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Clinical Nurse Specialist

Daughters of CharityDublinFull-time

Clinical Nurse Specialist – Care of Older Person
St Josephs - Clonsilla

1 WTE Permanent Post (39 hpw)

Req No. CNS / 19265

Daughters of Charity Disability Support Services, provides community and campus based services to people with an intellectual disability. We are looking for candidates who are committed to supporting people with disabilities and their families, in a person centred, community based, socially inclusive manner in accordance with our core values and national standards, and underpinned by quality, best practice and research.

Successful candidates will be an integral part of the specialist multidisciplinary team and will provide specialist nursing input to co-ordinate the care of a defined case load of service users with complex and diverse needs using evidence-based specialist nursing skills and person centred principles.


The successful candidate will have the following essential requirement

  • Registration with the Intellectual Disability Division of the Register of Nurses
  • Have a minimum of five years’ post registration experience, of which two must be in the specialist area.
  • Have the ability to practice safely and effectively fulfilling his/her professional responsibilities within his/her scope of practice.
  • Maintained annual registration with the NMBI.
  • Demonstrate evidence of continuous professional development.
  • Competent and possess an in depth knowledge and experience of the Microsoft Suite.
  • Excellent communication, interpersonal, teamwork and effective caseload management skills.
  • Full driving license with access to own transport
  • Applicants should possess Level 2 behavioural competencies of DOCDSS competency framework which can be found below the Job Description on this Advert .

Desirable

  • Post graduate qualification in the specialist area or show evidence of commitment to completing level 8 /9 in the specialist area

Applicants who were trained outside of Ireland need to submit a statement of equivalence from the Dept. of Health and Children with their application.

*Informal enquiries can be made to: Karina O’Sullivan, Nurse Practice Development Coordinator,
By email; karina.osullivan@docservice.ie or by Phone: (087) 3365610


We are unable to shortlist Applications, unless the following is submitted by all Candidates, including internal Staff:

  • CV
  • and a copy of relevant qualifications detailed on the advert to be submitted in ONE PDF Document


Closing date for receipt of applications: 8th July 2019

Daughters of Charity Disability Support Services Limited is an equal opportunities employer

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FULL JOB DESCRIPTION

JOB DESCRIPTION

JOB TITLE: Clinical Nurse Specialist (Care of the Older Person with an intellectual disability)

LOCATION OF POST: St Joseph’s Centre Clonsilla Dublin 15.

EQUIVALENT HOURS: Full time 39 hours per week (1 whole time equivalent)

REPORTING RELATIONSHIP: Service Manger operationally and to the Nurse Practice Development Coordinator professionally and clinically through to the Director of Nursing.

PURPOSE OF THE POST: St Joseph’s Service is predominately a service for the older person both centre based and for service users who have transitioned to local community living.

The application of gerontology focused knowledge and skills of the CNSp in care of the older person with intellectual disability will provide for the care and on-going management of service users with conditions relating to the ageing population and supporting positive ageing.

The post holder will be required to work as a key member of the multi-disciplinary team within the service providing physical, psychological and emotional support to the older person, their families and/or carers throughout the ageing process. The CNSp will provide a specialist service for the older person in St Joseph’s as well as providing an outreach service to service users in the Dublin service.

The CNSp in care of the older person with an intellectual disability will deliver care in line with the five core concepts of the role set out in the framework for the establishment of a clinical nurse specialist posts .

The CNSp in care of the older person with an intellectual disability also has a role in developing and delivering education/ training packages which highlight the role of the CNSp within the population of the older person in St Josephs and across the Dublin Service

The CNSp in care of the older person with an intellectual disability provides consultations and training for staff and other professionals providing advice on how to support individuals who are ageing.

The clinical nurse specialist in care of the older person with intellectual disability will base their practice on the five core concepts of clinical nurse specialist role as defined as:

• Clinical Focus

• Service user advocate

• Education and Training

• Audit and Research

• Consultant

Clinical focus:

The CNSp will have a strong service user focus whereby the specialty defines itself as nursing and subscribes to the overall purpose, functions and ethical standards of nursing. The CNSp will model excellence in clinical practice and clinical decision making and promote a person centred approach to the nursing care of the older person with intellectual disability. The clinical practice role may be divided into direct and indirect care. Direct care comprises the assessment, planning, delivery and evaluation of care to the services user, family and/or carer. Indirect care relates to activities that influence and support the provision of direct care.

