Clinical Nurse Specialist (Prescriber) in Lichfield

The Clinical Nurse Specialist (Prescriber) is a key senior role within the Nursing team, acting as the clinical specialist lead and overseeing the community nursing service for a defined area on a rotation basis. Working with an integrated team of nurses, you will contribute to the overall care of patients and families referred to St Giles Hospice within the community setting. This role will report directly into the Clinical Lead for Community Services. As a team member, you will contribute to a positive supportive working environment with an emphasis on teamwork and cooperation. You will participate in a rota system providing a 7 day a week, face to face and telephone service for patients and their families and, in the out of hours rota, providing telephone advice and support. This may include visiting out of hours in exceptional circumstances.

Main duties of the job

It is anticipated that the work plan will be 80% clinical (clinical management), 10% Service Development and 10% Education and Teaching. The role includes activities such as audit, quality and risk management initiatives and Nurses working at an advanced level will:

• Practice autonomously and be self-directed.
• Appropriately analyse complex situations.
• Undertake assessment of individuals using a range of different assessment methods, which may include physical examination, ordering and interpreting diagnostic tests or advanced health needs assessment.
• Draw on a diverse range of knowledge in their decision-making to determine evidence based therapeutic interventions; this may include prescribing medication and actively monitoring the effectiveness of therapeutic interventions.
• Actively seek and participate in peer reviews of their own practice.
• Appropriately define the boundaries of their practice and understand the parameters of their professional role.
• Promote and participate in the implementation of the local and national strategies and St Giles Hospice core standards.

About us

St Giles Hospice is a registered charity founded in 1983 by the Reverend Paul Brothwell, originally to improve the care of local people dying with cancer. We now support patients, and their loved ones, living with a terminal illness. Our dedicated team provides individually-tailored care, free of charge, either at the hospice or in patients' own homes across our communities. We spend close to £10 million a year providing our specialist services. With just 18% of this funded by the Government, we rely heavily on donations and income generation from the local community.

Job responsibilities

The role entails but is not limited to:

• Be an effective role model to the team and other primary healthcare colleagues.
• Provide effective leadership to the team, acting as a role model for best practice and with honesty and integrity.
• Provide professional/clinical leadership to other Clinical Nurse Specialists and other grades of staff, acting as a point of expertise, providing advice and support.
• Input into workforce planning process and maintaining effective use of resources (rota and rotation of staff) supported by clinical administration.
• Participate in multi-professional meetings, acting as a patient advocate and contribute to the decision making regarding service delivery.
• Attend appropriate patient related and team meetings.
• Participate in service development initiatives as required instigating and managing change within a complex environment.
• Work with the Head of Clinical Services to develop St Giles Hospice policies and processes and ensure team compliance.
• To be responsible for assurance of quality standards and clinical governance, standard setting and audit.
• Maintain high professional standard in accordance with Hospice policies and procedures and the NMC Code of Professional Conduct.

Clinical

Be responsible for the continued co-ordination of the content and delivery of your allocated patient's care plan and ensure that the patient is getting the right service from St Giles Hospice. Undertake patient clinical assessments and nurse prescribing. In liaison with other Clinical Nurse Specialists and other members of the community team, ensure the overall quality and provision of nursing care of patients and families referred to St Giles Hospice in the community setting and that their needs are met. To promote the principles and practice of palliative care as an extension of the Hospice into the community. To work across a range of settings, including community visits e.g. home/care home/community hospitals, telephone conversations and reviewing patients in outpatient settings. To assess the holistic needs of patients and their carers and identify their respective physical, psychological, social, cultural and spiritual needs. To work within a team framework, collaborating with colleagues and members of other disciplines. Work across all St Giles Hospice clinical areas. To use a proactive, sensitive and empathetic approach with patients and relatives to enable involvement in advance care/treatment planning. To undertake ReSPECT/Advanced Care Planning discussions and decisions where appropriate with patients and families. To assess people's information needs and provide relevant information to meet those needs. To offer bereavement support to carers in collaboration with the Family Support Worker Team or refer them onto the appropriate service. To work alongside and liaise with DNs, GPs and other external Health and social care providers to ensure patients and families receive appropriate care and support. To participate in the out of hours rota to provide telephone advice and exceptional visits if indicated. To contribute to patient management by attending Gold Standard Framework, hospital and other practice-based meetings. To liaise and communicate with community, nursing home and hospital staff in order to raise awareness and promote understanding of Hospice services. Ensure that all relevant information is documented and recorded on the appropriate systems. Foster positive working relations with the Primary Healthcare Team and with other health care professionals in the delivery of community based palliative care.

