Clinical Nurse Specialist - Lead

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MAIN DUTIES

 

 

Work autonomously and take responsibility for the on-going assessment, care and support for patients with chronic pain, in outpatient settings.   Work in an organised, flexible manner responding to the changing and challenging needs of the service.   To clinically assess, plan, implement and evaluate programmes of care, providing specialist advice and actively seeking evidence based practice which will improve the quality of care and meet the needs of a group of patients. A holistic bio-psychosocial approach to caring should be planned that will include

the appropriate level of physiological; pathological; spiritual, socio-economic and cultural aspects which influence the care of clients within the speciality.   Participate in the provision and delivery of nurse-led pain interventions for chronic pain such as TENS and neuromodulation in the outpatient setting.   On-going follow-up and supporting of patients with complex pain conditions. Adjusting medication autonomously within a trust approved personal formulary. Including the titration, rotation and weaning of analgesics, in collaboration with pain colleagues as required.   Facilitate short and long-term follow up of patients through provision of nurse-led pain clinics, telephone triage, facilitating consultant-led clinics and admissions.   ·         Review each patient’s response to treatment by regular contact, monitoring effect and ensuring early detection, and management of side effects from proposed medication changes.   ·         To understand when a patient’s care is beyond own clinical limitation and to liaise with senior members of the team or other professionals for advice.   ·         Manage episodes of care as own/joint shared caseload, discharging patients as per protocol.   ·         If a non-medical prescriber qualification is held, prescribe appropriate medication for pain management and symptom control or if not then advise on medications in accordance with local and national guidelines and agreed formulary.       ·         Lead the development of professional nursing practice policy/guidelines within the speciality, demonstrating commitment to share expertise and disseminate information.   ·         Take responsibility for all actions and practices for self and the nursing team in accordance with the NMC code of conduct, Trust and local policy.   ·         Maintain and update own clinical expertise and contribute as role model to ensure the delivery of nursing care is at highest possible level to meet patient care.   ·         Develop innovative ways which meet the needs of patients, carers and the changing healthcare economy.   ·         To act as patient advocate in line with the NHS plan and to actively apply in depth knowledge of holistic/socio-economic and cultural aspects of the care to clients within your specific speciality, acting as a role model and resource for patients, relatives and staff.   ·         Develops co-ordinated and comprehensive links across the Trust and with primary care to ensure patients receive effective and co-ordinated pain management.   ·         To assist in the implementation of the Trust’s framework for Clinical Governance within own clinical speciality and profession.   Maintain accurate, comprehensive and up-to-date documentation, in line with legal and departmental requirements, and communicate assessment and treatment results to the appropriate disciplines.   Assess capacity, gain informed consent and have the ability to work within a legal framework with patients who lack capacity to consent to treatment.   Undertake regular measurement and evaluation of your area of clinical work and current practices through the use of audit and other measures, individually and with colleagues.  Ensure that clinical outcomes and patient feedback are included in your audit plans. Compile high quality reports as appropriate.  Make recommendations for change, and manage the implementation of any agreed changes.   Be responsible for the clinical supervision of the nursing team and support staff to ensure there is effective assessment, care planning and review of agreed patient goals/outcomes.

 

     COMMUNICATION

 

• To build networks/links with stakeholders/agencies; attending meetings related to the specialism/pathway.

 

• To undertake joint working with clinical leads from other professions.

 

• Actively contribute to own and others development by attendance at and delivery of presentations and training sessions at staff meetings, tutorials, training sessions in house and by organising and attending appropriate external courses and practicing reflective practice.

 

• Communicate effectively and work collaboratively with medical and other therapy colleagues to ensure delivery of a co-ordinated multidisciplinary service.

 

• To report effectively to the MDT on patients assessment/goals/treatment plans/progress/recommendations/discharge planning outcomes.

 

• Lead or participate in relevant working groups in line with departmental requirements.

 

• Co-ordinate and produce formal reports as required, ensuring these are of a sufficient standard and including assessment/treatment outcomes and recommendations.

 

• To deal frequently with issues which are of a highly complex and sensitive nature.

 

• Participate in the NHS appraisal scheme and Personal Development Plan (PDP) as both appraiser and appraisee and take responsibility for ensuring that appraisals take place as required and in accordance with ELHT policy.

 

• Proactively participate in delivering Clinical Governance and Risk Management in line with Trust policies.

 

• Use a range of techniques to overcome barriers to communications.

 

• Adapt your own communication style and utilize advanced communication skilsl appropriate to the patient in order to foster an effective therapeutic relationship.

 

• Deal with challenging situations including verbal aggression/distress from patients, carers and relatives.

 

• Ensure that up to date written and electronic records and activity data are       maintained in accordance with professional standards and organizational guidance.

 

 

TRAINING AND DEVELOPMENT

 

• To develop and deliver training re: specialism/pathway to colleagues, patients/carers and other professionals as appropriate.

 

• To provide highly specialist opinion and support e.g. co-working cases, joint assessments / appointments as appropriate and required.

 

• To mentor and coach staff in relation to specialism/pathway.

 

• To facilitate the development of problem solving/negotiation skills and reflective practice within peer review/supervision of therapists, and other clinicians within IMPReS.

 

• To identify training needs for specific pathway and locality teams in conjunction with team leader.

 

• Responsible for you own continuing professional development including maintaining your own development portfolio and assisting others in the development of theirs.

 

 

Research & Audit

 

• To undertake or take part in research applicable to the specialism/pathway.

 

• To lead and undertake clinical audit to evaluate practice within the specialism/pathway.

 

 

ORGANISATIONAL RESPONSIBILITIES

 

• Agree priorities for own work area and that of relevant staff balancing other patient related and professional demands, and ensure that these remain in accordance with those of the section as a whole.

 

• Ensure that staff for whom you are responsible are supported and enabled to implement policy and service development changes.

 

• Be aware of Health & Safety aspects of your work and implement any policies, which may be required to improve the safety of your work area, including your prompt recording and reporting of incidents and ensuring that equipment use is safe.

 

• Demonstrate familiarity with and understanding of all relevant organisational and departmental policies and procedures and be involved in their development and review as appropriate.

 

• Work flexibly to support equity of nursing provision across the wider service.

 

• Undertake any other duties considered appropriate by the MDT Leads.

 

• Responsibility for the oversight and management of the department during operational hours and oversight of additional ad-hoc activity as necessary.

 

 

• Responsible for ensuring that the department expenditure stays within the budgetary allowance. Identifies problem areas, acts accordingly and escalates where necessary.

 

• Oversees the deployment of staff within the department and ensures that safe staffing levels are maintained reporting any deficiencies to the line manager.

 

• Monitors the estates and facilities (e.g. cleaning and portering) and transport services to the department reporting any deficiencies to the appropriate department.

 

• Involved in all departmental activities and managerial decisions, in conjunction with other professional leads, aimed at improving and developing the quality and cost effectiveness of the service.

 

• Act on concerns reported by team members or service users and manage accordingly.

 

• Leads in the recruitment and selection of staff for own area of responsibility.

 

 

PROFESSIONAL RESPONSIBILITIES

 

• Maintain registration with the NMC, and adhere to professional standards of conduct at all times.

 

• Maintain own clinical professional development through demonstrating up to date knowledge of research, policy, trends, and new developments relating to the clinical and clinical management aspects of the role/specialism/pathway