STRATHCARRON HOSPICE COMMUNITY TEAM
Clinical Nurse Specialist, Palliative Care
with particular responsibility for Neurological illness
30 hours/week, Permanent
Salary: £26,041 - £34,876 per annum, pro rata
Ref No 1406206
Do you want to work in specialist palliative care and have a passion for supporting patients with
neurological illness? Do you put patients and their families at the heart of your nursing practice?
We have a unique opportunity for a well developed registered nurse to blend skills in specialist
palliative care with an expert knowledge of neurological illness – in order to promote effective
support to patients and their families in NHS Forth Valley, Cumbernauld and Kilsyth.
(You will hold a caseload of patients with both neurological and malignant diagnoses).
You will need to have a sound knowledge of specialist palliative care/neurological illness, be able to
demonstrate excellent clinical practice and preferably have a relevant degree. You will be highly
aware of the challenges of delivering both general and specialist palliative care in a community
setting. A care and commitment to valuing people right up to their last moment of life is crucial.
In return, Strathcarron Hospice offers a supportive working environment, development in the
palliative care specialty, a highly driven clinical and educational team and job satisfaction which is
difficult to match.
For further information about the post please contact Marjory Mackay, Director of Nursing, on
01324 826222. Informal enquiries are encouraged.
Application forms and job descriptions are available on our website at www.strathcarronhospice.org or
by contacting Fiona Mulvany, HR Co-ordinator on 01324 826222 or via e-mail at
Fiona.Mulvany@nhs.net
Closing Date: Friday 20th June, 2014
Proposed Interview Date: Thursday 26th June, 2014
CNS (Neuro) – Job Description – June 2014
INFORMATION ABOUT THE POST
Strathcarron Hospice is the only Scottish hospice which has developed joint palliative /
neurological nurse specialist posts. These posts (currently two) have been established for
almost 30 years and sit within the Community CNS team at the hospice.
The palliative care needs of patients with neurological illness are considerable. The purpose
of these posts is to develop integrated ways of working with neurology (and related) teams in
delivering expert palliative care to the patients in Forth Valley, Cumbernauld and Kilsyth.
Collaborative working models are well established but as treatments develop and health
services are reconfigured, these post holders are crucial to maintaining the profile of the
needs of patients with advanced neurological illness and promoting an anticipatory approach
to care before patients’ lose their ability to speak up for themselves.
The post holders are also responsible for a small cancer caseload in a particular geographical
area – and this caseload mix has been a useful experience.
We do not anticipate recruiting anyone who is fully developed in all three areas - specialist
palliative care, neurology and community working. However, a passion for those with
neurological illness – which is by definition a longer term illness, is absolutely essential, as
well as a willingness to develop the other demands of the post. Development support will be
given in a bespoke way.
For further information, please contact Marjory Mackay, Director of Nursing on 01324
826222.
CNS (Neuro) – Job Description – June 2014
STRATHCARRON HOSPICE
JOB DESCRIPTION
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JOB DETAILS
Job Title:
Community Clinical Nurse Specialist, Palliative & Neurological Care
Responsible to:
Director of Nursing
Department:
Strathcarron Community Team
No. of Job Holders:
10
JOB PURPOSE
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3.
The post holder will be responsible for the delivery of specialist palliative care advice and
support to patients carers and a wide range of professionals within a designated geographical
area.
To develop joint working models between palliative care and neurology teams to effectively
support patients and carers in an integrated way
DIMENSIONS
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Strathcarron community nurse specialist team provide specialist palliative care advice to
primary care teams and their patients within Forth Valley and North Lanarkshire. Average
annual referrals to the team 850. Each CNS has responsibility for an average caseload of 40
patients within a designated geographical area. The service is currently available during office
hours but has the potential to extend in the future. The service responds flexibly to ensure
cover for other case loads during times of annual leave or exceptional demand.
The post holder will share a caseload of neurological patients with one colleague – delivering
specialist palliative care across the total area of NHS Forth Valley, Cumbernauld and Kilsyth
CNS (Neuro) – Job Description – June 2014
4.
