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 journey. 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.

Clinical Focus
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.
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 CNS :

The CNS will:

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.

Indirect Care:

The CNS will:

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/Client Advocate:

The CNS will:

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

Managerial Responsibilities:

The CNS will:

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:

The CNS will:

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
Create exchange of learning opportunities within the MDT in relation to evidence based survivorship care delivery through journal clubs, conferences etc.
Be responsible for addressing own continuing professional development needs.

Audit & Research:

The CNS will:

Establish and maintain a register of patients referred to the CNS.
Maintain a record of clinically relevant data aligned to National Key Performance Indicators (KPI’s) as directed and advised by the ADON Medical Services.
Identify, initiate and conduct nursing and MDT audit and research projects relevant to the area of practice.
Identify, critically analyse, disseminate and integrate best evidence relating to Cancer treatment and care.
Contribute to nursing research on all aspects of survivorship care for cancer patients.
Use the outcomes of audit to improve service provision.
Contribute to service planning and budgetary processes through use of audit data and specialist knowledge
Monitor, access, utilise and disseminate current relevant research to advise and ensure the provision of informed evidence based practice

Audit expected outcomes including:

Collate data (agreed KPIs/clinical targets as per the National Cancer Control Programmes Guidelines), which will provide evidence of the effectiveness of CNS interventions undertaken 3 or 4 - Refer to the National Council for the Professional Development of Nursing and Midwifery final report - Evaluation of Clinical Nurse and Midwife Specialist and Advanced Nurse and Midwife Practitioner roles in Ireland (SCAPE Report, 2010) and refer to the National KPIs associated with the speciality. They should have a clinical nursing focus as well as a breakdown of activity - patients seen and treated.
Evaluate audit results and research findings to identify areas for quality improvement in collaboration with nursing management and MDT colleagues.

Consultant:

The CNS will:

Provide leadership in clinical practice and act as a resource and role model for Oncology practice.
Generate and contribute to the development of clinical standards and guidelines and support implementation.
Use specialist knowledge to support and enhance generalist nursing practice.
Develop collaborative working relationships with local Oncology Clinical Nurse Specialist’s/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.
Where appropriate develop and maintain relationships 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.

Quality, Risk and Safety Responsibilities:

Network with other Clinical Nurse Specialist in Oncology and in related professional associations.

It is the responsibility of all staff to:

Participate and cooperate with legislative and regulatory requirements with regard to quality, risk and safety
Participate and cooperate with local quality, risk and safety initiatives as required
Participate and cooperate with internal and external evaluations of the organisation’s structures, services and processes as required, including but not limited to, The National Hygiene Audit, National Decontamination Audit, Health and Safety Audits, CHKS, DGSA, ISO and other audits specified by regulatory authorities
Initiate, support and implement quality improvement initiatives in their area which are in keeping with local organisational quality, risk and safety requirements
Contribute to the development of PPPGs and safe professional practice and adhere to relevant legislation, regulations and standards
Comply with UPMC Ireland Complaints Policy Ensure completion of incident/near miss forms and clinical risk reporting
Adhere to department policies in relation to the care and safety of any equipment supplied and used to carry out the responsibilities of the role of CNS.
It is the responsibility of all staff to ensure compliance with local organisational hygiene standards, guidelines and practices

Skills, competencies and/or knowledge:

Professional Knowledge
CNS will:

Practice in accordance with relevant legislation and with regard to The Code of Professional Conduct and Ethics for Registered Nurses and Registered Midwives (Nursing and Midwifery Board of Ireland) Incorporating, The Scope of Nursing & Midwifery Practice and Professional Guidance 2025)
Maintain a high standard of professional behaviour and be professionally accountable for actions/omissions. Take measures to develop and maintain the competences required for professional practice
Adhere to the Nursing & Midwifery values of Care, Compassion and Commitment (DoH, 2016)
Adhere to national, regional and local HSE PPPGs
Adhere to relevant legislation and regulation
Adhere to appropriate lines of authority within the nurse/midwife management structure.

CNS will demonstrate:

In-depth knowledge of the role of CNS Oncology liaison
In-depth knowledge of the pathophysiology of psychological issues with patients in their patient cohort.
The ability to undertake a comprehensive assessment of the patient experiencing complications of Systemic Anti-Cancer Therapies, including taking an accurate history of their condition and presenting problems.
The ability to employ appropriate diagnostic interventions including use of the UKONS Telephone Triage toolkit to support clinical decision making and the patients’ self- management planning
The ability to formulate a plan of care based on findings and evidence based standards of care and practice guidelines
The ability to follow up and evaluate a plan of care
Knowledge of health promotion principles/coaching/self-management strategies that will enable people to take greater control over decisions and actions that affect their health and wellbeing
An understanding of the principles of clinical governance and risk management as they apply directly to CNS role and the wider health service.
Evidence of teaching in the clinical area
A working knowledge of audit and research processes
Evidence of computer skills including use of Microsoft Word, Excel, E-mail, PowerPoint

Communication and Interpersonal Skills

Effective communication skills
Ability to build and maintain relationships particularly in the context of MDT working
Ability to present information in a clear and concise manner
Ability to manage groups through the learning process
Ability to provide constructive feedback to encourage future learning
Effective presentation skills.

