Access and Community Nurse Specialist (Band 6)

Job responsibilities

Access Team Support all aspects of the clinical referral process Assess the appropriateness and urgency of referrals seeking further information and advice as appropriate Liaison with other teams within St Peters Hospice regarding referrals to these teams Answer advice line calls and act as the first line of support and advice Community Nurse Specialist Team Manage and coordinate the day to day running of the team held caseload of patients living in the community Core Clinical Responsibilities Take and analyse a clinical history in a relevant, succinct and logical manner either remotely or face to face Independently assess the patients needs, identify their priorities and work with the patient and those close to them towards achieving them Demonstrate an in-depth knowledge of the options for achieving control of symptoms and the ability to make safe clinical decisions and offer advice to the primary health care team Provide information to patients, taking account of their individual needs, taking advice from those who are close to them, colleagues and external professionals where appropriate Refer to other members of the hospice multi-professional team. Refer/signpost patients and carers to other health and social care professionals where appropriate Demonstrate an ability to explore the personal resources of families/carers in order to facilitate where possible that patients are cared for in the place of their choice Support and coach carers at home in managing a relative whose condition is deteriorating Understand community medication administration processes and safely administer just in case subcutaneous injections when needed during a visit. Recognise and manage palliative care emergencies Bring closure to the nurse-patient relationship and provide for a safe transition to another care provider as appropriate Act as a resource to other professionals, both internally and externally, on specialist palliative care and end of life care issues Be involved with and support MDT meetings when required Deputise for team leader Work collaboratively with clinical and administrative colleagues to provide a responsive and patient-centred service Recognise the impact of caring for dying patients on yourself, internal and external colleagues and offer / seek support Potential Additional Clinical Responsibilities The post holder may undertake additional responsibilities when they have passed the relevant module and using the skills in current practice, as below. In addition, to practice Non-Medical Prescribing, the post holder must be registered as a Non-Medical Prescriber with the Nursing and Midwifery Council Use physical assessment and clinical reasoning skills as part of patient assessment and to support clinical advice, professional communication and documentation Perform Non-Medical prescribing within area of competence and practice according to local policy Governance, Quality and Clinical Practice KSF 3 Contribute to improving quality Promote care that is effective, safe and provides as positive an experience as possible Understand own role, its scope and how this may change and develop over time in a high-quality organisation Work to support the team and help and enable others to work as a team Prioritise workload and manages own time in a manner that maintains and promotes high quality and offers flexibility in response to changing situations Evaluate the quality of own and others work in own area and raises quality issues and related risks with the appropriate people Suggest and support changes in own area that improves the quality of systems and processes Take appropriate action when there is a persistent problem with quality Communication KSF 3 Can develop and maintain communication with people about difficult matters and/or in difficult situations Maintain high standards of integrity when communicating with patients and the wider public Manage complex communication issues with patients and families Structure an assessment using appropriate questioning, avoid jargon, using familiar language, at patients own pace Record concisely, accurately, confidentially, legibly and contemporaneously the appropriate elements of the history, results of investigations, problems identified and management plan Break bad news in steps appropriate to the understanding of the individual and be able to support distress and have discussions around prognosis and future care options Demonstrate an understanding of the need to involve patients and carers in decision making, offering them informed choices, respecting their views Use the Recommended Summary Plan for Emergency Care and Treatment Plus (ReSPECT+) process to support the documentation and communication of the patients preferences and clinical recommendations for emergency care and treatment Demonstrate skill in working with families facing loss Manage dissatisfied patients/relatives, anticipating potential problems and managing expectations Communicate with patients whose first language may not be English in a manner that they understand, using interpreters appropriately Present cases clearly, consistently and professionally to the multidisciplinary team (MDT) meeting, contributing effectively in patient management Provide feedback to others on their communication where appropriate Communicate effectively with the wider multidisciplinary team Demonstrate negotiation and diplomacy skills and partnership working with external agencies Demonstrate competent use of Electronic Patient Records and IT systems Write and maintain accurate notes/documentation and input computerised data, keeping all information up to date Personal & people development KSF3 Develop oneself and contribute to the development of others Take responsibility for identifying and meeting own development needs Generate and use appropriate learning opportunities and apply own learning to development of practice Assess how well last years personal objectives were met and helps set new ones for the year ahead Enable opportunities for others to apply their developing knowledge and skills Actively provides learning and development opportunities to others including mentoring new staff and clinical placements Apply evidence to patient care Use strategies to develop own resilience Practice effectively by reflecting to support practice improvement, this may be with colleagues and/or be engaging with clinical supervision. Health Safety and Security KSF 2 Monitor and maintain health, safety and security of self and others Look for potential risks to self and others in work activities, environments and processes Understand specific risks associated with lone working and follow lone working policy Manage identified risks in the best way possible Work in a way that complies with legislation and hospice policies and procedures on health, safety and risk management Demonstrate safe mobilisation, transfer and movement of patients in the community using slide sheets and bed systems but not other equipment such as hoists and standing aids; have a knowledge of who provides appropriate equipment and how to refer Take action to manage an emergency, calling for help immediately when appropriate Report actual or potential problems that may put health, safety or security at risk and suggests solutions Support and challenge others in maintaining health, safety and security at work Work within the guidance policy for the protection of vulnerable adults Service Improvement KSF 2 Contribute to the improvement of services Discuss with the team the likely impact of changing policies, strategies and procedures on practice and changes the team can make and how to make them effective Take on new work and make changes to own work when agreed with line manager, requesting relevant help if needed Support colleagues in understanding and making agreed changes to their work Evaluate own and others work when needed including engaging in audit Make suggestions to improve the service Constructively identifies where new ways of working, polices or strategies are having a negative impact on the service given to users or the public. Equality and Diversity KSF 2 Support equality and value diversity Challenge bias, prejudice and intolerance if appropriate or bring it to the attention of a manager Aware of the impact of own behaviour on others Demonstrate sensitivity and respect for people from different religious and cultural background and sexual orientation.