ORGANISATIONAL POSITION
Director of Nursing
Hospice@Home Lead
Post Holders
Community Staff Nurse
5.
ROLE OF DEPARTMENT/TEAM
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5.
The department/team operates at an expert level whereby they can directly and indirectly
influence all aspects of care and management of patients with specialist palliative care needs.
This applies to any point of a patient’s illness trajectory and to both malignant and nonmalignant illness. Fundamental to this, is effective, collaborative interdisciplinary and
multidisciplinary working both within Strathcarron Hospice, and the Primary, Secondary and
tertiary care settings.
KEY DUTIES/RESPONSIBILITIES
Clinical
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Triage referrals to the service
On acceptance, assimilate relevant necessary information regarding diagnosis, disease stage,
treatment, psychosocial background and use expert knowledge, skills, experience and risk
assessment to prioritise visits.
Visit patient and their families and carry out a comprehensive, holistic assessment, using
validated assessment tools.
Using an anticipatory approach, plan and review appropriate care with the patient and family.
Liaise with relevant health professionals and social care teams in order to achieve the best
outcomes for patients and families.
Using expert empathetic interpersonal and communication skills, build and maintain
therapeutic relationships with patients and their families to address on-going, developing and
often complex social, psychological and spiritual needs.
Advocate for patients with cognitive loss and for those at the end of life.
Act as a specialist resource and support system to patients and their families and colleagues in
the Primary, Secondary and Tertiary Care settings.
Attend multi-disciplinary meetings within the hospice, and in the Primary and Secondary Care
settings to provide specialist palliative care advice from a community perspective.
Apply specialist knowledge of pharmaceutical and non-pharmaceutical symptom management
to maximise quality of life
Screen for medical, oncological and palliative care emergencies
Assess bereavement needs and facilitate appropriate support.
CNS (Neuro) – Job Description – June 2014
Management
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Work autonomously in the community, supported by the hospice multi-disciplinary team.
Manage own geographical caseload, prioritising and organising work according to resources
available.
Maintain accurate and comprehensive patient records in accordance with local and national
guidelines.
Collect and collate statistical data relating to caseload activity.
Participate in the further development of the service by contributing to regular team
meetings.
Represent Strathcarron Hospice at events such as Managed Clinical Networks, Gold Standards
Framework and charity functions.
Assist with recruitment and selection of staff into the team.
Assist with Hospice bed management as required
Participate in the development of policies, protocols and clinical guidelines necessary to
support specialist palliative nursing care.
Contribute to decision-making regarding service delivery through the participation in key
meetings.
Understand and accept the parameters of his/her professional role. When
appropriate contribute to the expansion and development of the role to
meet the changing health needs of the patient group.
Education
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Take responsibility for own professional development, updating knowledge and skills in
neurological and palliative care.
To deliver quality education and training to a wide range of staff in a range of settings –
enhancing the cross-fertilisation of palliative care and neurological care.
Participate in induction and in-service programmes for all levels of hospice staff
Supervise the clinical performance of Clinical Nurse Specialists in development posts within
the area.
Participate in teaching programmes for pre and post registration nurses, post graduate nurses,
GPs, and all relevant health and social care professionals.
Provide health education and health promotion advice to patients, families and carers.
Provide experiential learning opportunities for visiting specialists.
Act as an information resource to patients and the primary and secondary care teams.
Provide mentorship and act as a role model for less experienced staff both in hospice and
community.
Research and Audit
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Use and promote evidence-based practice to ensure clinical effectiveness
Contribute to the body of evidence on the role of palliative care for people with neurological
illness.
Participate in and support pilot studies, audit and research or quality improvement projects
related to the specialty.
Use reflective skills to audit current practice
Participate in regular review and audit conducted by regulatory bodies i.e. Healthcare
improvement Scotland.
CNS (Neuro) – Job Description – June 2014
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6.
Promote the services provided by Strathcarron Hospice through attendance at conferences
and the publishing of papers.
