Associate Clinical Nurse Specialist/Clinical Nurse Specialist

Job responsibilities

The Associate Clinical Nurse Specialist delivers and facilitates evidence-based palliative and end of life care to patients with any diagnosis and to their carers/families. He/she will establish and develop relationships with those involved in delivering health and social care to patients at the end of life and their families/carers in all settings Provide information and specialist advice on all facets of palliative care (eg symptom management, practical and emotional support), to patients, their families/carers and other professionals involved in their care.

Actively disseminate best practice through example, education and training, professional development and learning, participation in nursing research and audit, publication and conference presentations.

Work as a member of a cohesive multi-professional palliative care team. As part of the specialist nursing team, participate in delivery of out of hours telephone advice (24 hours) and contribute to the seven day a week visiting service. (When working in community setting). (In the Hospital, is part of a 7 day service to cover weekends and Bank Holidays 9-5).

Key Responsibilities:

Clinical Practice & Leadership

To provide a high standard of holistic and individualised patient care to patients with palliative and end of life care needs by:

Acting as a role model for others to emulate, exhibiting high standards of professional behaviour and competence and providing leadership, support, advice and education to colleagues caring for people at the end of life in all settings.

Making assessments of patients and carers, identifying their psychological, physical, social, practical and spiritual needs in accordance with Hospice philosophy and demonstrating and applying a knowledge of the options for achieving control of symptoms to develop a plan of care to meet their needs with support of other members of the CNS team

Acting as a reflective practitioner, applying evidence based practice and critical thinking to all practices and processes of care.

In consultation and with support of the multiprofessional team and those professionals who are involved in the patients care, reviewing patients independently, initiating changes as required. Greenwich & Bexley Community Hospice Job Description

Working collaboratively day with other professionals involved in the patients care in any setting, to provide a co-ordinated, high quality service. This will involve working with statutory, independent, charitable and voluntary agencies in health and social services.

Prioritising own workload according to the day to day needs of the service and seeking support where required.

Providing guidance, support, advice and information to patients and their family / carers throughout their illness. Know when to refer on to other professionals for additional guidance, support, advice and information.

Promoting patient autonomy, providing information, empowering them and acting as an advocate so that the individual is able to make informed choices about their own care.

Participating in the 7 day a week visiting service working Saturday and/or Sunday to cover a rota for community patients when competencies achieved (NB When working in the community only)

Participating in the Teams 24 hour telephone on call service from home, providing specialist advice to professionals in the hospital or community and to patients and carers/families on the caseload when competencies achieved. (NB When working in the community only)

Participating in developing guidelines and protocols to deliver a quality comprehensive, evidence-based and patient-focused service for patients and families

Ensuring that all necessary documentation is completed whether on the electronic patient record, (EPR), or paper-based and that appropriate data is collected

Participating in own clinical supervision.

As required by the Head of Community Services, (if working in community), or the Nurse Consultant (when working in hospital), representing the Hospice at external groups to further develop palliative care in Bexley, Greenwich, SE London and nationally. Communication

Fostering positive working relations with all members of the hospital, Hospice, social care and primary healthcare teams.

Participating in multidisciplinary meetings relating to the care of patients and their families/carers as required.

Promoting and practicing excellent communication skills with patients, family and members of the multi-disciplinary team.

Helping patients formulate an individual care plan by promoting the use of the London Urgent Care Plan (UCP)within the service and with external colleagues in primary and secondary care

Contributing positively to the development of Greenwich and Bexley Community Hospice as an anti discriminatory organisation, actively promoting equality and diversity.

Quality

Monitoring standards of care and reporting issues back using Hospice clinical governance structures.

Within the multidisciplinary team, working to ensure that patient dignity is respected at all times both before and after death, including acting as the patients advocate.

Participating in Hospice, PCT and Hospital forums for discussion of research and audit programmes, including contributing to the design and management of practice based audit.

Grief & Loss

Supporting colleagues in managing loss including providing support for distressed patients, bereaved relatives, students and staff.

Supporting and educating colleagues in issues surrounding tissue and organ donation.