Clinical focus - Direct care:

The Clinical Nurse Specialists Care of the Older Person with Intellectual Disability will

  • Practice nursing according to the Code of Professional Conduct and Ethics for Registered Nurses and Registered Midwives (NMBI 2014) and the Scope of Nursing and Midwifery Practice Framework (NMBI 2015) as laid down by the Nursing and Midwifery Board of Ireland (An Bord Altranais agus Cnáimhseachais na hEireann).
  • Adhere to national, regional and Daughters of Charity Disability Support Services/Health Service Executive (HSE) best practice guidelines, policies, protocols and legislation.
  • Work within their scope of practice and take measures to develop and maintain the competence necessary for professional practice.
  • Demonstrate a high level of specialist clinical knowledge and skills in areas ageing and intellectual disability to effectively carry out the duties and responsibilities of the CNSp role.
  • The CNSp will manage a caseload which will be specific to intellectual disability and complex age related conditions for persons over 65 years of age.
  • Provide a specialist gerontological nursing service for service users with age related conditions that require specialist care and support through the ageing process.
  • Undertake comprehensive geriatric service assessment to include physical, psychological, social and spiritual elements of care using best evidence based practice in the care of the older person. The aim of this assessment is to facilitate safe, quality care with appropriate services and supports in place such as, falls programme, continence promotion, medication management and access to community activities.
  • Relevant geriatric assessment tools to assess and implement plans of care for service users with age related conditions that will meet service user’s needs in conjunction with the multi-disciplinary team, service users’, families and carers.
  • Provide healthy ageing amongst all service users to avoid preventable deterioration.
  • Monitor and evaluate the service users’ response to interventions and amend the plan of care accordingly in conjunction with the multi-disciplinary team, service users’, families and carers as appropriate.
  • Make adjustments in the management of service user’s conditions in collaboration with multi-disciplinary team and the service user in line with agreed pathways, policies and procedures, protocols and guidelines.
  • Accept appropriate referrals from multi disciplinary colleagues within the agreed criteria and effectively manage referrals demonstrating the ability to coordinate a defined caseload of service users.
  • Co-ordinate investigations, treatment therapies and service user follow up arrangements.
  • Provide and promote holistic person centred care that takes into account the communication needs that service users with complex needs may experience at different periods and as their ageing health progresses.
  • Communicate with the service user, family and/or carer, as appropriate, to assess service user needs and provide relevant support, information, education, advice and counselling, as required.
  • Demonstrate and promote enabling environments to support the care of the service user with complex needs.
  • Where appropriate work collaboratively with multi-disciplinary team colleagues across primary and secondary care to provide a seamless service delivery to the service user, family and or carer as appropriate.
  • Identify and promote specific symptom management strategies as well as the identification of triggers which may cause exacerbation of symptoms. Provide the service user, family and/or cares with appropriate self management strategies and escalation pathways.
  • Manage nurse led clinics with multi disciplinary team input as appropriate. Support the delivery of sub specialty clinics in conjunction with the consultant and multi-disciplinary team.
  • Liaise with the specialist geriatric team / old age psychiatry team and other teams based on the CNSp caseload ensuring that the most appropriate care is provided to service users.
  • Identify health promotion priorities for the service user, family and or carer and support the service user’s self care in line with best evidence.
  • Encourage service user in taking responsibility for engaging in health promotion activities. Act as a support for the staff caring for the person with complex needs in the emergency department , acute medical wards, out patients departments, day hospital with proactive involvement in discharge planning.
  • Monitor the discharge plan for service user and support this plan when service user is returning from the acute hospital to their home.
  • Use every opportunity to provide healthy ageing to reduce frailty. Emphasise improving the quality of life and functional status.

Clinical focus- Indirect care

The Clinical Nurse Specialist Care of the Older Person with Intellectual Disability will:

