Macmillan Skin Cancer clinical nurse specialist

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Supporting Patient Excellence

Ensure everyone diagnosed with a Skin cancer receives a supported conversation about

their needs, repeated as their needs change. To include Melanoma and High-Risk SCC patients

To undertake a comprehensive holistic assessment of patient’s needs (HNA) at key stages during the illness experience from the point of suspicion of cancer in line with National Directives using a recognised tool that can electronically record the patient’s/carers expressed needs. 

To develop a comprehensive care and support plan in consultation with the patient/family, ensuring a written copy is shared with the patient. 

To enable patients/carers to navigate to supportive services through referrals and/or sign posting to meet their individual range of needs.

To attend weekly multidisciplinary team meetings and contribute to the discussion and patient assessment/care planning decisions. This is to include specialist meetings where the CNS represents the patient.

To identify patients to be added to multidisciplinary meetings and complete proformas to add patients to specialist meetings, inform the consultants of the outcomes of these meetings.

To act on scan findings and escalate findings to consultants.

To run diagnosis clinics for new melanoma patients.

To support skin cancer patients during significant consultations in Head and Neck, Plastics, and radiotherapy department .

To implement remote monitoring for patients diagnosed with SCC and melanoma in line with national directives  and the ongoing development of risk management stratified follow-up

To be deemed competent to undertake a clinical assessment of patients on remote monitoring, identifying any signs of recurrence and escalating to the name clinician.  

To screen patients for psychological distress using a recognised tool

To provide Level 2 psychological support for patients and their careers, referring those with complex needs to the Macmillan Clinical Psychologist.

To develop and implement nurse led clinics to support the patient pathway.

Where appropriate interpret and present clinical information to patients and their relatives, demonstrating highest levels of interpersonal and communication skills ensure that patients and their carers, have sufficient relevant verbal and written information during the patient’s stay

To lead on communication issues and co-ordinate the patient’s pathway acting as the Key Worker or responsible for nominating the Key Worker for the patient depending on their individual needs.  

Offer specialist emotional, psychological and practical support to the patients and family, referring patients psychological advice. To include support to patients with complex physical and psychological related problems. This sentence doesn’t make sense.  Regarding psychological support you have already said they act as level 2 practitioner, referring complex issues to Consultant Clinical psychologist 

To ensure that all communication, (which may be complex, contentious or sensitive) is undertaken in a responsive and inclusive manner, focussing on improvements and ways to move forward.

Ensuring all communication is presented appropriately to the different recipients, according to levels of understanding, type of communication being imparted and possible barriers such as language, culture, understanding or physical or mental conditions.

To identify and meet patient/carers informational needs utilising the Macmillan Information & Support Service 

To ensure patients receive verbal and written information at the appropriate point in their illness experience in line with the national information pathway for skin cancer.

Supports the development of patient focussed education, including training to self-manage ongoing consequences of treatment.

To identify and address the palliative care needs of patients and their families, referring patients with complex needs to the Specialist Palliative Care Team

To identify AMBER patients working with the multidisciplinary team to agree ceiling of intervention.

To identify the patient’s Preferred Place of Care at the appropriate point in the illness experience, ensuing patients and able to die in a place of their choice where possible.

To respond to EAU alerts for patients diagnosed with Skin cancer co-ordinating their pathway from the point of admission.

To lead the development of Health & Wellbeing events for patients living with Skin cancers, ensuring they are tailored to meet their individual needs.

To support patients in the development of an Advance Care Plan, identifying their preferences and wishes

To initiate proactive telephone support for patients in the palliative stage of their disease

To promote a culture that supports and enables self-management.

Utilise patient/carer experience feedback to drive innovation and change. 

To implement “exit interviews” for patients at the end of treatment, ensuring their survivorship needs are identified and addressed.