UHWN Clinical Nurse Specialist

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Principal Duties and Responsibilities

The post holder’s practice is based on the five core concepts of Clinical Nurse Specialist role as defined by the NCNM 4th edition (2008) in order to fulfil the role. The concepts are:

• Clinical Focus
• Patient/Client Advocate
• Education and Training
• Audit and Research
• Consultant

Clinical Focus

Clinical Nurse Specialist will have a strong patient focus whereby the specialty defines itself as Nursing and subscribes to the overall purpose, functions and ethical standards of nursing. 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 patient, family and/or carer. Indirect care relates to activities that influence and support the provision of direct care.

Direct Care

Clinical Nurse Specialist will:

• Provide a point of telephone contact for patient experiencing disease/treatment related symptoms and assess patients using the UKONS telephone triage system.
• Actively participate in planning and carrying out of unscheduled review of patients presenting unwell to the Oncology/Haematology Day Ward with disease/treatment related side effects.
• Provide support to the family/ significant other, through listening, problem solving and education.
• Provide outreach support for the patient at home.
• Assess patients regarding their need for referral to specialist cancer services.
• Report such patients promptly to the consultant/ clinical leader and discuss referral.
• Co-ordinate relevant services in preparation for treatment.
• Attend multidisciplinary team meetings.
• Participate in ongoing patient education in relation to management of disease and treatment related side effects.
• Foster good working relationships with all members of the clinical team, which are both professional and supportive.
• Maintain accurate clinical records complying with legislation and best practice.
• Demonstrate specialist knowledge of and clinical expertise in the delivery of patient care.
• Be aware of all hospital policies and procedures and collaborate with other health care professionals to ensure that these are observed.
• Be actively involved in the preparation and implementation of policies and nursing guidelines in relation to the management of care to oncology patients.
• Demonstrate leadership ability and good communication skills.

Indirect Care

Clinical Nurse Manger 2 will:

• Identify and agree appropriate referral pathways for Oncology/Haematology patients who are experiencing a disease or treatment related complication.
• Participate in case review with MDT colleagues.
• Use a case management approach to patients with complex needs in collaboration with MDT in both Primary and Secondary Care as appropriate.
• Take a proactive role in the formulation and provision of evidence based PPPGs relating to care.
• Take a lead role in ensuring the service for oncology/haematology patients experiencing disease or treatment related complications is in line with best practice guidelines and the Safer Better Healthcare Standards (HIQA, 2012).

Patient/Client Advocate

Clinical Nurse Specialist will:

• Provide an efficient, effective and high quality service, respecting the needs of each patient.
• Act as a resource/ contact person for Haematology/Oncology patients attending other departments within the hospital or outside the hospital for treatment.
• Provide patients and family/ significant others with contact details for acute oncology nurse specialist and advise for out of hours contact.
• Be aware of existing resources/ services, which help patients and their family/ significant others, e.g. social services, support groups, entitlements.
• Participate in team discussions regarding treatments for oncology/haematology patients.
• Facilitate development of information leaflets for patients and families.

Education & Training:

Clinical Nurse Specialist will:

• Assist in the development and delivery of training programmes for nursing staff.
• Play an active role in teaching all grades of nursing staff and other disciplines as required.
• Use relevant educational opportunities to maintain the highest standards and up to date care offered to the patients.

Audit & Research:

Clinical Nurse Specialist will:

• Ensure that his/her own practice is compliant and up to date with “best practice”, which is reflected in research and development.
• Participates in the regular audit of his/her own clinical practice.
• Collect and maintain data in relation to this service improvement initiative and the impact of the role within the oncology/haematology service as determined and developed nationally
• Ensure the development and maintenance of a quality assurance programme which is patient centred utilising up to date research findings.
• Use such research findings to influence care within the specialty.
• Set objectives and develop policies, procedures and standards for the cancer nursing services based on current nursing research and relevant research from other disciplines.
• Identify areas within the specialty relevant to nursing practice, which would benefit from research.
• Promote an awareness of research-based practice amongst staff.
• Participate in departmental research related to the specialty.