  • Provide a high level of Professional Leadership in the area of care of the older person with an intellectual disability.
  • Integrate and maintain the values and principles of person centered care in nursing practice.
  • Develop standards of care / interventions within the intellectual disability specialist area and ensure appropriate audits are in place to monitor all aspects of work.
  • Identify and agree appropriate referral pathways for service users. Manage own caseload by providing a detailed response to referrals using specific case training for individual service users.
  • Maintain an active caseload based on the CNSp referral system which involves the operation of a referral criteria checklist, waiting list and maintenance system of case load management.
  • Use a case management appropriate to older persons with complex needs in collaboration with multi disciplinary team in both primary/secondary care as appropriate.
  • Provide a service which optimises quality and continuity of care.
  • Maintain professional standards in relation to confidentiality, ethics and legislation.
  • Work closely with the multi disciplinary team and families to monitor and evaluate interventions.
  • Collaborate with service user's family, carers and other staff members in the provision of support, advice and education.
  • Co-ordinate and participate in multi disciplinary team case review meetings and service committees as appropriate.
  • Maintain nursing records in accordance with the Daughters of Charity Disability Support Services and professional standards.
  • Take a lead role in ensuring the service for individuals is in line with best practice guidelines and the health Act 2007.
  • Have a working knowledge of the Health act 2007 (Care and Support of Residents in Designated Centres for Persons (Children And Adults with Disabilities) Regulations 2013, Health Act 2007 as they apply to the role of the CNSp.
  • Take a proactive role in the formulation and provision of evidence based policies, procedures, protocols and guidelines relating to the care of the older person with complex needs.
  • Avail of clinical supervision to support clinical practice and participate in the clinical governance process working in partnership with the service manager, the Director of Nursing and Nurse Practice Coordinator within the Daughters of Charity Disability Support Services.

Service user advocate

Clinical Nurse Specialist (Care of the Older Person with Intellectual Disability) will:

  • Act as a service user advocate using appropriate communication methods, negotiating and representing the service users values and decision making capacity with the multi-disciplinary team members during meetings.
  • Support the concept of advocacy, particular in relation to service user participation in decision making, thereby enabling informed choice on treatment options – demonstrate accountability and professional responsibility to the service user.
  • Ensure the ethos and core values of the Daughters of Charity Disability Support Service are reflected within the work of the CNSp.
  • Respect and maintain the privacy, dignity and confidentiality of the service user, family and or carer.
  • Maintain and enhance the opportunities for social inclusion for the service user.
  • Establish maintain and improve procedures for collaboration and cooperation between the acute services and primary care.
  • Proactively challenge any interaction which fails to deliver a quality service.
  • Utilise, listen and empathise with the lived experience of service users and their families and or carer.

Education and training

The Clinical Nurse Specialist (Care of the Older Person with Intellectual Disability) will:

  • Maintain clinical and nursing competence through engaging in continuing professional development by keeping up to date with nursing literature, recent research and engaging in training appropriate to role development.
  • Deliver specialist information/education training programmes as part of the ongoing in service training to support staff, professional colleagues, and students within the Daughters of Charity Disability Support Services, Dublin Services and families of those accessing services.
  • Contribute to the design, development and implementation of education programmes and resources for the service users family and/or carer in relation to healthy ageing and keeping well, in the appropriate format of communication.
  • Deliver service user specific training to staff teams as part of planned interventions.
  • Engage in performance review process including personal development planning as appropriate.
  • Provide mentorship and preceptorship for nursing colleagues as appropriate. Liaise with primary care and acute hospitals and provide information regarding the role of the CNSp in care of the Older Person with Intellectual Disability
  • Create exchange of learning development opportunities within multi-disciplinary team and other healthcare professionals involved in providing care of the older persons in relation to evidence-based care through meetings, journal clubs conferences.
  • Develop and maintain links with HSE educational support structures for example; local Nursing and Midwifery Planning and Development Units (NMPDUs) and relevant Higher Education Institutes (HEIs).

Audit and research

The Clinical Nurse Specialist (Care of the Older Person with Intellectual Disability) will:

  • Contribute to the development and implementation of information sharing protocols, audit systems, referral pathways and person centered care plans.
  • Identify, initiate and conduct nursing audit and research relevant to the area of specialist practice, to evaluate the quality of service user care. Outcomes should contribute to the service plan and care of service users and families.
  • Continuously review current research and practice findings to ensure skills are up to date. Initiate and participate in research studies as appropriate.
  • Evaluate the outcome of audit results and research findings to identify areas for quality improvement in collaboration with nursing management and multi disciplinary members. Ensure that the views of service users are effectively sought and integrated into the management and delivery of services.
  • Contribute to service planning and budgetary processes through use of audit data and specialist knowledge.
  • Maintain a record of clinically relevant data aligned to national key performance indicators (KPI’s) as directed and advised by the DON.
  • Liaise with the speciality nursing team nationally to promote a streamlined approach to supports offered by the speciality.
  • Identify, initiate and conduct nursing and multi disciplinary audit and research projects relevant to the area of practice.
  • Participate in and contribute to research studies which are relevant to nursing practice and maintain professional links with the Nursing and Midwifery Practice Development Unit (NMPDU)
  • Monitor the role of the CNSp in care of the older person with Intellectual Disability with regard to outcomes for the service and the impact on the individuals accessing the CNSp in the care of the older person with intellectual disability. Ensure that the views of services users are effectively sought and integrated in the management and delivery of services.
  • Monitor, access, utilise and disseminate current relevant research to advise and ensure the provision of informed evidence based practice.

