Overview
Job Overview
The Liaison Psychiatry Team at St Mary’s Hospital provides a consultation and liaison service for all patients over the age of 18 years who are referred from A&E, inpatient wards and outpatient clinics within the hospital. The role involves psychosocial assessment, management and review of adult and older adult patients as part of your day-to-day clinical activity.
The work will involve the comprehensive psychosocial assessment of mental health needs in a diverse patient population (including risk assessment and the development of risk management plans).
As a member of a large multidisciplinary team, the types of referral that you would expect to receive would include:
* Deliberate self-harm
* Disorders of mood – depression, anxiety, mania
* Psychological reactions to physical illness
* Psychotic illness
* Medically unexplained symptoms and somatisation
* Acute behavioural disturbance due to delirium
* Associated substance misuse issues
* Mental health difficulties commonly associated with old age, including dementia, delirium and depression
* Learning disabilities
You will be required to make clear autonomous decisions based on an analysis of the complex presenting problems and judgements based on available treatment options. The options will include the admission and discharge of patients.
Main duties of the job
* Be responsible for the completion of autonomous psychosocial assessments and reviews of the mental health needs of patients presenting with a wide variety of clinical conditions.
* Provide a comprehensive consultation liaison service to St Mary’s Hospital ward teams and individual clinicians to advise in the development of psychological care plans, and to advise in cases where patients are exhibiting complex psychosocial needs and/or challenging behaviours.
* Be required to teach acute hospital staff in both formal and informal settings.
* Be responsible for providing a broad range of treatments and clinical interventions as appropriate to the needs of each individual patient.
* Within 4-6 weeks of appointment to work to grade 4 competency levels as specified by, A Competence Framework for Liaison Mental Health Nursing (Hart and Eales 2004), within 3 to 6 months to work to grade 5 competency levels.
* Be responsible for specific clinical and managerial projects as negotiated with the Team Manager/Deputy Team Manager and undertake all necessary work to complete these, including facilitating meetings, liaising and/or negotiating with other staff.
* Be expected to participate fully in quality assurance initiatives, and clinical governance, with particular emphasis on patient first approach.
Working for our organisation
* Prioritise and organise own work effectively. Triage all urgent psychiatric referrals from the acute hospital and manage the clinical service on a shift-by-shift basis.
* When requested facilitate and support ward staff in identifying the specific psychiatric or behavioural based skills required to care for individual patients in a holistic manner.
* Ensure the promotion of the health and safety, and well-being of patients, staff and all visitors who come into contact with the team and its service environment.
* At all times follow the Code of Professional Conduct NMC (2008) and ensure that all staff within their sphere of responsibility also follow the code as laid down.
* Supervise, monitor and appraise the performance of unqualified staff within the sphere of responsibility, and report to the Team Manager/Deputy Team Manager.
* Promote collaboration between Imperial Healthcare NHS Trust and CNWL NHS Foundation Trust.
* Act as a change agent to promote innovation and high standards (evidence-based) practice.
Detailed Job Description and Main Responsibilities
Job Summary
The Liaison Psychiatry Team at St Mary’s Hospital provides a consultation and liaison service for all patients over the age of 18 years who are referred from A&E, inpatient wards and outpatient clinics within the hospital. The role involves psychosocial assessment, management and review of adult and older adult patients as part of your day-to-day clinical activity.
The work will involve the comprehensive psychosocial assessment of mental health needs in a diverse patient population (including risk assessment and the development of risk management plans).
You will be required to make clear autonomous decisions based on an analysis of the complex presenting problems and judgements based on available treatment options. The options will include the admission and discharge of patients.
Your interpersonal skills will be expected to be excellent and you must be able to confidently communicate at a high level both verbally and in writing. You must be able to demonstrate de-escalation skills with challenging and/or acutely distressed patients in potentially hostile situations.
You will be expected to be a source of mental health knowledge and expertise and be able to provide support to staff in their day to day management of patients who present with acute psychological distress and acute mental health problems.
The Psychiatric Liaison Nurse will promote excellence in mental health nursing practice through the integration of expert clinical practice, education and consultancy, acting as an important resource and being committed to nursing research. The post holder will also be responsible for ensuring that patient contact data is diligently collected and recorded so that the effectiveness of the role can be comprehensively evaluated and that specific performance related data can be reported regularly. The post-holder will also contribute to the development of relevant local policy and practice and provide advice on the implementation of national guidance and policy.
The post holder will act in accordance with nursing procedures to a standard that ensures safe and effective care, and complies with The Nursing and Midwifery Council's Code of Professional Conduct. There is an expectation that the post holder will place the needs of service users at the centre of care delivery in accordance relevant Trust Policies.
* Principal duties and responsibilities
* Be responsible for the completion of autonomous psychosocial assessments and reviews of the mental health needs of patients presenting with a wide variety of clinical conditions.
* Provide a comprehensive consultation liaison service to St Mary’s Hospital ward teams and individual clinicians to advise in the development of psychological care plans, and to advise in cases where patients are exhibiting complex psychosocial needs and/or challenging behaviours.
* Be required to teach acute hospital staff in both formal and informal settings.
* Be responsible for providing a broad range of treatments and clinical interventions as appropriate to the needs of each individual patient.
* Within 4-6 weeks of appointment to work to grade 4 competency levels as specified by, A Competence Framework for Liaison Mental Health Nursing (Hart and Eales 2004), within 3 to 6 months to work to grade 5 competency levels.
