Job responsibilities
The post holder is an experienced nurse who, acting within their professional boundaries will provide care for the patient from referral, history taking, clinical assessment, diagnosis, treatment and evaluation of care. They will demonstrate safe, clinical decision making and expert care. They will be able to demonstrate critical thinking in the clinical decision-making process.
The post-holder will work collaboratively with colleagues to best meet the needs of the patient, supporting delivery of policy and procedures and providing nursing leadership as required. In order to work at this level, RCN requirements for advanced practice must be met.
This role also requires some flexibility to meet the needs of the service.
Principal Responsibilities:
To function as part of the medical team led by the Medical Director
Use advanced practice skills to identify, assess, diagnose, treat and manage patients with palliative care needs.
As part of a multidisciplinary team exercise complex levels of judgement, discretion and decision-making in clinical care
Make appropriate use of the latest evidence base to supervise practice, audit clinical care, teach and support professional colleagues and to provide skilled leadership to clinical decision making
To champion innovative practice within the field of hospice and end of life care and work closely with both the Medical Director/CEO/Registered Manager/Quality Assurance Team to develop progressive professional practice policies.
The Advanced Nurse Practitioner will demonstrate and work as part of the medical team at an advanced practice level applying their extended knowledge and skills in the principles and practice of palliative care settings as required by the hospice strategic plan.
To utilise advanced communication skills when interacting with patients families.
To work as part of the hospice specialist palliative care team, carrying out a high standard of holistic clinical assessment, determining and providing plans treatment/ interventions, advice or support as appropriate.
Manage a caseload of patients whenever the clinical need arises
Maintain clinical records in line with hospice, NMC, RCN and GDPR guidance
Uses advanced clinical skills and judgement to diagnose, plan, implement and evaluate care for patients with complex palliative needs throughout the hospice, community and via telephone advice line.
Anticipates problems and risks and takes action before crises arise.
Fulfils the requirements of being a non-medical prescriber in keeping with RCN guidance and hospice policy.
As an independent prescriber, prescribes medicines for patients in accordance with local policies, national standards and formularies relating to independent prescribing
Undertakes medication reviews with patients and takes a proactive approach in ensuring patients understanding of their medication
When on-call at weekends and bank holidays, will attend ward to assess, reassess and review patients instigating treatment for symptom control and psychological support.
Admits patients at weekends and out-of-hours as appropriate.
Provide advice to patients and professionals as required.
Provides a source of expertise to all health care practitioners, including undertaking joint assessments as required.
Identifies clinical issues and incidents within the specialty that may affect the quality of palliative care services raising with medical director and CEO/Registered Manager as appropriate to ensure the delivery of a safe, effective service.
Participates in the allocated duties and responsibilities of the medical team covering the in-patient unit.
Liaises daily with the medical and nursing teams and ensures all are kept fully briefed of all palliative care patient activity under the responsibility of the advanced nurse practitioner.
Ensures senior nurse managers and nursing and therapy colleagues are aware of clinical activity ensuring the role links appropriately with all other nursing and therapy interventions in the best interests of the patient.
Demonstrates leadership skills when undertaking the clinical assessment process and when planning and delivering care.
Actively promotes the rehabilitative and therapeutic approaches to specialist palliative care.
Motivates all staff and other through providing training, supervision and mentorship.
Applies a repertoire of interpersonal skills in response to the different needs of staff and colleagues
Encourages proactivity and innovation amongst the MDT and demonstrates flexibly within parameters of hospice policies
Acts as role model and is accountable for own professional actions and decisions
Leads the development of ideas and specialist practice within the scope of the role.
Innovates through exploring ideas with other and takes action which brings in different ways of working.
Works with Medical Director and CEO/Registered Manager to ensure development of progressive professional practice policies.
Ensures the delivery of high quality, clinically effective care by prioritising and using research and audit in practice
An active participant within the clinical audit and quality improvement group and clinical governance committees and work plan as required and directed by Medical Director.
Leads on specific projects required and directed by Medical director and CEO/Registered Manager
Identifies and supports audits and evaluation and work that may be required to develop and improve palliative/ end of life care for patients and their carers.
Identifies and supports quality improvement initiatives and evidence based in service development plans/ projects wherever possible
Manages own time and work effectively to meet objectives and requirements of the role.
Is proactive as part of the clinical team in ensuring the totality of hospice skills are used to best effect to ensure appropriate and timely responses for patients.
Makes proactive use of the multidisciplinary team discussions and review meetings to ensure skills, expertise and use of hospice and professional resources are utilised in the patients interest
Is aware of the local policies of partner organisations with regard to care practices, treatments and prescribing formularies.
Contribute to the clinical governance process
Supports the implementation and monitoring of clinical practice guidelines including standards, policies and protocols in line with local, regional and national directives.
Facilitates and participates in reflective reviews of palliative care.
To be aware of ones own continuous professional development needs and maintain an annual personal develop plan in association with Medical Director.
Actively participates in clinical supervision and resilience training.
Influences the setting and monitoring of standards of practice, ensuring cost-effective delivery and evidence-based care.
Continuous quality improvement through care review.
Work with other disciplines to optimise integrated care and coordinated care
Maintain links with other Palliative Care Specialists in order to share or learn examples of good practice.
Critically evaluate relevant research findings in order to develop practice
Represents the hospice and the work of the hospice at local, regional and national level as required through conference presentations.
- As part of their duties the employee will work as a Non-Medical Prescriber at the Hospice.
- Must work in line with contemporaneous Hospice Non-Medical Prescribing Policy and Medicines Policies.
- Must maintain registration with the appropriate professional body as a non-medical prescriber and provide registration details annually to HR for their records.
- Must work within the standards and codes of professional conduct as set out by appropriate regulatory bodies (see below), as well as all Hospice Policies and Procedures:
o Nursing and Midwifery Council: Standards for Non-Medical Prescribers
OR
o Health and Care Professions Council: Standards for Prescribing.
- Must maintain appropriate and up to date Continuous Professional Development (CPD). Maintain evidence of competency as described in the Royal Pharmaceutical Society Prescribing Competency Framework adopted by the Hospice.
- Must only prescribe for patients whilst they are appropriately admitted to Halton Haven Hospice In-Patient Unit (IPU) or Day Hospice
- Must not prescribe for yourselves or for anyone with whom you have a close personal or emotional relationship.
- Must prescribe according to relevant evidence-based guidelines and formularies - whilst working within your own level of professional competence and expertise.
- Must maintain appropriate indemnity insurance which covers your prescribing and provide details annually to HR for their records.
Will be accountable for all aspects of your prescribing decisions, including actions and omissions.
