Job responsibilities
WORCESTERSHIRE ACUTE HOSPITALS NHS TRUST
JOB DESCRIPTION
Post
Title: Clincal Nurse Specialist in Palliative Care
Pay
Band: 7
Hours:
Contract:
Location / Department: Worcestershire Royal Hospital /Alexandra
Hospital
Accountable to: Chief Nurse
Reports to: Lead Nurse Specialist
Palliative and End of Life Care
Ref:
Key Working Relationships:
Internal (Acute
Trust)
Upper GI Support Nurse, Lung Cancer Support Nurse,
Patients, Relatives/carers, Oncology Medical and Nursing Teams. Medical and
Surgical Teams, Outpatients, Physiotherapy, Occupational Therapy, Discharge and
Care Co-ordinators, Social Services, Dietetics, Radiology, Haematology,
Biochemistry, Infection Control, Chaplaincy, Pharmacy, Bereavement Office, All
nursing staff CNSs, matrons, ward teams and outpatients, Directorate
Managers, Multi-Professional Teams, Medical Records, Palliative Care Teams in
other acute settings.
External
(Primary Care Team)
Community Palliative Care Team: Redditch and Bromsgrove, Malvern, Wyre Forest, Pan Birmingham,
Warwickshire, St Richards Hospice, Kemp Hospice, Kidderminster Hosptial and Wyre Forest Ward. Primrose at the Princess Palliative Care Unit
Bromsgrove, Macmillan Unit Evesham, Primrose Cancer Help Centre and
Hospice, Hospices, Bereavement Services, Community Hospitals, GPs, District
Nurses, Hospital at Home, Red Cross, Nursing and Residential Homes.
Risk Assessment:
VDU prolonged periods inputting data and information.
Manual Handling.
Frequent exposure to body fluids when caring
for patients.
Infection risks.
Occasional aggressive verbal behaviour from
patients and carers.
Occasional exposure to cyctotoxics.
Continuous exposure to emotional and
psychological distress from patients, carers and staff that are associated with
palliative care issues, ie. Frequently imparting news of terminal
illness/bereavement.
Job
Purpose:
To work as a clinical nurse specialist
practitioner in palliative care across the accepted domains of the role as a
clinician, educator, researcher and manager.
To work as a member of a hospital
based specialist palliative care team, as part of the wider primary and
secondary muti-disciplinary teams and the independent sector to ensure a
cohesive, holistic and research based approach to the management of palliative
care patients.
The role will be innovative
and encompass all aspects of the patient care pathway, acting and a nurse
advisor to support patients and their carers with cancer or a life threatening
illness, within a formal/informal setting.
The role will provide highly specialist nurse input to the
palliative patient in line with government directives.
Key Duties:
Clinical/Professional
Constantly practices autonomously by assessing and effectively
prioritising referrals to the service in order to deliver patient focused
appropriate care in the context of a whole service approach.
Provide a specialist and holistic palliative care assessment of
patients and their carers needs following referral, which realistically
minimises physical symptoms and the social, financial, emotional and spiritual
implications of the disease process.
In negotiation with the patient, their carers, and the wider
multidisciplinary team, formulate a plan of care using specialist knowledge and
skills dependent on the level of specialist intervention required.
Provides highly specialist care and advice for patients and
carers, and assists the multidisciplinary team in delivering and evaluating the
interventions/ plan of care, reviewing and amending this care as appropriate.
Frequently acts as a primary resource for site-specific specialist
nurses, nursing/medical teams and the multi disciplinary team.
Acts as a key-worker in co-ordinating care across different
professionals and agencies. Facilitates and assists with complex discharge
planning to home, hospice or other facility.
Regularly assesses patient for inpatient admissions to specialist
palliative care level 2 bedded units. Has admission rights to palliative care
inpatient unit in liaison with Consultant in Palliative Medicine.
Frequently elicit and analyse complex patient/carer/ family
reaction, needs, dynamics occurring throughout the patient/carers journey.
Instigate action to facilitate the development of a therapeutic relationship
between the patient/carer and members of the MDT to enhance intra-family
communication.
Frequently initiates and participates in highly sensitive and
complex communication issues with patients, carers, nursing/medical teams;
including pre-bereavement support, advice and imparting life changing news, e.g
a terminal illness.
Regularly attends oncology, palliative care and other appropriate
consultant clinics, providing highly specialist advice and support.
Regularly participates and contributes to relevant site-specific
multidisciplinary team meetings.
Regularly reviews and develops appropriate patient documentation
in line with Trust policy and Department of Health recommendations.
Participates and contributes to cancer network meetings to ensure
the profile of palliative care is maintained.
An understanding of the National Cancer Agenda and its impact on
cancer service delivery in practice.
Be involved in the consultation of a 24 hour palliative care
advice service in line with Department of Health guidelines.
To offer a nurse prescribing service to palliative care patients
in line with Department of Health and Acute Trust guidelines which will reduce
patient and carers distress by being able to prescribe immediately and
appropriately in response to patient needs.
Uses a palliative care database that includes patient
registration, clinical details and interventions that are shared with the community
palliative care team, the consultant in Palliative Medicine, the Primrose
Hospice and the inpatient palliative care unit.
To participate in a 7 day palliative care visiting service that
includes weekends and bank holidays.
Education
Constantly acts as a resource for information on specialist
palliative care within the Worcestershire Acute Hospitals NHS Trust,
disseminating evidence based knowledge and skills to clinical staff at levels.
Effectively utilises informal education opportunities with
patients, carers and professionals.
Educates patients and their carers in the understanding of their
illness, treatments and provides other sources of information, help and
support.
Plan and coordinate formal and informal educational programmes to
involve all aspects of generic and specialist palliative care within the acute
and community trust, and for other agencies e.g The Primrose Hospice, St
Richards Hospice.
Specifically identifies the educational needs of
multi-professionals and delivers programmes to meet these needs, locally and as
part of a county wide network.
Participates in county wide palliative education initiatives and
development, e.g the Palliative Education Strategy.
Works in conjunction with the Consultant in Palliative Medicine to
provide education and training to rotational specialist registrars and the
induction of medical and surgical house officers.
Provides placements/mentorship for professionals studying palliative
care/oncology at undergraduate and postgraduate level.
Develops and produces written information for patients, carers and
professionals on palliative care services.
Research and Audit
Ensures clinical effectiveness by critically appraising current
research and applying it to practice.
Develops and participates in appropriate nursing and medical
research.
Undertakes research relevant to palliative care following Trust
guidelines, disseminating findings to the multi-professional team.
Regular audit of issues relevant to current service provision,
reviewing and amending practice as a result.
Co-ordinates the development, implementation and review of
relevant nursing policies, procedures and documentation, ensuring a consistent
evidence based approach to patient care.
Personal and Professional Responsibilities
Maintains a programme of personal and professional development by
attending in-service training and utilising relevant educational opportunities.
e.g, courses, conferences, seminars.
Functions effectively as a specialist practitioner in line with
the recommendations of the Nursing and Midwifery Council and the Department of
Health and operates as a member of the Palliative Care Team and wider
multidisciplinary teams.
Uses clinical supervision to maintain and improve practice.
To be alert to ones own psychological health needs with reference
to working in palliative care and the needs of others and to be able to receive
and offer support when needed.
Work with the service manager in developing service policy and
delivery, participating in projects, education and consultation as appropriate.
Maintain high professional standards of care and professional
expertise.
