Palliative Care CNS

Job responsibilities

MAIN DUTIES

Clinical Practice

Use advanced communication skills on a daily basis to:

• Use excellent interpersonal skills to support those who have an illness and their family carers.
• Support patients and carers suffering significant losses and distressing conditions from diagnosis to death and into bereavement.
• Support complex care issues with patients and carers, some who may have physical/psychological/social/cultural barriers to communication whilst working in an emotional environment where collusion, hostility and anger exist.
• Provide evidence-based information in a sensitive manner for patients and their carers on all aspects of palliative care, dealing skilfully with highly charged emotional situations.
• Support patients to make informed choices about treatment and care where expert opinion may be highly contentious.
• Explain results of investigations to patients and their family carers, using developed communication skills to provide the information in a supportive manner.
• Establish and maintain effective communication with professionals across health and social care services.
• Influence, negotiate, challenge and empower all health and social care professionals to develop and deliver the highest quality individualised palliative care.
• Establish and maintain therapeutic relationships with patients and their carers throughout the care pathway.
• Act as patient and family advocate as appropriate.
• Perform comprehensive assessment/diagnosis of the specialist needs of patients and their families and plan, implement and evaluate designed programmes of care with them according to changing health care needs, working across hospital and community boundaries as expected of a specialist practitioner.
• Use highly specialist analytical skills and expert judgement to evaluate the appropriateness of referrals and prioritise accordingly.
• Plan and instigate discharge from specialist palliative care caseload, as appropriate.
• Actively manage a clinical caseload and while remaining responsive to the fluctuating and unpredictable needs of patients and carers, consistently deliver the other core components of the role.
• Collect, collate, analyse, evaluate and report information using IT skills.
• Maintain accurate patient records.
• Involve patients and carers/relatives in the planning and delivery of their care and development of services.
• Provide expert advice on symptom management devising care plans.
• Lead and work collaboratively with other professionals and agencies to ensure patients specialist palliative care needs are met, in relation to ongoing needs incorporating psychological problems, spiritual issues, social and financial needs and discharge arrangements.
• Administer prescribed drugs using subcutaneous injections and/or continuous subcutaneous infusions via a syringe driver if required to do so

Professional Leadership/Management

• Work autonomously across hospital and community boundaries.
• Support specialist palliative care multidisciplinary meetings and development planning.
• Lead critical incident analysis for other colleagues on an individual/group basis.
• Evaluate service delivery, identify areas for improvement and initiate change in consultation with senior colleagues/Consultants/Nurse Managers.
• Interpret and implement National, Regional and Local policy frameworks, influence service development, long term strategic planning and provide direction within specialist area.
• Make recommendations to ensure the effective and efficient use of physical and financial resources, supplies and equipment within the specialist area to improve and inform practice.
• Monitor health, safety and security of self and others to promote best practice in the community / ward / department and/or area of speciality.
• Delegate admin tasks to the admin team appropriately to ensure best time management
• Contribute to and influence the strategic planning and development of the palliative care services across the catchment area.
• Directly influence the development of policy and services beyond the boundaries of palliative care through participation in and recommendation to other disciplines.

Clinical Governance

• Identify need for and lead on research, clinical audit and benchmarking in order to inform practice and improve effectiveness of patient care.
• Analyse data from audit/research and disseminate finding through presentation to professional groups and publication.
• Lead on the implementation of audit/research in the specialist area.
• In Collaboration participate in the development and implementation of policies, protocols, procedures and guidelines relevant to own area of work supported through participation in specialist forums/groups (local, regional and national) and through Hospice Policies.
• Contribute to the production of an annual report circulating it widely and appropriately.
• Participate in a regular service review.
• Promote patient and public involvement activities in the specialist area, leading to service improvement.
• Promote peoples equality, diversity and rights.
• Be involved in the investigation and response to complaints.
• Participate in Personal Development Plan process. Agreeing development plans for identified needs with a clinical supervisor/mentor.
• Facilitate and engage in clinical supervision for, and with other Clinical Nurse Specialists to suit individual needs.

