JOB DESCRIPTION

TITLE: Clinical Nurse Specialist(CNM2) - Older People Services

REPORTING TO:AssistantDirector of Nursing

RESPONSIBLE TO: Director of Nursing

SALARY SCALE:€50,096 to €59,570 pa pro rata

HOLIDAYS:25 – 28 days per annum pro rata

HEALTH:A candidate for and any person holding the office must be free from any defect or disease which would render him/her unsuitable to hold the office and be in a state of health as would indicate a reasonable prospect of ability to attend regular and efficient service.

CHARACTER:A candidate for and any person holding the office must be of good character.

HOURS OF WORK:39 hours per week- 19.5 hours solely to CRU and 19.5 for older People Services. Details of starting and finishing times, which may vary in accordance with Hospice needs, will be notified to you by your Head of Department/Deputy. There will be times when you will be required to work outside of the normal office hours.

WORKING WEEK:Will be determined by Director of Nursing

ETHICAL CODE:The post holder is requested to respect the special charism, ethos and tradition of Our Lady’s Hospice and Care Services and to observe and comply with its general policies, procedures and regulations.

CONFIDENTIALITY:You will have access to various types of records/information in the course of your work. Such records and information are strictly confidential and unless acting on the instruction of an authorised person, on no account must information concerning staff, patients/residents or other Hospital business be divulged or discussed except in the performance of normal duty. In addition, records may never be left in such a manner that unauthorised persons can obtain access to them and must be kept in safe custody when no longer required.

JOB PURPOSE:The remit of the CNS will be in both Anna Gaynor House (AGH) and the Community Reablement Unit (CRU). 0.5WTE is solely allocated to CRU and the remaining 0.5 is allocated to these two units and will be determined by service need at any given time.

The CNS Older People Services will co-ordinate and lead in theimplementation and provision of quality care. He/she will:

  • Assess community dwelling patients with multiple comorbidities for the Community Reablement programme.
  • Assist the Older Person to obtain self made goals in order to adapt healthier lifestyle choices and behaviours.
  • Support, assist and facilitate colleagues in achieving positive outcomes as developed for the CRU programme
  • Develop and advance the quality of nursing practice for Older People Services overall in conjunction with the nursing department.
  • Work on the development of an Advanced Nurse Practitioner Post in Older People Services for Our Lady’s Hospice & CS
  • Encourage a culture of openness and participation through effective Communication.

DUTIES AND RESPONSIBILITIES

1.0CLINICAL RESPONSIBILITIES

1.1To assess potential CRU patients who have suffered a recent decline in health and function and persons who are recovering from an acute phase of illness but who are now discharged from Hospital or those who need re-education in safety awareness post a traumatic fall.

1.2To ensure the appropriateness of referrals; organise and conduct the initial patient assessment in the Medicine for the Elderly Clinics in St. James's Hospital two days per week (usually on Tuesday and Wednesdays).

1.3To conduct home visit assessments for admission to CRU where necessary.

1.4To develop a Care Pathway to support the CRU patient to sustain their current level of independence and encourage the patient to cope with new mechanisms in dealing with existing deficits. Currently the Orem model of Nursing is used in CRU.

1.5To attend multidisciplinary ward rounds and identify patients/residents in AGH & CRU who require specialist expertise.

1.6To be a member of the Interdisciplinary Admissions Committee (IDAC) and to conduct required assessments to ensure the appropriateness of supportive palliative care referrals to AGH.

1.7To work with the CRU CNS to provide a collaborative and cohesive plan of care for the needs of patients based on CRU

1.8To collaborate with the Advanced Nurse Practitioner for Palliative Care to ensure a cohesive plan of care where this is an overlap of service (AGH residents).

1.9To work closely with the Medical team and Pharmacist to avoid Polypharmacy issues arising.

1.10To promote a person centred approach to care, utilising specialist knowledge relating to the care of the patient and family.

1.11To act as an effective role model and resource/advisor to colleagues in the delivery of nursing care and provide a high level of professional and clinical leadership.

1.12To support family and relatives through times of change and stress in their lives, liaising with and referring to other professionals/specialists/support groups as appropriate.

1.13To participate in ward meetings on patient/family care, management and progress.

1.14To plan, liaise, and prepare patient’s transfer back home or to hospital if applicable.

1.15To ensure that the family or carer of the discharged patient has adequate knowledge of their care plan prior to discharge (CRU).

1.16To create a good learning environment by keeping up to date with new developments and supporting and encouraging open discussion.

