JOB DESCRIPTION TEMPLATE 1. JOB IDENTIFICATION Job Title Senior

JOB DESCRIPTION TEMPLATE 1. JOB IDENTIFICATION Job Title: Responsible to: Department (s): Directorate : Operating Division: NHS Tayside Senior Clinical Nurse Specialist SGCD Nurse Consultant and National Lead SGCD Clinical Genetics To download application form please go to Tayside Region Show site and Job Reference: locate the post ref. no P/HC/34 09. All applications must be processed through NHS Tayside . No of job holders: Last update: 1 New Post 2. JOB PURPOSE The remit of this post is • To take lead inter – regional responsibility (working as part of the SGCD national team )to ensure the highest standard of care for adults with single gene conditions whom as a consequence of the condition are challenged by complex disability (SGCD). i.e. Severe and enduring mental health, physical, cognitive and learning challenges To provide expert professional and clinical care advice to patients, carers and the multidisciplinary team. Much of this advice may be of a highly complex, specialist and sensitive nature requiring careful analysis, interpretation and comparison of various outcomes To develop specialised programmes of care / care packages (working as part of the SGCD team) : providing highly specialised advice concerning care to meet the needs of this very complex care group To develop bespoke training packages (both visual and audio) and facilitate specialist training for patients, their families and the multi disciplinary teams To take overall responsibility in their region for the development and delivery of the SGCD initiative to ensure optimal patient outcomes To undertake the design and development of social research and evaluation within the remit of the project To influence policy at a local and national level • • • • • • 3. DIMENSIONS • As a key member of the wider national team the post holder has lead inter –regional clinical and mentoring responsibility for the development and supervision of highly specialised care with the multidisciplinary teams for patients with SGCD. This is critical to the delivery of integrated health and social care services. The post holder will manage a new case load referred initially via the patients lead consultant geneticist. (from an approximate 1.25million population per post) The postholder will direct managed care, and as the project develops will take a managed clinical network inter –regional responsibility for SGCD The postholder will take responsibility at an inter –regional level for developing and implementing nurse led clinics for people with SGCD dovetailing with other service provision The postholder will play a key role as a member of the National team in the development of; a needs assessment tool quality of life indicators a managed clinical network The post holder will facilitate an audit of care against any future agreed guidelines The post holder will take a regional lead, coordinating an assessment of need, and gathering and evaluating data from quality of life indicators. The post holder will have regional responsibility for monitoring change, measuring the impact of resources and will inform local decision makers about priorities for action, the best use of existing resources and where future resources should be allocated. The post holder will take inter – regional responsibility (as part of a wider team initiative) to progress all relevant European and Local initiatives for patients in the SGCD project (e.g. LTCA and Mental Health collaborative, NICE, Euro HD network) The post holder will take a regional developmental lead to promote service user involvement in setting the strategic framework for services and service delivery The post holder will facilitate multi / interdisciplinary working with a focus on ‘best value’. The post holder will promote e-health (primarily electronic medical records and consumer health informatics) • • • • • • • • • • • 4. ORGANISATIONAL POSITION Chair of the National Clinical Genetics Forum National Lead Lothian Health Board Dept Clinical Genetics Scottish Government Health Department Snr . Clinical Nurse Specialist SGCD South East Region Lothian Health Board Dept Clinical Genetics Snr. Clinical Nurse Specialist SGCD South West Region Greater Glasgow Health Board Dept Clinical Genetics Snr. Clinical Nurse Specialist SGCD Central Scotland Region Tayside Health Board Department Clinical Genetics Snr. Clinical Nurse Specialist SGCD Northern Region Grampian Health Board Department Clinical Genetics 5. ROLE OF DEPARTMENT The Scottish Government is wholly supportive of this new and innovative nurse led initiative. It anticipates that this project will have a sizeable impact on the future care needs of those with SGCD. The SGCD services will work inter regionally, each post co-located in the regional genetic centres and will be lead by the National project lead. The SGCD project is a highly specialist project committed to substantially improving the lives of people with complex and challenging disabilities and building the capacity of others to do so. As the delivery of health and social care packages evolve for people with SGCD in Scotland the project will be proactive in determining best practice, best use of resources and advising relevant departments to ensure the efficient and effective delivery of patient care. The key aims of the department are: • To build an effective team • To provide better information • To build services around people • To develop proactive, and shape new and innovative approaches to care • To improve quality of life • To work in close partnership with all relevant stakeholders • To understand better cultural barriers to improving services • To provide a strategic approach to care • To assist planners develop services • To develop research initiatives • To promote non discrimination 6. KEY RESULT AREAS Professional 100% Practice at all times within the Nursing and Midwifery Council Code of Professional Conduct Develop the role by using evidence-based practice, innovative practice and continuously