Audit expected outcomes including:

• Evaluate audit results and research findings to identify areas for quality improvement in collaboration with nursing management and MDT colleagues

• Maintain and report outcome measures locally and to the NCCP on activity levels from source of referral to management and follow up.

Consultancy:

• Provide leadership in clinical practice and act as a resource and role model for cancer services
• Generate and contribute to the development of clinical standards and guidelines, having regard to national and international advancements in cancer nursing.
• Establish collegial partnerships and in the context of cancer, contribute to the professional development of students, peers, colleagues and others through consultation, education, leadership, mentorship and coaching.
• Work with, support, advise and help build up knowledge of expertise of the primary care team in providing an appropriate system of care to meet the needs of the patient and their family/carers.
• Develop and maintain good collaborative working relationships and communication with all members of the speciality’s MDT and other health care professionals within and outside the service.
• Participate in the implementation of the national clinical care programmes and their agreed models of care for patients and their families as they relate to the role.
• Use specialist knowledge to support and enhance the care and management of unscheduled care patients ensuring the prompt, correct management of these patients and consequently reduced bed days

Health & Safety:

These duties must be performed in accordance with local organisational and the HSE health and safety polices. In carrying out these duties the employee must ensure that effective safety procedures are in place to comply with the Health, Safety and Welfare at Work Act (2005). Staff must carry out their duties in a safe and responsible manner in line with the local policy documents and as set out in the local safety statement, which must be read and understood.

Quality, Risk and Safety Responsibilities

It is the responsibility of all staff to:

• Participate and cooperate with legislative and regulatory requirements with regard to quality, risk and safety.
• Participate and cooperate with local quality, risk and safety initiatives as required.
• Participate and cooperate with internal and external evaluations of the organisation’s structures, services and processes as required, including but not limited to, The National Hygiene Audit, National Decontamination Audit, Health and Safety Audits and other audits specified by the NCCP/HSE or other regulatory authorities.
• Initiate, support and implement quality improvement initiatives in their area which are in keeping with local organisational quality, risk and safety requirements.
• Contribute to the development of PPPGs and safe professional practice and adhere to relevant legislation, regulations and standards.
• Comply with Health Service Executive (HSE) Complaints Policy.
• Ensure completion of incident/near miss forms and clinical risk reporting.
• Adhere to department policies in relation to the care and safety of any equipment supplied and used to carry out the responsibilities of the role
• Specific Responsibility for Best Practice in Hygiene
• Hygiene is defined as: “The practice that serves to keep people and environments clean and prevent infection. It involves the study of preserving one’s health, preventing the spread of disease, and recognising, evaluating and controlling health hazards. In the healthcare setting it incorporates the following key areas: environment and facilities, hand hygiene, catering, management of laundry, waste and sharps, and equipment” (HIQA, 2008; P2). It is the responsibility of all staff to ensure compliance with local organisational hygiene standards, guidelines and practices.

Management/Administration:

Clinical Nurse Specialist will:

• Provide an efficient, effective and high quality service, respecting the needs of each patient, family and/or carer.
• Effectively manage time and caseload in order to meet changing and developing service needs.
• Continually monitor the service to ensure it reflects current needs.
• Implement and manage identified changes.
• Ensure that confidentiality in relation to patient records is maintained.
• Represent the specialist service at local, national and international fora as required.
• Maintain accurate and contemporaneous records and data on all matters pertaining to the planning, management, delivery and evaluation of care and ensure that this service is in line with NCCP/HSE requirements.
• Contribute to the service planning process as appropriate and as directed by the DoM.
• Have a working knowledge of the Health Information and Quality Authority (HIQA) Standards as they apply to the role for example, Standards for Healthcare, National Standards for the Prevention and Control of Healthcare Associated Infections, Hygiene Standards etcand comply with associated HSE protocols for implementing and maintaining these standards as appropriate to the role.
• To support, promote and actively participate in sustainable energy, water and waste initiatives to create a more sustainable, low carbon and efficient health service.

The above Job Specification is not intended to be a comprehensive list of all duties involved and consequently, 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.