Senior Clinical Nurse Specialist (Band 7)
Senior Clinical Nurse Specialist role in a hospice setting, responsible for leading clinical management, coordination, and development of palliative care for patients and their families.
Responsibilities
* 1. Acts as a clinical resource for less experienced/non‑prescribing colleagues.
* 2. Manage and coordinate the day‑to‑day running of the team, held clinical caseload of patients in the inpatient unit nurse‑led beds and patients referred to the CNS Response Team.
* 3. Take and analyse a clinical history in a relevant, succinct and logical manner.
* 4. Independently assess the patients’ needs, identify their priorities and work with the patient and family towards achieving them.
* 5. Use physical assessment and clinical reasoning skills as part of patient assessment and to support clinical advice, professional communication and documentation.
* 6. 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.
* 7. Demonstrate an in‑depth knowledge of the options for achieving control of symptoms and ability to advise the primary and community health care teams.
* 8. 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.
* 9. Support and coach carers at home in managing a relative whose condition is deteriorating.
* 10. Recognise the impact of caring for dying patients on yourself, internal and external colleagues and offer / seek support.
* 11. Safely administer medication in the community.
* 12. Recognise and manage / appropriately escalated palliative care and oncological emergencies.
* 13. Bring closure to the nurse‑patient relationship and provide for a safe transition to another care provider as appropriate.
* 14. Support palliative care meeting work and attend and present at MDT meetings.
Communication
* 1. Develop and maintain communication with people about difficult matters and/or in difficult situations.
* 2. Role model best practice and provide feedback to others on their communication.
* 3. Maintain high standards of integrity when communicating with patients, their families and the wider communities.
* 4. Manage complex communication issues with patients and families as a lone worker in the community.
* 5. Structure an interview using appropriate questioning, avoid jargon, use familiar language at patients' own pace.
* 6. Demonstrate an understanding of the need to involve patients and carers in decision making, offering informed choices, respecting their views.
* 7. Break bad news in steps appropriate to the understanding of the individual and provide support around distress and discussions about prognosis and future care options.
* 8. Demonstrate skill and sensitivity when working with families facing loss.
* 9. Use the Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) process and form to support the documentation and communication of patients' preferences and clinical recommendations for emergency care and treatment.
* 10. Record concisely, accurately, confidentially and legibly the appropriate elements of history, results of investigations, problems identified and management plan.
* 11. Manage dissatisfied patients/relatives, anticipating potential problems and managing expectations.
* 12. Investigate and respond to complaints, incidents and concerns.
Personal and People Development
* 1. Develop and deliver the Palliative Care Nurse Specialist role development programme for Hospice Community Nursing.
* 2. Support the development of community and inpatient unit teams.
* 3. Identify development needs of others.
* 4. Enable opportunities for others to apply their developing knowledge and skills in both community and inpatient roles.
* 5. Provide learning and development opportunities to others including clinical placements.
* 6. Lead on evaluating the effectiveness of others' learning and development.
* 7. Take responsibility for identifying and meeting own development needs.
* 8. Generate and use appropriate learning opportunities and apply own learning to development of practice.
* 9. Assess how well previous years' objectives were met and help set new ones for the year ahead.
* 10. Apply evidence to patient care.
* 11. Use strategies to develop own resilience.
* 12. Practice effectively by reflecting to support practice improvement, possibly with colleagues and/or by engaging with clinical supervision.
* 13. Become a Designated Prescribing Supervisor (DPS) after practising as an Independent Prescriber for at least one year.
* 14. 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
* 1. Identify and manage risk at work and support others to do the same.
* 2. Make sure others work in line with legislation and hospice policies on health, safety and risk management.
* 3. Carry out and support others to carry out risk assessments.
* 4. Check work area to ensure it is free from risks and conforms to legislation and hospice policies.
* 5. Take appropriate action when risk is identified.
* 6. Identify and action ways of improving health, safety and security.
Service Improvement
* 1. Identify and evaluate potential improvements to the service.
* 2. Discuss improvement ideas with appropriate people and agree a prioritised plan of implementation.
* 3. Contribute positively to service development and improvement.
* 4. Support and work with others to help them understand the need for change and to adapt to it.
* 5. Enable and encourage others to suggest change, challenge tradition and share good practice with other areas of the trust.
* 6. Evaluate the changes made and suggest further improvements where needed.
* 7. Write and give feedback on draft policies and procedures.
Governance, Quality and Improving Clinical Practice
* 1. Promote quality approaches and make others aware of the impact of quality.
* 2. Understand own role, its scope and how this may change over time in a developing organisation.
* 3. Review effectiveness of own team and help and enable others to work as a team.
* 4. Prioritise own workload and manage own time in a manner that maintains and promotes high quality.
* 5. Evaluate the quality of own and others' work and raise quality issues and related risks with the appropriate people.
* 6. Support changes in own area that improve the quality of systems and processes.
* 7. Take appropriate action when there is a persistent problem with quality.
* 8. Contribute to, support and develop audit and research projects.
* 9. Contribute to the ongoing appraisal, evaluation and development of the Response and NLB services.
Equality and Diversity
* 1. Interpret equality, diversity and rights in accordance with legislation, policies, procedures and good practice.
* 2. Actively act as a role model in own behaviour and foster a non‑discriminatory culture.
* 3. Promote equality and diversity in own area and ensure policies are adhered to.
* 4. Manage people and apply internal processes in a fair and equal way.
Leadership and Management
* 1. Manage a small team and lead by example.
* 2. Take ownership and be prepared to be held accountable.
* 3. Role model ethical behaviour and hospice values.
* 4. Maximise current opportunities to make improvements.
* 5. Develop and communicate standards and expected levels of performance.
* 6. Delegate effectively and develop team members.
* 7. Support the evaluation of strategic aims in own delivery area.
Seniority Level
* Mid-Senior level
Employment Type
* Full-time
Job Function
* Health Care Provider
* Hospitals
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