Registered Mental Health Nurse, CARIAD Palliative Dementia Care

Job responsibilities

JOB PURPOSE -To work effectively as an autonomous practitioner within a multidisciplinary palliative care team, promoting and maintaining quality of life for patients with dementia, cancer or other life limiting illnesses requiring palliative care and into bereavement for relatives and carers.

Provide engage in the assessment of complex symptom and psychological problems, provide support, advice and leadership to healthcare professionals in line with national and local guidelines ensuring a cohesive, holistic and evidence-based approach to the management of palliative patients. To empower and equip healthcare professionals with skills and knowledge to deal with a variety of less complex problems through education and being an available resource.Contribute to the development of the service through research and audit. Promote and facilitate the implementation of evidence based palliative care throughout Blaenau Gwent.

ROLE OF DEPARTMENT -The aim of the CARIAD service is to provide high quality palliative care for people with dementia and their families who are experiencing complex symptoms that are not being effectively managed by generalist practitioners. This work aims to enable them to remain in their identified preferred place of care, avoiding unnecessary admission to hospital.

The service provides high quality, comprehensive education, for health and social care professionals and carers of people with dementia, facilitating an improved understanding of the disease process of dementia, the value of early implementation of a palliative care approach and recognition of the importance of advanced care planning

Contribute to the campaign to raise public awareness of dementia on matters relating to death and dying, supporting families to have difficult and sensitive discussions and address the issue of advanced care planning. Support and facilitate choice and the fulfilment of the wishes of people with dementia.

SCOPE AND RANGE -Carry a complex caseload and in doing so undertake the generic responsibilities required of all Registered Mental Health Nurses. Work in collaboration to deliver sustained improvements in performance, quality and consistency of practice across the team. Thereby achieving the best outcomes possible for adults living with dementia.

Develop innovative ways of working to ensure positive outcomes for those receiving the service. Represent and promote the service in relevant multi agency meetings;

To ensure the transfer of knowledge and sharing of best practice across the Team and Services.

To ensure effective partnership working and engagement to achieve and deliver these objectives.

To formulate, design and deliver expert evidence-based interventions.

To engage in the strategic development of the Team and Service.

MAIN TASKS, DUTIES AND RESPONSIBILITIES -To work autonomously, assessing patients and carers, with complex physical, emotional, social and psychological symptoms on a daily basis to enable an appropriate plan of care to be developed within the community, day centre or care home setting.

To provide leadership, support and give specialist clinical advice to health care professionals, patients and carers, concerning the care and treatment for palliative patients in all areas, hence ensuring effective decision making can be reached and appropriate treatment plans are developed. This will include frequently advising on medication, psychological issues and further treatments.

Frequently working with nurse prescribers prescribing mediation and assessing effectiveness.

To establish and maintain effective communication relating to complex, sensitive and potentially stressful situations on a regular basis. Breaking bad news with patients, carers, relatives and other professionals throughout the patients illness. Supporting relatives, carers and staff in bereavement with the ability to recognise and refer on for complicated grief reactions.

To identify, organise and evaluate specialist intervention in response to complex needs on a daily basis. This includes identifying crisis / deterioration / medical / palliative care emergencies, options and liaising with appropriate member of the multidisciplinary team. Analysing clinical options, liaising with appropriate member of the multidisciplinary team.

To contribute toward the development of protocols and policies in this specialist field of practice and act as a resource in all areas of the community, leading to service development.

To contribute to case conference, multidisciplinary team and strategic meetings on a regular basis to enable complex and ethically challenging decisions to be made regarding treatment plans.

Frequently contribute toward a core training programme relating to the specialist area for all Hospice staff and wider community including primary healthcare teams, social services staff and the voluntary sector, which encompasses negotiating and influencing changes in professional practice to a multi-professional workforce.

To develop own and others knowledge and practice in order to influence clinical decision making across professional and organisational boundaries.

To maintain accurate and contemporaneous records. To input and retrieve patient information from computer-based systems.

To use enhanced levels of both verbal and non-verbal communication and inter-personal skills with patients, relatives and carers, other multidisciplinary teams and multiple outside agencies.

KNOWLEDGE, SKILLS AND EXPERIENCE REQUIRE

Registered Mental Health Nurse.

A minimum of 5 years in-depth NHS experience, of which 2 years should be contact with dementia,palliative care, oncology or community.

Evidence of clinical specialist qualification at post-graduate level.

Ability to identify learning needs in others, and to utilise education opportunities.

Ability to demonstrate contribution to policy development.

Basic level competence in the standard range of IT programs.

Able to demonstrate excellent interpersonal and communication skills.

PRACTICE, EDUCATION & SERVICE DEVELOPMENT

To take personal responsibility for keeping up to date with legislation, research findings and practice knowledge, including attendance at appropriate training;

Contribute to training and practice development.

Contribute to qualifying and post qualifying education curricula development and in the promotion of the Nursing pathway.

Provide training within the team and clinical services.

To support the provision of learning opportunities.