Allocated Lead Responsibilities

For those working in the community, these roles will also take lead responsibility for a defined area on a rotational basis working on:

• Audit and research programmes.
• Input into Clinical Governance framework.
• Chairing the Caseload Review meetings.
• Undertake leadership responsibilities for all areas.

Service Development

Provide input to service development initiatives. Ensure systems are in place to ensure continuous improvement, quality assurance and effective Clinical Governance and participate in the development of policies, protocols and clinical guidelines to support specialist palliative care nursing. Promote and engage staff in new ways of working - such as the use of technology and working off site. Support and review departmental policies and processes and ensure team compliance. Keep abreast of current advances in nursing practice and research. Together with the Deputy Director of Clinical Services, initiate, promote and participate in nursing and inter-disciplinary audit projects. Together with the Deputy Director of Clinical Services, take a key role in supporting the hospice Clinical Governance framework. Work across professional boundaries using creative reasoning and problem solving.

Education and Training

To take responsibility for attending mandatory Hospice training and in-house courses in line with organisational policy and current legislation. To actively participate in and contribute to the ongoing educational programme of the Hospice. To attend and actively participate in the identified CPD opportunities provided. To proactively maintain appropriate level of clinical competence as identified within the St Giles Hospice Competencies. To identify training and education needs, in line with service provision, with the clinical education team. To assist in orientation programmes for new members of staff. To act as a mentor/supervisor for developing staff under the direction of the Head of Clinical Services. To participate in research projects as required. To take personal responsibility for life-long learning, self-development and reflection. To participate in informal and formal education.

Key relationships:

• Director of Clinical Services
• Head of Clinical Services
• Clinical Lead for Community Services
• Head of Clinical Quality and Safety Governance
• Medical team
• Inpatient Unit team
• Education team
• Governance team
• Wider multi-disciplinary team
• Family Support Worker Services

Person Specification

Values

Exhibits our hospice values and behaviours.

Skills

• Sound reflective and facilitation skills
• Expert communication, counselling and interpersonal skills
• Teaching skills - informal and formal and ability to contribute to education programme
• Ability to work independently and as part of a team
• Ability to make expert clinical decisions
• Emotionally resilient

Experience

• Community nursing experience
• Experience and evidence of clinical audit
• Published original work
• Proven experience within specialist palliative care
• Experience and evidence of effective change management
• Experience and evidence of research/evidence based practice
• Experience and competence in managing complex palliative care cases - symptoms, psychological, grief/loss needs, ethical dilemmas and patient advocacy
• Fully comprehends contemporary CNS role
• Experience of development, implementation and appraisal of quality and audit initiatives
• Knowledge of corporate and clinical governance
• Fully comprehends and implements research and evidence based practice process
• Diverse specialist palliative care knowledge and awareness - national and local agenda

Personal Attributes

• Sound reflective and facilitation skills
• Expert communication, counselling and interpersonal skills
• Teaching skills - informal and formal and ability to contribute to education programme
• Ability to work independently and as part of a team
• Ability to make expert clinical decisions
• Emotionally resilient

Other requirements

• Valid driving licence
• Eligibility to work in the UK

Please note that St Giles Hospice does not hold a sponsorship licence and is therefore unable to accept sponsorship requests.

Qualifications

• Registered Nurse (Degree/Masters level)
• Current NMC Registration
• Recognised teaching qualification or equivalent
• Physical Health Assessment Level 6 minimum
• Willing to undertake additional study as required
• Degree in specialist practice related to specialist palliative care
• Community Nursing qualification
• Leadership course
• Management course

This post is subject to the Rehabilitation of Offenders Act (Exceptions Order) 1975 and as such it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service (formerly known as CRB) to check for any previous criminal convictions.

£47,065.39 to £54,085.12 a year pro rata for part time hours (plus enhancements where applicable).