Organisation and Management Skills:

Evidence of effective organisational skills including awareness of appropriate resource management
Ability to attain designated targets, manage deadlines and multiple tasks
Ability to be self-directed, work on own initiative
A willingness to be flexible in response to changing local/organisational requirements.

Building & Maintaining Relationships including Team and Leadership skills

Leadership, change management and team management skills including the ability to work with MDT colleagues.

Commitment to providing a quality service:

Awareness and respect for the patient’s views in relation to their care
Evidence of providing quality improvement programmes
Evidence of conducting audit
Evidence of motivation by ongoing professional development.

Analysing and Decision Making

Effective analytical, problem solving and decision making skills

Qualifications & Experience:

Key Requirements:

Candidates must have at the latest date of application:

Professional Qualifications, experience etc.
(a) I) Be a registered nurse on the active Register of Nurses and Midwives held by An Bord Altranais agus Cnáimhseachais na hÉireann (Nursing and Midwifery Board of Ireland) or be eligible to be so registered
Evidence of career development and personal development plan
And
Demonstrate evidence of continuing professional development and
competence in delivering a professional service in Cancer Nursing
(b) Have the ability to practice safely and effectively fulfilling his/her professional responsibility within his/her scope of practice
Annual registration
(i) Practitioners must maintain live annual registration on the appropriate/relevant
Division of the register of Nurses and Midwives maintained by the Nursing and
Midwifery Board of Ireland (Bord Altranais agus Cnáimhseachais na hÉireann) for the role
And
(ii) Confirm annual registration with NMBI to UPMC Ireland.

Skills/Competencies:

Practice in accordance with relevant legislation and with regards to The Scope of Nursing and Midwifery Practice Framework (Nursing and Midwifery Board of Ireland, 2015) and the Code of Professional Conduct and Ethics for Registered Nurses and Registered Midwives (Nursing and Midwifery Board of Ireland, 2014) Demonstrate:
Effective communication skills.
Organisation and time management skills.
Effective analytical, problem solving and decision-making skills.
Commitment to provide a quality service
Have an Oncology Qualification from an accredited institution
Have a recognised post-registration nursing course - Higher Diploma or Post Grad course or be in pursuit of same.
Have extensive experience and clinical expertise i.e. minimum of 4 years post registration experience in the specialist area of Cancer Care.
Have the ability to practice safely and effectively fulfilling his/her professional responsibility within his/her scope of practice.

Job Specific Competencies and Knowledge:

Competent in IV/Oral Chemotherapy administration
Competent in accessing, maintaining & care of CVAD devices
Competent in IV Cannulation & Venepuncture

Equal Opportunity Statement and Benefits

UPMC is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.

At UPMC we provide a total rewards program that is not only market competitive, but fair and provides growth opportunities for all our colleagues.

Compensation – Competitive pay for the work employees do – base pay, performance related pay and premium pay where applicable.

Benefits – Fully paid maternity and paternity leave for new parents. Competitive Pension Plan, company funded Death in Service Benefit x 3 times. Critical Illness cover for all employees up to the age of 66.

Performance and Recognition – Rewards for performance that supports the goals and mission of UPMC through our annual ACES programme.

Work-Life Balance – Enhanced annual leave up to a maximum of 27 days. Flexible working opportunities to support you to work around external family commitments.

Development and Career Opportunities – Opportunities for each employee to reach their career goals through continued learning and/or advancement.

About UPMC

UPMC is a renowned multinational academic medical centre committed to delivering people-focused care that’s close to home. Headquartered in Pittsburgh and affiliated with the University of Pittsburgh Schools of the Health Sciences, UPMC shapes the future of health through clinical and technological innovation, research and education. UPMC expands its expertise globally, bringing world-class care across continents through its UPMC International division — an owned and operated network of hospitals and ambulatory care centres in Italy, Ireland and Croatia. UPMC International brings new access to the signature specialty services of UPMC Hillman Cancer Centre, UPMC Sports Medicine and others to more people in more places around the world.

In Ireland UPMC has provided high-quality healthcare in the South East since 2006. UPMC’s operations in Ireland now include UPMC Whitfield Hospital in Waterford, UPMC Sports Surgery Clinic in Dublin, UPMC Kildare Hospital in Clane, and UPMC Aut Even Hospital in Kilkenny. Outpatient care is available at the UPMC Carlow Outreach Centre, UPMC Hillman Cancer Centre radiotherapy locations in Waterford and Cork, UPMC The 4th Practice in Mallow, and across UPMC Sports Medicine Clinics in Dublin, Waterford, Limerick, Tipperary, Cork, and Mayo. UPMC has also established a nationwide Concussion Network. UPMC's Global Technology Operation Centre is based in Kilkenny.

Clinical Nurse Specialist Medical Oncology - Limerick Cancer Centre

Benefits

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