Clinical Nurse Specialist (CNS) / Clinical Midwife Specialist (CMS)
Job Specification Template, Terms & Conditions
Job Title and Grade / Clinical Nurse Specialist (CNS)Diabetes(Grade Code2632)
Competition Reference / NRS575
Closing Date / 12 noon Wednesday 15th February 2012
Proposed Interview date(s) / Week commencing 12th March 2012
Taking up Appointment / A start date will be indicated at job offer stage
Location of Post / Diabetic Day Centre, Cavan General Hospital, Cavan Monaghan Hospital Group
Organisational Area / HSE Dublin North East
Details of Service / The Diabetic Service provides Education and Management to all patients with Diabetes, Paediatric and Adults Type 1 and Type 2 and Gestational Diabetes.
The possible future developments for the service will include:
1. Implementing Chronic Illness Programmes.
2. To have an Advances Nurse Practitioner in post.
3. To develop Joint Renal and Cardiac Diabetes services.
The team structure at present consists of Consultant Physician, Consultant Paediatrician, Clinical Nurse Specialist, Dietician, Chiropodist and Secretarial Support.
The areas covered by this service are Cavan, Monaghan and parts of Counties Leitrim, Longford and Meath.
Reporting Relationship / –Professional Accountability: Director of Nursing.
–Operational Accountability: Assistant Director of Nursing, Medical Services Manager.
–Clinically responsible to: Consultant
Purpose of the Post / The management of Diabetes demands a broad range of professional skills which includes communication, counselling, leadership, teaching and research. The Clinical Nurse Specialist is described as an administrator, leader, manager, collaborator, practitioner, advanced clinician, consultant, educator and researcher. The role has emanated from the premise for the need to provide social and psychological support and education on how to manage disease for patients and their families.
The Diabetes Nurse Specialist has the expertise and specialist knowledge to incorporate these skills into practice and develop standards of care that benefits the patient. It has been suggested that patient orientated outcomes are positively influenced and significant benefits accrue for patients with the involvement of the Clinical Nurse Specialist. The Clinical Nurse Specialist is considered an important contribution to advancing clinical practice and nursing diagnosis and recognised as an advisor in setting standards and policies of care.
The Diabetes Nurse Specialist plays a pivotal role within the multi-disciplinary team. The recognition of the contribution of the Diabetes Nurse Specialist in helping patients achieve good glycaemic control highlights his/her essential role in diabetes care. The Diabetes Nurse Specialist works in collaboration with the team to ensure continuity of care lends towards more successful management. The role of the Diabetes Nurse Specialist is defined as the provision of primary, secondary and tertiary care to people who are diagnosed with Diabetes where nursing intervention contribute to a healthy lifestyle and prevention of complications associated with diabetes.
Principal Duties and Responsibilities / Clinical Focus
The CNS will:
- Articulate and demonstrate the concept of nursing and midwifery specialist practice within the framework of relevant legislation, the Scope of Nursing & Midwifery Practice Framework (ABS 2000), The Code of Professional Conduct (ABA 2000) and Guidelines for Midwives (ABA 2001)
- Perform nursing / midwifery assessments and plan and initiate care and treatment modalities within agreed interdisciplinary protocols to achieve patient / client centred outcomes; evaluates their effectiveness
- Identify health promotion priorities in the area of specialist practice
- Implement health promotion strategies for patient / client groups in accordance with the public health agenda
- Have a working knowledge of 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.
- Organising the planning and implementation of carefor people with diabetes and their significant others.
- Encouraging a healthy lifestyle behaviour as part ofhealth promotion strategy.
- Working in collaboration with other colleagues and as amember of the multidisciplinary team to provide specialist advice for people with diabetes.
- Providing a telephone advice service for ongoingassistance and advice.
- Participating in the provision of a specialist outpatientservice for people with diabetes.
- Participating in the provision of psychological care for people with diabetes and their significant others.
- Altering treatments within the prescribed clinical options recognising agreed protocols.
- Maintaining accurate and completes nursing records.
