1 Job Identification Job Title: Job Reference: Department & Base: Hours of Work: JOB DESCRIPTION Clinical Nurse Specialist (Chronic Pain Management) NM1703 Chronic Pain Service Department of Anaesthetics, Borders General Hospital 37.50 hours per week Pay Band: Band 7 2 Job Purpose The post holder will act as the nurse member and team leader of the multidisciplinary team who care for this group of patients. The post holder will have direct clinical involvement in working with patients experiencing chronic pain utilising higher levels of clinical expertise and skills. The post holder will work collaboratively to provide support, advice and education for all appropriate health care professionals. The post holder will develop effective and multi-disciplinary professional working relationships across all clinical groups and organisational boundaries promoting enhancement of care of patients with chronic pain. 1
3 Organisational Position Planned Care Service Manager Associate Director of Nursing Senior Nurse/Operational Manager Critical Care Clinical Nurse Specialist 4 Scope and Range Ensure the highest standard of personalised nursing care is delivered to patients and their families in partnership with all members of the multi disciplinary team. Contribute to the assessment of care needs and the delivery and maintenance of optimal care outcomes. The individual is expected to motivate staff to provide high standards of care by acting as a role model. Provide professional and clinical care advice to patients, carers and multi-disciplinary team. Participate in the provision of specialist education and training programmes for health care professionals and other professional groups. Contribute to research activities ensuring evidence-based practice in the specialist area. 2
5 Main Duties/Responsibilities MAIN DUTIES To work within a multidisciplinary team (MDT) setting to enable the Chronic Pain Service to be responsive to the needs of patients with chronic pain. To demonstrate an informed and evidence based criteria in comprehensive biopsychosocial assessment and management of patients with chronic pain evaluating pain management outcomes. To work and lead within multidisciplinary team in developing chronic pain management care pathways/protocols and treatment directives. To clearly document and communicate planned episodes of care relating to chronic pain management and/or relevant forward referrals. To generate audit and quality assurance systems in order to evaluate the effectiveness of chronic pain services. CLINICAL To advise and provide a specialist nursing resource for patients with chronic pain within the hospital and community setting as appropriate. To achieve a working relationship with patients and significant other on an individual or group setting, demonstrating advanced clinical practice. To ensure effective communication with the patient, carers, General Practitioner and MDT. To develop a planned episode of care for chronic pain management Maintain reviews of individual patients cases to decide on continuing treatment options. To work collaboratively with patients to review behavioural life style strategies and coping strategies To undertake recognised training/update knowledge and skills as indicated. To maintain evidence-based knowledge of analgesic and co-adjuvant therapies in order to recommend, manage and monitor their effectiveness. To maintain and monitor explicit standards of care in relation to chronic pain management and identify and participate with clinical/nursing audits as appropriate. To act as an exemplary role model and promote effective care delivery. To promote safe administration of all drugs and medicines used for chronic pain control in liaison with Drugs and Therapeutic Committee guidance. To utilise, where appropriate, frameworks and national guidelines e.g. Pain Society. To work collaboratively with appropriate others in order to promote optimal chronic pain management. 3
Duties/Responsibilities contd. PROFESSIONAL/MANAGERIAL Within the realms of the Chronic Pain Service, to ensure that resources meet the demands of the service. To be a resource for strategic and business planning in regard to the Chronic Pain Service and Trust Pain Services. To demonstrate professional leadership and support when delivering chronic pain management. To assist in designing protocols/guidelines/standards/pathways that are evidence based and aim to standardise and improve management of patients in pain. To demonstrate exemplary delivery NMC Codes and standards of practice. To seek and be involved with local Network initiatives that promote evidence based practice and benchmarking in regard to chronic pain management. To facilitate the development and participate within the Collaborative Pain meetings (acute/chronic/palliative). To take an active role in the Trust Specialist Nurse Forums / Research forums and adhere to the forum s terms of reference. To maintain responsibility for own professional development. This includes complying with Mandatory training and appraisal processes. EDUCATIONAL RESPONSIBILITES To identify patients and carers educational needs and direct care to meet these needs using a cognitive behavioural framework as appropriate. To identify the training needs of nursing and other healthcare staff involved in patient care especially in relation to service developments and research evidence. To provide teaching programmes to meet these needs within the multidisciplinary setting To assess own educational needs in relation to the position and to identify own objectives in conjunction with the nurse manager in order to promote personal and professional development 6 Systems and Equipment Display sound information technology skills (Word Processing, Database entry) Maximise the use of information technology to benefit of patient care Printer / Photocopier Transcutanoeus Electrical Nerve Stimulation devices Use of medical equipment including complex monitoring and resuscitation equipment Use of manual handling equipment 4
