1. Main purpose
Provide nursing care, treatment and follow-up of patients according to the doctors’ prescriptions where applicable, the protocols applied in the service and the universal hygiene standards and precautions, in order to ensure the quality and continuity of care for the target population.
In addition, the post holder is responsible for the referral of patients requiring care beyond the capacity of the facility: assessing the need for referral, coordinating it with the receiving structure, documenting it and following it up until the outcome is known.
2. Standard accountabilities (fixed)
• Know, promote, implement and follow up the universal hygiene standards and precautions, bio-hazard prevention and infection control, security rules and other protocols and procedures in the medical premises, and ensure high standards of hygiene in his/her working environment. Respect medical secrecy and confidentiality at all times.
• Organise and carry out care and treatments according to medical prescriptions, and assist during consultations, daily rounds and other medical procedures. Participate in the health education of the patient and the family where necessary.
• Identify survivors of sexual and gender based violence and refer them to the medical team so that they can receive the necessary treatment. Know and be aware of the importance and the appropriate use of the Post Exposure Prophylaxis (PEP) kit.
• Ensure that patients are properly received and installed, and that those lacking autonomy are assisted, in particular as regards feeding, personal hygiene, movement and comfort.
• Carry out the admission, surveillance and follow-up of patients, including assessment of the evolution of their state of health and identification of any emergency situation or deterioration.
• Carry out and supervise the administrative procedures and documents – consumption, statistics, registers, health files – reporting any problematic situation or case that may arise. Participate in data collection and keep the doctors and supervisors informed.
• Participate in the control and maintenance of the pharmacy and medical equipment of the department, including quality and functioning, storage conditions, follow-up of expired drug inventories, and stock takes of medicines and material at every team changeover, ensuring that no material is taken without prior authorisation.
• Perform cleaning and minor maintenance of the biomedical equipment used.
• Supervise and train nurse aides, nutritional assistants, cleaners and other related staff under his/her supervision, ensuring teamwork and adherence to all the appropriate protocols and procedures.
3. Contextualised accountabilities – Afghanistan mission
Assessment and decision to refer
• Conduct the initial assessment of patients to determine the severity of the illness and the need for referral, on the basis of the established criteria and guidelines.
• Refer only in accordance with the agreed referral criteria and, where required, with the validation of the Medical Doctor. Where the criteria are not met but the patient’s condition gives concern, escalate to the Medical Doctor rather than decide alone.
• Ensure that the patient is stabilised before departure and accompanied where the condition requires it.
Coordination of the referral
• Coordinate referrals for patients requiring specialised services, diagnostic tests or consultations with external health facilities or specialists.
• Establish and maintain working relationships with external health facilities, specialists and community resources, in order to facilitate timely and appropriate referrals.
• Collaborate with the internal clinical teams and the other departments to ensure the coordination of care and the continuity of treatment.
• Communicate clearly with patients, families and health providers about the reason for the referral, the referral process and the follow-up care instructions, in a language the patient understands.
• Obtain the patient’s informed consent before a referral is made, and ensure that only the clinical information necessary for the care of the patient is shared with the receiving structure.
Documentation and follow-up
• Maintain accurate and complete documentation of referral requests, approvals and outcomes in the patient’s medical record and in the referral tracking system.
• Follow up with patients to ensure that they have received the necessary services and support after the referral, including appointments, test results, and any barrier to care encountered.
• Record every referral that is made, including those that were declined by the receiving structure or not completed by the patient, and report the reasons to the Medical Activity Manager. No referral is omitted from the record.
• Report recurring obstacles in the referral pathway – cost, distance, transport, refusal of the receiving structure, mahram or movement constraints – so that they can be addressed at project level.
Direct nursing care and additional support
• Provide direct nursing care to patients, including dressing changes, catheterisation, monitoring of vital signs and administration of medicines, in accordance with prescriptions and protocols.
• Apply injection safety and the safe handling and disposal of sharps and medical waste at all times.
• Assist in the INTERSOS supported clinics, as assigned by the line manager, in particular during periods of heavy patient flow or gaps in staffing.
• Support the identification of malnutrition cases in the health facilities and in the community through screening of the relevant groups, refer them to the treatment points, and follow up defaulters.
• Perform any other duty related to the function of the position, as assigned by the line supervisor.
Conduct and compliance
• Treat every patient with respect and without discrimination, and never request or accept any payment from a patient or a caretaker. INTERSOS services are free of charge.
• Ensure that the data recorded in the registers is accurate and complete, and that no patient is left unregistered and no record altered in order to influence a reported indicator.
• Report immediately any incident affecting patient safety, and any protection or safeguarding concern.
• Comply with the INTERSOS Charter of Values, Code of Ethics, the Policy for the Protection from Sexual Exploitation and Abuse (PSEA), the Safeguarding Policy and the Anti-Fraud Policy, and report any concern through the established channels.
