JOB DESCRIPTION. Consultant Nurse (Community Nursing) Overall aim of post
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1 JOB DESCRIPTION JOB TITLE: DEPARTMENT: RESPONSIBLE TO: Consultant Nurse (Community Nursing) Nursing Director of Nursing Overall aim of post Our community nursing teams, including outpatients work together co-hesively, and encompass leading and coordinating care for patients and their families at home, in care homes and in our outpatient clinics. A number of new initiatives have been introduced in the last year such as a single point of contact introducing a rapid telephone assessment for new referrals, creating corporate services using a new approach to case management incorporating validated outcome tools. A skill mix into the community teams has also been introduced. These have been an exciting developments, and an integral part of St Christopher s delivery of services in to the future as we work towards our 5 year Strategic plan of Extending our reach Driving Innovation through new models of hospice care Improving the quality of care and support provided by St Christopher s and other providers in end of life care Empowering the public about issues related to death, dying and loss Strengthen our long term sustainability particularly that related to finance and workforce. In order to achieve these objectives St Christopher s requires the consultant nurse group to work closely with the consultant medical group and heads of services for other disciplines. The consultant medical and nursing workforce will further integrate to provide expert clinical practice across the organisation. The consultant group will take initiative and lead further developments advising the executive team on models of care into the future. This is likely to involve further skill mix development, the differentiation between an advanced nurse practitioner/clinical nurse specialist, the consideration of assistant practitioner roles, health care assistants, and the possible introduction of para medics into the service. Exploration of the use of supervision and case management and delegated responsibility by the use of the zoom facility. St Christopher s operates on two sites, one in Sydenham and one in Orpington. The consultant nurses are generally based on one site only and on our Orpington site St Christopher s also runs a care co-ordination centre for patients with advanced frailty and multiple co-morbidities. Two consultant nurses are based on this site and they jointly lead the community,outpatient and care co-ordination. The consultant nurse group will specifically lead on the development of self-managed teams, enabling the community teams to grow through responsibility and freeing the consultant nurse group up to play a greater role in the direct management of patients, practice development of St Christopher s clinical staff, courses run by St Christopher s learning hub and to fully participate in the research and audit programme at St Christopher s. Future plans being discussed and developed for the inpatient unit may also involve a greater role for the consultant nurse group.
2 The community nursing team will continue to be a nurse-led service, working with the multidisciplinary team, responding to the needs of their caseloads, at home, in clinics and their use of the in-patient beds at the Hospice. Our consultant nurses and doctors will also provide an interface with our external stakeholders, to support the development of new patient pathways. Principal Accountabilities Expert Practice 1. To independently assess and prescribe individual holistic needs based care 2. To utilise advanced clinical reasoning skills and evidence based knowledge in the management of patients with highly complex presentations and to be clinically competent to utilise expert skills and knowledge 3. To make independent clinical decisions and initiate investigations, care/treatment and technological intervention within an agreed framework 4. To direct and use the results of specialist investigations (e.g. blood tests, CXR) to assist formulation of diagnosis and plan patient management from a range of interventions 5. Develop and conduct skilled nursing intervention with patients with palliative care needs, assessing and addressing issues such as quality of life, futility, prognosis, withdrawing and withholding treatment and end of life decision making within an ethical framework 6. To undertake independent prescribing in accordance with St Christopher s policy 7. Demonstrate an ability to discover the personal resources of families/carers and help them develop resilience and coping skills. 8. Support and coach carers at home in managing a relative whose condition is deteriorating 9. Co-ordinate effectively the multi professional team 10. Demonstrate negotiation and diplomacy skills and partnership working across the Multidisciplinary team 11. Communicate effectively at all levels of the organisation and across organisational boundaries 12. Actively promote equality and diversity 13. Write accurate notes and input computerised data, keeping all information up-to-date 14. To be professionally and legally accountable for all work undertaken and to practice at an advanced level of professional autonomy and accountability within St Christopher s policies and the NMC Codes of Conduct