Consultant

The Clinical Nurse Specialist (Care of the Older Person with Intellectual Disability) will:

  • Provide specialist advice and leadership and act as a role model to staff, carers and families on the needs of Service Users with intellectual disabilities and complex age related conditions.
  • To be cognisant of the difficulties faced by families and carers who support these individuals and provide practical advice on interventions and support strategies. To be aware of the difficulties faced by staff, carers and families, including the stressful and emotional nature of working with individuals who exhibit complex and severe behaviours that challenge and to adapt the way information is given accordingly.
  • Ability to work independently, reliably and consistently and seek supervision and support as appropriate.
  • Develop collaborative working relationships with local clinical nurse specialist’s nurse and midwife colleagues as appropriate, developing person centred care pathways to promote the integrated model of care delivery.
  • Develop collaborative working relationships with local CNSp’s, advanced nurse practitioners and multi disciplinary team colleagues as appropriate, developing person cantered care pathways to promote the model of care delivery.
  • With the support of the service manager or designate will attend integrated care planning meeting as required.
  • To provide supervision to identified staff, give advice on clinical work and managing risk.
  • Where appropriate, develop and maintain relationships with specialist services in the acute hospitals, primary care and community.
  • Promote the role of the CNSp among healthcare staff.
  • Generate and contribute to the development o clinical standards and guidelines and support implementation.

The Clinical Nurse Specialist (Care of the Older Person with Intellectual Disability) will use skills to :

  • Maintain a high standard of professional behaviour including confidentiality, ethics and legislation and be professionally accountable for actions/omissions. Take measures to develop and maintain the competences required for professional practice.
  • Provide an efficient, effective and high quality service, respecting the needs of each service User, family and or carer.
  • In-depth knowledge of the role of the CNSp. Care of the Older Person with intellectual disability including the pathophysiology of complex age related conditions.
  • Source appropriate assessment tools and evaluate progress and or interventions regularly.
  • Ability to perform a comprehensive assessment of the person with an intellectual disability and complex age related conditions which encompasses comprehensive history taking, physical examination and identification of risk factors employing appropriate diagnostic interventions and ‘Quality of Life Scales’ to support clinical decision making.
  • Undertake a comprehensive assessment of the Service User over 65 years and or those with very complex care needs.
  • Ability to support individuals and carers through the screening and/or diagnostic processes.
  • The ability to formulate a plan of care based on findings and evidence based standards of care and practice guidelines and to follow up and evaluate these plans of care.
  • In-depth knowledge of pharmacological and non-pharmacological relief measures.
  • An understanding of the principles of clinical governance and risk management as they apply directly to the CNSp. role and the wider health service.
  • Provide an efficient, effective and high quality service, respecting the needs of each service user, family and or carer.
  • Work in line with national, regional and local Daughters of Charity Disability Support service policies, procedures and guidelines.
  • Perform any other duties as may be assigned from time to time by the Director of Nursing or their appointee.

Garda Vetting:

Daughters of Charity Disability Support Services recognise its responsibilities under the National Vetting Bureau (Children and Vulnerable Persons) Act 2012-2016.This act applies to those employees who provide care for children and vulnerable adults. Daughters of Charity Disability Support Services appointed liaison person will apply for vetting disclosure for new and current employees.

The post holder may be required to perform other duties as appropriate to the post, which may be assigned to him/her from time to time, and to contribute to the development of the post while in office. This job description will be subject to review in the light of changing circumstances. It is not intended to be exhaustive but should be regarded as providing guidelines within which individuals work.

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Level 2 Core Competencies

Core Competencies


Quality Service

  • Pro-active and uses Initiative.
  • Undertakes holistic approach to ensure the best possible service is provided.
  • Ability to encourage and develop quality led practice initiatives.
  • Demonstrates an ability to evaluate, audit and review practice
  • Provides a flexible service that is responsive to the needs of the service user, colleagues and service.
  • Optimises resources within own areas to achieve appropriate outcomes.
  • Identifies and prioritises the requirements of change within own service area at all times considering how it will affect other parts of the organisation.