- Establishing clear referral patterns for communicatingand co-operating with medical, nursing and other relevant professionals such as general practitioners, public health and practice nurses.
- Providing a service that is evidence based and aims toimprove quality of life for people with diabetes.
- Improving the standards of care by promoting nursing research and developing nursing expertise.
- Evaluating the effectiveness of education programmes on an on-going basis.
Components of the role of the Diabetes Nurse Specialist include:
- Patient assessment and diagnosis.
- Care prioritized based on assessment.
- Nursing interventions based on evidence based practice.
- On-going assessment, monitoring and evaluation.
- Patient education, discharge planning and referral to other sources of care within their specialist practice.
- Setting realistic educational and treatment goals.
- Assessing and evaluating the learning abilities of patients.
- Educating people with diabetes so that they can manage their diabetes and enable them to learn to lead a full, active and healthy life.
- Involving significant others where appropriate in the teaching process.
- Encourage people with diabetes to become active partners in their care.
- Acting as a resource person for people with diabetes.
- Providing individual and group education for people with diabetes and their families.
- Providing a service for special needs groups with diabetes, suchas paediatrics and adolescents, young adults, expectant mothers, ethnic minorities and those with learning difficulties.
This includes:
- Actively participating in the management of the Diabetes Service.
- Making management decisions for which the Diabetes Nurse Specialist is professionally accountable.
- Making autonomous decisions with/or on behalf of the patient to augment and support their health potential and promote their continuity of care.
- Promoting a safe environment for patients in accordance with Health and Safety, Infection Control and Risk Management Guidelines.
- Devising appropriate protocols, policies and guidelines with the multidisciplinary team.
- Setting standards appropriate for a learning environment for both patients and staff.
- Be actively involved in clinical decision making.
- Be actively involved in the on-going development and implementation of service plans with the relevant personnel.
- Participating in the development and successful implementation of multidisciplinary care pathways incorporating national and local guidelines.
- Establishing and maintaining links across services by providing a pivotal role between primary and secondary care.
- Identifying service needs in relation to change and best utilizing available resources.
The CNS will:
- Enable patients / clients, families and communities to participate in decisions about their health needs
- Articulate and represent patient / client interests in collaboration with the multidisciplinary team
- Implement changes in healthcare service in response to patient / client need and service demand
- Organise, interpret, intervene and monitor care ofthe patient with diabetes.
- Act as a patient advocate using clinical specialistknowledge and skills in the area of diabetes care.
- Take responsibility for initiating primary, secondaryand tertiary care for people with diabetes.
- Act as a role model and uses non-cohesive influence todirect others.
- Ensure that the approach to care recognises the uniqueneeds and views of individual patients and their families.
- Establish and maintain communication links withservice users and voluntary groups to promote patient centred care.
- Promote public and professional awareness for the careof people with diabetes.
The CNS will:
- Provide mentorship, preceptorship, teaching, facilitation and professional supervisory skills for nurses and midwives and other healthcare workers
- Educate patients / clients, families and communities in relation to their healthcare needs in the specialist area of practice
- Identify own continuing professional development needs and engage accordingly
- Assess and respond to the educational needs of staffand students.
- Continually liaise with the training and academicdepartments to deliver on-going programmes of diabetes education both in the hospital and in the community.
- Demonstrate responsibility for professional growth byensuring personal and professional development.
- Demonstrates a knowledge of, and work within An Bord Altranais Code of Professional Conduct.
- Ensures that professional practice is researched based best practice and is clinically effective.
The CNS will:
- Identify, critically analyse, disseminate and integrate nursing / midwifery and other evidence into the area of specialist practice
- Initiate and participate in evaluations and audits
- Use the outcomes of audit to improve service provision
- Contribute to service planning and budgetary processes through use of audit data and specialist knowledge
- Being actively involved in research that is relevant toclinical practice.
- Being actively involved in data collection for thepurpose of auditing and evaluating the service provided.
- Setting standards appropriate to a learning environment.