* Be responsible for specific clinical and managerial projects as negotiated with the Team Manager/Deputy Team Manager and undertake all necessary work to complete these, including facilitating meetings, liaising and/or negotiating with other staff.
* Be expected to participate fully in quality assurance initiatives, and clinical governance, with particular emphasis on patient first approach.
The post-holder will act as a role model in providing a service for people with mental health problems for all staff within St Mary’s Hospital.
The post-holder will initiate and participate in audit research projects (as negotiated with the Team Manager/Deputy Team Manager) associated with the work of the service. You may be required to take on a range of non-clinical management duties at the request of, and after discussion with the Team Manager/Deputy Team Manager. You may be required to deputise, in accordance with your level of seniority and experience, in the absence of, and after discussion with the Team Manager/Deputy Team Manager.
Clinical
* Working as an autonomous practitioner, you will promote the health and well-being of patients and maintain a safe, caring and therapeutic environment.
* Provide a specialist assessment (usually working alone) of a patient’s mental/psychological state, including assessment of deliberate self-harm and initial risk assessment. Arrange referral or follow up as necessary.
* Provide support and information for significant others involved in patient care, or referral to appropriate agencies.
* Utilise a wide variety of clinical skills appropriate to the needs of individual patients and the clinical setting in which they are required to be seen.
* Provide specialist advice and support with decision-making on a range of care, treatment and patient management issues.
* Be available for consultation regarding patient care, and offer information and support, in particular advice on nursing management, ensuring patients with severe and enduring mental illness on wards at St Mary’s Hospital are receiving care that is of a high quality and specific to their needs.
* Work alongside all members of the Liaison Psychiatry Team, and attend and contribute to meetings and ward rounds, presenting complex cases for discussion within the team.
* Liaise with other disciplines (statutory services) working within the community, offer input, education and support regarding patient care.
* Give information/support to telephone callers to switchboard regarding mental health issues, documenting as required.
Demonstrate a high standard of record keeping and documentation with adherence to CNWL NHS Foundation Trust policy, and understanding of professional guidelines and application of confidentiality, always adhering to NMC guidelines.
* Work with colleagues to develop and promote the service’s philosophy, operational policy and strategic objectives, taking responsibility for specific areas of policy and strategy delivery, as negotiated with team leader.
Communications
* Demonstrate a high level of interpersonal skills, self-awareness and empathy in all communications.
* Be able to receive and give complex clinical details clearly, to both patients and colleagues.
* Be able to manage all aspects of communication with clients and relatives clearly and sensitively especially in situations that may become contentious and/or hostile.
* Provide support and information for significant others involved in patient care, or referral to appropriate agencies.
* Utilize advanced knowledge and skills in recognising and de-escalating potentially serious and violent situations.
* Use negotiation, conciliation and problem solving skills in contentious and/or challenging situations where agreement is required, or communicate clear decisions and rationale when agreement cannot be reached, for example in situations where use of the Mental Health Act (2007) may need to be considered.
* Develop and maintain good working relationships with colleagues within the Liaison Psychiatry Team, CNWL and the Acute Trust. As far as possible act to ensure the continuing safety of all acute hospital colleagues in their interactions with patients displaying difficult, demanding or potentially violent behaviours.
* Interact clearly, sensitively and with empathy to relatives and carers in all situations, especially highly charged situations, which may have come as a surprise or shock to them.
* Offer clear information and support to telephone callers seeking psychiatric input or support via the hospital switchboard, and liaison psychiatry department office.
Management
* Prioritise and organise own work effectively. Triage all urgent psychiatric referrals from the acute hospital and manage the clinical service on a shift-by-shift basis.
* When requested facilitate and support ward staff in identifying the specific psychiatric or behavioural based skills required to care for individual patients in a holistic manner.
* Ensure the promotion of the health and safety, and well-being of patients, staff and all visitors who come into contact with the team and its service environment.
* At all times follow the Code of Professional Conduct NMC (2008) and ensure that all staff within their sphere of responsibility also follow the code as laid down.
* Supervise, monitor and appraise the performance of unqualified staff within the sphere of responsibility, and report to the Team Manager/Deputy Team Manager.
* Promote collaboration between Imperial Healthcare NHS Trust and CNWL NHS Foundation Trust.
* Act as a change agent to promote innovation and high standards (evidence-based) practice.
Knowledge
* Ability to communicate clearly and effectively both written and oral. Computer skills.
* Computer skills including good speed at typing.
* A comprehensive understanding of the Mental Health Act (1983), the Mental Health Code of Practice and the CPA process.
* Comprehensive understanding of the Mental capacity Act
* Specialist knowledge of mental health problems and their relationship to physical disorders.
Desirable criteria
* European Computer Driving License
* C&G 7.730 Teaching Cert (Adults).
Experience
* Significant experience as a qualified nurse in any combination of the following; Liaison Psychiatric Nurse, acute psychiatric setting, working within a CMHT, Older adults, Home treatment teams.
* Risk assessment/management.
* Ability to interpret research and apply to practice.
* Knowledge of counselling skills/cognitive behavioural skills/psychosocial interventions/brief solution focused therapy.
Qualifications
* RMN on live register.
* Evidence of an active interest in further professional development.
* Educated to diploma level or equivalent in Psychiatric Nursing, Psychotherapy, Counselling or a related discipline.
* Practice assessor, ENB 998 or equivalent
Additional notes: The original contained duplications and inconsistent formatting; this version preserves content while removing extraneous boilerplate where possible. IsExpired: false
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