Clinical Nurse Specialist Medical Oncology – UPMC Whitfield Hospital

Location: UPMC Whitfield Hospital
Job type: Permanent

Overview of role:

The Clinical Nurse Specialist (CNS) in Medical Oncology will provide expert nursing care and support to patients diagnosed with cancer, undergoing systemic anti-cancer therapy (SACT). 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

Primary Duties and Responsibilities:

Professional /Clinical
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 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)

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

Patient/Client Advocate
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.

Managerial Responsibilities
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.

Education & Training
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

Audit & Research:
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.
Quality, Risk and Safety Responsibilities:
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.

Qualifications & Experience:

Candidates must have at the latest date of application: -
1. 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

And
II) Have successfully completed a post registration programme of study, as
certified by the education provider, which verifies that the applicant has
achieved a Quality and Qualifications Ireland (QQI), National Framework of
Qualifications (NFQ) major academic Level 8 or higher relevant in Cancer
Nursing.

Or
Can provide written evidence from higher education institute that they have
achieved the number of ECTS credits equivalent to a Level 8 or higher
standard, relevant to the specialist area prior application

And
III) Have a minimum of 5 years post registration full time experience or an
aggregate of 5 years full time in Cancer Nursing.

And
IV) Evidence of career development and personal development plan

And
V) 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

2. 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.

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 – UPMC Whitfield Hospital

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