Provide and deliver a high standard of nursing care, recognising and meeting the specific needs of patients, to include pre and post haemodialysis. The preparation of highly complex machines. Commencement and termination of haemodialysis, Cannulation of fistulas and grafts. Care of the haemodialysis patient with percutaneous access. Interpret any machine alarms and correct when appropriate, informing the Registered Nurse. Assist in the care of patients undergoing minor surgical interventions. To manage, under indirect supervision, own workload within clinical area and competencies of the post. To carry out clinical observations on patients, recognising, recording and reporting all changes in patients condition, including the early recognition and intervention of dialysis side effects. Undertake the escort of patients to other departments under the direction of the registered nurse. To support maintenance of fluid balance and dietary charts, of inpatients. Recognising, recording and reporting all adverse findings to senior staff. To carry out observations of skin integrity over pressure points, recognising and reporting all findings to senior staff. To complete documentation for Manual Handling Charts, on inpatients, to be assessed by registered staff. To recognise the importance of health education and teaching of patients and carers, and to be able to advise and refer patients on where to access information. Document and sign for all observations and care given with counter signature from a registered practitioner. To maintain his/her own professional development, attending courses/further training to enhance and optimise his/her role within the work area. To participate in the training and development of junior staff on the unit, and participate in the supervision and support of trainee Health Care Assistants. Act as a mentor to new Health Care Assistants & HCA Trainees, participating in induction programmes, and on-going development of their practice. To promote and safeguard the well-being of patients, their families and colleagues. To participate in the development and implementation of Unit area policy and nursing strategies. To supervise and share responsibility in the care and maintenance of all equipment on the Unit and stock control. In the absence of a Ward Clerk undertake general ward clerk duties Participate in unit research and audit work to include date collection To respect confidential information, in line with Trust policy Data Protection Act. To be familiar with and adhere to Trust and Departmental policies and procedures, mindful of responsibilities to self, colleagues and patients. Report untoward incidents, complaints, clinical emergencies to senior staff. Following patient assessment by Registered staff, undertake extended skills specific to individual competence under the indirect supervision of Registered staff. To participate in the development and implementation of Unit area policy and nursing strategies. To be familiar with Trust infection control, decontamination and cleanliness polices. To undertake the decontamination and cleaning of department equipment. To participate in department cleaning.