Registered Advanced Nurse Practitioner, Rheumatology, OPD University Hospital

Details of Service

Cork University Hospital (CUH) has approximately 800 beds and this will increase further to 1,000 beds on completion of the transfer of additional services to the CUH campus. CUH currently employs approximately 3,269 (WTE) staff of multiple professions and is the primary teaching hospital for the Faculty of Health and Science in University College Cork (UCC). UCC is the Academic partner of the South/South West Hospital Group. CUH has very strong relationships with each of the six schools within the Science Faculty of UCC and this is a key area for future development to maximise the opportunities for both the service and academia.

CUH is a Major Trauma Centre for the Republic of Ireland due to the wide range of specialties delivered by the hospital – including Neurosciences, Cardiac Services, Orthopaedics, General Surgery, Renal, Internal Medicine, Vascular, Ophthalmology, Urology, Plastic Surgery, Maxillary-Facial, Paediatrics, Intensive Care, Oncology, Haematology, Obstetrics, Gynaecology, Neonatology and Emergency Medicine. CUH is JAG accredited and is a Magnet4Europe Hospital.

CUH is the tertiary referral centre for the HSE Southern area, and the supra regional area of Limerick, Clare, Tipperary, Waterford and Kilkenny. CUH therefore acts as a regional centre for secondary and tertiary care for the catchment population of approx. 550,000 served by the HSE Southern area and a supra-regional centre for a total a population of 1.1 million.

In 2021 (which was a Covid year), CUH had 69,087 ED presentations; 215,529 physical out-patient attendances; 50,173 virtual out-patient attendances; 29,966 inpatient discharges and 27,960 day cases.

Rheumatology is the medical speciality caring for patients with musculoskeletal disease. Rheumatology services are essentially ambulatory and out-patient based with small numbers of in-patient beds required for acute rheumatic diseases and for patients requiring intensive periods of rehabilitation. The Rheumatology service provides out-patient facilities with a full time on call rheumatology service, two procedure areas and a dedicated ultrasound clinic area. In CUH the Rheumatology service have dedicated day-patient beds in the Infusion Unit for patients who require infusions to manage their disease.

The Rheumatology Department (RD) at CUH is the largest of three rheumatology centres in Cork City. The RD in CUH operates under the Medical Directorate and has a designated business manager/ quality & safety lead and assistant director of nursing. Other disciplines under the Medical Directorate include respiratory, neurophysiology and dermatology. Inpatient and outpatient referrals are received and sent to these services via “shared care” patient pathways and are seen in combined out-patient clinics. This streamlines the patient experience by improving patient outcomes, reducing clinical risk and is more cost efficient. It also provides for close links between the RD nursing staff and each discipline facilitating more learning opportunities across the spectrum of overlapping diseases. Rheumatology OPD clinics are led by four consultants, the RANP, the Clinical Nurse Specialists (CNSps) and the Clinical Specialist Physiotherapist MSK triage. Each clinic is structured to facilitate patients with similar diseases and treatments to improve the patient experience, the quality of the patients’ journey, and streamline patients flow through the OPD. This also promotes learning opportunities for staff.

Purpose of the Post

The advanced practice service is provided by nurses who practice at a higher level of capability as independent, autonomous and expert advanced practitioners.

The overall purpose of the Registered Advanced Nurse Practitioner – Rheumatology post is to provide safe, timely, evidenced based nurse-led care to people with rheumatic diseases at an advanced nursing level. This involves undertaking and documenting a complete episode of patient care (assess, diagnose, plan, treat and discharge patients) according to collaboratively agreed protocols and scope of practice in the clinical setting; demonstrating advanced clinical and theoretical knowledge, critical thinking and decision making skills.

The RANP (Rheumatology) demonstrates advanced clinical and theoretical knowledge critical thinking, clinical leadership and complex decision-making abilities

To support a safe environment for patients with rheumatic diseases by increasing the use of evidence based clinical guidelines, address patient expectations and promote wellness and evaluate care given.

To provide professional and clinical leadership in order to develop nurse led practice and health policy at local, regional and national level.

To lead, conduct, disseminate and publish nursing research to shape and advance nursing practice, education and health care policy at local, national and international levels.

Informal Enquiries

Nora Twomey,

Assistant Director of Nursing,

Medical Directorate,

Cork University Hospital

Email: Nora.Twomey@hse.ie

Tel: 087 2186170