POSITION DESCRIPTION MENTAL HEALTH & ADDICTIONS CLINICAL NURSE SPECIALIST - PRIMARY CARE INTEGRATED PATHWAY This role is considered a non-core children s worker and will be subject to safety checking as part of the Vulnerable Children Act 2014 Position Holder's Name:... Position Holder's Signature:... Manager/Supervisor's Name:... Manager/Supervisor's Signature:... Document ID: MH&J_JD_Clinical Nurse Specialist Primary Care Integrated Pathway Version: 1.0 Department: Mental Health & Addictions Last Updated: 03/2016 Document Owner: Medical Resources & Management Support Administrator Next Review Date: 03/2017 Approved by: Clinical Nurse Director Date First Issued: Counties Manukau Health
Position description: Counties Manukau Health 2
PURPOSE OF THE POSITION Each of the four Community Mental Health Centres (CMHCs) within the Integrated Care Adult Mental Health Services will have a dedicated Clinical Nurse Specialist Primary Care Integrated Pathway. This senior nursing position will report to the respective Team Manager and will be responsible for improving care for service users by developing and managing the relationships between the Community Mental Health Centre and the Primary Health Sector (including the aligned Locality) and / or other community groups. Their focus will be to facilitate access, increase linkages with the Primary Care Mental Health & Addictions Coordinators, develop effective communication channels and facilitate appropriate clinical care and pathways. They will support and enable other members of the CMHC to work alongside primary care. The physical health of people coming to the attention of mental health services is a significant priority for the person in this role. Finding ways to promote wellness, drive initiatives which address better health outcomes, and ensuring access to good quality health care are key aspects to this role. This position will also work within the non-urgent pathway. The Clinical Nurse Specialists Primary Care Integrated Pathway will form a virtual team which will be clinically and operationally supported by the Nurse Lead Integrated Care. This role will be responsible for actively managing the CMHC non-urgent whiteboard, undertaking clinical assessments and facilitating the transfer of service users to the most appropriate pathway. This role will develop working relationships with Primary Mental Health coordinator roles based within Primary Health Organisations. PLACE IN THE ORGANISATION Clinical Nurse Director General Manager Mental Health & Addictions Clinical Director Mental Health & Addictions Service Manager Integrated Care Adult Mental Health Clinical Head Team Manager Clinical Nurse Specialist Primary Care Integrated Pathway Nurse Lead Integrated Care Working relationship with Primary Care MH&A Coordinators Position description: Counties Manukau Health 3
NATURE AND SCOPE OF RESPONSIBILITIES Key Accountability Standards / Achievements Professional leadership Contributing and participating in the comprehensive clinical MH & A assessment, including completion of core documentation regarding mental state assessment, risk assessment, and clinical note writing that is reflective of assessments, intervention and rehabilitative treatment planning. Establishing good therapeutic engagement is essential while providing a range of clinical interventions that support the service user s recovery. This may include Motivational Interviewing, CBT, DBT, and Sensory Modulation depending on your individual skills and training. Ensures the provision of positive recovery focussed service user outcomes and person and family/whaanau centred care. Supports the ongoing development of integrated service delivery across the continuum of care. In a virtual team model, works closely with the other Clinical Nurse Specialists Primacy Care Integrated Pathway to ensure consistency of approach, equity of workload and peer support. Regular liaison and review with the Nurse Lead Integrated Care to ensure alignment with Integrated Care Pathways development. Promotes effective teamwork and collaborative relationships across the secondary / primary health care provider continuum. Actively contributes to multi-disciplinary research and practice development within the CMHC by participating in appropriate local, regional, national, and international forums. Applies critical reasoning and professional judgement to nursing practice issues/decisions. Identifies situations of clinical risk and takes appropriate actions to ensure a safe environment for service users, families/whaanau and staff. Participates in the development of nursing strategies to facilitate the recruitment, retention and succession planning for nurses. Participates in Mental Health service and organisation development initiatives/activities. Contributes to cost containment initiatives, and assists to develop efficiencies in nursing practice. Position description: Counties Manukau Health 4