Qualifications

Essential

• Current NMC registration
• Relevant qualification at degree level (or equivalent)
• Communication skills training, or willingness to undertake
• Valid UK driving licence

Desirable

• Mentoring training
• Experience of teaching
• Non-medical prescribing, or willingness to undertake
• Physical assessment and clinical reasoning, or willingness to undertake

Experience

Essential

• Minimum 3 years post registration
• Recent significant palliative care experience
• Possess a working knowledge of clinical governance and evidence-based practice
• Possess a working knowledge of safeguarding individuals who are at risk

Desirable

• Possess a sound knowledge of issues related to the provision of palliative care in the community
• Demonstrate a working knowledge of relevant statutory and voluntary agencies and organisational structure
• Experience of holding conversations around advance care planning
• Experience of audit processes
• Experience of using EMIS database
• Knowledge and experience in symptom management for people with malignant and non-malignant disease

Additional Criteria

Essential

• Possess an ability to analyse complex facts and situations and develop a range of options
• Problem solving skills and ability to work methodically and flexibly,
• Ability to work to tight and often changing timescales
• Ability to work autonomously
• Own and take responsibility for constructive feedback to improve patient care and/or team working
• Ability to think laterally and be able to cope with uncertainty and change when required
• Possess an innovative approach and an ability to inspire others
• Robust emotional resilience to manage excessive exposure to dying people and family/carer distress
• Ability to maintain a professional, calm and efficient manner with strong self-management skills

Desirable

• Computer literate to be able to use Word/Excel/Power Point

Additional Criteria

Essential

• Demonstrate ability to work flexibly to meet the challenges and opportunities of working within the hospice environment
• Demonstrate a commitment to anti-discriminatory practice and equal opportunities
• Be able to demonstrate and uphold the hospice values
• Access to a vehicle for work purposes

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.

UK Registration

Applicants must have current UK professional registration. For further information please see NHS Careers website (opens in a new window).