About this role
Job summary
We are seeking an enthusiastic registered nurse with a genuine interest in specialist adult bowel care to join our Gastrointestinal (GI) Physiology service. You will work closely with the Clinical Scientists to perform diagnostic investigations and provide patient specific management.
You will learn, and then independently deliver, anorectal physiology testing, biofeedback, transanal irrigation and wider bladder and bowel management for adults with functional bowel conditions. Full training, supervision and a structured competency programme will be provided, with the aim of progressing to autonomous practice within an agreed timeframe
The team are also integrated within the Urodynamic department and support the running of urodynamics and continence care. This role will give you exposure to these procedures and the opportunity to help treat complex pelvic floor patients in a holistic manner.
You will work as part of a multi-disciplinary team (MDT) and will be required to present cases and lead discussion at MDT meetings.
Main duties of the job
Work as part of the GI Physiology team to provide diagnostic investigations and implement conservative treatment options.
Records and IT
o Keep a high standard of prompt and accurate patient records using IT systems, in line with Trust policy and NMC standards.
o Use IT systems to produce accurate written reports, assessments and clinic letters.
Teamwork, service development and deputising
o Engage in team training and service development, contribute to clinical and data collection audits, and attend and participate in team and other service-relevant meetings.
o Contribute to updating guidelines and patient information.
o Use your initiative to seek additional work that supports the smooth running of the team, for example team administrative tasks, stock ordering, responding to group tasks, booking appointments and contacting patients or carers.
Education, supervision and professional development
o Take part in regular clinical supervision and reflective practice, and maintain a portfolio of evidence.
o Commit to ongoing professional development, including learning to perform anorectal physiology, biofeedback, urodynamics and other specialist skills, and undertaking further study relevant to the role.
o Support and supervise less experienced staff and students effectively when required, including informal teaching on bladder and bowel care.
o Attend conferences and training events, occasionally outside the area.
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 description
Job responsibilities
Clinical assessment and care
Complete comprehensive, holistic clinical assessments of patients with bladder and bowel problems, taking a detailed history and using validated symptom and quality-of-life scores.
Undertake intimate clinical examinations, including pelvic floor assessment and digital rectal examination (DRE), recording findings accurately and following evidence-based guidelines for care and clinical procedures.
Assess, diagnose, plan and promote an excellent standard of bladder and bowel health for every patient, irrespective of age, ethnicity, gender, religion, disability or sexuality.
Encourage patients to take ownership of their pelvic floor problem, supporting them to improve symptoms through education and engagement with treatment, self-help and lifestyle approaches.
Observe, report and act on any changes in a patient's condition, using clinical judgement to recognise when action or escalation is required.
Work within your own clinical competencies, following the agreed competency framework, and seek advice from colleagues within the service or from external sources when required.
Caseload, triage and telephone advice
Manage your daily patient caseload and appointments during your shift.
Undertake telephone-based initial clinical assessments, and provide advice and follow-up by telephone and other remote methods to patients, carers and colleagues.
Anorectal physiology
Undertake a structured training programme in anorectal physiology, working under supervision until signed off as competent.
Perform anorectal physiology tests, such as anorectal manometry and rectal sensation testing, and use the results to inform patient care.
Once competent, run anorectal physiology clinics, including preparing patients, carrying out and recording tests, and producing accurate reports.
Maintain, calibrate and clean equipment in line with infection prevention and manufacturer guidance.
Bowel management
Develop and review individualised bowel management plans, including dietary and lifestyle advice, fluid intake, toileting position and routine, and medication optimisation.
Escalate complex cases to senior colleagues and seek medical advice where appropriate.
Biofeedback and pelvic floor rehabilitation
Learn and, once competent, deliver biofeedback-assisted pelvic floor and anorectal retraining for constipation, evacuation difficulty and faecal incontinence.
Teach patients exercises and techniques, monitor progress and adjust treatment accordingly.
Transanal irrigation
Learn and, once competent, assess patients' suitability for transanal irrigation (TAI) and initiate treatment.
Train patients and carers to use TAI systems safely and confidently, with follow-up to review effectiveness, troubleshoot problems and support long-term adherence.
Recognise contraindications, complications and when to seek medical or senior advice.
Bladder care and urodynamics
Assess patients with bladder dysfunction and develop and review individualised bladder management plans, including fluid intake, toileting routine and lifestyle advice, escalating complex cases to senior colleagues.
Learn and, once competent, perform urodynamic studies and use the results to inform patient care.
Teach patients and carers specialist methods of bladder management, such as intermittent self-catheterisation (ISC), and review effectiveness and any complications.
Maintain, calibrate and clean urodynamic equipment in line with infection prevention and manufacturer guidance.
Communication and relationships
Communicate effectively, assertively and non-judgementally with a diverse range of patients of differing ages, ethnicity, gender, religion, disability and sexuality, and with family members, carers and other members of the multidisciplinary team (MDT), including GPs when appropriate.
Communicate sensitively about intimate and often distressing symptoms, showing an empathetic and compassionate approach and supporting informed choice and shared decision-making.
Work collaboratively with colorectal surgeons, gastroenterologists, urologists, gynaecology, continence services, dietitians, physiotherapists, GPs and community teams.
Contribute to MDT meetings and case discussions.
Work with integrity and maintain patient confidentiality at all times.
Person Specification
Essential
- Registered Nurse (Adult), NMC
- Post-registration experience in colorectal, gastroenterology, continence, surgical or a related specialty
Desirable
- Experience in specialist bladder and bowel assessment, e.g. pelvic floor assessment, digital rectal examination (DRE)
Disclosure and Barring Service Check
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.
Certificate of Sponsorship
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).
UK Registration
Applicants must have current UK professional registration. For further information please see NHS Careers website (opens in a new window).
Employer details
Employer name
Bristol NHS Foundation Trust
Address
Southmead Hospital, Brunel Building
Bristol
BS10 5NB
United Kingdom
Employer's website
https://www.nbt.nhs.uk/ (Opens in a new tab)