Key Accountability Standards / Achievements Undertakes or leads specific service or organisational portfolio responsibilities as required including related activities which occur across the Counties Manukau region (eg SASI). Being able to work autonomously; be up to date with skills and knowledge essential to be able to provide a rationale for judgements and actions which can withstand scrutiny of peers. Clinical leadership Uses advanced nursing knowledge and skills to provide comprehensive assessment, brief intervention and evaluation for designated service users focusing on the primary/secondary care continuum, including the nonurgent pathway. Understands and identifies improvements in the triage criteria and pathways of care for people presenting in the non-urgent pathway. Develops and facilitates communication networks across the continuum to co-ordinate and integrate effective to achieve best health outcomes for service users. Facilitates effective discharge planning and or referral processes to health care providers and support agencies to meet identified health needs. Educates and provides information to service users/family/whaanau and primary care to improve mental health literacy and wellness planning. Documentation is of a high standard and able to reflect the service users presenting needs. The emergence of Project Swift and mobilisation of the workforce will require the ability to convey the clinical outcomes/ plan to multiple audiences (service user, primary care, specialist services etc). Will support the Nurse lead role and maintain the responsibilities that are within the senior nursing role. Education and clinical teaching Provides expert advice and consultation to primary health care providers regarding mental health and addiction. Models expert skills within clinical practice area. Demonstrates skilled mentoring/coaching, teaching and supervision of nursing staff and other health care professionals. Participates in case review and debriefing activities as required. Position description: Counties Manukau Health 5
Key Accountability Standards / Achievements Identifies and supports staff education and professional development based on knowledge of service needs and Counties Manukau Health (CMH) strategic direction. Fulfils the requirements of a Senior Nurse within Mental Health Services CMH. Continuous quality improvement Participates in the development of primary health care integration / locality projects and initiatives for CMH. Professional development and clinical competency Demonstrates commitment to quality improvements, risk management and resource utilisation. Reviews and develops clinical standards / protocols and policies and facilitates clinical audits processes. Evaluates the effectiveness, efficiency and safety of clinical practice. Identifies barriers and solutions to access for service users, family or whaanau. Participates in the development of strategic and operational plans related to integrated care. Works with the nursing leadership to help define and implement strategies to support continuous quality improvement, maximising the involvement of the nursing staff. Assists in the implementation of nursing practice and models of care that are appropriate to service user population needs. Acts to identify and minimise organisational risk. Leads professional conduct by example. Practices in accordance with legal, ethical, culturally safe and professional standards. Maintains and develops own clinical expertise and knowledge in speciality nursing. Proactively participates in own performance development and review. Attends educational opportunities/ conferences relevant to nurse specialist role and scope of practice. Receives professional development support from the Nurse Lead Integrated Care. Proficient with providing clinical supervision where appropriate. Responsible for ensuring they receive regular professional clinical supervision as per policy. Position description: Counties Manukau Health 6
Key Accountability Care coordination Standards / Achievements Support the service user & family/whaanau to identify the service users health goals and coordinate services to meet those goals by: Encouraging self-management and self-advocacy, and advocating on their behalf where appropriate. Identifying the strengths that the individual and family/ whaanau bring. Ensuring documentation is accurate, timely and concise, and complies with clinical documentation policy. Ensuring Care Plans are current and include both strengths and family/ whaanau as appropriate. Coordinating care delivery to include the wider health environment including community/social/ intersectoral and primary health services. Clarifying responsibilities and tasks in the Care Plan for those involved with the service user (to ensure clarity of roles). Using excellent communication skills, both face to face and electronically. Communicating with and support service users to be able to confidently navigate complex systems. Role as key point of contact for service user, family/whaanau and associated services for: Regular contacts, emergency or crisis support. Utilising discipline-specific skills sets support the care plan. Regular reporting on progress and discharge planning. Where a multi-discipline approach is indicated all relevant disciplines will be included in care discussions. Promoting health and wellness Access and work with individuals, families/whaanau and the community to promote health and decrease risk of illness. Assist the service user, their family/whaanau and groups within the community to achieve maximum control over identification and prioritisation of their own health needs. Assist the service user, their family/whaanau and the community to attain access to accurate and relevant health knowledge. Initiate and/or contribute to professional and community activities designed to promote health. Position description: Counties Manukau Health 7