SYSTEMS AND EQUIPMENT
Equipment
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Computers
Syringe pumps
Mobile phones
Systems
The post holder will be trained and required to maintain expertise in the following systems:
 Keeping accurate and comprehensive patient records according to Hospice guidelines –
manual and electronic.
 Clinical policies and procedures manual/ Human Resources manual
 Collecting ongoing data to inform activity levels and trends.
 Relevant risk assessments
 Working knowledge of current complaints procedures
 Policies for vulnerable patients (adults and children)
 Intranet and NHS mail system
 SCI store / KIS
 Working knowledge of Crosscare and other software packages in use within the Hospice
7.
ASSIGNMENT AND REVIEW OF WORK
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8.
Each practitioner is responsible for the management of their own geographical caseload. The
daily workload is unpredictable as each patient/family is an individual with their own
frequently changing complex needs. The number of referrals per month varies and reasons for
referrals are identified on the referral forms. Each practitioner is responsible for caseload
management which is inclusive of triage, admission, transfer (internally and externally) and
discharge of patients. Each practitioner makes autonomous decisions on a daily basis and
works closely with other members of the multi-disciplinary team to facilitate effective
palliative care.
Each CNS is responsible to Director of Nursing for clinical practice, professional management,
work review and formal appraisal of performance. One of the Hospice Consultants is also
nominated to provide the CNS team with clinical advice and guidance when required.
Decisions and Judgements
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To operate at a high level of decision making within the hospice framework, recognising when
it is appropriate to refer to other multi-disciplinary team members and/or external
agencies/services.
CNS (Neuro) – Job Description – June 2014
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9.
Most Challenging and Difficult Parts of the Job
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10.
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Advanced communication skills are an essential part of this role
An ability to motivate and negotiate with others.
Demonstrate effective communication skills and sensitivity when breaking bad news
Facilitate the development of communication skills of other health care professionals
especially in the areas of breaking bad news, dealing with angry and difficult situations.
Frequently facilitate emotive discussions/interactions with patients, families and health care
professionals
Attend multi disciplinary meetings within the hospice, in primary care setting, and occasionally
in hospitals to offer community specialist palliative nursing perspective and advice.
Maintain patient and staff confidentiality at all times.
Promote good relationships with patients, public and staff through effective verbal and
written communication.
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PHYSICAL DEMANDS OF THE JOB
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Decision making in a wide range of settings.
Frequent exposure to emotionally demanding situations.
Demonstrating self awareness with regard to role limitations and boundaries.
Establishing and maintaining flexible relationships within the multi-dimensional community
settings.
Maintaining a flexible approach to manage constantly changing priorities.
Moral and ethical issues.
Communicating with patients with dysarthria/cognitive loss
COMMUNICATIONS AND WORKING RELATIONSHIPS
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11.
Use advanced communication skills during the pre and post bereavement phase to identify
where possible, the risk factors associated with complicated grief behaviour. Liaise with other
professionals to facilitate continued support.
Long periods of time spent driving in addition to navigating unfamiliar territory.
Issues of moving and handling in accordance with Hospice policy
MENTAL/EMOTIONAL DEMANDS OF THE JOB
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Retention and communication of knowledge and information
Personal study and updating self with nursing practice and advances in palliative care.
Unpredictable workload with changing demands and fluctuating patient numbers.
Driving skills and concentration required between patient visits.
An ability to read maps and navigate without assistance.
Frequent assessing of terminally ill patients in order to guide relatives and their carers on
expected prognosis and care needs.
Working in a constantly emotionally demanding environment and demonstrating coping
mechanisms to manage same.
CNS (Neuro) – Job Description – June 2014
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Communicating, negotiating and maintaining relationships and gaining the co-operation of
others.
Through contact with patients, be alert to changes in their behaviour that may result from
disease progression or side-effects of medication.
Supporting staff members during professional crises.
Managing conflict.
Balancing of clinical and non-clinical roles: prioritising and meeting competing demands from
patients, relatives and members of the various multi-disciplinary teams.
