Palliative Care Nurse Specialist - Community and Access (Band 6)
We have an exciting opportunity for Band 6 Palliative Nurse Specialists to join the Community Nursing Service and rotate between the Access and Community Nurse Specialist Teams.We are a supportive and dynamic team delivering outstanding palliative care to people in our community. You will need knowledge and experience of palliative care, confident decision-making skills and a passion to continuously improve and develop. This role is primarily advisory, with minimal hands-on nursing care.The Access Team manage the clinical Telephone Advice Line between 08:00 and 20:00 Monday to Sunday in addition to triaging all urgent external referrals to the hospice. The team are currently trialling a mix of long and short shifts over 7 days.The Community Nurse Specialist Team support a complex patient caseload of 400-450 patients, triaging all routine external referrals to the hospice. The team work 7.5 hr days Monday to Friday with a regular commitment to the weekend/ bank holiday rota.
Main duties of the job
This rotational role will work across both the access and community nurse specialist teams. The Nurse Specialist is an expert in ensuring high quality palliative care is delivered to patients and their families. They work both independently and as part of the wider health care team.The role includes -Skilled holistic assessment, both remote and face to face, to effectively identify the needs of patients and those close to them.Supporting and advising patients and those close to them using specialist knowledge and skills in physical symptom control, social, emotional and spiritual care.Working collaboratively with the hospice multidisciplinary and external teams.Providing advice, support and education to the primary health care and community teams where appropriate, as part of a multi professional approach.
About us
Weve spent over 40 years helping people die in peace, and with dignity. Combining compassion with clinical expertise, we provide patients with the best possible care at the end of their lives.Were here for the people around our patients too those closest to them. Before, during and after a bereavement, we provide support thats remembered forever.We think its that unforgettable support that inspires people to give back to St Peters. To fundraise for us. Donate. Volunteer. Were not exaggerating when we say that we couldnt do what we do without our wonderful supporters. We really cant thank them enough.We want to help many more people to die well. And were doing this by teaching others. As a centre of educational excellence, we share our skills with other health professionals, helping the NHS and care homes to provide better end-of-life care.Were here for all, for free, forever.
Job responsibilities
Access TeamSupport all aspects of the clinical referral processAssess the appropriateness and urgency of referrals seeking further information and advice as appropriateLiaison with other teams within St Peters Hospice regarding referrals to these teamsAnswer advice line calls and act as the first line of support and adviceCommunity Nurse Specialist TeamManage and coordinate the day to day running of the team held caseload of patients living in the communityCore Clinical ResponsibilitiesTake and analyse a clinical history in a relevant, succinct and logical manner either remotely or face to faceIndependently assess the patients needs, identify their priorities and work with the patient and those close to them towards achieving themDemonstrate an in-depth knowledge of the options for achieving control of symptoms and the ability to make safe clinical decisions and offer advice to the primary health care teamProvide information to patients, taking account of their individual needs, taking advice from those who are close to them, colleagues and external professionals where appropriateRefer to other members of the hospice multi-professional team.Refer/signpost patients and carers to other health and social care professionals where appropriateDemonstrate 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 choiceSupport and coach carers at home in managing a relative whose condition is deterioratingUnderstand community medication administration processes and safely administer just in case subcutaneous injections when needed during a visit.Recognise and manage palliative care emergenciesBring closure to the nurse-patient relationship and provide for a safe transition to another care provider as appropriateAct as a resource to other professionals, both internally and externally, on specialist palliative care and end of life care issuesBe involved with and support MDT meetings when requiredDeputise for team leaderWork collaboratively with clinical and administrative colleagues to provide a responsive and patient-centred serviceRecognise the impact of caring for dying patients on yourself, internal and external colleagues and offer / seek supportPotential Additional Clinical ResponsibilitiesThe post holder may undertake additional responsibilities when they have passed the relevant module and using the skills in current practice, as below. In addition, to practice Non-Medical Prescribing, the post holder must be registered as a Non-Medical Prescriber with the Nursing and Midwifery CouncilUse physical assessment and clinical reasoning skills as part of patient assessment and to support clinical advice, professional communication and documentationPerform Non-Medical prescribing within area of competence and practice according to local policyGovernance, Quality and Clinical Practice KSF 3Contribute to improving qualityPromote care that is effective, safe and provides as positive an experience as possibleUnderstand own role, its scope and how this may change and develop over time in a high-quality organisationWork to support the team and help and enable others to work as a teamPrioritise workload and manages own time in a manner that maintains and promotes high quality and offers flexibility in response to changing situationsEvaluate the quality of own and others work in own area and raises quality issues and related risks with the appropriate peopleSuggest and support changes in own area that improves the quality of systems and processesTake appropriate action when there is a persistent problem with qualityCommunication KSF 3Can develop and maintain communication with people about difficult matters and/or in difficult situationsMaintain high standards of integrity when communicating with patients and the wider publicManage complex communication issues with patients