3 Clinical Leadership 15. To be an authoritative expert assessor/advisor on pain and symptom management, psychological /spiritual/ social /practical and ethical decisions at the end of life and to work in partnership with a range of health professionals to improve their skills in these areas 16. To lead the development of clinical expertise in palliative care nursing enabling nurses to develop advanced assessment, decision-making and prescribing skills 17. Become an expert in the use of OACC (Outcome Assessment & Complexity Collaborative) as an outcome tool and a way to measure the patient need and service response. 18. Lead the further implementation into clinical practice. 19. Work closely with all members of the multi-disciplinary team to manage the patient pathways across all care settings 20. Work closely with all hospice services to ensure timely and appropriate responses, using our resources effectively 21. Strive to improve services, acting on user feedback and complaints. 22. Ensure learning from other organisations who have developed similar services and utilise this experience 23. Demonstrate advanced presentation skills, both oral and written Service Development 24. Play a key role in external partnerships and tenders that St Christopher s decides to bid for in line with the strategy. 25. Lead the prioritisation of clinical need in patient referrals to the community nursing team using stratification tools. 26. Ensure the systems and processes are in place to smoothly manage patient flows across all care settings 27. Actively engage all relevant external stakeholders in working towards improving the patient pathway. 28. Work in partnership with the Service Development and Transformation lead and project teams to develop and modify care pathways throughout the organisation Management 29. Provide expert clinical leadership to the entire community nursing team with other Consultant Nurse(s).
4 30. Lead the development of self-managing teams working closely with HR in the change management process. 31. Until a point in time when the community nursing team is self-managing, provide line management to the Clinical Nurse Specialist team, supervising their work, having regular documented monthly meetings, and conducting annual appraisals. 32. Develop the team objectives in line with St Christopher s strategic objectives 33. Collect and interpret data, engaging self and team in the performance of the service 34. Develop mechanisms to ensure regular feedback from stakeholders and respond to any informal or formal feedback 35. Manage complaints, as requested to do so and feedback relevant information to external agencies 36. Select and recruit new staff 37. Ensure that an appropriate induction and development programme is in place for new staff, paying particular attention to the associate CNS posts and the introduction of the skill mix in the community and outpatient teams. 38. Ensure all staff within area of responsibility are effectively managed 39. Assess risk and minimise threat to personal safety 40. Encourage formal teambuilding 41. Chair meetings effectively 42. Develop partnership working with external stakeholders eg. Continuing Health Care, Local authority, Commissioners, Voluntary Sectors etc 43. Work in close collaboration with the senior nursing team Education & Training 44. Model the palliative care approach in all training and education 45. To be competent in delivering education and training sessions at all levels from Masters, degree level, vocational and volunteers 46. Utilise experiential learning methods and reflective practice 47. Demonstrate competence in lecture and discussion based teaching 48. Recognise individual learning needs and identify the most effective ways of addressing them 49. Develop the teaching skills of staff in the team
5 50. Mentor new staff and clinical placements 51. Consistently draw on research and literature to influence specialist palliative care teaching 52. Write articles for publication, deliver at conferences, and produce posters for presentation Professional Behaviour: Code of Conduct The post holder must comply with their relevant professional code of conduct at all times, where this exists. All roles have identified competencies to which post-holders will be regularly assessed against. A job description does not constitute a term and condition of employment. It is provided only as a guide to assist employees in the performance of their role. St Christopher s is a fast moving organisation and therefore changes to employees duties may be necessary on occasion. The job description is not intended to be an inflexible or finite list of tasks and may therefore be varied from time to time, after discussion with the post-holder. Safeguarding/MCA and DoLS Staff are required to take responsibility in all areas of work for safeguarding people at risk (both adults and children) from any form of abuse or neglect. When delivering care and support, staff are required to comply with the requirements of legislation relating to care in the UK, including the Care Act (2014), and Mental Health Capacity Act 2005, which incorporates the Deprivation of Liberty Safeguards (DoLS). In order to achieve this, all staff are required to read St. Christopher s