Advanced Nurse Practitioner Specialist. Palliative

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1 JOB DESCRIPTION ellenor Advanced Nurse Practitioner Specialist Palliative Care Responsible to Accountable to: Head of Adult Community Services Director of Patient Care General ellenor is a specialist palliative care provider for adults in the Dartford, Gravesham and Swanley locality. The organisation has in-patient and day therapy facilities at Northfleet, a comprehensive Hospice at Home service and a range of outpatient and community services, all supported and delivered through a multi-disciplinary team approach. The Hospice at Home team provides specialist palliative care at home with regular contact by Specialist Nurses and Doctors to assess and address the patient and family s needs and problems. This is achieved with the support of GPs and other local health and social care services, and is available 24 hours a day, 365 days a year. Our team also includes nurses, health care assistants and volunteers who assist and relieve the family, providing respite, companionship and practical nursing care where appropriate. Job Summary Working at an advanced practice level as part of an integrated multidisciplinary team, the purpose of this role is to facilitate optimum quality of life for patients and families with advanced progressive life limiting disease. This will be achieved in collaboration with patients through the provision of specialist palliative care nursing interventions at advanced level, based on comprehensive holistic assessment, diagnosis and prescribing treatment through self-care or medication. The role supports primary care key workers in the delivery of high quality palliative and end of life care through the giving of information and specialist advice, training and education. They will also act as a specialist resource for the multidisciplinary team across the organisation, developing special interest, knowledge and skills in a defined area of specialist palliative care in relation to specific advanced progressive illness and care at the end of life, and play a leading role in policy and service development implementation. ANP JD Dec

2 Duties and Responsibilities 1. Clinical Practice To work at an advanced practice standard, plans and implements the highest possible standards in individual packages of care for patients, prioritising need in line with available resources. To ensure that the patient s dignity is promoted and respected and that equality and diversity are a top priority in the care of patients and families. To undertake a comprehensive advanced specialist palliative care nursing assessment in an outpatient or home setting, agreeing a plan of care for patients and families based on clear goals intended to bring about effective, measurable patient / family outcomes. To provide specialist supportive and palliative care for patients who have complex or rapidly changing physical symptoms, emotional or psychological needs To ensure patients / families preferred place of care is clearly discussed and identified and advanced care plans are in place to support this wherever possible. To act as the patients advocate where appropriate; being able to educate on relevant treatment options to empower patient s to make informed choices. To make proactive patient referrals to appropriate alternative internal or external services. To actively plan and discharges patients / families when identified goals have been met or when disease progression is stable in line with the hospices policies and protocols To provide high-level advice and guidance related to complex symptom management, and psychological, social and spiritual needs referring onto the appropriate professional or service accordingly. To facilitate the provision of bereavement support to families and other carers, identifying strategies for coping with loss, grief and change To identify an area of special interest to study and act as a specialist resource for colleagues, both internal and external. To work as a non-medical prescriber, prescribing medication within the context of palliative care underpinned by national and local guidance. To utilise advanced knowledge of medicines management in order to prescribe and recommend appropriate treatment within the scope of practice and competency level. To increase awareness about the effects of medication, monitoring and reviewing the patient s symptoms and the effectiveness of medication. To evaluate the outcomes of interventions and makes changes as appropriate. To undertake bereavement follow up in line with the agreed pathway and bereavement risk assessment. To actively promote the rehabilitative and therapeutic approach to specialist palliative care. To participate in a seven day per week operational service including out of hours provision. To ensure patients and professionals have appropriate links to colleagues in the absence of the post holder ensuring continuity of advice and intervention through effective team working. To regularly attend and chair (on a rota) multidisciplinary team meetings proactively discussing patients, ensuring the most appropriate plans of action are in place for individuals. ANP JD Dec

3 To proactively collaborate, in the best interests of patients and families, with a wide range of community and hospital based health and social care services including voluntary support groups. To regularly attend and provide services to GP practices supporting and advising on up to date, evidence based palliative care practice facilitating establishment and review of Gold Standards Framework, disease registers, proactive advanced care planning and clear understanding of patients and families preferred place of care. To promote the work of the organisation in all settings, encouraging collaborative working and the referral of appropriate patients with all diagnoses. To utilise the electronic patient administration system and makes full use of the information and technology resources to ensure high quality patient care, maximise patient benefit and make best use of resources. To ensure accurate and contemporaneous records, inputting patient data as required by the organisation. 2. Administrative and managerial To supervise the work of Palliative Care Nurse Specialists, where appropriate, providing a point of expertise and knowledge for the most complex patient problems. To provide senior nursing support and mentorship to colleagues. To undertake appraisal of CNSs and other team members as required. To support the Head of Adult Community Services in the active development of the Nursing roles within the team. To undertake caseload reviews with CNSs, ensuring that plans in place for patients and families are appropriate, and quality and cost effective. To develop effective working relationships with all members of the multidisciplinary team. To foster positive working relationships with members of the primary healthcare team, and in particular supports GPs and Community Nurses with the delivery of palliative care at home. To works in partnership with administrative teams. To actively participate in service development initiatives as appropriate, contributing to service redesign in response to the demands of the national and local agenda. To propose policy or service changes as appropriate. To plan and organise workload effectively, and to prioritise particularly in times of pressure in order to maintain quality standards. To assist the Head of Service in the investigation and timely resolution of any relevant complaints or comments regarding service provision. 3. Education, Training and Professional Development To maintain own expert clinical knowledge and skills, including advanced communication skills, and achieves the educational standards set out in line with the skills, knowledge and competency level required of advanced practitioners and by the role. To play a lead role in the induction, training and support of new staff and the extended Hospice at Home team, acting as a mentor and role model. To play a key supporting role to health and social care students undertaking training within the organisation. To work with the Education Department to initiate, facilitate and actively participate in the delivery of training sessions including internal and ANP JD Dec