1.17To guide, support, teach, and to work closely with the Clinical Nurse Managers and Nursing Staff in the delivery of a high standard patient care.

1.18To maintain open lines of communication and liaise with external and internal agencies such as Allied Health in St. James’s Hospital and Primary Care Centres.

1.19To redirect inappropriate referrals to the appropriate services.

1.0CONSULTANT RESPONSIBILITIES

1.1To be available on a consultative basis guiding assessment and delivery of care.

1.2To develop a clinical career pathway for nurses in Gerontological Nursing

1.3To enhance the quality of service delivered by the Multidisciplinary team to older people in the community.

1.4To provide an individualised care package thus enhancing patient satisfaction.

1.5To provide professional and academic development and personal satisfaction for nurses working within the speciality.

1.6To Support the vision of the Year’s Ahead Report and the National Health Strategy, and work on the continued development of intermediate care for older people in the community.

1.7To use advanced knowledge, skills and judgement to improve client care and deal with challenging situations.

1.8To provide clinical leadership by acting as a resource, facilitator, co-ordinator, role model and advocate, helping to foster the advancement of the specialty locally, regionally, and nationally.

1.9To work with the Assistant/Director of Nursing to develop an Advanced Nurse Practitioner role for Gerontology.

2.0TEACHING/EDUCATION RESPONSIBILITIES

2.1To act as a resource to members of the multidisciplinary team and to students from external agencies.

2.2To participate in the identification, development and delivery of education, training and development programmes for nursing and non-nursing staff.

2.3To provide health promotion strategies and education sessions as part of the patients programme of reablement.

2.4To work closely with multidisciplinary team in the delivery of group and individual education sessions with patient and family members.

2.5Provide CRU patients education regarding Medication Compliance and Self-medicating prior to discharge which involves creating a Medication Planner.

2.6To reinforce with CRU patients on advice given from other disciplines (e.g. Falls Education) prior to discharge.

3.0PATIENT/CLIENT ADVOCATE

3.1To work as a strong patient advocate maintaining effective channels of communication with patients, relatives and all members of the multidisciplinary team.

3.2To maintain effective lines of communication with the primary health care team for the purpose of optimising patient care and disease management.

3.3To provide a detailed Multidisciplinary discharge Summary to GP’s & Allied Health Workers involved for CRU patients.

3.4To negotiateappropriate services for CRU patients in their homes. Early planning is empirical to a successful discharge.

3.5To liaise with the CRU Medical Social Worker to promote awareness of potential problems within the domestic setting which ensures a proactive approach towards successful discharge planning for CRU patients.

4.0AUDIT & RESEARCH

4.1To maintain and monitor a database for each patient referred to the CRU service for audit /evaluation using the Patient Administration System (PAS).

4.2To use hospital resources to access applicable research to support evidence based practice i.e. library journals and internet access.

4.3To identify and encourage research based practice, policies and standards in relation to Gerontology.

4.4To evaluate the effectiveness of nursing practice and participate in multi-disciplinary audit.

4.5To critically evaluate research and assist in the dissemination of research and implementation of evidence-based best practice in all aspects of patient care.

4.6To identify and participate in research related to Older People.

4.7To actively participate in the development of clinical policies, protocols and guidelines in liaison with the Medical Director and Director of Nursing.

4.8To participate in the Hospice performance management system setting realistic objectives in order to maintain a personal professional profile and demonstrate a high level of specialist practice.

5.0GENERAL

5.1To adhere to Departmental and Hospice policies at all times.

5.2To perform such other duties appropriate to the post as may be assigned from time to time by the Manager or a nominee.

6.0SELF DEVELOPMENT

6.1To be aware of current developments and issues in health care by reading current literature and keeping abreast of new developments, attending ‘in-house’ seminars, lectures and courses when possible and as appropriate in consultation with your head of Department.

6.2To assume responsibility for his/her own professional development and safe work practice.

6.3To ensure a safe environment for himself/herself, colleagues and visitors.

6.4Maintain Professional Development Portfolio reflecting both continuous professional education and specific disease education.

6.5Gain membership in organisations such as the All Ireland Nurses Association (AIGNA), Irish Gerontological Society, Annual Conference for Clinical Nurse Specialists and Age Action.

7.0PROFESSIONAL

7.1To have a working knowledge of Our Lady’s Hospice and Care Services policies.

7.2To present and act in a professional manner at all times and ensure colleagues do likewise.

7.3To ensure patient confidentiality is respected and maintained at all times.