To comply with Gwent Safeguarding Boards Safeguarding procedures and practice.

To ensure the maintenance of such records and management information systems as appropriate.

Facilitate training and education to wider stakeholders, in line with funding acquired within the service.

EQUIPMENT AND MACHINERY

Post holder will be provided with a mobile telephone, laptop, and guardian 24 device for lone working.

SYSTEMS -The post holder will be responsible for working within the policies and procedures of the organisation and will be responsible for updating policies relevant to the service area. The employee handbook will be provided which will outline all relevant policies and processes.

DECISIONS AND JUDGEMENTS -High-level assessment, problem solving and decision-making skills will be required.High-level assessment, problem solving and decision-making skills will be required.

PHYSICAL, MENTAL, EMOTIONAL AND ENVIRONMENTAL DEMANDS OF THE JOB

Physical Effort

Working in an open plan office where confidentiality and sensitive conversations are difficult due to noise level.

Concentration required for patient related activities with an unpredictable environment where patients may display anger, abuse or extreme emotion.

Ability to manage challenges and possible conflict with other professionals in the process of ensuring best practice is established.

Working within all aspects of Health and Safety at Work and Governance guidelines to ensure they are adhered to and to highlight to appropriate staff when health or safety of staff, patients or carers is at risk.

There is a requirement that the post holder will drive.

Mental Effort

Be expected to deal with frequent interruptions due to the unpredictability of the work and service user group.

Be required to exert prolonged periods of concentration during assessments, report writing and documentation.

Problem solving for service users, their family members and carers who have complex needs.

Emotional Effort

Frequently work with service users and their carers who sometimes exhibit challenging and emotional behaviours and will potentially be exposed to distressing and emotional circumstances.

To support Hospice patients, families and carers in making decisions about their future needs as they adjust to a new and changing situation, and offer appropriate interventions. This includes work with Hospice patients, families and carers coming to terms with the illness and possible death of someone close.

MOST CHALLENGING/DIFFICULT PARTS OF THE JOB

Challenging healthcare professionals decisions and practice from an advisory and teaching role to ensure all patients have access to equally high standards of care.

Dealing with highly complex situations such as loss, grief and death on a daily basis.

Communicating bad news to terminally ill patients and their relatives / carers on a regular basis.

Being involved in the care and support of people with complex needs relating to their dementia diagnosis and managing the distress and upset this brings;

Some involvement in ethical decision making and dilemmas.

Supporting staff in residential, nursing and local mental health care units.

Working within a fast paced and ever-changing clinical environment.

Managing safeguarding concerns.

Lone working

Qualifications

Essential

• Registered nurse / RMN / RNLD.
• Degree (or will work towards).
• Advanced communication skills training (or willing to work towards).
• Current driving licence.
• Non-medical prescriber (or willing to work towards).

Desirable

• Qualification in palliative care or relevant modules at diploma / degree level.
• Community Nursing qualification.

Experience

Essential

• Post registration experience in a variety of settings.
• Significant experience at Band 5 in specialist palliative care or caring for palliative care patients in a community or hospital setting.
• Experience and knowledge of symptom management.
• Experience of managing a caseload.
• Experience of communicating regarding complex, sensitive issues with patients, carers and professionals.
• Experience of implementing change.
• Awareness of key policy drivers.
• Experience of multidisciplinary and multi-agency working.
• Understanding loss and grief and its impact on individuals and families.
• Experience in implementation of aspects of the clinical governance agenda.
• Experience of managing and prioritising a variety of responsibilities.
• Experience of participating in service development.
• Knowledge of advance care planning.
• Specialist palliative care experience.
• Community experience.
• Experience chairing a group.
• Experience of presenting to a group.

Skills and Knowledge, special aptitudes

Essential

• Demonstrates clear and advances communication skills; written, verbal and non-verbal.
• Understanding of and ability to implement aspects of the clinical governance agenda.
• Ability to facilitate change, motivating and influencing staff over whom no management relationship exists.
• Able to establish and maintain credibility with a diverse range of professionals and lay people.
• Able to develop effective interpersonal relationships with a diverse range of professionals and lay people.
• Demonstrate the ability to identify personal development needs, fulfil them and apply the learning to practice with demonstrable outcome.
• Excellent planning and organisation skills.
• Ability to supervise students and other staff.
• Ability to assess risk regarding self and others and take appropriate action.
• Ability to apply effective leadership skills, responsive to a wide variety of circumstances.
• Able to work independently and deliver objectives within a given timeframe.
• Able to advocate for others, representing their views in an objective manner.
• Able to access information from different sources and use critical appraisal skills.
• Computer literacy with ability to use email, internet, Word, electronic records and literature searching.

Desirable

• Experience in taking part in research.

Personal qualities and circumstances

Essential

• Ability to form professional relationships within a multidisciplinary team.
• Excellent interpersonal skills.
• Motivated and enthusiastic.
• Ability to work independently and as a member of the multidisciplinary team.
• Approachable and adaptable.
• Ability to manage the emotional impact of working within palliative / dementia care.

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).