4 external courses, education and awareness raising events for professionals. To help with identifying local needs through close networking and liaison with General Practitioners, Community Nurses, Allied Health Professionals, Social Care Peams and Voluntary Organisations To engage in promoting opportunities to develop advanced nursing practice in order to deliver high quality care. To participate fully in clinical supervision sessions in line with organisational policy. 4. Quality, audit and research To play a lead role in ensuring regular clinical audit to aid ongoing service improvement and development. To keep abreast of research and audit activity to ensure that his / her practice is appropriately updated in line with latest guidance, research findings and local policies and procedures. To play a lead role in the implementation of research and development programmes to support the clinical and service development of the specialist homecare teams. To assess, report and manage risks in line with the Nursing and Midwifery Council s Code and the organisation s policies. To identify and reports verbal complaints in line with the organisation s policy. To contribute to the Clinical Governance framework of the organisation, playing a lead role in the Care Practice Group and chairing the Medicines Management Group. To keep up to date with governance activity and latest policies and procedures. To support the work of the User Governance Sub Group to ensure that patient and carer views actively inform service improvements. To work with colleagues to actively seek and identify areas where changes to routines and practices will result in quality improvements. To actively work to ratify clinical policies and procedures. To abide by all organisational policies and guidance in relation to confidentiality and information governance. 5. General Undertakes appropriate clinical risk assessments and to inform the service leads of any circumstances that contribute to an unsafe environment for patients and staff. Organises and prioritises any competing demands of the role, completing duties as required within working hours. Adapts and develops in line with changing needs of the role. Acts as an ambassador for ellenor in order to raise the profile of the organisation at a local, regional and national level as required. Works flexibly across sites and departments from time to time as may be requested by their managers. Undertakes other duties commensurate with the seniority of the post as maybe requested by their managers. ANP JD Dec

5 The post holder will work within the NMC Code of Conduct and Scope of Professional Practice at all times. All organisational policies and procedures will be followed. This job description is not exhaustive and may be reviewed and changed by discussion with the post holder to meet the needs of the service. Signed and agreed with the current post holder: Name (please PRINT) Signature Date And Line Manager.. ANP JD Dec

6 PERSON SPECIFICATION Advanced Nurse Practitioner ESSENTIAL DESIRABLE QUALIFICATIONS First Level Registered Nurse with demonstrable senior experience in Palliative Care Postgraduate qualification: Masters degree in an appropriate subject (or commitment to work towards on a fast track basis) and / or Advanced Practitioner qualification Appropriate postgraduate qualifications in specialist palliative care Nurse prescribing qualification, or wiliness to work towards Teaching qualification Qualifications / training in the following end of life / specialist palliative care areas: Managing malignancies Managing organ failure Managing dementia Managing neurological disease Advanced Communication Skills certificate / training Evidence of commitment to ongoing professional development KNOWLEDGE, SKILLS AND ATTRUBUTES Good understanding of the role of specialist palliative care in end of life care Ability to communicate end of life care issues with clarity to patients and colleagues Advanced level of professional practice including self-directed learning, autonomous practice Good knowledge of end of life care tools and improvements they bring to patient care Evidence of skills in medicines management, assessment, review and independent / supplementary prescribing Expert sound knowledge of ANP JD Dec

7 complex symptom management and specialist palliative care Ability to communicate effectively at advanced level with patients and families with complex specialist palliative care needs Ability to work effectively with a diverse range of colleagues / individuals involved in palliative care service delivery and demonstrate positive outcomes for patients Ability to deliver training programmes / packages with confidence and clarity Ability to undertake clinical audit and recommend change to practice if appropriate Ability to maximise use of IT in the workplace EXPERIENCE Ability to develop more junior nurses in the attainment of expertise require Experience working in community specialist palliative care at a senior level Effective caseload and workload management Experience in effective delivery of training Significant experience of productive multi and interdisciplinary working Experience in service development and policy implementation Experienced in undertaking appraisals Experience in the following end of life / specialist palliative care areas: Managing malignancies Managing organ failure Managing dementia Managing neurological disease ANP JD Dec Innovative and resourceful practitioner

8 Personal Attributes Resilient and able to meet the complex demands of the post, able to take on unscheduled tasks and work competently and effectively under pressure Flexible approach with ability to adapt to changing or conflicting priorities Ability to work autonomously and with unpredictable work patterns, managing time, work commitments and priorities within the working hours allocated. Acts as a good role model for junior staff and colleagues at all times Identifies any limitations to own ability within the role and actively plans how to address these Conscientious, reliable, punctual and acts with integrity at all times. OTHER REQUIREMENTS Strategic awareness and knowledge of wider health and social care agenda Car owner / driver with full license Flexible approach to working hours, times and days of week ANP JD Dec

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