Safeguarding Policy and Procedure and to participate in both regular training and training updates and to incorporate preventative strategies into their work, as applicable. General All employees are required to undertake the following: To make positive contributions to all internal and external quality and/or best practice measures/processes. To fully participate in the annual appraisal process, to agree targets and objectives with line managers and to report on activity against agreed targets on a regular basis. To fully comply at all times, with St. Christopher s policies and procedures and to take responsibility for own actions/inactions. To fully comply with all mandatory and StC role specific training requirements To act in accordance with workplace legislation/requirements including Health and Safety, Equality and Diversity and Data Protection. To share and model St. Christopher s values and expected behaviours at all times. To fully support and engage with St. Christopher s fundraising activities and initiatives. To participate in all employee engagement activities including team, departmental or other staff meetings as required and to contribute to St. Christopher s annual staff survey. To maintain professional registrations (where applicable) and to keep up to date with mandatory training and other training requirements within own area of specialism/responsibility. Those in managerial or supervisory roles are expected to support the teaching, training and development of staff, and in some cases volunteers, as appropriate. A job description does not constitute a term and condition of employment, it is provided only as a guide to assist employees in the performance of their role. St Christopher s is a fast moving organisation and therefore changes to duties and responsibilities may be necessary on occasion. The job description is not intended to be an inflexible or finite list of tasks and may therefore be varied from time to time in discussion with the post-holder.
6 PERSON SPECIFICATION: Consultant Nurse (Community Nursing) Qualifications Essential Desirable RN Level 1 Registered specialist qualification on palliative care Advanced assessment and independent prescribing qualification Educated to PG dip, Masters level MPhil/PhD Knowledge and Experience Essential Desirable Substantial recent experience at Band 8a within palliative care Advanced theoretical and practical knowledge of a wide range of approaches to the management of patients, demonstrated by advanced clinical reasoning Advanced expert level of knowledge of palliative care nursing Demonstrate involvement with innovative practice developments and demonstrate evidence of significant achievements gained Experience of facilitating change by collaborating with stakeholders within a specialist area, across other professions to produce innovative practice and service development showing improved patient outcomes Demonstrated understanding of the role of end of life care within the current health environment and the impact of current government/regional policy developments Clear understanding of other disciplines roles and expectations Previous experience of formal presentations to multi professional groups Substantial recent experience at Band 8a within palliative care Advanced theoretical and practical knowledge of a wide range of approaches to the management of patients, demonstrated by advanced clinical reasoning Advanced expert level of knowledge of palliative care nursing Demonstrate involvement with innovative practice developments and demonstrate evidence of significant achievements gained Experience of facilitating change by collaborating with stakeholders within a specialist area, across other professions to produce innovative practice and service development showing improved patient outcomes Demonstrated understanding of the role of end of life care within the current health environment and the
7 impact of current government/regional policy developments Clear understanding of other disciplines roles and expectations Previous experience of formal presentations to multi professional groups Skills and Competencies Essential Desirable Ability to lead: within the nursing profession and multi-professional working; within an organisation and across organisation boundaries Ability to manage change and contain conflict ensuring resolution with positive outcomes, with the use of negotiation skills Evidence of continued professional development reviewing current practice and research developments with cancer and palliative care and its application to clinical practice Leadership and management skills and ability to facilitate, supervise and assess others in the delivery of care Robust understanding of all aspects of clinical governance including previous experience of quality issues, audit and risk management Evidence of contributions to conferences, courses or publications Demonstrable resilience to working in palliative care To have an understanding of, and an ability to promote and implement equal opportunities Personal Attributes Essential Desirable Willingness to work flexible shifts and participate in our out of hours shift system A commitment to the vision, values and objectives of St Christopher s Hospice
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