outreach

la's job interview

what is the role of an outreach nurse

CCOT nurse is an experienced nurse who is specially trained in providing support to patients who are outside of intensive care.

• support wards / doctors / patients with deterioration of the acutely unwell.

• escalation of care

• support appropriate referrals to ITU

• support ICU discharging of patients

• be a member of MET team

• educate wards / teaching

key role of CCOT

• recognise and respond to deterioration

• the CCOT will assess and formulate a plan to support the patient based on the patients condition, with nurse and doctor support.

appropriate referrals

the CCOT can act as a filtration system between the ward and ICU, promoting appropriate and early referral.

CCOT will assess and utilise skills to recognise signs of deterioration / organ support.

• can identify and support limitations

• recommend plan to monitor, investigate and remain on ward.

support / MET team

• met teams are ??? called to review patients experiencing clinical deterioration and assist possible prevention of arrest

• ALS trained

• assist intubation

• aid in planning ITU admission

• assist in arrest

ICU discharge

essential part of recommended in ???? post ITU discharge care

• follow up 12 hours ideally / 24 max

• high risk of deterioration, readmission

• support care on ward & rehabilitation recommendations

• recognise limitations

• NORF standards - the rehabilitation ??? critical illness

supporting ward / patient deterioration

• experienced nurses who are trained in supporting patients outside of critical care

• recognise & respond to deterioration appropriately

• devise / formulate an idea of what the patient could need

• organise / recommend further monitoring & investigations.

• limitations of patient

• assess need for higher level of care safely

• work as a filtration system in promoting appropriate / early referrals

• recognise rapid deterioration and organ disfunction

• can patients go other wards such as padan ward or dialysis

teaching

• education, training & support

• key element of NORF

• inkeeping with clinical government & CCOT framework pillars

• address own education needs, self directed

• work to support team learning

• develop my own competence.. CADS, ALS, X-RAY

• audit / review - show ward needs

• teaching ward staff

• using datex to guide learning, teaching & self reflection

what is call 4 concern

marthas rule, explain it, its a call for concern

• patients & family can raise concern of deterioration

• call goes to site

• communication - site deal with

• care concern - outreach assess

what can i offer to this job?

I can contribute my experience in patient assessment and care management, enhance team collaboration, support educational initiatives, and ensure early identification of patient deterioration.

• 7 years ITU

• journey through junior - senior

• outreach

• love learning

• courses

• i think differently. why?

• amanda

• horse lady

• gallerbame ?

good relationship building with staff + doctors as well. im funny as fuck

LIMITATIONS OF CCOT

escalation of care

• difference in opinions

• finding ways to discuss ??? respectfully

• ????

• knowing my role but expressing my concern

• supporting decisions

LIMITATIONS OF CCOT

workload

• only one in hospital

• not knowing day to day

• collecting all information available - handover, results, nursing notes.

• prioritising patients on list ???

• listening to med handover / whats highlighted

• asking ITU if any patients are on the radar

• ward walk about

• leaving scope for more referrals

• im only human.. (factors) breaks, water, toilet

conflict

there are times where there will be conflicts, some doctors dont believe in outreach.

some are not open to discussion.

in serious cases - phone medical registrar / consultant in extreme cases

competence / confidence

difficult to feel confidence by challenging decisions

• being placed in / navigating situations you have not been in before.

• understand own limits and competence

• have the humility and understanding of my capabilities to ask for support when necessary

• use good working relationships

• work within remit

working within my limitations

• i respect my role / working within my role as a supporting figure

• i am not there to diagnose

• i am able to recommend and support

• using and collecting evidence

• sepsis six - do as much as i can. use golden hour

• use specialist teams for support ie. pan nurse, resp nurse, chest physio

• busy doctors / night shifts

• my own work load

what are the limitations of outreach nurse — introduction

• escalation of care

• working within my limitations

• the work load

• conflict

• competence / confidence