Supporting people who are bereaved and Identifying those who are at risk in bereavement, or as they anticipate loss, where required referring them on to appropriate professionals within the team and externally.

Education & Training

Identifying, assessing and helping to meet the information needs of the patient and their family/carers

Identifying own and others learning needs, liaising with the Nurse Consultant or Head of Community Services, and attending training seminars, courses and study days as appropriate, attend mandatory training yearly.

Participating in teaching members of the MDT, through practice, modelling, teaching, and mentorship, ensuring that colleagues are supported to develop their skills in end of life care and to enhance their professional development.

Acting as a mentor to nurses undertaking further studies in palliative care or educational visits/placements with the Team.

Participating in the Hospices Clinical Education Programme and external education programmes delivered through the Hospice Education and Learning Programme (HELP)

Research and Audit

Participating in audit of services on a regular basis so that patient care is continuously reviewed and improved.

Using up-to-date research / evidence to deliver patient care, disseminating this knowledge to all members of the multi-professional team.

Identifying areas of practice within the speciality that would benefit from audit or research and in liaison with the Lead Nurse for Hospice outreach services initiate such enquiry, sharing findings outside the Team through presentations, publication and teaching.

Being aware of current clinical/research trials being conducted within own specialist area and to be able to inform patients about these.

Prescribers

Postholders who are already registered as Independent prescribers must satisfy the Non-Medical Prescribing Lead and Lead Clinician once their probationary period has elapsed, of their fitness to prescribe in their palliative nursing practice in the context of the multiprofessional team. Where newly appointed postholders have not previously worked in specialist palliative care having come from a different practice background, they must undertake specific learning in the speciality such as a degree level symptom management module on an approved pathway and complete an initial period of supervised practice with support from an experienced palliative care prescriber before being considered for resumption of prescribing in practice. Once competence in managing symptoms/palliative care prescribing is attained, the post holder will submit a scope of practice for approval by the Hospices Non-Medical Prescribing Lead and Lead Clinician. Once this has been approved, the post holder may resume prescribing.

Qualifications

Essential

• Registered Nurse
• Degree in relevant area or completing within next 6 months.
• Evidence of further study in Palliative Care

Desirable

• Masters level study in appropriate area
• Advanced Communications Skills Course (MacGuire or similar)
• Teaching qualification
• Independent prescriber
• Clinical assessment skills qualification

Experience

Essential

• Experience of palliative care practice in a variety of settings including hospital, hospice and/or community
• Experience of delivering Teaching/ Training

Desirable

• Experience of working with multiple stakeholders
• Has worked in a specialist palliative care setting.

Knowledge and skills

Essential

• Knowledge of Use of Tools for Advanced Care Planning (at the End
• of Life)
• Awareness of health and safety procedures and how they affect
• people in the workplace.
• Ability to give advice to other professionals while appreciating
• issues of role overlap and the limits of own knowledge
• Understanding of loss and grief and its impact on individuals and families and their social networks
• Working knowledge of relevant statutory and voluntary agencies and
• organisational structures
• A knowledge of the issues related to provision of specialist palliative care in a variety of settings (care homes, home, hospital) and an
• understanding of some of the challenges that may arise.
• Knowledge of current legislation and policy relevant to end of life care.
• Excellent communication and presentation skills
• Participation in audit or research.
• Computer literacy with knowledge of Windows based applications
• A valid UK driving licence and access to own car for daily use
• Ability to work independently and as
• a member of the multi-disciplinary
• team
• Able to manage time and meet deadlines
• Assertive and developed influencing or persuasive skills.
• Excellent problemsolving skills
• Approachable and adaptable.
• Motivated and enthusiastic.
• Ability to manage the emotional impact of working with the dying and
• bereaved: able to be calm in the face of distress and negative emotions
• Demonstrable commitment to anti-discriminatory practice and equal
• opportunities
• A flexible approach to work including an ability to work
• evenings and weekends.
• Ability to undertake training and direct own learning.

Desirable

• Research skills
• Able to demonstrate effective working with members of a variety of professional groups at varying levels of seniority across a number of different organisations

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).