Clinical Nurse Specialist – Palliative Care

The Hermitage Clinic is an acute care hospital with 110 inpatient beds, seven operating theatres, a 7 bed ICU, an Emergency Department, many outpatient services, and a wide range of modern technically complex medical diagnostic and treatment facilities, providing high quality patient care. As a part of the Blackrock Health Group, the Hermitage Clinic offers a range of services in areas such as cardiology, oncology, and urology.Working with Blackrock Health is a unique opportunity. We offer the chance to work at some of Ireland's most advanced hospitals while still enjoying a sustainable work-life balance. We ensure all our people have the support they need to progress their career, and we offer a package of unmatched benefits across our three hospitals and diagnostic clinic. Blackrock Health Hermitage Clinic is a private hospital providing a full range of medical and surgical care across a broad spectrum of specialities. Each Ward provides a range of services and this role is important in making a significant contribution, developing and maintaining best practice in nursing services at clinical areas.Job Title Clinical Nurse Specialist – Palliative CareDepartment NursingJob Function NursingReporting to Assistant Director of Nursing/ Director of Nursing & TransformationLocation Hermitage Clinic Job PurposeAs a key member of the Nursing team, the post holder will demonstrate excellent clinical skills, quality patient care initiatives and facilitate effective interpersonal communication with colleagues in the unit(s) and hospital. The role will provide comprehensive nursing care to patients using evidence-based practice and adjusting resources to ensure continuity of care, will act as a role model for excellence in patient care.The CNS will communicate and collaborate with the medical/nursing staff teams in the delivery of quality continuing care for the patient, including liaison with Consultants, and GP’s. The position requires a strategic approach to the development of services and structures, embracing continuous quality improvement and the management of changes necessary to achieve organisational objectives. The role demands a broad range of professional skills and knowledge as well as skills in communication, leadership, teaching, education, research and counselling all in keeping with the Framework for the Establishment of Clinical Nurse/Midwife Specialist Posts, 4th edition, National Council for the Professional Development of Nursing and Midwifery (NCNM) 2008. Key Responsibilities Clinical FocusThe CNS 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·      Provide a specialist nursing service for patients with a life limiting diagnosis, primarily cancer who require support and treatment through the continuum of care.·      Undertake comprehensive patient assessment to include physical, psychological, social, and spiritual elements of care using best evidence based practice in palliative care.·      Use the outcomes of patient assessment to develop and implement plans of care/case management in conjunction with the multidisciplinary team (MDT) and the patient, family and/or carer as appropriate.·      Monitor and evaluate the patient’s response to treatment and amend the plan of care accordingly in conjunction with the MDT and patient, family, and/or carer as appropriate.·      Make alterations in the management of patient’s condition in collaboration with the MDT and the patient in line with agreed pathways and policies, procedures, protocols, and guidelines (PPPGs).·      Accept appropriate referrals from MDT colleagues.·      Co-ordinate investigations, treatment therapies, and patient follow-up.·      Communicate with patients, family, and/or carer as appropriate, to assess the patient’s needs and provide relevant support, information, education, advice, and counselling as required. ·      Where appropriate work collaboratively with MDT colleagues across Primary and Secondary Care to provide a seamless service delivery to the patient, family, and/or carer as appropriate. ·      Participate in medication reconciliation taking cognisance of poly-pharmacy and support medical and pharmacy staff with medication reviews and medication management. ·      Identify and promote specific symptom management strategies as well as the identification of triggers which may cause exacerbation of symptoms. Provide patients with appropriate self-management strategies and escalation pathways. ·      Coordinate nurse led palliative clinics with MDT input. ·      Identify health promotion priorities for the patient, family and/or carer and support patient self-care in line with best evidence. This will include the provision of educational and health promotion material which is comprehensive, easy to understand and meets patients’ needs.  Indirect Care·      Identify and agree appropriate referral pathways for patients with end-of-life conditions, primarily cancers.·      Participate in case review with MDT colleagues.·      Use a case management approach to patients with complex needs in collaboration with the MDT in both Primary and Secondary Care as appropriate.·      Take a proactive role in the formulation and provision of evidence based PPPGs relating to palliative care.·      Take a lead role in ensuring the service for patients with end-of-life condition is in line with best practice guidelines and the Safer Better Healthcare Standards (HIQA, 2012) or the relevant National Clinical Care Programme and JCI standards. ·      Establish and maintain clear referral lines.·      Participate actively in the development and strategic planning of the palliative care service. Patient / Client Advocate·      Communicate, negotiate, and represent patient’s, family, and/or carer values and decisions in relation to their condition in collaboration with MDT colleagues in both Primary and Secondary Care as appropriate.·      Develop and support the concept of advocacy, particularly in relation to patient participation in decision making, thereby enabling informed choice of treatment options.