Clinical Nurse Specialist Medical Oncology - Limerick Cancer Centre

Clinical Nurse Specialist Medical Oncology - Limerick Cancer Centre Location: Limerick Cancer Centre
Job type: Permanent

Overview of role: The CNS in Medical Oncology will provide expert nursing care and support to patients diagnosed with cancer, undergoing systemic anti-cancer therapy (SACT). The CNS will act as a key liaison between patients, families, and multidisciplinary teams, ensuring continuity of care, symptom management, and psychosocial support throughout the cancer. The CNS Medical Oncology will work closely with the patient, patient's medical team, nursing team, multidisciplinary team members to ensure evidence-based practice in delivering high standards of care in all areas of patient care. This will include, but is not limited to:

• Patient and family education pre and post treatment
• Serve as a clinical resource in relation to care of the patient undergoing medical oncology treatment (chemotherapy, infusions, immunotherapy etc.)
• Maintain a clinical database of patients and their treatment and outcomes (survivorship)
• Document all procedures, evaluations, treatments, outcomes, education and referrals consistent with Hospital policy and national / international standards
• Participate in follow up clinics / phone calls as required

Roles and responsibilities are developed around five core concepts which include:

• Clinical focus
• Service user / client advocacy
• Education and Training
• Audit and Research
• Consultancy - including leadership in clinical practice

The CNS Medical Oncology will be dynamic, enthusiastic, conscientious and passionate with strong clinical leadership and the ability to develop the role to meet the evolving needs of the Medical Oncology patient. The CNS will be responsible for acting as a point of contact for patients in the out-patient setting, providing a telephone triage hotline service using a validated assessment tool (UKONS), undertaking detailed patient assessments and actively participate in planning and performing unscheduled review of patients presenting unwell to the oncology/haematology day units with disease/treatment related side effects. The CNS will provide increased access to specialised cancer nursing care for patients on active treatment to enhance patient safety and minimise risks. The CNS will work within the acute haematology and oncology services as part of the MDT, forging relationships especially with, but not exclusively, ED, acute medical assessment units and CIT/community services and continue to develop the role in line with evidence based practice and NCCP guidelines.

Primary Duties and Responsibilities: Professional/Clinical: The post holder's practice is based on the five core concepts of Clinical Nurse Specialist role as defined by the NCNM 4th edition (2008) in order to fulfil the role. The concepts are:

• Clinical Focus
• Patient/Client Advocate
• Education and Training
• Audit and Research
• Consultant Clinical Focus.

ClinicalFocus The Clinical Nurse Specialist (CNS) will have a strong patient focus whereby the specialty defines itself as nursing and subscribes to the overall purpose, functions and ethical standards of nursing. The clinical practice role may be divided into direct and indirect care.

Directcare comprises the assessment, planning, delivery and evaluation of care to the patient, family and/or carer. Indirect care relates to activities that influence and support the provision of direct care.

DirectCare CNS :

• Provide a specialist nursing service for patients with a new diagnosis of cancer.
• Undertake comprehensive patient assessment to include physical, psychological, social and spiritual elements of care using best evidence based practice.
• Use the outcomes of patient assessment to develop and implement plans of care/case management in conjunction with the multi-disciplinary team (MDT) and the patient, family and/or carer as appropriate.
• Monitor and evaluate the patient's response to treatment and amend the plan of care accordingly in conjunction with the MDT and patient, family and/or carer as appropriate.
• Make alterations in the management of patient's condition in collaboration with the MDT and the patient in line with agreed pathways and policies, procedures, protocols and guidelines (PPPG's).
• Accept appropriate referrals from MDT colleagues
• Co ordinate investigations, treatment therapies and patient follow up - Communicate with patients, family and/or carer as appropriate, to assess patient's needs and provide relevant support, information, education, advice and counselling as required
• Where appropriate work collaboratively with MDT colleagues across Primary and Secondary Care to provide a seamless service delivery to the patient, family and/or carer as appropriate
• Participate in medication reconciliation taking cognisance of poly pharmacy and support medical and pharmacy staff with medication reviews and medication management
• Identify and promote specific symptom management strategies as well as the identification of triggers which may cause exacerbation of symptoms. Provide patients with appropriate self management strategies and escalation pathways.
• Manage nurse lead clinics with MDT input.
• Identify health promotion priorities for the patient, family and/or carer and support patient self care in line with best evidence. This will include the provision of educational and health promotion material which is comprehensive, easy to understand and meets patient's needs.

IndirectCare:

• Participate in case review with MDT colleagues
• Use a case management approach to patients with complex needs in collaboration with MDT in both Primary and Secondary Care as appropriate.
• Take a proactive role in the formulation and provision of evidence based PPPGs relating to supportive care for cancer patients.
• Take a lead role in ensuring the service for patients who require survivorship care is in line with best practice guidelines and the Safer Better Healthcare Standards (HIQA, 2012)

Patient/ClientAdvocate:

• Communicate, negotiate and represent patient's family and/or carer values and decisions in relation to their condition in collaboration with MDT colleagues as appropriate
• Develop and support the concept of advocacy, particularly in relation to patient participation in decision making, thereby enabling informed choice of treatment options
• Respect and maintain the privacy, dignity and confidentiality of the patient, family and/or carer
• Establish, maintain and improve procedures for collaboration and cooperation between UPMC Ireland Services and other organisations as appropriate
• Proactively challenge any interaction which fails to deliver a quality service to patients

ManagerialResponsibilities:

• Provide an efficient, effective and high quality service, respecting the needs of each patient, family and/or carer.
• Effectively manage time and caseload in order to meet changing and developing service needs.
• Continually monitor the service to ensure it reflects current needs.
• Implement and manage identified changes.
• Ensure that confidentiality in relation to patient records is maintained. •Represent the specialist service at local, national and international fora as required.
• Maintain accurate and contemporaneous records and data on all matters pertaining to the planning, management, delivery and evaluation of care and ensure that this service is in line with HSE requirements.
• Contribute to the service planning process as appropriate and as directed by the ADON Medical Services.
• Have a working knowledge of the Health Information and Quality Authority (HIQA) Standards as they apply to the role for example, Standards for Healthcare, National Standards for the Prevention and Control of Healthcare Associated Infections, Hygiene Standards etc. and comply with associated HSE protocols for implementing and maintaining these standards as appropriate to the role.
• To support, promote and actively participate in sustainable energy, water and waste initiatives to create a more sustainable, low carbon and efficient health service.

KPI's The identification and development of Key Performance Indicators (KPIs) which are congruent with the Hospital's service plan targets.

• The development of Action Plans to address KPI targets.
• Driving and promoting a Performance Management culture.
• In conjunction with line manager assist in the development of a Performance Management system for your profession.
• The management and delivery of KPIs as a routine and core business objective.

Education& Training:

• Maintain clinical competence in patient management within cancer nursing and nursing/midwifery, keeping up-to-date with relevant research to ensure the implementation of evidence based practice.
• Provide the patient, family and/or carer with appropriate information and other supportive interventions to increase their knowledge, skill and confidence in managing their condition.
• Contribute to the design, development and implementation of education programmes and resources for the patient, family and/or carer in relation to diagnosis and survivorship issues thus empowering them to self-manage their condition.
• Provide mentorship and preceptorship for nursing colleagues as appropriate.
• Participate in training programmes for nursing and MDT colleagues as appropriate.
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