and familiesStructure an assessment using appropriate questioning, avoid jargon, using familiar language, at patients own paceRecord concisely, accurately, confidentially, legibly and contemporaneously the appropriate elements of the history, results of investigations, problems identified and management planBreak 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 optionsDemonstrate an understanding of the need to involve patients and carers in decision making, offering them informed choices, respecting their viewsUse the Recommended Summary Plan for Emergency Care and Treatment Plus (ReSPECT+) process to support the documentation and communication of the patients preferences and clinical recommendations for emergency care and treatmentDemonstrate skill in working with families facing lossManage dissatisfied patients/relatives, anticipating potential problems and managing expectationsCommunicate with patients whose first language may not be English in a manner that they understand, using interpreters appropriatelyPresent cases clearly, consistently and professionally to the multidisciplinary team (MDT) meeting, contributing effectively in patient managementProvide feedback to others on their communication where appropriateCommunicate effectively with the wider multidisciplinary teamDemonstrate negotiation and diplomacy skills and partnership working with external agenciesDemonstrate competent use of Electronic Patient Records and IT systemsWrite and maintain accurate notes/documentation and input computerised data, keeping all information up to datePersonal & people development KSF3Develop oneself and contribute to the development of othersTake responsibility for identifying and meeting own development needsGenerate and use appropriate learning opportunities and apply own learning to development of practiceAssess how well last years personal objectives were met and helps set new ones for the year aheadEnable opportunities for others to apply their developing knowledge and skillsActively provides learning and development opportunities to others including mentoring new staff and clinical placementsApply evidence to patient careUse strategies to develop own resiliencePractice effectively by reflecting to support practice improvement, this may be with colleagues and/or be engaging with clinical supervision.Health Safety and Security KSF 2Monitor and maintain health, safety and security of self and othersLook for potential risks to self and others in work activities, environments and processesUnderstand specific risks associated with lone working and follow lone working policyManage identified risks in the best way possibleWork in a way that complies with legislation and hospice policies and procedures on health, safety and risk managementDemonstrate safe mobilisation, transfer and movement of patients in the community using slide sheets and bed systems but not other equipment such as hoists and standing aids; have a knowledge of who provides appropriate equipment and how to referTake action to manage an emergency, calling for help immediately when appropriateReport actual or potential problems that may put health, safety or security at risk and suggests solutionsSupport and challenge others in maintaining health, safety and security at workWork within the guidance policy for the protection of vulnerable adultsService Improvement KSF 2Contribute to the improvement of servicesDiscuss with the team the likely impact of changing policies, strategies and procedures on practice and changes the team can make and how to make them effectiveTake on new work and make changes to own work when agreed with line manager, requesting relevant help if neededSupport colleagues in understanding and making agreed changes to their workEvaluate own and others work when needed including engaging in auditMake suggestions to improve the serviceConstructively identifies where new ways of working, polices or strategies are having a negative impact on the service given to users or the public.Equality and Diversity KSF 2Support equality and value diversityChallenge bias, prejudice and intolerance if appropriate or bring it to the attention of a managerAware of the impact of own behaviour on othersDemonstrate sensitivity and respect for people from different religious and cultural background and sexual orientation.
Person Specification
Qualifications
* Current NMC registration
* Communication skills training, or willingness to undertake
* Valid UK driving licence
* Mentoring training
* Experience of teaching
* Non-medical prescribing, or willingness to undertake
* Physical assessment and clinical reasoning, or willingness to undertake
Experience
* Minimum 3 years post registration
* Recent significant palliative care experience
* Possess a working knowledge of clinical governance and evidence-based practice
* Possess a working knowledge of safeguarding individuals who are at risk
* Possess a sound knowledge of issues related to the provision of palliative care in the community
* Demonstrate a working knowledge of relevant statutory and voluntary agencies and organisational structure
* Experience of holding conversations around advance care planning
* Experience of audit processes
* Experience of using EMIS database
* Knowledge and experience in symptom management for people with malignant and non-malignant disease
Additional Criteria
* Possess an ability to analyse complex facts and situations and develop a range of options
* Problem solving skills and ability to work methodically and flexibly
* Ability to work to tight and often changing timescales
* Ability to work autonomously
* Own and take responsibility for constructive feedback to improve patient care and/or team working
* Ability to think laterally and be able to cope with uncertainty and change when required
* Possess an innovative approach and an ability to inspire others
* Robust emotional resilience to manage excessive exposure to dying people and family/carer distress
* Ability to maintain a professional, calm and efficient manner with strong self-management skills
* Computer literate to be able to use Word/Excel/Power Point
Additional Criteria
* Demonstrate ability to work flexibly to meet the challenges and opportunities of working within the hospice environment
* Demonstrate a commitment to anti-discriminatory practice and equal opportunities
* Be able to demonstrate and uphold the hospice values
* Access to a vehicle for work purposes
Disclosure and Barring Service Check
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.
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