Key Accountability Cultural capability Standards / Achievements Promote mental wellness by maximising the range of lifestyle choices and informed decisions available to service users of mental health care. Work collaboratively with colleagues, other health professions, individuals and community groups to improve mental health awareness. Working knowledge of the Mental Health and Addictions Cultural Capability Plan Commitment to the principles of Treaty of Waitangi Application of cultural competencies within the HPCA Act 2003 evidenced in annual Performance Development Review and Recognition Programme (PDRP). Recognise Maaori as tangata whenua. Understand the importance of equal opportunity to healthcare access and outcomes from that service. This may require differing levels and types of service provision. Respect, sensitivity, cultural awareness is evident in interpersonal relationships. Honouring Cultural Diversity Our cultural differences are acknowledged by respecting spiritual beliefs, cultural practices and lifestyle choices. Utilise information technology Demonstrate the ability to access and utilise clinical information systems. Champion and lead initiatives related to Project Swift and workforce mobilisation. Is conversant with applications required for specific discipline/role. For example, PIMS, HCC, Concerto, Outlook, etc. Maintains own professional development by attending relevant IT educational programmes. Position description: Counties Manukau Health 8
COMMUNICATION AND INTERPERSONAL SKILLS Will be required to interact on a regular basis with a range of Counties Manukau Health staff members including: Multidisciplinary team colleagues Members of other mental health teams Cultural advisors Family advisors Specialist advisory support e.g. AOD, eating disorders Externally there will be contact with: Primary Health Organisations and other community health providers General Practitioners Practice Nurses Community Agencies Non-Government Organisations Locality groups/ clusters (& related project groups) Situations may often call for tact, diplomacy and will require information to be handled in a discreet and sensitive manner. In conflict situations will be required to exercise sound judgement, negotiation and persuasiveness skills, toward facilitating a workable outcome. PROBLEM COMPLEXITY Will be regularly challenged by a wide range of complex mental health issues including suicide prevention and co-existing problems. There will be a requirement to be able to prioritise issues and negotiate time frames, while still providing a quality customer service. The range of problems will be diverse and require solutions customised to meet the circumstances of the service user/ service delivery. Therefore opportunities will arise to provide innovative options to the service user/ service delivery based on proven outcomes. There will be demands to meet deadlines, maintain accuracy and quality of information. Failure to do so could impact on the organisation in terms of quality of service to service users and relationships within the integrated care pathway. Will refer to Nurse Lead Integrated Care, the Team Manager or Clinical Nurse Director Mental Health for advice or second opinion. Position description: Counties Manukau Health 9
SCOPE FOR ACTION Are empowered to make decisions or recommendations relating to position holders scope of practice and work related to this role. Are encouraged to use initiative and problem solving skills to develop innovative approaches to issues. Discretion is required to be exercised in releasing confidential information to the appropriate parties and in all aspects of the use of social media. This position description is not exhaustive and the incumbent may be requested to perform any reasonable task within the scope of the position as requested by the Manager /or Nurse Lead. This position description will be reviewed from time to time in consultation with the incumbent. DIMENSION OF THE POSITION Will be responsible to the Team Manager for the achievement of agreed objectives and operates within the confines of CM Health. POSITIONS REPORTING IN THIS ROLE (numbers) Directly : Indirectly : Nil Nil PERSON SPECIFICATIONS Minimum Qualifications New Zealand Nursing Registration with current annual practicing certificate Preferred Clinical Masters, nursing Formal supervision training Have or are working towards Post graduate certificate/diploma in Speciality Nursing Practice Have a professional development plan and /or career plan and current portfolio A full NZ Driver s Licence with no limitations Currently undertaking post graduate study in relevant subject Position description: Counties Manukau Health 10