Frequent exposure to death and dying.
Frequently communicating and providing support to distressed/anxious/worried
patients/relatives.
Frequently managing the process of communicating unwelcome news to patients and their
families with cancer and palliative conditions.
Supporting the families and other health care professionals through a patient’s dying process
Frequently clarifying the perceptions and understanding of patients and families
Working Conditions
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Working in isolation
Exposure to body fluids
Exposure to infection
Exposure to unmanaged pets/animals
Exposure to verbal and physical aggression
Exposure to tobacco, drug abuse and alcohol addiction
Fluctuating noise levels in the office
Exposure to extreme weather conditions
CNS (Neuro) – Job Description – June 2014
13.
KNOWLEDGE, TRAINING AND EXPERIENCE REQUIRED TO DO THE JOB
Criteria for Selection
Essential Requirements
Desirable Requirements
Qualifications
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Registered nurse – sub part 1
Degree or equivalent in palliative care
and/or neurology
Advanced Communication Skills
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Experience
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Skills
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Significant post-registration experience
– some of which should be in
neurological or specialist palliative care.
Community nursing experience
Experience of collaborating working
Knowledge and experience of handling
complex relationships & interpersonal
dynamics.
Teaching experience
Involvement in Research /Audit
A passion for patients with neurological
illness and in advocating for their needs
in the advanced stages of their illness.
Expert skills in facilitating highly
sensitive end of life discussions
including breaking bad news of
terminal illness.
Advanced skills in pain and symptom
control
Ability to deal with highly complex
clinical scenarios including managing
contentious and challenging behaviors
Excellent oral, written and IT skills
including recognition of those who
have a barrier to understanding.
Ability to effectively manage change
Good teaching and presentation skills
Ability to prioritise workload, achieving
a balance between clinical work and
other aspects of the post.
Ability to work in a patient/family
centred way
Ability to communicate in creative ways
with patients with dysarthria/ cognitive
loss.
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Postgraduate qualification in
Palliative Care
Possess or be willing to undertake
training in Advanced
Communication skills
Post reg teaching /mentorship
qualification
Conducted own audit/research
project
Experience or working with
patients with cancer and
neurological illness
Analytical skills – interpreting
national and network guidelines
and applying them to practice,
both within and outside the
hospice
Ability to plan and organise
complex activities and
programmes – training, service
delivery models.
Well developed leadership skills
Contribute to national
programmes or networks to
improve practice
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CNS (Neuro) – Job Description – June 2014
Criteria for Selection
Essential Requirements
Desirable Requirements
Knowledge
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Clinical expert within the specialty of
Palliative Care and/or neurology.
Expert point of reference, required to
advise Healthcare Professionals in the
area of Specialist Palliative Care.
Demonstrate knowledge of national
policies influencing palliative care
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Evidence of professional and academic
development
Demonstrate commitment to
continuous self-development.
Demonstrate ability to use initiative,
make sound decisions and work
autonomously.
Positive, professional role model.
Self-aware and reflective
Commitment to team working
Enthusiasm/motivation
Good interpersonal skills
Able to travel from work base to
patients’ homes and other healthcare
premises
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Other
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Ability to undertake Audit,
Research, Report Writing (lead or
contributor, national or local
basis)
Management qualifications/
experience
Solution and achievement
oriented.
Flexible and adaptable to change
CNS (Neuro) – Job Description – June 2014
STRATHCARRON HOSPICE
Terms and Conditions:
The terms and conditions of service are those laid down in line with the
Whitley Council terms and conditions.
Location:
Strathcarron Hospice.
Salary Scale:
Band 6 £26,041to £34,876 per annum, pro rata.
Staff taking up a new appointment with Strathcarron Hospice will
normally enter the scale at the minimum of the pay band/range. Any
appointment above the lowest point of the pay band/range will be
subject to verification of previous NHS/Hospice services or experience
outside the NHS/Hospice, which is given in recognition of relevant
complete years of experience.