improve own knowledge following guidance outlined in PREP Act as an exemplary role model for leading specialist nursing services Collaborate with multidisciplinary services in providing highly specialised care for people with SGCD Leadership and Management 25 % Direct and lead relevant multidisciplinary teams caring for individuals with SGCD (inter-regionally) Direct and lead relevant regional initiatives in the development, implementation and maintenance of policies, procedures, standards and protocols for SGCD services Take responsibility for the management of a caseload, ensuring that patients needs are assessed, care planned, implemented and evaluated working in partnership with families and other relevant agencies Lead and direct the relevant multi-disciplinary teams to ensure appropriate skills and competencies are used, effectively building the capacity of teams to improve quality of life To provide leadership, coaching and mentoring, to relevant multi-disciplinary team members Endorse that all members of the multi-disciplinary team are aware of and work within relevant, local, directorate and division policies and procedures to ensure that safe working practices are maintained for both patients and staff To promote and maintain defined standards of nursing care in line with the Nursing and Midwifery Council’s Codes of Professional Conduct and current Nursing, Directorate and Service Policies To ensure the accuracy and production of relevant reports concerning the work of the project Take regional responsibility, in conjunction with key stakeholders, for the direction and development of future service provision planning for people with SGCD The post holder is not responsible for managing the budget but needs to be aware of the resources available and commit to work within the financial envelope Take regional responsibility for Clinical Governance relevant to the SGCD project Clinical 50% In summary Lead and act as a specialist regional resource for SGCD by promoting the service and increasing the awareness of single gene conditions and their management improving quality of life Lead the monitoring, evaluation and audit of services for people with SGCD Develop, implement and evaluate highly specialist programmes of care for people with SGCD The post holder has direct regional responsibility for developing and implementing nurse led clinics for people with SGCD dovetailing with other relevant services Responsible for contributing to the National Project’s outcomes relevant to the development of MCN’s Communication with patient and families. Elicit clients concerns and expectations Interpret medical, family and psycho-social history Communicate genetic information to patients and their relatives Receive and provide highly complex, sensitive and possibly conflicting information Communicate very sensitive, complex condition related information to patients and their families with empathy and reassurance Identify and respond to emerging issues for the client or family Take responsibility for communicating and applying new scientific information Interpret & communicate genetic test results or at risk status to patients & health care professionals Take a lead role in referring clients to genetic services and explaining test procedures and implications of test results (Excludes genetic counselling) Expertly communicate highly sensitive and potentially psychologically damaging information which may cause high levels of distress Identify and manage conflict within families, created by e.g. sensitive genetic information Manage conflict/frustration when clients’ demands are incompatible with professional responsibilities and resources Support clients who have great difficulty accepting a positive or negative test result Use communication and counselling approach sensitively when dealing with cases where there is antagonism and/or highly sensitive atmosphere e.g. when clients have psychiatric illness or drug/ alcohol problems Have the ability to motivate clients to comply with treatment programmes when suffering from a degenerative illness, resulting in either difficult behaviours, depression, lack of motivation or insight Develop and utilise client information leaflets. To utilise knowledge of the theories of loss and bereavement and relate these to clients and their carers who experience this. Client care Facilitate highly specialist assessment of physical, cognitive, learning and mental health challenges and develop, implement and evaluate programmes of care Assess clients to determine the need for referral to relevant members of the multidisciplinary teams e.g. genetics, GPs, carers, voluntary and other statutory services. Build the capacity of relevant care agencies to provide better health and care Respond to telephone enquiries from clients and other health professionals regarding SGCD Ensure that the views of the clients or those speaking on their behalf are well received and that complaints are received courteously and responded to promptly according to relevant guidelines Maintain and promote high standards and quality of care Maintain the safety and wellbeing of clients and staff in accordance with Health and Safety policy. To have knowledge of child protection issues Planning and Organisation Organisation of own clinical case load Responsibility for policy/service development, including internal and external audit To plan and forecast budgets, spending and purchasing To ensure and be responsible for regional ¼ rly and annual reports, collating all figures and presenting in graph and pie chart form; this includes statistical data which measures the activity and performance of the regional SGCD project. To ensure the supervision and maintenance of accurate confidential records concerning patient care (both written and electronic). Contribute to the writing of literature specific to SGCD Lead Managed Clinical Network strategy for SGCD Keep up to date with database logging Facilitate regional / local user forums Facilitate opportunities for those directly affected by SGCD to