- Devising and updating local written protocols and
- guidelines based on evidence based best practice thatmeet national and international standards.
- Playing an active role in service development byworking in conjunction with the multidisciplinary team and management in devising service plans based on audit and research.
The CNS will:
- Provide leadership in clinical practice and act as a resource and role model for specialist practice
- Generate and contribute to the development of clinical standards of practice and guidelines
- Use specialist knowledge to support and enhance generalist nursing / midwifery practice
- Acts as a role model and resource by providingprofessional leadership in clinical practice.
- Utilise specialist knowledge to support generalistnursing knowledge.
- Promote and foster good relationships withother professionals and departments to enhance multidisciplinary team working and develop efficient and effective patient care pathways.
- Promote research and development andparticipate in local, national and international committees and conferences.
- Contribute to the development of policies, procedures, guidelines and safe professional practice and adhere to relevant legislation, regulations and standards
- Have a working knowledge of HIQA Standards as they apply to the role / care setting, for example, Standards for Healthcare, National Standards for the Prevention and Control of Healthcare Associated Infections, Hygiene Standards etc.
- Provide an efficient, effective, and high quality service, respecting the needs of each patient / client
- Effectively manage time and caseload in order to meet the needs of a changing and developing service
- Continually monitor the service to ensure it reflects current needs
- Implement and manage identified changes
- Ensure that confidentiality in relation to patient /client records is maintained
- Maintain accurate and up to date statistics of the service provided, including audit of patient / client contacts
- Represent the specialist service at local, national and international meetings as required
- Maintain accurate and contemporaneous records / data on all matters pertaining to the planning, management, delivery and evaluation of this service in line with HSE requirements
Eligibility Criteria
Qualifications and/ or experience / Candidates must:-
On the latest date for receipt of application forms for the post
- Be registered in the relevant Division of the Register of Nurses kept by An Bord Altranais or be entitled to be so registered
- Have at least 5 years post registration experience in the division of the register in which the applicant is currently practising
- Have a minimum of 2 years experience in the specialist area
- Have the ability to practice safely and effectively fulfilling his/her professional responsibility within his/her scope of practice
- Must demonstrate evidence of continuing professional development
- From 1st September 2010 must have a Level 8 post registration National Qualifications Authority of Ireland major academic award relevant to the specialist area prior to application
No age restriction shall apply to a candidate where he/she is not classified as a new entrant (within the meaning of the Public Service Superannuation Act, 2004). In this case the candidate must be under 65 years of age on the first day of the month in which the latest date for receiving completed application forms for the office occurs.
Health
Candidates for and any person holding the office must be fully competent and capable of undertaking the duties attached to the office and be in a state of health such as would indicate a reasonable prospect of ability to render regular and efficient service.
Character
Candidates for and any person holding the office must be of good character.
Post Specific Requirements, additional qualifications and/or experience required / n/a
Skills, competencies and/or knowledge / Candidates must demonstrate:
- practitioner competence and professional credibility – demonstrates a high level of clinical knowledge to effectively carry out the duties and responsibilities of the role
- the ability to lead on clinical practice and service quality
- promotion of evidence-based decision making; evidence-based clinical knowledge in making decisions regarding patient / client care
- the ability to plan and manage resource effectively
- effective analytical, problem solving and decision making skills
- strong interpersonal skills including the ability to build and maintain relationships
- effective communication and influencing skills
- initiative and innovation in the delivery of service
- resilience and composure
- openness to change
- integrity and an ethical stance
- a commitment to continuing professional development
- the ability to relate nursing research to nursing practice
- knowledge of quality assurance practices and their application to nursing procedures
- awareness of relevant legislation and policy e.g. legislation relevant to the service area, health and safety, infection control etc.
- awareness of current and emerging nursing strategies and policies in relation to the clinical/designated area
- awareness of the Health Service Transformation Programme
- a willingness to develop IT skills relevant to the role
Other requirements specific to the post / Access to transport as post may involve travel.
