Senior Clinical Nurse Specialist (Band 7)
Join a dynamic team delivering outstanding palliative care.
We are delighted to offer an exciting opportunity for a Band 7 Senior Clinical Nurse Specialist (or Band 6 development position) to join our Community Nursing Service, working across both the Hospice Inpatient Nurse Led Beds and CNS Response.
About Us
Our progressive and dynamic team is at the forefront of delivering exceptional palliative care. We are committed to continual improvement and outstanding patient outcomes.
What the role involves
As a Senior Clinical Nurse Specialist you will:
* Utilise your clinical palliative care knowledge and experience to provide high‑quality care.
* Demonstrate confident decision‑making skills and a passion for ongoing improvement.
* Support and develop more junior staff members.
* Work within the CNS Response / Nurse Led Beds Team, led by an Advanced Practitioner, to:
o Manage patients admitted to the nurse led beds for end of life care.
o Triage the majority of urgent referrals.
o Support patients requiring urgent assistance.
* Work 7.5 hour days, covering 7 days a week.
Main duties of the job
The Senior Clinical Nurse Specialist is an expert in ensuring high quality palliative care is delivered to patients and their families. They work independently and as part of the wider healthcare team, having specific responsibility for those referred to CNS Response and Nurse Led Bed Services. They lead on the care of patients admitted into the nurse led beds on the inpatient unit. Clinical leadership role supporting the wider team to work efficiently and effectively in the delivery of high quality and progressive palliative care in line with the Hospice strategy and policies. They offer the patient and families the skills of a clinical nurse specialist in symptom control, social, emotional and spiritual care. Independent Prescriber. Offer advice, support and education to Hospice Teams, Primary and Community Healthcare staff as part of a multiprofessional team. Work using a multiprofessional approach to care. Develop collaborative working relationships with other hospice teams and the wider community services. Work flexibly, including at weekends, to further develop the NLB service into a 7 day per week service.
Person Specification
Qualifications
* Current NMC registration
* Communication skills training, or willingness to undertake
* Independent prescribing (if band 7)
* Physical assessment and clinical reasoning, or willingness to undertake
* Leadership training
* Mentoring training
Experience
* Minimum experience in a specialist palliative care role (18 months if band 6, and 2 years if band 7)
* Complex symptom management
* Advance Care Planning
* Knowledge of clinical governance and evidence‑based practice
* Knowledge of issues related to the provision of palliative care in the community
* Knowledge of safeguarding individuals who are at risk
* Knowledge of relevant digital systems e.g. EMIS
* Experience of teaching
* Leadership
Additional Criteria
* Excellent verbal/written and digital communication skills
* Professional behaviour and communication
* Demonstrate ability to holistically assess and offer interventions in complex palliative and end of life care
* Time and organisation management
* Audit and practice development
* Practising independent prescribing
* Staff development and performance management
* Facilitation of learning
* Physical examination skills
* Managing complaints
Additional Criteria
* Demonstrate St Peters Hospice Values
* Compassion
* Respect
* Passion
* Flexible and resilient
* A people person who enjoys staff development
* A problem solver and decision‑maker
* Organised and can manage changing priorities
Additional Criteria
* Current driving licence
* Access to a vehicle for work purposes
Disqualification
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.
Salary
£47,810 to £54,710 a year FTE, dependent on experience.
Job responsibilities
* Clinical practice
o Acts as a clinical resource for less experienced/ non‑prescribing colleagues.
o Manage and coordinate the day‑to‑day running of the team and hold clinical caseload of patients in the inpatient unit nurse led beds and patients referred to the CNS Response Team.
o Take and analyse a clinical history in a relevant, succinct and logical manner.
o Independently assess the patients needs, identify their priorities and work with the patient and family towards achieving them.
o Use physical assessment and clinical reasoning skills as part of patient assessment and to support clinical advice, professional communication and documentation.
o Perform Independent Prescribing within area of competence once registered as an Independent Prescriber with the Nursing and Midwifery Council and practice according to local policy.
o Demonstrate an in‑depth knowledge of the options for achieving control of symptoms and ability to advise the primary and community health care teams.
o Demonstrate an ability to explore the personal resources of families/carers in order to facilitate, where possible, that patients are cared for in the place of their choice.
o Support and coach carers at home in managing a relative whose condition is deteriorating.
o Recognise the impact of caring for dying patients on yourself, internal and external colleagues and offer / seek support.
o Safely administer medication in the community.
o Recognise and manage / appropriately escalategative care and oncological emergencies.
o Bring closure to the nurse‑patient relationship and provide for a safe transition to another care provider as appropriate.
o Support palliative care meeting work and attend and present at MDT meetings.