meet with decision makers Liaison with the European Huntington’s Association, the International Huntington’s Association and World Congress of HD To actively seek development opportunities for the service through funding prospects, networking and strategic awareness, contributing to local strategy Research and Development 25% Research and development is a major job requirement and will be undertaken on a daily basis. The post holder will develop research and audit programmes to support best practice and ‘best value’ services Access and interpret scientific literature relating to clinical practice Contribute to the design of a regional / national data base and maintain records and data collation in the support of project outcomes Keep patients informed of research options available Work alongside research colleagues to facilitate programmes of research for the client group Monitor change, the impact of resources and inform decision makers about priorities for action, the best use of existing resources and where future resources should be allocated based on research findings Educational Responsibility 25% Develop, provide and support appropriate specialist education and training programmes to promote a wider understanding of SGCD, locally, nationally and internationally to influence best practice Lead the development and the delivery of specialist education programmes with a core curricula for institutes of higher education Have a sound understanding of effective learning techniques Act as an educational resource for clients, carers, relatives, health care professionals and the general public Teach, advise and support clients and carers with regard to their condition and treatment options Interpret and present findings of research/audit or clinical practice to relevant health professionals, patient groups and members of the public, regionally or nationally Ensure that on-going personal development needs are identified and met Collaborate, communicate and be a key partner in the national and international field of SGCD. This includes participating in national and international conferences and communicating effectively with other key members and professionals who have expertise in SGCD. 7a. EQUIPMENT AND MACHINERY • • • • • Mobile phone Telephone Answer machine Fax machine Desktop computer • • • • • • • • Personal laptop computer Personal Digital Assistant (hand held computer) Projector Dictaphone Digital camera Video recorder Photocopier Car 7b. SYSTEMS • • • • • • • • • • • • Specialist data base Genesis – collect and input patient data Inview - electronic filing Med trak- patient tracking system Internet and intranet Human resource administration system Maintaining patient records – ensure that all clinical documents are up-to-date and accurate, legible and appropriately filed Use of word processing to produce standard and non-standard letters and communication as appropriate Use of Access to accurately collect and record data on patient databases Use of Powerpoint for the production of educational resources Use of Excel for the production of financial spreadsheets and collation of statistics Use of email for effective communication Utilising the NHS e-library resources and internet to inform clinical practice 8. ASSIGNMENT AND REVIEW OF WORK • • • • • • • • Referrals for the SGCD project will initially come from the regional co-located consultant clinical geneticist via a central referral system managed by the Nurse consultant lead. The post holder will work autonomously as a very specialist practitioner reviewing referrals for admission to the project dependent on admission criteria The post holder will work continuously towards problem solving using their own initiative to resolve the frequent challenges they will face managing such complex needs The post is primarily self directed and self generated in response to the needs of SGCD patients, their families and project outcomes Facilitation of very specialist and comprehensive assessments Workload will be reviewed very regularly, with the regional post holder and the team led by the Nurse Consultant Lead The post holder will have a Professional Personal Development plan reviewed 3 monthly by the direct line manager The post holder will have professional accountability to the National Lead who will undertake • • • • • regular supervision, annual appraisal and performance review The post holder will be responsible for the production of ¼ reports and end of year reports The post holder will lead the development of services with the multi-disciplinary team Facilitate regular independent audit led by the nurse consultant lead. Faciliate regular case reviews as appropriate with a high frequency of difficult/complex cases to discuss Attend relevant SGCD professional conferences 9. DECISIONS AND JUDGEMENTS • • • • The post holder is expected to make clinical and professional autonomous decisions on a daily basis, including the provision of advice to the multi-disciplinary team The post holder is expected to make all operational judgements within their region within the remit of the SGCD project Informing clinical decision making with regard to improving the patients quality of life through stringent monitoring of the patients condition and acting on clinical judgement Freedom to act is guided by precedent and clearly defined divisional policies, protocol / procedures and codes of conduct in accordance with NMC regulations and the clinical and staff governance framework Acting as the patients advocate to ensure their rights are upheld during the decision making process. If this is inappropriate to do so e.g. because of conflict of interest, to refer if possible to a patient advocacy service Independently assess, implement and develop programmes of care. Autonomous in managing own clinical caseload – clinical judgment regarding all aspects of SGCD management Ability to recognise own limitations and seek advice from colleagues or Managers as appropriate To prioritise and re-assign team workload and develop caseload management system