Education and Training

• Support the planning, design, implementation and evaluation of programmes of education in palliative care to meet identified needs for hospice, hospital and community staff.
• Within specialist field identify learning needs of student nurses, doctors, clinical support workers and AHPs within NLCCG, Hospital and independent and voluntary sector.
• Provide training for health & safety care professionals in required areas of palliative care.
• Produce patient information and learning resources with support of the communications department
• Keep up to date with developments in specialist palliative care to ensure advanced clinical practice and education programmes represent current best practice.
• Address specific health target e.g. NICE, CQC, NSF related to own area of practice through education.
• Ensure own compliance with regard to mandatory training and PREP requirements.
• Provide education and support for patients and their relatives/carers. Professional responsibilities
• Maintain professional registration and work within Nursing and Midwifery Councils (NMC) Code of Professional Conduct at all times. Also to work within other NMC statutory guidelines such as Confidentiality, Record Keeping, Accountability, Scope of Practice and Administration of Medicines.
• Use lifelong learning to continue professional development relevant to the role and personal needs..
• Attend Team Briefing and Staff Meetings.
• Advise management of any factors which may affect the treatment given to patients, and to produce reports in writing when requested. Report and assist in investigation of patient complaints.
• Report to the Director of Nursing & Quality all incidents of injury to patients or self. Complete Incident forms within 24 hours, or in case of weekends or Bank Holidays, as soon, as is practicable.
• Adhere to all protocols and procedures of St Johns Hospice.
• Ensure that all statistical returns and expense sheets are submitted promptly.
• Notify the Head of Community Services of any sickness/absence and report return to work immediately in accordance with Hospice Policy.

Due to the Hospices commitment to continuous improvement, it is likely that the post will evolve over time.

These duties will be subject to regular appraisal and any amendments will be made in consultation and agreement with the post holder.

The above list of duties and responsibilities is not intended to be fully comprehensive and may be amended to take account of changing circumstances or requirements following consultation with the post holder.

Where necessary relevant training in the operation of new or unfamiliar equipment, software or procedures will be provided or arranged.

• OTHER- please see uploaded job description

Experience

Essential

• Extensive post qualification experience, including significant experience in palliative care.
• Evidence of management and leadership experience.
• Evidence of continued professional development in palliative care.
• Evidence of teaching and developing staff.
• Experience of and ability to work as a member of the multidisciplinary clinical team.
• Experience of undertaking audit.

Desirable

• Experience of undertaking research.

Skills & Attributes

Essential

• Ability to lead and influence change.
• Exercises a high degree of autonomy within specialist area.
• Ability to motivate self and others.
• Knowledge of clinical governance and its application.
• Ability to develop standards of care.
• Committed to Continued Professional Development of self and others.
• Conflict and problem solving, negotiation skills.
• Ability to concentrate in an unpredictable work environment.
• Understanding of current Health & Social care issues and initiatives.
• Ability to apply research into practice.
• Exceptional organisational and time management skills.
• IT Literate.
• Highly developed expert communication skills both verbal and written.
• Ensure that own actions support equality, diversity, rights and maintain quality.
• Adaptable to the changing needs of the service.
• Self-motivated, enthusiastic, innovative, flexible.
• Approachable.
• Assertive.
• Able to deal with difficult and sensitive situations with tact and diplomacy.
• Able to prioritise a range of tasks under pressure.

Desirable

• Confident in electronic patient records.

Qualifications

Essential

• Registered nurse (1st level).
• Educated to degree level or equivalent.
• Advanced Assessment skills.
• Evidence of recent study at Masters/post graduate/Highly specialist level in a relevant area or prepared to work towards.
• Post-registration qualification in palliative care.

Desirable

• Non-Medical Prescribing qualification.
• Examination & Diagnostic Skills.
• Teaching qualification.
• Advanced Communication Skills Training.

Other

Essential

• Full UK manual driving licence with use of own vehicle during working hours. Must hold insurance cover which includes business use.

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).