Planning & Organising

  • Effective use of time focussed on managing self and developing others in a busy working environment.
  • Sets clear, realistic goals and targets for self and others.
  • Keeps appropriate and accessible documentation.
  • Utilises established systems and processes for prioritising and delivering on tasks.
  • Delegates effectively to ensure objectives are met.
  • Consistently focuses work effort to where it will have most impact.
  • Anticipates Problems and issues and takes preventative action to address these.
  • Demonstrates an ability to plan and deliver care in an effective and resourceful manner within a culture of person-centeredness.
  • Advance planning to ensure adequate resources are available
  • Effective and efficient utilisation of resources.

Professionalism

  • Deals fairly and consistently with others.
  • Approachable and accountable and professionally courteous with others.
  • Shows ability to work under pressure; handles stress in a constructive manner.
  • Self-aware; recognises own response while retaining objectivity.
  • Is cognisant of own strengths/limitations, and scope of one’s practice.
  • Shows resilience; keeps others focussed on a successful outcome.
  • Maintains appropriate level of visibility.
  • Maintains highest standard of confidentially in all areas of work.

Continuous Learning & Development

  • Participate in the Service Development Review System.
  • Organises and structures department to create a continuous learning environment.
  • Creates “on the job” opportunities to address staff learning needs.
  • Demonstrates application of theory to practice and influences staff in this regard.
  • Encourages colleagues/team to undertake a broad range of development initiatives and to maintain an active performance development plan.
  • Mentors, coaches and provides constructive feedback on performance to staff in order to improve capability and confidence.
  • Acknowledge staff strengths and achievements.

Organisational Knowledge

  • Familiar with Health Service trends related to area of discipline.
  • Understands the contribution of each department to the organisational goals and objectives
  • Uses knowledge of mission, values and service structures to deliver on organisational goals.
  • Understands health strategies relevant to own discipline.

Innovation & Creativity

  • Works within teams to maximise the number of ideas and creative inputs for best outputs.
  • Encourages others to ‘think outside the box’.
  • Generates new ideas that have a positive impact on the department/service and its ultimate success.
  • Creates an environment where people are encouraged to put forward ideas, experiment and learn from their mistakes.
  • Challenges the status quo to ensure areas for improvement are identified and addressed
  • Proposes new approaches, methods or technologies.

Leadership Potential

  • Inspires others to consistently perform at a high level and achieve their potential.
  • Is approachable and treats people in a fair and consistent manner in order to gain trust.
  • Is seen as an effective leader, setting high standards of behaviour for others to follow and addresses inappropriate behaviour.
  • Coaches others in maintaining a flexible approach to their work.
  • Embraces change and looks for ways to make positive changes within the team.
  • Ability to understand how individuals, at all levels, operate and applies this knowledge to achieve change objectives in the most efficient and effective way.
  • Seizes opportunities to influence the future direction of departments and the overall business.
  • Encourages, inspires and supports others to deliver successful outcomes through change.
  • Is politically attuned, knowing when to communicate with key stakeholders.
  • Understands importance of getting input and buy-in from others when making decisions.

Problem Solving & Decision Making

  • Is comfortable making decisions with incomplete or uncertain information
  • Has basic finance and budgeting knowledge and draws on this to make decisions when applicable.
  • Understands the effect of ones decision on colleagues/service users, departments and the organisation
  • Anticipates probable consequences of decisions.
  • Consults with others to improve decision making.
  • Takes a proactive approach to problem solving and able to recognise early warning signs of potential problems and takes pre-emptive action.
  • Demonstrates a reflective approach when dealing with problems, carefully evaluating different options/solutions.
  • Able to act quickly to address urgent matters.

Team work

  • Fosters a collaborative working team with complementary strengths.
  • Recognise the talents and contributions each team member brings to the work environment.
  • Proactively develops and nurtures workplace relationships.
  • Utilises team skills and attributes in achieving goals.
  • Encourages input from all team members.
  • Adapts interpersonal style to engage all members of the team.
  • Identifies areas of potential conflict within the team and takes steps to resolve it.
  • Is open and approachable to discuss issues.

Communication & Interpersonal Skills

  • Supports a culture of open communication to maintain a climate of trust and honesty.
  • Communicates at all levels, both internally and externally.
  • Supports ideas with appropriate research and information to persuade others.
  • Focused Listening: Gains’ understanding through accurately clarifying what was heard.
  • Shares information within – and to – other sections and departments in an open timely manner.
  • Delivers presentations to groups with confidence and credibility.
  • Documents important relevant communications.
  • Facilitates two way communications between conflicting parties.
  • Uses an appropriate business writing style.

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