Investigate complaints made regarding service Risk assessment, decisions based on presentation and behaviour. • • • • • • 10. MOST CHALLENGING/DIFFICULT PARTS OF THE JOB • • • • • • • • • • Communicating highly emotive and distressing information to clients Managing conflict in families and maintaining confidentiality Frequently managing individuals with challenging behaviour Suicide/loss issues Balancing demands of caseload and project outcomes while effectively managing the service Working with people with a degenerative condition over a long period of time Working with people at the end of their life Working with families facing death, separation and loss Securing appropriate resources for adults with complex needs Improving equity of access and quality of care within defined resources 11. COMMUNICATIONS AND RELATIONSHIPS Communication with Clients and Families • Elicit clients concerns and expectations • Expertly communicate highly sensitive, life threatening and potentially psychologically damaging information which may cause high levels of distress e.g. telling a client they have inherited a progressive, neurodegenerative disease with no cure • Communicate genetic information to patients and their relatives • Take responsibility for communicating and applying new scientific information for the benefit of • • • the family Interpret and communicate genetic test results or at risk status to patients and health care professionals Use communication and counselling approach sensitively when dealing with cases where there is antagonism and/or highly sensitive atmosphere e.g. when clients have psychiatric illness or drug/ alcohol problems Communicate with the patient and their family on the delivery of care acting as a signposting facility Communication with Decision makers • To promote service user involvement in setting the strategic framework for services and service delivery. (People’s experience of living with a SGCD must be central to how services are designed). Communication regarding Clinical Caseload • Liaise with colleagues to obtain and provide information and to establish understanding and cooperation • Liaise with the multidisciplinary team about patients needs and how to effectively meet those needs • Compile letters to clinicians and other relevant practitioners • Co-ordinate client appointments • Liaise regionally, nationally and internationally with other SGCD services to obtain or provide information Communication regarding Education/Training • To facilitate and participate in conferences, workshops, training sessions on SGCD • Prepare bespoke training packages for relevant stakeholders • Communicate appropriately and effectively with educational institutes • Empower patients and their families to both contribute to education and training programmes and participate in same Communication regarding Research • Participate in the Euro HD network as appropriate and liaise regularly with public health and ISD Internal • Project lead based in Edinburgh :- communication by telephone re service issues, performance issues, difficult or complex cases, project development – telephone communication 3-4 times weekly, meetings 4 - 6 weekly. • Plethora of internal communications include, general manager, clinical genetics team, psychologist, psychiatry team, IT, Human resources, Finance, procurement, support services, health and safety, risk management, palliative care team, R&D department, OT, Physio, dietetics. External • • • • • • • • • All Health Boards throughout Scotland but primarily region specific Professional links with Statutory, non statutory agencies including our community health partners, specialist voluntary organisations and social work Specific services e.g. Neuro psychiatry, Psychology, Speech and Language therapy, Dietetics, Physiotherapists, home care managers, OT’s and CPN’s Patients and their families Educational institutes General public Hospices and the independent sector European networks e.g. Euro HD network International networks e.g. WHO 12. PHYSICAL, MENTAL, EMOTIONAL AND ENVIRONMENTAL DEMANDS OF THE JOB Physical Skills • • • • • Driving skills Lifting and handling Computer skills Activities of daily living Ergonomics Mental Demands • • • • • • • • • Concentration during consultations – frequent Maintenance of precise and accurate nursing and audit records-frequent Careful compilation and analysis of research information-regular Compiling letters to other professionals – frequent Working with individuals with complex and challenging behaviours - frequent Possibility of interruptions from clients, relatives, colleagues or other professionals, either directly or indirectly – frequent Maintenance of precise and accurate clinical and research records - frequent Recognising and responding to ethical issues that may arise in clinical and research practice – regular Communication difficulties significant as a consequence of patients brain impairment , speech may become slurred and non coherent, cognitively sizeably challenged increasing communication difficulties – frequent Time management – frequent Planning teaching sessions and developing teaching material – frequent Critically reviewing published literature to inform practice – regular Developed responsibility skills – frequent Service changes - ongoing Political influence- regular Challenging inappropriate/poor clinical practice – regular Autonomous worker therefore professional judgement and decision making requirement – constant- frequent • • • • • • • • Emotional Demands • • • • • • Conveying highly emotive and distressing information to clients – regular Communicating with distressed/ anxious/ worried/angry patients/relatives-regular Communicating complex issues within the multi-disciplinary teams- frequent Managing conflict within families – regular Communicating with bereaved relatives – regular Highly sensitive issues e.g. continual loss issues, disinhibited behaviour, communication difficulties, PEG feeding, abortion, prenatal testing/diagnosis, pre-implantation, relationship problems, family