Minimum Experience/knowledge Comprehensive understanding of the concepts embedded in Rising to the Challenge along with an extensive knowledge of mental illness, co-existing problems and treatment interventions Specific skills/personal and professional qualities Solid understanding of the expectations of: Equally Well, Health Literacy and Self Management programmes Minimum 5 years postregistration experience in Mental Health Functioning at RN Expert level 3 or senior nurse level on the PDRP Basic knowledge and understanding of medico/ legal and ethical responsibilities Leadership and client management skills Demonstrated knowledge of quality improvement skills Able to work with all CMH populations with a specific understanding of the cultural needs for Maaori Ability to facilitate change effectively at a personal and service level Works collaboratively across teams and sectors to achieve positive outcome for service users Knowledge of nursing professional development issues Knowledge of Mental Health Legislation Proven ability to prioritise and manage time High level of verbal and written communication Preferred Previous experience of working in a variety of clinical settings including a community mental health setting Demonstrated ability in advanced health assessment and diagnostic reasoning nursing practice Have or are working towards level 4 Expert nursing Demonstrated ability in programme development, project management, strategic planning and policy development Research skills including data, critical appraisal skill and clinical audit Demonstrated ability in expert practice working collaboratively across settings and within interdisciplinary environment Advanced clinical skills in assessment and treatment of a range of people with mental health issues including coexisting problems Active involvement in relevant, professional/ other organisations Position description: Counties Manukau Health 11
Minimum Able to share knowledge with a wide range of recipients Intermediate level of computer literacy Understands personal limitations and takes actions as necessary Demonstrated awareness of the implications for clinical practice of mental health sector policy and standards Preferred Position description: Counties Manukau Health 12
HEALTH AND SAFETY ACCOUNTABILITIES (Management roles) Health and Safety (H&S) is a key accountability of all Counties Manukau Health (CM Health) staff. All CM Health Managers are responsible to: Zero harm Risk management Safety Management System Requirements Work safely Engage in safe workplace practices and manage the health and safety of your employees and other people in the workplace. Engage in safe work practices. Ensure all Incidents involving staff are reported, investigated and any corrective actions are completed and closed off when completed in the Incident reporting system in line with CM Health Policies and Procedures. Ensure all corrective activities are completed and controls are reviewed after incidents. Ensure all staff are Inducted/Oriented to the division/service/work area and recorded in the OneStaff database and participate in Occupational Health and Safety matters. Manage all hazards, risks and incidents in the workplace by identifying, evaluating, reporting and controlling them effectively by maintaining a Hazard and Risk Register that is reviewed and kept up to date on an ongoing basis. Stop work where there is an immediate risk of serious harm and escalate to the appropriate manager. Maintain Occupational Health of employees due to workplace hazardous exposures. Ensure you and the employees understand and follow CM Health s Occupational Health and Safety policies and Health and Safety regulations, what your responsibilities are under the policies and implement these requirements effectively into your work area. Manage the work area s risk profile and how these relate to the corporate risk profile and implement and resource mitigation controls. Engage your employees to participate in Occupational Health and Safety matter. Report for duty in a fit state, free from the influence of alcohol or other drugs. Provide and wear the necessary Personal Protective Equipment for yourself and your staff when undertaking specific activities, or when in nominated areas. Ensure procedures are in place for clinical and plant equipment to be operated safely. Participate in relevant safety training, manage and maintain safety related competencies for yourself and your employees. Be in possession of required and current Certificates of Competency (If relevant to your position). Position description: Counties Manukau Health 13
HEALTH AND SAFETY ACCOUNTABILITIES (non-management roles) Health and Safety (H&S) is a key accountability of all Counties Manukau Health (CM Health) staff. All CM Health Employees are responsible to: Zero Harm Risk Management Safety Management System Requirements Work Safely Engage in safe workplace practices and take care of the health and safety of themselves, other employees and people in the workplace. Identify, evaluate and report all hazards and incidents they are aware of in the workplace. Adhere to apply risk controls, identified in risk assessments, such as Safe Operating Procedures. Follow safety instructions. Stop work when there is an immediate risk of serious harm and notify the appropriate manager. Ensure nothing they do or don t do will cause harm to themselves or others. Understand and follow CM Health s Occupational Health and Safety policies, Health and Safety regulations, and personal responsibilities as outlined by these policies. Follow all Occupational Health and Safety policies and procedures. Report for duty in a fit state, free from the influence of alcohol or other drugs. Participate in consultation activities regarding matters affecting your health, safety and wellbeing. Wear the required Personal Protective Equipment when undertaking specific activities, or when in nominated areas. Operate clinical or plant equipment safely. Participate in relevant safety training, and maintain safety related competencies. If relevant to your position, be in possession of required and current Certificates of Competency. Position description: Counties Manukau Health 14