Clinical nurse specialist medical oncology

Clinical Nurse Specialist Medical Oncology (Permanent) - Limerick Cancer Centre

Overview of role:
Primary Duties and Responsibilities:

The post holder's practice is based on the five core concepts of Clinical Nurse Specialist role as defined by the NCNM 4th edition in order to fulfil the role. The concepts are:

* Clinical Focus
* Patient/Client Advocate
* Education and Training
* Audit and Research
* Consultant Clinical Focus.

Clinical Focus
The 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 CNS :

* Provide a specialist nursing service for patients with a new diagnosis of cancer.
* Undertake comprehensive patient assessment to include physical, psychological, social and spiritual elements of care using best evidence based practice.
* Use the outcomes of patient assessment to develop and implement plans of care/case management in conjunction with the multi-disciplinary 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 (PPPG's).
* 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 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.
* Manage nurse lead 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 patient's needs.

Indirect Care:

* Participate in case review with MDT colleagues
* Use a case management approach to patients with complex needs in collaboration with MDT in both Primary and Secondary Care as appropriate.
* Take a proactive role in the formulation and provision of evidence based PPPGs relating to supportive care for cancer patients.
* Take a lead role in ensuring the service for patients who require survivorship care is in line with best practice guidelines and the Safer Better Healthcare Standards (HIQA, 2012)

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 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 UPMC Ireland Services and other organisations as appropriate
* Proactively challenge any interaction which fails to deliver a quality service to patients

Managerial Responsibilities:

* Provide an efficient, effective and high quality service, respecting the needs of each patient, family and/or carer.
* Effectively manage time and caseload in order to meet changing and developing service needs.
* Continually monitor the service to ensure it reflects current needs.
* Implement and manage identified changes.
* Ensure that confidentiality in relation to patient records is maintained. * Represent the specialist service at local, national and international fora as required.
* Maintain accurate and contemporaneous records and data on all matters pertaining to the planning, management, delivery and evaluation of care and ensure that this service is in line with HSE requirements.
* Contribute to the service planning process as appropriate and as directed by the ADON Medical Services.
* Have a working knowledge of the Health Information and Quality Authority (HIQA) Standards as they apply to the role for example, Standards for Healthcare, National Standards for the Prevention and Control of Healthcare Associated Infections, Hygiene Standards etc. and comply with associated HSE protocols for implementing and maintaining these standards as appropriate to the role.
* To support, promote and actively participate in sustainable energy, water and waste initiatives to create a more sustainable, low carbon and efficient health service.

KPI's

The identification and development of KPIs which are congruent with the Hospital's service plan targets.

* The development of Action Plans to address KPI targets.
* Driving and promoting a Performance Management culture.
* In conjunction with line manager assist in the development of a Performance Management system for your profession.
* The management and delivery of KPIs as a routine and core business objective.

Education & Training:

* Maintain clinical competence in patient management within cancer nursing and nursing/midwifery, 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 condition.
* Contribute to the design, development and implementation of education programmes and resources for the patient, family and/or carer in relation to diagnosis and survivorship issues thus empowering them to self-manage their condition.
* Provide mentorship and preceptorship for nursing colleagues as appropriate.
* Participate in training programmes for nursing and MDT colleagues as appropriate
* Create exchange of learning opportunities within the MDT in relation to evidence based survivorship care delivery through journal clubs, conferences etc.
* Be responsible for addressing own continuing professional development needs.

Audit & Research:

* Establish and maintain a register of patients referred to the CNS.
* Maintain a record of clinically relevant data aligned to National Key Performance Indicators (KPI's) as directed and advised by the ADON Medical Services.
* Identify, initiate and conduct nursing and MDT audit and research projects relevant to the area of practice.
* Identify, critically analyse, disseminate and integrate best evidence relating to Cancer treatment and care.
* Contribute to nursing research on all aspects of survivorship care for cancer patients.
* 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

Audit expected outcomes including:

* Collate data (agreed KPIs/clinical targets as per the National Cancer Control Programmes Guidelines), which will provide evidence of the effectiveness of CNS interventions undertaken 3 or 4 - Refer to the National Council for the Professional Development of Nursing and Midwifery final report - Evaluation of Clinical Nurse and Midwife Specialist and Advanced Nurse and Midwife Practitioner roles in Ireland (SCAPE Report, 2010) and refer to the National KPIs associated with the speciality. They should have a clinical nursing focus as well as a breakdown of activity - patients seen and treated.
* Evaluate audit results and research findings to identify areas for quality improvement in collaboration with nursing management and MDT colleagues.

Consultant:

* Provide leadership in clinical practice and act as a resource and role model for Oncology 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 Oncology Clinical Nurse Specialist's/Registered Advanced Nurse/Midwife Practitioner/MDT colleagues as appropriate, developing person centred care pathways to promote the integrated model of care delivery.
* With the support of the Director of Nursing, attend integrated care planning meetings as required.
* Where appropriate develop and maintain relationships with specialist services in voluntary organisations which support patients in the community.
* Liaise with other health service providers in the development and on-going delivery of the National Clinical Programme model of care.

Quality, Risk and Safety Responsibilities:

Network with other Clinical Nurse Specialist in Oncology and in related professional associations.

