Clinical Nurse Specialist in Palliative Care, Queen Elizabeth Hospital

Job responsibilities

Job Summary

The Clinical Nurse Specialist delivers evidence-based palliative and end of life care to patients with any diagnosis and to their carers/families. They 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 (symptom management, practical spiritual and emotional support), to patients and 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 closely with multiprofessional colleagues in a cohesive palliative care team. Participate in the seven days a week visiting service, and (Community only) in the 24 hour on call advisory service (from home)

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 in these ways:

- Act 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.

-Make expert assessments of patients and carers, identifying their psychological, physical, social, practical and spiritual needs in accordance with Hospice philosophy and demonstrating and applying an in depth knowledge of the options for achieving control of symptoms to develop a plan of care to meet their needs Be a reflective practitioner, applying evidence based practice and critical thinking to all practices and processes of care.

-Understand the boundaries of own expertise/role and work with others to achieve best possible outcomes for the patient and their families/carers. Avoid role clash, respect and complement other professionals and informal carers capabilities.

- In consultation with colleagues in the multiprofessional team and those professionals who are involved in the patients care, review patients independently, initiating changes as required.

- Work collaboratively with other professionals involved in the patients care in any setting, providing a co-ordinated, high quality service.

- Prioritise own workload day to day in the light of the demand on the whole service.

- Provide 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.

- Promote patient autonomy, providing information, empowering others. Be an advocate allowing the individual to make informed choices about their own care.

- Participate 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. (NB When working in the community only)

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

- Ensure that all necessary documentation is fully completed on the Hospices electronic patient record, and any other patient records, (eg Hospital or community nursing/other records, and Urgent Care Plans).

- Fully use the Hospice electronic patient record to make referrals to other Hospice services, communicate with colleagues about patient care, enable accurate reporting, demonstrate accountability for professional practice and fully understand the patients palliative care journey.

- Participate in clinical supervision.

- Represent the Hospice at external fora when requested.

Communication

- Foster positive working relations with all members of hospital, hospice, social care and primary healthcare teams.

- Participate in multidisciplinary and family meetings about patient care.

- Practise excellent communication skills with patients, family and colleagues

- Help patients formulate an individual Urgent Care Plan Access other electronic records as appropriate.

Quality

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

- Monitor standards of care and report issues using Hospice clinical governance structures.

- At all times work to ensure that patient dignity is respected, before and after death.

- Participate in Hospice, and other local fora for discussion of research and audit.

- Contribute to the design and management of practice based audit.

Grief & Loss

- Support colleagues in managing work related stressors.

- Provide support for distressed patients, bereaved relatives, students and staff.

- Recognise own limitations

- Support and educate colleagues in issues surrounding tissue and organ donation.

- Support people who are bereaved and identify those who are at risk in bereavement or as they are anticipating loss. Identify when onward referral to appropriate professionals is required. Education & Training

Education & Training

- Identify and help to meet the information needs of the patient and their family/carers

- Identify own and others learning needs, seeking advice when needed from colleagues/Nurse Consultant.

- Engage in appropriate learning opportunities to support and enhance performance in role; fulfil regular mandatory training requirements

- Participate in teaching and sharing palliative care knowledge/skills learning. Achieve this 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.

- Act as preceptor to novices taking up roles within the field of specialist palliative care, and as a mentor to nurses undertaking further studies in palliative care or educational visits/placements with the Team.

- Participate in sharing learning within the Hospice and on external courses delivered by the Hospice Education and Learning Partnership with St Christophers Hospice (HELP).

Research and Audit

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

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

- Identify areas of practice that would benefit from audit or research and initiate such enquiry, sharing findings outside the Team through presentations, publication and teaching.

- Be aware of current clinical/research trials being conducted within own specialist area and 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 postholder will submit a scope of practice for approval by the Hospices Non Medical Prescribing Lead and Lead Clinician. Once this has been approved, the postholder may resume prescribing.

Experience

Essential

• - Evidence of having worked in a senior role eg B6 and above
• - Experience of palliative care practice in any setting including hospital,
• and/or hospice and/or community
• - Experience of delivering teaching/training

Desirable

• - Experience of working with multiple stakeholders
• - Experience of working in both community and hospital and
• - Experience of having worked in a specialist palliative care setting.

Skills, Knowledge and abilities

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 Continuing Health Care and other relevant
• legislation/regulation
• - 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 policy relevant to end of life care.
• - Excellent communication and presentation skills
• - Computer literacy with knowledge of Windows based applications
• - A valid UK driving licence and access to own car for daily use

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
• - Knowledge of local health economy in Greenwich and Bexley
• - Evidence of participation in audit or research.

Aptitude, Personal Characteristics

Essential

• - Ability to work independently and as a member of the multi-disciplinary team
• - Able to manage time and meet deadlines
• - Assertive with well 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 and to be calm in the face of distress/negative emotions
• - An understanding of the mission and values of Greenwich & Bexley
• Community Hospice
• - Demonstrable commitment to antidiscriminatory practice and equal
• opportunities
• - A flexible approach to work including an ability to work (evenings
• community) and weekends.
• - Ability to undertake professional development, direct own learning.

Qualifications

Essential

• - Registered Nurse
• - Degree in relevant area or evidence of working towards same
• - Evidence of further study in Palliative Care

Desirable

• - Masters level study in relevant area
• - Advanced Communications Skills Course
• - Teaching qualification
• - Independent prescriber
• - Clinical assessment skills qualification

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).