7 Decisions and Judgements Functions autonomously in clinical practice. Demonstrates expert nurse practice and clinical skills Has the ability to anticipate, by using expert knowledge, changes in the patients condition and implement the appropriate actions required Make contemporaneous judgments in the care and treatment/ medication use in accordance with service guidelines and agreed protocols Has the ability to challenge decisions made by others if they are against policy or not in the patients best interests. Has the ability to respond to complex/ emotionally demanding patient situations both clinically and administratively Has the ability to discuss risk issues and achieve mutually agreed treatment plans with patient, carers and team members Has the ability to utilise continuous and contemporaneous reflective practice to constantly monitor competences and to identify and act to rectify knowledge deficits Has the ability to recognise limitations of clinical skills, communicate these effectively and refer as appropriate within and outwith team setting. 8 Communications and Relationships Engages at a therapeutic level with individual and groups utilising core-counselling conditions. Maintains patient confidentiality at all times Networks with Primary, Secondary and tertiary services and specialist groups nationally Utilising a collaborative approach engages therapeutically with patients to agree treatment approaches Engages in effective communication with patients, carers team members, General Practitioners and clinicians from all other disciplines as appropriate Utilises highest level of communication skills to provide and receive highly complex, sensitive and contentious information, dealing with resistance and barriers to acceptance of difficult emotional and physical conditions Has the ability to respond empathetically and supportively to highly distressing and emotive situations adopting a pragmatic and individualised problem solving approach. Has the ability to deliver both formal and informal teaching sessions organisation wide and to support others in providing education for patients and carers. Is able to communicate at all levels throughout the organisation in a mature and reasoned manner Plays a pivotal role in the dissemination of information with the team and relevant clinical areas. 5
9 Physical Demands of the Job The post holder is mobile between clinical areas. Assist with the positioning of patients for procedures while ensuring all moving and handling guidelines are adhered to. Moving and handling items such as linen, case notes, relaxation mats. Moving furniture to set up for group based activities Be able to respond speedily and accurately to emergency situations Potential control and restraint of physically aggressive patients 10 Most Challenging/Difficult Parts of the Job Dealing with situations that arise, especially distressing emotional situations Ability to support patient who may project anger and frustration towards professional due to distressing nature of condition Having the ability and experience to challenge decisions made by other, often senior, members of the multidisciplinary team that do not adhere to policy or are not in the patients best interests To mange time effectively and to balance clinical, administrative, research and service development duties. To set and meet realistic targets for team / research projects To balance current duties with ongoing personal education and professional development 6
TERMS AND CONDITIONS Grade and salary: Hours of work: Annual leave: Public Holidays: Superannuation: Band 7: 30,460-40,157 per annum 37.5 hours per week, Fixed term for 12 months 27 days per annum Details of other types of leave entitlement (such as sick leave) are set out in the Agenda for Change handbooks. 8 days per annum on dates designated by NHS Borders Details of other types of leave entitlement (such as sick leave) are set out in the Agenda for Change handbook. The post-holder is entitled to join the NHS superannuation pension scheme. If Unsuccessful: If you have NOT heard from us within 4 WEEKS of the closing date, then we regret that your application has not been successful on this occasion. However, we appreciate your interest in working with NHS Borders and your time and effort in completing the application form. We would welcome your application for future posts. Equal Opportunities: In NHS Borders, we believe that all staff should be treated equally in employment. We will not discriminate against any member of staff, or job applicant, on grounds of age, disability, gender reassignment, marriage and civil partnership, pregnancy and maternity, race, religion and belief, sex and sexual orientation. Trade Union membership. Disclosure checks: We carry out criminal record checks on new staff who fall within certain staff groups within NHS Borders, through Disclosure Scotland. We send out Disclosure Forms to all shortlisted candidates for these staff groups, and ask for these to be completed and returned at interview. If a successful-at-interview candidate forgets to bring their completed form to interview, then they will be required to return the form (and proofs of identity) within 7 days, otherwise the provisional job offer will be withdrawn. Unsuccessful candidates forms will be shredded. The Rehabilitation of Offenders Act does not apply to this post. Tobacco policy: We have a Tobacco policy in place. When selecting staff, we do not discriminate against applicants who smoke, but staff must observe our policy on smoking. Hepatitis B: We offer Hepatitis B immunisation through our Occupational Health Service (OHS). If you think you may be at risk of contracting Hepatitis B through your job, you should ask for this immunisation at OHS. If your work involves exposure-prone procedures, you must keep to the document Protecting Health Care Workers and Patients from Hepatitis B, and the NHSiS Management Executive Directive on this issue. You must be immune to Hepatitis B, and if you cannot prove that you are immune, OHS will investigate to find out whether you are Hepatitis B positive or not. 7
Health and Safety at Work: You must take look after the health and safety of yourself and anyone else who may be affected by what you do at work. You must also co-operate with us to make sure that we keep to legal and organisational safety regulations. You can get more information from the NHS Borders Health & Safety Adviser. The closing date for completed application forms is: 5pm on Wednesday 6 March 2013 8