Clinical Nurse Specialist Medical Oncology - Limerick Cancer Centre
Location: Limerick Cancer Centre
Job type: Permanent
Overview of role:
The CNS in Medical Oncology will provide expert nursing care and support to patients diagnosed with cancer, undergoing systemic anti-cancer therapy (SACT).
The CNS will act as a key liaison between patients, families, and multidisciplinary teams, ensuring continuity of care, symptom management, and psychosocial support throughout the cancer journey.
The CNS Medical Oncology will work closely with the patient, patient's medical team, nursing team, multidisciplinary team members to ensure evidence – based practice in delivering high standards of care in all areas of patient care. This will include, but is not limited to:
•Patient and family education pre and post treatment
•Serve as a clinical resource in relation to care of the patient undergoing medical oncology treatment (chemotherapy, infusions, immunotherapy etc.)
•Maintain a clinical database of patients and their treatment and outcomes (survivorship)
•Document all procedures, evaluations, treatments, outcomes, education and referrals consistent with Hospital policy and national / international standards
•Participate in follow up clinics / phone calls as required
Roles and responsibilities are developed around five core concepts which include:
•Clinical focus
•Service user / client advocacy
•Education and Training
•Audit and Research
•Consultancy – including leadership in clinical practice
The CNS Medical Oncology will be dynamic, enthusiastic, conscientious and passionate with strong clinical leadership and the ability to develop the role to meet the evolving needs of the Medical Oncology patient.
The CNS will be responsible for acting as a point of contact for patients in the out-patient setting, providing a telephone triage hotline service using a validated assessment tool (UKONS), undertaking detailed patient assessments and actively participate in planning and performing unscheduled review of patients presenting unwell to the oncology/haematology day units with disease/treatment related side effects.
The CNS will provide increased access to specialised cancer nursing care for patients on active treatment to enhance patient safety and minimise risks. The CNS will work within the acute haematology and oncology services as part of the MDT, forging relationships especially with, but not exclusively, ED, acute medical assessment units and CIT/community services and continue to develop the role in line with evidence based practice and NCCP guidelines
Primary Duties and Responsibilities:
Professional
/Clinical:
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
Clinical Nurse Specialist (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 :
The
CNS will:
* 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:
The
CNS will:
* 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:
The
CNS will:
* 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:
The
CNS will:
* 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 Key Performance Indicators
(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:
The
CNS will:
* 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:
The
CNS will:
* * 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:
The CNS will:
* 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
CNS
will:
* 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.
CNS
will 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.
Building
& Maintaining Relationships including Team and Leadership skills
* 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.
Analysing
and Decision Making
* Effective analytical, problem solving and
decision making skills
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.
At UPMC we provide a total rewards program
that is not only market competitive, but fair and provides growth opportunities
for all our colleagues.
Compensation – Competitive pay for the work employees do – base pay, performance related pay
and premium pay where applicable.
Benefits –
Fully paid maternity and paternity leave for new parents. Competitive Pension
Plan, company funded Death in Service Benefit x 3 times. Critical Illness cover
for all employees up to the age of 66.
Performance and Recognition – Rewards for performance that supports the goals and mission of
UPMC through our annual ACES programme.
Work-Life Balance – Enhanced annual leave up to a maximum of 27 days. Flexible
working opportunities to support you to work around external family
commitments.
Development
and Career Opportunities – Opportunities for each employee to reach
their career goals through continued learning and/or advancement.
About
UPMC
UPMC is a renowned multinational academic medical
centre committed to delivering people-focused care that's close to home.
Headquartered in Pittsburgh and affiliated with the University of Pittsburgh
Schools of the Health Sciences, UPMC shapes the future of health through
clinical and technological innovation, research and education.
UPMC expands its expertise globally, bringing world-class care across
continents through its UPMC International division — an owned and operated
network of hospitals and ambulatory care centres in Italy, Ireland and
Croatia. UPMC International brings new access to the signature specialty
services of UPMC Hillman Cancer Centre, UPMC Sports Medicine and others to
more people in more places around the world.
In Ireland UPMC has provided high-quality healthcare in the South East since
2006. UPMC's operations in Ireland now include UPMC Whitfield Hospital in
Waterford, UPMC Sports Surgery Clinic in Dublin, UPMC Kildare Hospital in
Clane, and UPMC Aut Even Hospital in Kilkenny. Outpatient care is available at
the UPMC Carlow Outreach Centre, UPMC Hillman Cancer Centre radiotherapy
locations in Waterford and Cork, UPMC The 4th Practice in Mallow, and across
UPMC Sports Medicine Clinics in Dublin, Waterford, Limerick, Tipperary, Cork, and
Mayo. UPMC has also established a nationwide Concussion Network. UPMC's
Global Technology Operation Centre is based in Kilkenny.