Clinical Nurse Specialist for Neurovascular Services

Overview Post Title: Clinical Nurse Specialist (CNS), Neurovascular Service Post Status: Specified Purpose Department: NeuroCent Directorate, Beaumont Hospital Location: Beaumont Hospital, Dublin 9 Reports to: Neurosurgical Consultant Team for Clinical Matters, Directorate Nurse Manager (DNM) and Clinical Nurse Manager 3 for Professional Nursing Matters Salary: Appointment will be made on CNS Pay scale at a point in line with Government pay policy. (€ 62,078 - € 78,443) Hours of work: 37.5 hours/week Closing Date: 11th June noon

Please note the hospital reserves the right to close the competition early should a substantial number of applications be received

Position Summary:

Subarachnoid haemorrhage is a severe subtype of haemorrhagic stroke that is associated with high morbidity and mortality and occurs when a blood vessel bursts within the subarachnoid space which is part of the brain's outer protective layers known as the meninges. An alternative form of haemorrhagic stroke, known as intracerebral haemorrhage, involves the bursting of a blood vessel within the brain tissue. These conditions exact a high social and economic cost, causing a potential loss of productive life years, and is a disease of relatively young people (median age 50 years for SAH). Outcomes for these conditions are poor with a significant prevalence of death within the initial months following survival as well as a high likelihood of inability of survivors to independently manage their activities of daily living. The positive impact that specialised nursing care has on the outcomes of patients and families for this cohort group and this is well documented in the contemporary literature. The Beaumont Hospital Neurovascular Service provides both acute and elective care of patients with cerebral and spinal vascular pathologies (e.g. subarachnoid haemorrhage (SAH), arteriovenous malformation (AVM) and dural arteriovenous fistulas). The majority of the patients in this category are those patients with ruptured or unruptured aneurysms. The clinical nurse specialist acts as a single point of contact for the patient and family through admission, discharge, and recovery. Providing a visible, accessible specialist nurse presence to key stakeholders, using influencing and collaboration skills across different levels of multidisciplinary professionals, optimising key performance indicators, maintaining and developing standards, provision of education and training, and leading a nurse clinic specific to this patient cohort are some of the competencies expected of this role. Please see the information below for a more elaborate description of the job role and responsibilities.

Responsibilities Principle Duties and Responsibilities:

The post holder's practice is based on the five core concepts of the Clinical Nurse Specialist role as defined by the National Council for the Professional Development of Nursing and Midwifery (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:

The clinical practice role may be divided into direct and indirect care. Direct care 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.

Direct Care:

The clinical nurse specialists will:

• Provide a specialist nursing service for patients within their remit who require support and treatment through the continuum of care
• 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 multidisciplinary 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 (PPPGs)
• 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
• Support (where appropriate) 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.

Indirect Care:

Clinical Nurse Specialists will:

• Support and facilitate agreed referral pathways for patients
• 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
• Ensure that practice is evidence based and guided by policy or local protocols
• Take a lead role in ensuring the service for patient is in line with best practice guidelines and the Safer Better Healthcare Standards (HIQA, 2012).

Patient/Client Advocate:

Clinical Nurse Specialists will:

• Communicate, negotiate, and represent patient's family and/or carer values and decisions in relation to their condition in collaboration with MDT colleagues in both Primary and Secondary Care 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 Acute Services, Primary Care, and Voluntary Organisations as appropriate
• Proactively challenge any interaction which fails to deliver a quality service to patients

Education & Training:

Clinical Nurse Specialists will:

• Maintain clinical competence in patient management within nursing, 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 thus empowering them to self-manage their condition
• Provide mentorship and preceptorship for nursing colleagues as appropriate
• Participate and lead training programmes for nursing/midwifery, MDT colleagues and key stakeholders as appropriate
• Be responsible for addressing own continuing professional development needs

Audit & Research:

Clinical Nurse Specialists will:

• The post holder will maintain a register of patients within the CNS remit
• Maintain a record of clinically relevant data aligned to National Key Performance Indicators (KPIs)
• Support and/or lead audit and research projects relevant to the area of practice
• Utilise and disseminate current relevant research to advise and ensure the provision of informed evidence based practice

Consultant:

Clinical Nurse Specialists will:

• Provide leadership in clinical practice and act as a resource and role model
• Use specialist knowledge to support and enhance generalist nursing practice
• Develop collaborative working relationships with local Clinical Nurse Specialists/Registered Advanced Nurse/Midwife Practitioner/MDT colleagues as appropriate, developing person centred care pathways to promote the integrated model of care delivery
• With the support of the Director of Nursing, attend integrated care planning meetings as required
• Develop and maintain collaborative networks with specialist services in voluntary organisations which support patients in the community
• Liaise with other health service providers in the development and on-going delivery of the National Clinical Programme model of care

Health & Safety:

These duties must be performed in accordance with local organisational and the HSE (Health Service Executive) health and safety policies. In carrying out these duties the employee must ensure that effective safety procedures are in place to comply with the Health, Safety and Welfare at Work Act (2005) . click apply for full job details