* Communication KSF
o Can develop and maintain communication with people about difficult matters and/or in difficult situations.
o Role model best practice and provide feedback to others on their communication.
o Maintain high standards of integrity when communicating with patients, their families and the wider communities.
o Manage complex communication issues with patients and families as a lone worker in the community.
o Structure an interview using appropriate questioning, avoid jargon, using familiar language, at patients own pace.
o Demonstrate an understanding of the need to involve patients and carers in decision‑making, offering them informed choices, respecting their views.
o Break bad news in steps appropriate to the understanding of the individual and be able to support distress and have discussions around prognosis and future care options.
o Demonstrate skill and sensitivity when working with families facing loss.
o Use the Recommended Summary Plan for Emergency Care and Treatment (ReSPECT plus) process and form to support the documentation and communication of the patients preferences and clinical recommendations for emergency care and treatment.
o Record concisely, accurately, confidentially and legibly the appropriate elements of the history, results of investigations, problems identified and management plan.
o Manage dissatisfied patients/relatives, anticipating potential problems and managing expectations.
o Investigate and respond to complaints, incidents and concerns.
* Personal and People Development KSF
o Develop oneself and others in area of practice.
o Develop and deliver the Palliative Care Nurse Specialist role development programme for Hospice Community Nursing.
o Support the development of community and inpatient unit teams.
o Identify development needs of others.
o Enable opportunities for others to apply their developing knowledge and skills in both community and inpatient roles.
o Provide learning and development opportunities to others including clinical placements.
o Lead on evaluating the effectiveness of others learning and development.
o Take responsibility for identifying and meeting own development needs.
o Generate and use appropriate learning opportunities and apply own learning to development of practice.
o Assess how well the previous years objectives were met and help set new ones for the year ahead.
o Apply evidence to patient care.
o Use strategies to develop own resilience.
o Practice effectively by reflecting to support practice improvement, this may be with colleagues and/or by engaging with clinical supervision.
o Become a Designated Prescribing Supervisor (DPS) after practising as an Independent Prescriber for at least one year.
o Become a Designated Prescribing Practitioner (DPP) after practising as an Independent Prescriber for at least three years and having carried out the DPS role.
* Health Safety and Security KSF
o Promote, monitor and maintain best practice in health, safety and security including issues specific to lone working.
o Identify and manage risk at work and support others to do the same.
o Make sure others work in a way that complies with legislation and hospice policies and procedures on health, safety and risk management.
o Carry out and support others to carry out risk assessments.
o Check work area to make sure it is free from risks and conforms to legislation and hospice policies and procedures on health, safety and risk management.
o Take the appropriate action when risk is identified.
o Identify and action ways of improving health, safety and security.
* Service Improvement KSF
o Appraise, interpret and apply suggestions, recommendations and directives to improve services.
o Identify and evaluate potential improvements to the service.
o Discuss improvement ideas with appropriate people and agree a prioritised plan of implementation to take forward agreed improvements.
o Contribute positively to service development and improvement.
o Support and work with others to help them understand the need for change and to adapt to it.
o Enable and encourage others to suggest change, challenge tradition and share good practice with other areas.
o Evaluate the changes made and suggest further improvements where needed.
o Write and give feedback on draft policies and procedures.
* Governance, Quality and Improving Clinical Practice KSF
o Contribute to improving quality.
o Promote quality approaches making others aware of the impact of quality.
o Understand own role, its scope and how this may change over time in a developing organisation.
o Review effectiveness of own team and help and enable others to work as a team.
o Prioritise own workload and manage own time in a manner that maintains and promotes high quality.
o Evaluate the quality of own and others work and raise quality issues and related risks with the appropriate people.
o Support changes in own area that improve the quality of systems and processes.
o Take appropriate action when there is a persistent problem with quality.
o Contribute to, support and develop audit and research projects.
o Appraise, evaluate and develop the response and NLB services.
* Equality and Diversity KSF
o Promote equality and value diversity.
o Interpret equality, diversity and rights in accordance with legislation, policies, procedures and good practice.
o Actively act as a role model in own behaviour and fosters a non-discriminatory culture.
o Promote equality and diversity in own area and ensure policies are adhered to.
o Manage people and apply internal processes in a fair and equal way.
* Leadership and Management KSF
o Manage a small team and lead by example.
o Take ownership and be prepared to be held accountable.
o Role model ethical behaviour and Hospice values.
o Maximise current opportunities to make improvements.
o Develop and communicate standards and expected levels of performance.
o Delegate effectively and develop team members.
o Support the evaluation of strategic aims in own delivery area.
In summary
This role requires a highly skilled and compassionate Clinical Nurse Specialist who can work autonomously within both community and inpatient settings, lead multidisciplinary teams, and drive continuous improvement in palliative care delivery across the Hospice Service.
We want to hear from
We welcome applications from nurses who are passionate about delivering high quality palliative care, who possess strong clinical, leadership and communication skills, and who are committed to continuous professional development and service improvement.
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