7.4To be familiar with and act according to NMBI professional code of conduct.

Garda Vetting:

Arrangements have been introduced, on a national level, for the provision of Garda Clearance in respect of candidates for employment in areas of the Health Services, where it is envisaged that potential employees would have substantial access to children or vulnerable individuals. Each candidate will be required to complete a Garda Clearance form.

The post holder may be required to perform other duties as appropriate to the post, which may be assigned to him/her from time to time, and to contribute to the development of the post while in office. This job description will be subject to review in the light of changing circumstances. It is not intended to be exhaustive but should be regarded as providing guidelines within which individuals work

PERSON SPECIFICATION

Factors

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Essential

/

Desirable

Qualifications

/
  • Registered on the Live Register in the General Division of the Register of Nurses as maintained by the Nursing and Midwifery board of Ireland (NMBI).
  • Hold/willing to work towards a post-graduate diploma in Gerontology
  • Hold a Full Driving Licence and access to a car
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  • Msc in Gerontology
  • Other relevant post-graduate courses
  • Nurse Prescriber qualification

Experience

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  • Have at least 5 years post registration experience.
  • Two years post registration experience in Gerontology.
  • Evidence of consistent updating of clinical skills and knowledge
  • Experience ofactive participation within an MDT.

CORE COMPETENCIES / ESSENTIAL / DESIRABLE
Knowledge & Skills /
  • Use of Patient Administration System (PAS) or willing to learn
  • Ability to collect and report on data
  • Knowledge of principles and practices of Gerontology
  • High level of English and numeracy skills
  • Competent and confident IT skills - Word, Excel, Power Point and e-mail
  • Knowledge of an NMBI directives
  • Demonstrate high level of clinical knowledge & competencies
  • Competent in phlebotomy or willing to undertake course
  • Demonstrate promotion of evidence-based decision making
  • Demonstrate practitioner competence and professionalism
  • Demonstrate a commitment to continuing professional development
  • Demonstrate the ability to relate nursing research to nursing practice
  • Demonstrate an ability to conduct research and audit
  • Demonstrate knowledge of quality assurance practices and their application to nursing procedures
  • Demonstrate an awareness of current and emerging nursing strategies and policies in relation to the clinical / designated area e.g. falls prevention and management.
  • Demonstrate an ability to work within a regulated environment
  • Demonstrate a knowledge of and an ability to ensure infection control and hygiene standards are adhered to
  • Demonstrate an awareness of the Health Service Transformation Programme
  • Ability to work under pressure
/
  • Competent in IV Cannulation

Core Competencies /
  • Influencing skills
  • Proven decision making and leadership skills
  • Demonstrate the ability to lead on clinical practice and service quality
  • Demonstrate the ability to plan organise effectively
  • Resourceful and proactive
  • Demonstrate an ability to work in a changing environment.
  • Demonstrate strong interpersonal skills including the ability to build and maintain relationships and work within a multi-disciplinary team
  • Demonstrate an ability to coach staff members to develop their skills.
  • Demonstrate initiative and innovation in the delivery of service
  • Willing to train and mentor others.

Scope of Practice/Professional Development /
  • Adhere to a professional code of practice
  • Understands the need to apply hospice and/or professional standards, policies and procedures to their area of practice
  • Good organisational and self-management skills
  • Demonstrate ability to be a reflective practitioner
  • Demonstrate evidence of continuing professional development at an appropriate level
  • Demonstrate a willingness for continued self-development in a professional capacity.

Communication Skills /
  • Excellent interpersonal and communication skills
  • Clearly and confidently articulates ideas and opinions and their underlying rationale
  • Draws on a variety of communication methods to fit situation/circumstances
  • Listens openly, using questions to check for understanding/avoid misinterpretation
  • Adapt a professional approach at all times
  • Non-judgemental in attitude.

Quality Service /
  • Is patientcentred at all times.
  • Is flexible/adaptable to meet unexpected demands
  • Ability to act as an advocate for nursing/residents/patients

Team Player /
  • Is understanding of diverse values and beliefs
  • Considers how one’s behaviour might impact others
  • Knows when and where to ask for help

Confident and friendly manner with patients/residents and staff /
  • Display awareness of confidentiality issues
  • Display awareness of patient/resident advocacy issues
  • Display eagerness to learn more on speciality
  • Express interest in career development

Core Values /
  • Demonstrate a knowledge of the ethos and core values of Our Lady’s Hospice and Care Services

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Job Description & Person Specification – CNS – CRU & Older People Services, Specified Purpose Post October 2015