conflict and guilt – regular/frequent Caring for patients for which there is no cure, witnessing the unrelenting degenerative nature of single gene conditions Personal / interpersonal stressors • • Environmental and working conditions • • Dealing with verbal / physical aggression / anxiety – frequent Temperature/air quality of working environment - infrequent • • Flexibility in working hours – frequent Ergonomics 13. KNOWLEDGE, TRAINING AND EXPERIENCE REQUIRED TO DO THE JOB 1st Level qualification in nursing with a minimum of 5 years post registration experience essential Evidence of further education including post-graduate certification/diploma/continuous professional development essential Educated to masters level or working towards is desirable Relevant experience demonstrating the appropriate competencies and skills for the job essential Will need to demonstrate excellent team working skills Evidence of management, education and training Must have highly developed specialist knowledge, underpinned by theory and experience Highly attuned analytical and judgement skills enabling analysis, and interpretation of complex facts and situations concluding in comparison of a range of outcomes Effective listening and interpersonal skills essential Time management skills/ability to prioritise workload essential Use own initiative / be innovative Evidence of effective problem solving skills Requires excellent IT skills including production of power point presentation Expert clinical practitioner Evidence aptitude for research Excellent communication, planning and organisational skills essential The post holder must be able to work without supervision work in a multidisciplinary/agency team co-ordinate and supervise the work of others 14. JOB DESCRIPTION AGREEMENT A separate job description will need to be signed off by each jobholder to whom the job description applies. Job Holder’s Signature: Head of Department Signature: Date: Date: NB. When reference is made to the multi-disciplinary teams this includes all of our partners in the Health, Voluntary, Social and Independent sector. To download application form please go to Tayside Region Show site and locate the post ref. no P/HC/34 09. All applications must be processed through NHS Tayside . Skills/ Knowledge Personal Attributes /Competencies Essential Criteria Qualifications First level qualification in Nursing Qualification to degree level or ability to demonstrate extensive relevant experience. Experience Minimum of 5 years post registration experience and a minimum of 3 years experience in a relevant field (e.g. neurology, mental health, acquired brain injury, genetics, oncology). Demonstrable experience of working with • people who live with very complex needs • the wider clinical and community teams who support them • care planning tools A robust understanding of the voluntary and public sectors. An understanding of and commitment to the support needs of those affected by progressive genetic conditions. Demonstrable skills to optimize patient outcomes. Practical experience of researching information, monitoring, evaluation and audit. Demonstrable teaching experience (incl. presentation skills, preparation of training materials e.g. power point presentations, training packs, literature). A comprehensive understanding of the healthcare environment and the systems and processes that support it. A comprehensive understanding of policy in relation to health, equality and diversity, and the impact of inequality on healthcare experience. Skills Clinical & Interpersonal Expert in ability to carry out complex specialist assessment and interpretation, followed by appropriate action. Have the capacity to enable decision makers. Excellent interpersonal and writing skills and ability to relate to a wide range of stakeholders appreciating the value of differing views and perspectives and what they bring to a solution. Have the capacity to mentor others, direct care and supervise highly specialized care with the multi-disciplinary teams. Have the ability to provide and receive highly complex, sensitive, and at times contentious information to /from patients and at times other professionals. Have a comprehensive understanding of confidentiality issues. Have the skills to manage hostile or antagonistic behaviour. To work with other team members in an enabling way to achieve team goals. Self-motivated to initiate, lead and complete work (meeting deadlines) in complex areas without supervision. Client Care Highly developed specialist knowledge underpinned by theory and practice. Be an accomplished practitioner. Able to skillfully support those who assess, develop and implement programmes of care with an inter /multidisciplinary approach. Have the capacity to establish and lead effective regional clinics for people living with complex genetic conditions Planning and Organisation Working as an autonomous practitioner, the clinical nurse specialist must have the ability to plan and organize complex activities or programmes at an inter- regional level whilst at all times being accountable for own professional actions. (e.g. working with relevant MCN’s) Financial Management Ability to review own budget and work within the financial envelope. Education and training Facilitate a high standard of training and education opportunities. Provide highly specialist information. Have an understanding of how adults learn. Have the capacity to produce relevant literature. Research & Development Ability to assess and synthesize complex qualitative and quantitative health related information and use findings to propose and develop potential solutions. Communicate results to all key stakeholders. IS Skills Should have excellent IT skills and be very familiar with Microsoft Office, PowerPoint and other relevant software Programmes. Ability to understand health care information systems and how the information they contain can be utilised. Desirable Specialist practitioner qualification Attainment / working towards Masters level qualification Reviewed October 08