Competition Specific Selection Process
Shortlisting / Interview / Short listing may be carried out on the basis of information supplied in your application form. The criteria for short listing are based on the requirements of the post as outlined in the eligibility criteria and skills, competencies and/or knowledge section of this job specification. Therefore it is very important that you think about your experience in light of those requirements.
Failure to include information regarding these requirements may result in you not being called forward to the next stage of the selection process.
Those successful at the shortlisting stage of this process (where applied) will be called forward to interview.
Code of Practice / The Health Service Executive will run this campaign in compliance with the Code of Practice prepared by the Commission for Public Service Appointments (CPSA). The Code of Practice sets out how the core principles of probity, merit, equity and fairness might be applied on a principle basis. The Codes also specifies the responsibilities placed on candidates, feedback facilities for candidates on matters relating to their application, when requested, and outlines procedures in relation to requests for a review of the recruitment and selection process, and review in relation to allegations of a breach of the Code of Practice. Additional information on the HSE’s review process is available in the document posted with each vacancy entitled “Code Of Practice, Information For Candidates”.
Codes of Practice are published by the CPSA and are available on the document posted with each vacancy entitled “Code of Practice, Information For Candidates” or on
The reform programme outlined for the Health Services may impact on this role and as structures change the job description may be reviewed.
This job description is a guide to the general range of duties assigned to the post holder. It is intended to be neither definitive nor restrictive and is subject to periodic review with the employee concerned.
Clinical Nurse Specialist (CNS) / Clinical Midwife Specialist (CMS)
Terms and Conditions of Employment
Tenure / The initial vacancy for this post is permanent and whole time. This post is pensionable. A panel will be formed from this recruitment campaign and future permanent or specified purpose vacancies will be filled from this panel. The tenure of these posts will be indicated at ‘expression of interest’ stage.Appointment as an employee of the Health Service Executive is governed by the Health Act 2004 and the Public Service Management (Recruitment and Appointment) Act 2004.
Remuneration / The Salary scale for the post is: €47,089 – €55,852 p.a.
(9 points on the Salary Scale)
Working Week / The standard working week applying to the post is:37.5 hours weekly
HSE Circular 003-2009 “Matching Working Patterns to Service Needs (Extended Working Day / Week Arrangements); Framework for Implementation of Clause 30.4 of Towards 2016” applies. Under the terms of this circular, all new entrants and staff appointed to promotional posts from Dec 16th 2008 will be required to work agreed roster / on call arrangements as advised by their line manager. Contracted hours of work are liable to change between the hours of 8am-8pm over seven days to meet the requirements for extended day services in accordance with the terms of the Framework Agreement (Implementation of Clause 30.4 of Towards 2016).
Annual Leave / The annual leave associated with the post is 24- 28days
0-5 years service 25 days
5-10 years service 26 days
More than 10 years service 28 days
Superannuation / Membership of the HSE Employee Superannuation Scheme applies to this appointment.
Existing Members who transferred to the HSE on 1st January 2005 pursuant to Section 60 of the Health Act 2004 are entitled to superannuation benefit terms under the HSE Scheme which are no less favourable to those to which they were entitled at 31st December 2004.
Appointees to posts in the Mental Health Services which formerly attracted fast accrual of service should note that the terms of Section 65 of the Mental Treatment Act 1945 do not apply to New Entrant Public Servants as defined by Section 12 of the Public Service Superannuation (Miscellaneous Provisions) Act 2004.
Probation / Every appointment of a person who is not already a permanent officer of the Health Service Executive or of a Local Authority shall be subject to a probationary period of 12 months.
Protection of Persons Reporting Child Abuse Act 1998 / This post is one of those designated in accordance with Section 2 of the Protection of Persons Reporting Child Abuse Act, 1998. You will remain a designated officer for the duration of your appointment in this post or for the duration of your appointment to such other post as is included in the categories specified in the Ministerial Direction. Such officers will, on receiving a report of child abuse, formally notify the Senior Social Worker in the community care area in which the child is living.
Infection Control / Have a working knowledge of 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.
1