It is the responsibility of all staff to:

* 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
* Participate and cooperate with internal and external evaluations of the organisation's structures, services and processes as required, including but not limited to, The National Hygiene Audit, National Decontamination Audit, Health and Safety Audits, CHKS, DGSA, ISO and other audits specified by regulatory authorities
* Initiate, support and implement quality improvement initiatives in their area which are in keeping with local organisational quality, risk and safety requirements
* Contribute to the development of PPPGs and safe professional practice and adhere to relevant legislation, regulations and standards
* Comply with UPMC Ireland Complaints Policy Ensure completion of incident/near miss forms and clinical risk reporting
* Adhere to department policies in relation to the care and safety of any equipment supplied and used to carry out the responsibilities of the role of CNS.
* It is the responsibility of all staff to ensure compliance with local organisational hygiene standards, guidelines and practices

Skills, competencies and/or knowledge:

Professional Knowledge

* Practice in accordance with relevant legislation and with regard to The Code of Professional Conduct and Ethics for Registered Nurses and Registered Midwives (Nursing and Midwifery Board of Ireland) Incorporating, The Scope of Nursing & Midwifery Practice and Professional Guidance 2025)
* Maintain a high standard of professional behaviour and be professionally accountable for actions/omissions. Take measures to develop and maintain the competences required for professional practice
* Adhere to the Nursing & Midwifery values of Care, Compassion and Commitment (DoH, 2016)
* Adhere to national, regional and local HSE PPPGs
* Adhere to relevant legislation and regulation
* Adhere to appropriate lines of authority within the nurse/midwife management structure.

Demonstrate:

* In-depth knowledge of the role of CNS Oncology liaison
* In-depth knowledge of the pathophysiology of psychological issues with patients in their patient cohort.
* The ability to undertake a comprehensive assessment of the patient experiencing complications of Systemic Anti-Cancer Therapies, including taking an accurate history of their condition and presenting problems.
* The ability to employ appropriate diagnostic interventions including use of the UKONS Telephone Triage toolkit to support clinical decision making and the patients' self- management planning
* The ability to formulate a plan of care based on findings and evidence based standards of care and practice guidelines
* The ability to follow up and evaluate a plan of care
* Knowledge of health promotion principles/coaching/self-management strategies that will enable people to take greater control over decisions and actions that affect their health and wellbeing
* An understanding of the principles of clinical governance and risk management as they apply directly to CNS role and the wider health service.
* Evidence of teaching in the clinical area
* A working knowledge of audit and research processes
* Evidence of computer skills including use of Microsoft Word, Excel, E-mail, PowerPoint

Communication and Interpersonal Skills

* Effective communication skills
* Ability to build and maintain relationships particularly in the context of MDT working
* Ability to present information in a clear and concise manner
* Ability to manage groups through the learning process
* Ability to provide constructive feedback to encourage future learning
* Effective presentation skills.

Organisation and Management Skills:

* Evidence of effective organisational skills including awareness of appropriate resource management
* Ability to attain designated targets, manage deadlines and multiple tasks
* Ability to be self-directed, work on own initiative
* A willingness to be flexible in response to changing local/organisational requirements

* Leadership, change management and team management skills including the ability to work with MDT colleagues.

Commitment to providing a quality service:

* Awareness and respect for the patient's views in relation to their care
* Evidence of providing quality improvement programmes
* Evidence of conducting audit
* Evidence of motivation by ongoing professional development.

Qualifications & Experience:
Key Requirements:

Candidates must have at the latest date of application:

1. Professional Qualifications, experience etc.

(a) I) Be a registered nurse on the active Register of Nurses and Midwives held by An Bord Altranais agus Cnáimhseachais na hÉireann (Nursing and Midwifery Board of Ireland) or be eligible to be so registered

Evidence of career development and personal development plan

And

Demonstrate evidence of continuing professional development and

competence in delivering a professional service in Cancer Nursing

(b) Have the ability to practice safely and effectively fulfilling his/her professional responsibility within his/her scope of practice
2. Annual registration

(i) Practitioners must maintain live annual registration on the appropriate/relevant

Division of the register of Nurses and Midwives maintained by the Nursing and

Midwifery Board of Ireland (Bord Altranais agus Cnáimhseachais na hÉireann) for the role

And

(ii) Confirm annual registration with NMBI to UPMC Ireland.

Skills/Competencies:

* Practice in accordance with relevant legislation and with regards to The Scope of Nursing and Midwifery Practice Framework (Nursing and Midwifery Board of Ireland, 2015) and the Code of Professional Conduct and Ethics for Registered Nurses and Registered Midwives (Nursing and Midwifery Board of Ireland, 2014) Demonstrate:
* Effective communication skills.
* Organisation and time management skills.
* Effective analytical, problem solving and decision-making skills.
* Commitment to provide a quality service
* Have an Oncology Qualification from an accredited institution
* Have a recognised post-registration nursing course - Higher Diploma or Post Grad course or be in pursuit of same.
* Have extensive experience and clinical expertise i.e. minimum of 4 years post registration experience in the specialist area of Cancer Care.
* Have the ability to practice safely and effectively fulfilling his/her professional responsibility within his/her scope of practice.

Job Specific Competencies and Knowledge:

* Competent in IV/Oral Chemotherapy administration
* Competent in accessing, maintaining & care of CVAD devices
* Competent in IV Cannulation & Venepuncture

Equal Opportunity Statement and Benefits
UPMC is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.