Breast Advanced Nurse Practitioner (Annex 21) | Liverpool University Hospitals NHS Foundation Trust

Liverpool University Hospital NHS Foundation Trust Breast & Endocrine Surgery Service is recruiting two Advanced Nurse Practitioners to work within the Specialist Nursing Team and alongside the Surgical Team in the diagnosis and management of patients with breast disease. You will be joining a well established nursing team which currently includes seven experienced Advanced Breast Nurse Practitioners and twelve Macmillan Clinical Nurse Specialists.

The successful applicant will be instrumental in the provision of diagnostic, surveillance and follow up services, working both independently and as part of a multidisciplinary team. Ideally, the successful candidate will possess advanced clinical and communication skills and will be able to demonstrate a sound understanding of the issues related to breast disease. While those who already have the requisite skills will be welcome to apply, further postgraduate and in house training will be available and the successful candidate will be provided with any educational support needed.

There are several Nurse Led services provided by the nursing team. The ANPs are a vital member of the MDT and are pivotal in both the diagnostic services and follow up clinics. These are permanent full-time positions, 37.5 hours per week, across the Breast Units in both Aintree and Royal Liverpool Hospitals.

• Assist the development of Breast Care Services in collaboration with members of the multi disciplinary team in line with local and national initiatives.
• Promote and assist the development of clinical practice, education and research through collaborative partnerships with higher educational institutions.
• Improve patient care and nursing practice based on evidence based practice in Breast Care Nursing.
• Act as a resource for patients referred to the Trust and their families.
• Actively participate in delivery of education for nurses and other professions allied to medicine.
• Take a key role in the initiation of nursing research programmes, in partnership with the University Departments.
• Establish and develop liaison with clinical services involved in patients care.
• Provide the initiative to establish advanced nursing practice and empower team members to adopt new skills to continue to advance the role of nursing within the Breast Unit and to offer a range of skilled interventions.
• Act as a catalyst for change.

Work as an autonomous and independent practitioner only seeking advice from senior medical colleagues where necessary. Develop and promote advanced nursing practices to improve access to care, clinical care and patient experiences of care. Act as an information resource for patients and family. Participate in the development of Care Pathways and Guidelines written for use within the Breast unit. Write new protocols developed for breast nurse practitioner practice. Be expert in knowledge and understanding of Breast Cancer and benign breast disorders, diagnoses and treatments.

Provide service for vetting of >100 new patient referrals per week which entails decisions around urgency and appropriateness of referrals for breast services, clinical need of patient and planned radiological investigations. Establish and maintain nurse led clinics within hospital and nurse led follow up care in the community ie family history clinic and breast cancer home visits. Possess excellent interviewing and communication/counselling skills. This may include counselling in situations of bereavement or breaking bad news.

Enhance effective partnerships with a range of services in primary care and the voluntary sector to ensure continuity of care and optimum access to support services. Be expert in assessment of genetic risk associated with Breast Cancer. Collect familial information by questionnaire from patients. Use relevant knowledge of cancer inheritance theory and devise and analyse pedigree for all new patients to family history clinic. Liaise with the Clinical Genetics department and attend joint clinics. Record patients’ clinical history. Carry out clinical examination and patient assessment in order to establish a breast diagnosis.

Arrange Assess the need for patients to undergo clinical investigations and order same in line with Trust protocols (and Nurse Practitioner protocols as above). Be responsible for the recording and interpretation of patients’ investigation results and discuss the results and their implications with the patient. Perform complex invasive procedures ie core biopsies, FNA and punch biopsies according to nurse practitioner written protocols. Be competent in seroma assessment and drainage.

Provide a nurse practitioner service in the following areas of breast disease: Rapid diagnostic services to assess, diagnose, plan treatment and discharge patients, providing written resources where applicable. Breast Follow-up services for benign and malignant conditions, discharging patients as per agreed breast unit protocols.