Hours:
30 hours per week
Employees may be required to vary the pattern of their working week
subject to the exigencies of the service.
Duration:
This is a substantive post
Annual Leave:
27 days rising to 29 days after 5 years service and to 33 days after 10 years
service plus 8 public holidays (pro rata).
Or
202.5 hours rising to 217.5 hours after 5 years service and to 247.5 hours after
10 years service plus 60 hours public holiday (pro-rata)
Sick Leave & Pay:
Superannuation:
In accordance with Strathcarron Hospice provisions
This post is superannuable under The Falkirk Council Local Government
Superannuation Scheme and your remuneration will be subject to
deduction unless you choose to opt out of the scheme.
Right to work in the UK:
Strathcarron Hospice has an obligation to ensure it does not employ
any worker who has not been granted the relevant permission to work
in the UK. This permission is without exception granted by the UK
Border Agency. We are required to check the entitlement to work in the
CNS (Neuro) – Job Description – June 2014
UK for all prospective employees, regardless of nationality or job
category
Pre-employment Health Assessment:
No appointment can be confirmed until a satisfactory
medical examination has been undergone.
Protecting Vulnerable Groups Scheme:
(if applicable):
From 28th February 2011 the Scottish Government
introduced a new membership scheme to replace and
improve upon current disclosure arrangements for people who work
with vulnerable groups. If the duties of this post involve regulated work
with children and young people and/or protected adults, the successful
candidate will require to be a member of the PVG Scheme and consent
to Strathcarron Hospice obtaining a Scheme Record or a Scheme Record
Update, if they are already a member of the Scheme. More information
of the PVG Scheme can be found at www.disclosurescotland.co.uk
Police Act Disclosure Check
(if applicable):
If the duties of this post require the declaration and validation of
criminal convictions, the successful candidate will be required to
complete a standard or enhanced Police Act Disclosure Scotland check
prior to any offer of appointment being made. In the event of
employment, any failure to disclose such convictions could result in the
withdrawal of any offer, disciplinary action or dismissal by Strathcarron
Hospice.
Confidentiality:
In the course of your duties you may have access to confidential
information concerning patients or staff. Unauthorized disclosure or
removal of information may lead to consideration of disciplinary action.
Equality in Employment:
Strathcarron Hospice fully supports the principle of equality in
employment and opposes all forms of unlawful and / or unfair
discrimination which cannot be shown to be justified. Strathcarron
Hospice is committed to ensuring equality of treatment for both present
and potential employees.
Tobacco Policy:
In line with Strathcarron Hospice’s tobacco policy, Strathcarron Hospice is
a smoke free environment. This means that smoking will not be permitted
by staff anywhere within the Hospice premises including residences and
grounds.
CNS (Neuro) – Job Description – June 2014
Health & Safety:
All employees have a responsibility for their own health & safety and
the health & safety of others who may be affected by what they do.
Employees also have a duty to co-operate with their employer by
following Strathcarron Hospice policies and procedures and safe
systems of work; by using equipment safely and by bringing any
shortcomings in health and safety arrangements to the attention of
their employer. Where something is provided in the interests of health
& safety employees must not interfere or misuse it. All employees have
a legal responsibility to report any shortcomings in terms of this in their
area. Managers and supervisors have a responsibility for monitoring
health & safety arrangements and ensuring staff are following policies
and procedures and safe systems of work.
Partnership Agreement:
Contributing to the development of partnership working by: supporting
Strathcarron Hospice in delivering its goals and objectives; supporting
continuous improvement in own performance and the performance of
the department, directorate and Strathcarron Hospice; attending
training, development and other activities aimed at improving own skills
and for the benefit of the organisation and patient care.
Completed application forms should be returned to:
Fiona Mulvany
HR Co-ordinator
Strathcarron Hospice
Randolph Hill
Denny
FK6 5HJ
Closing date:
20th June 2014
Ref No:
1406206
Proposed Interview Date: Thursday 26th June, 2014
CNS (Neuro) – Job Description – June 2014