·      Respect and maintain the privacy, dignity, and confidentiality of the patient, family, and/or carer.·      Establish, maintain, and improve procedures for collaboration and cooperation between Acute Services, Primary Care, and Voluntary Organisations as appropriate.·      Proactively challenge any interaction which fails to deliver a quality service to patients.  Education & Training·      Maintain clinical competence in patient management within palliative care nursing, keeping up-to-date with relevant research to ensure the implementation of evidence based practice.·      Provide the patient, family, and/or carer with appropriate information and other supportive interventions to increase their knowledge, skill, and confidence in managing their end-of-life care.·      Contribute to the design, development, and implementation of education programmes and resources for the patient, family, and/or carer in relation to their end-of-life care thus empowering them to self-manage their condition.·      Provide mentorship and preceptorship for nursing colleagues as appropriate.·      Participate in training programmes for nursing, MDT colleagues, and key stakeholders as appropriate.·      Create exchange of learning opportunities within the MDT in relation to evidence based palliative care delivery through journal clubs, conferences etc.·      Develop and maintain links with relevant third level Higher Education Institutes (HEIs) in the design, development, and delivery of educational programmes in specialist palliative care.·      Be responsible for addressing own continuing professional development needs. Audit, Research & Quality·      Establish and maintain a register of patients with end-of-life conditions within the CNS service.·       Maintain a record of clinically relevant data aligned to National Key Performance Indicators (KPIs) as directed and advised by the ADON/DON/Lead Consultant.·      Identify, initiate, and conduct nursing/midwifery and MDT audit and research projects relevant to the area of practice.·       Identify, critically analyse, disseminate, and integrate best evidence relating to care palliative care into practice.·      Contribute to nursing/midwifery research on all aspects of palliative care.·      Use the outcomes of audit to improve service provision.·      Contribute to service planning and budgetary processes through use of audit data and specialist knowledge.·      Monitor, access, utilise, and disseminate current relevant research to advise and ensure the provision of informed evidence based practice.·      Develop a database that is live and contemporary focus as well as a breakdown of activity - patients seen and treated.·      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.·      Adequately identifies, assesses, manages, and monitors risk within their area of responsibility.·      Participate and cooperate with internal and external evaluations of the organisation’s structures, services, and processes as required·      Initiate, support, and implement nursing quality improvement initiatives in their area which are in keeping with local organisational quality, risk, and safety requirement.·      Develop a culture of safety, promoting positive reporting of incidents and near misses; investigate and take remedial action on incidents or near misses involving patients and staff according to hospital policies, protocols and guidelines.  Consultant·      Provide leadership in clinical practice and act as a resource and role model for palliative care practice.·      Generate and contribute to the development of clinical standards and guidelines and support implementation.·      Use specialist knowledge to support and enhance generalist nursing practice.·      Develop collaborative working relationships with local community palliative care CNS, Registered Advanced Nurse/ /MDT colleagues as appropriate, developing person centred care pathways to promote the integrated model of care delivery.·      Where appropriate develop and maintain relationships with specialist services in voluntary organisations which support patients in the community.·      Network with other CNS in Palliative Care and in related professionals associations Essential CriteriaKnowledge/ Experience ·      Be registered in the general division of the Register of Nurses maintained by NMBI·      Have at least five years recent relevant post-registration nursing experience (full-time or equivalent hours part-time) in an acute hospital setting and a minimum of two years nursing experience in  the specialist area·      Have acquired a level 8 post registration Quality and Qualifications Ireland (QQI), National Framework of Qualifications (NFQ) major academic award relevant to the specialist area of Palliative Care Nursing (or similar) or be willing to complete within one year of taking up post.Skills/ Competencies·      Clinical Skills·      Management skills·      Leadership skills·      IT skills·      Quality focus·      Risk Management·      Clinical audit·      Excellent interpersonal and communication skills Desireable SkillsKnowledge/ Experience  ·      Experience in teaching & assessing·      Experience with JCI standardsWhy work at the Hermitage Clinic?The Hermitage Clinic are passionate about our people and believe in their development and growth. As a member of the Hermitage Clinic team you can benefit from: An Education Support ProgrammeDevelopment opportunitiesOpportunities for career progressionAccess to a Pension SchemeSubsidised RestaurantFree staff car parkingEmployee Assistance ProgrammeLife Assurance  This Job Description is intended as a basic guide to the scope and responsibilities of the position and is subject to regular review and amendment. The role holder will be required to be flexible in this position and is expected to facilitate working additional hours on occasion, when requested.The Hermitage Clinic is an Equal Opportunities Employer with a strong commitment to diversity, inclusion and equality at all levels of the organisation. If you require assistance due to a disability during the recruitment process, please email hr@hermitageclinic.com