Palliative care clinical nurse specialist

Job overview

A part time, fixed term clinical nurse specialist vacancy has arisen within the specialist palliative care team at North Bristol NHS Trust.

The Palliative Care Team is a hospital based multi-disciplinary team who receive approximately 2,150 patient referrals per year from all specialities within the Trust

The role involves:

• facilitating the highest possible quality of care to palliative care patients and their families.
• providing specialist symptom control advice and support to patients, their relatives and carers and to professional colleagues in an acute hospital setting.
• facilitating rapid or complex discharges enabling where possible preferred place of care at end of life.
• support health care professionals who are involved in caring for palliative care patients in both hospital and community settings through role and education.
• acting as an independent practitioner with a defined clinical caseload.

Main duties of the job

The Palliative Care Team is a hospital based multi-disciplinary team who receive approximately 2,150 patient referrals per year from all specialities within the Trust

This role involves:

• facilitating the highest possible quality of care to palliative care patients and their families.
• providing specialist symptom control advice and support to patients, their relatives and carers and to professional colleagues in an acute hospital setting.
• facilitating rapid or complex discharges enabling where possible preferred place of care at end of life.
• support health care professionals who are involved in caring for palliative care patients in both hospital and community settings through role and education.
• acting as an independent practitioner with a defined clinical caseload.

Detailed job description and main responsibilities

Responsibilities for patient care

• To provide specialist advice to nursing, medical and paramedical staff within the provider unit regarding all aspects of evidence based palliative care and cancer related issues
• To offer support, advice and information to patients, their families and carers on all aspects of palliative care
• To regularly review the effectiveness of treatment plans and suggest changes as a result of new information or changes in a patients condition
• To act as a patients advocate where necessary
• To independently manage a caseload of patients, assessing, planning, implementing and evaluating individual care needs in a manner that maintains and promotes quality
• To respect patients dignity, wishes and beliefs involving them in shared decision-making
• To liaise and establish good working relationships with health care professionals and other disciplines involved in the patient’s care
• To recognise and advise on changes in a patient’s condition that may affect care planning, discharge and treatment
• To achieve effective changes in practice to ensure a palliative care approach using diplomatic interaction and negotiation skills with all grades of staff.
• To contribute to effective discharge planning in order to ensure continuity of care between hospital and community
• To ensure resources are used effectively and liaise with relevant health and social care agencies when deficiencies in patient care arise
• To contribute to multidisciplinary meetings
• To refer patients to other specialist agencies as necessary

Responsibilities for policy, service development and implementation:

• To keep professionally updated on research evidenced based care delivery
• To continually reflect on practice to improve patient outcomes
• To actively promote equality and diversity
• To recognise and understand financial budgets when recommending on specialist palliative care equipment and drugs
• To works in conjunction with budget holders to ensure cost effective approach to symptom management and equipment use
• To contribute to the development, dissemination and implementation of guidelines and protocols on palliative care issues
• To contribute to clinical governance initiatives
• To propose changes to working practices within own and other specialist areas to improve patient outcomes

Responsibilities for Research, Audit and Development

• To regularly lead/contribute in clinical audit initiatives and research, which influence practice development
• To disseminate clinical audit outcomes to improve professional practice and/or patient care
• Responsibilities for information resources and systems
• To maintain accurate and contemporaneous records and data, protecting confidential information in compliance with the Data Protection Act and Trust Policy

Responsibility for Human Resources

• To regularly provide specialist training and education on cancer and palliative care to a wide range of multi-professionals, including pre-registration nurses and medical students, medical, nursing and all other allied health care professional teams
• To provide effective clinical placements for pre and post registration nurses and medical students
• To act as a role model for good practice
• To be aware of the well being of all members of the palliative care team and support them appropriately
• To act as an educational resource and adviser to staff, patients and their carers
• To provide clinical supervision/mentorship to other health care professionals
• To evaluate the effectiveness of learning and development informed by learners, others in the team and own reflections and use the evaluation to inform future practice
• To practice within NMC Code of Professional Conduct
• To work within the policies and procedures of the North Bristol NHS Trust
• To keep up to date with current developments in the field of palliative care and other related areas
• To attend mandatory training as defined by the Trust
• To be aware of local infection control policies and procedures
• To ensure working conditions are safe, in accordance with the Health and Safety at Work Act
• To ensure a secure environment is maintained and that breaches of security are brought to the attention of the team leader, and promptly reported and recorded according to Trust policy
• To keep up to date in national, local and Trust development/policy
• To respond to, record and report any adverse events or incidents relating to interventions/ treatments
• To report on accidents/ incidents using RADAR  as appropriate
• To engage in appropriate exercises, training and investigations to update and extend knowledge to ensure safe and competent practice

Significant post registration experience of which 2 years involves recent experience in caring for patients with end stage non-malignant disease, cancer or patients who are receiving palliative care.

• Recognised teaching qualification (ENB 998 or equivalent)
• Evidence of recent study at degree /M level
• To work autonomously and without direct supervision
• To be accountable for own actions when making clinical decisions regarding patient management
• To carry out key responsibility for management of client caseload regarding provision of specialist palliative care support and advice.
• Advanced interpersonal, communication and organisational skills.
• To motivate and empower staff to address palliative care needs in a holistic manner.
• To communicate bad news to patients and families in a sensitive manner and

support and guide staff in the breaking of bad news.

• To identify and resolve complex physical and psycho-social needs using expert/ evidence based assessment and facilitatory skills.
• To assess palliative care patients needs using a systematic process of reasoning including making of a differential diagnosis.
• To use and disseminate in-depth knowledge of symptom management using drug and non-drug measures.
• To coordinate and negotiate care packages with internal and external health and social care agencies.
• To recognise and respond appropriately to complex bereavement issues.
• IT skills including Microsoft Word, email, Excel and Powerpoint