skills prioritising workload in a variety of clinical settings on a daily basis including the ability to reprioritise workload in emergency situations.
• Participate in organising duty rotas/annual leave and study leave to ensure that there is adequate nursing cover and appropriate skill mix at all times.
• Act as an expert practitioner and clinical leader and have the ability to facilitate, initiate, manage and evaluate change in practice to improve quality of care.
• Work with systems in place for safe use of medical devices and ensure that incidents/accidents on faulty devices are recorded, reported and investigated in accordance with Trust policy.
• Participate in working parties implementing policy changes.
• Participate in recruitment and selection of staff.
• Observe any signs of ill health or stress factors in staff and report as appropriate to the nursing services manager.
• Ensure efficient use of resources.
• Adhere to all Belfast Trust policies.

Communication

• Ensure that appropriate, consistent and realistic information is provided to patients and families.
• Initiate discussions, where appropriate, with the multi-disciplinary team, relatives and patients on the highly sensitive and complex issues surrounding the futility of continuing treatment, the appropriateness of resuscitation decisions and life threatening conditions.
• Find alternative communication methods with patients who are difficult to communicate with due to their current medical condition i.e. hypoxic patients, altered airway patients, confused and delirious patients.
• Demonstrate effective decision making that is patient centered and consistent with Trust policies.
• Use excellent diplomatic communication to break down barriers and develop inter-professional collaborative working relationships with staff Trust wide.
• Ensure confidentiality is maintained without compromising patient care.
• Promote good relationships between the wards and Critical Care.
• Liaise and communicate with the Hospital at Night Team in the management of acutely ill patients on the ward.
• Maintain and promote effective communication both verbally and in writing with all members of the multi-disciplinary team and other Wards or Departments.
• Work in a collaborative manner, providing clear decision making skills in consultation with nursing and medical staff, being prepared to pursue line management structures as needed in order to achieve best outcomes for patients ensuring patient safety is adhered to at all times.
• Take responsibility for ensuring all Outreach data is accurately inputted on a database for generating monthly reports on activity and patient outcomes in order to improve and build on the effectiveness of the Outreach service.
• Actively participate in audit to improve service, including national audits.

General Responsibilities
Employees of the Trust are required to promote and support the mission and vision of the service for which they are responsible and:

• At all times provide a caring service and to treat those with whom they come into contact in a courteous and respectful manner.
• The post holder will promote and support effective team working, fostering a culture of openness and transparency. The post holder will ensure that they take all concerns raised with them seriously and act in accordance with Belfast Trust's Whistleblowing Policy and their professional code of conduct, where applicable.
• Demonstrate their commitment by their regular attendance and the efficient completion of all tasks allocated to them.
• Comply with the Trust's Smoke Free Policy.
• Carry out their duties and responsibilities in compliance with the Health and Safety Policies and Statutory Regulations.
• Adhere to Equality and Good Relations duties throughout the course of their employment.
• Ensure the ongoing confidence of the public in-service provision.
• Maintain high standards of personal accountability.
• Comply with the HPSS Code of Conduct.

Information Governance
All employees of Belfast Health & Social Care Trust are legally responsible for all records held, created or used as part of their business within the Belfast Health and Social Care Trust, including patient/client, corporate and administrative records whether paper based or electronic and also including e-mails. All such records are public records and are accessible to the general public, with limited exceptions, under the Freedom of Information Act 2000, the Environment Regulations 2004, the General Data Protection Regulation (GDPR) and the Data Protection Act 2018. Employees are required to be conversant and to comply with the Belfast Health and Social Care Trust policies on Information Governance including for example the ICT Security Policy, Data Protection Policy and Records Management Policy and to seek advice if in doubt.

For further information on how we use your personal data within HR, please refer to the Privacy Notice available on the HUB or Your HR

Environmental Cleaning Strategy
The Trusts Environmental Cleaning Strategy recognises the key principle that “Cleanliness matters is everyone's responsibility, not just the cleaners” Whilst there are staff employed who are responsible for cleaning services, all Trust staff have a responsibility to ensure a clean, comfortable, safe environment for patients, clients, residents, visitors, staff and members of the general public.

Infection Prevention and Control
The Belfast Trust is committed to reducing Healthcare associated infections (HCAIs) and all staff have a part to play in making this happen. Staff must comply with all policies in relation to Infection Prevention and Control and with ongoing reduction strategies. Standard Infection Prevention and Control Precautions must be used at all times to ensure the safety of patients and staff.

This includes:-

• Cleaning hands either with soap and water or a hand sanitiser at the appropriate times (WHO '5 moments');
• Using the correct '7 step' hand hygiene technique;
• Being 'bare below the elbows' when in a clinical environment;
• Following Trust policies and the Regional Infection Control Manual (found on intranet);
• Wearing the correct Personal Protective Equipment (PPE);
• Ensuring correct handling and disposal of waste (including sharps) and laundry;
• Ensuring all medical devices (equipment) are decontaminated appropriately i.e. cleaned, disinfected and/or sterilised;
• Ensuring compliance with High Impact Interventions.

Personal Public Involvement
Staff members are expected to involve patients, clients, carers and the wider community were relevant, in developing, planning and delivering our services in a meaningful and effective way, as part of the Trust's ongoing commitment to Personal Public Involvement (PPI).

Please use the link below to access the PPI standards leaflet for further information.

Clause: This job description is not meant to be definitive and may be amended to meet the changing needs of the Belfast Health and Social Care Trust.

PERSONNEL SPECIFICATION
JOB TITLE / BAND: Critical Care Outreach Nurse / Band 7
DEPT / DIRECTORATE: RVH / ACCTSS & Surgery

Essential criteria

• Must be a Registered Nurse (Adult) on the NMC register.
• Post graduate certificate in Intensive care Nursing (Short course).
• Must have valid ILS/Scream certificate at time of interview and have or be willing to undertake ALS within three months of commencing post.
• Five years' post-registration working in an adult critical care setting, three of which must be at Band 6.
• Must be able to demonstrate evidence of post registration/post graduate study.
• Must be able to demonstrate advanced clinical nursing assessment skills and knowledge.
• Must be able to demonstrate the ability to make complex judgements in a wide range of acute and complicated clinical situations.
• Must be able to demonstrate effective people management, governance, leadership and organisational skills.
• Must be a skilled communicator.
• Experience as mentor/teacher.