Cns Palliative Care

6 months ago


Worcester, United Kingdom Worcestershire Acute Hospitals NHS Trust Full time

**Key Duties**: Clinical/Professional Constantly practices autonomously by assessing and effectively prioritising referrals to the service in order to deliver patient focused appropriate care in the context of a whole service approach. Provide a specialist and holistic palliative care assessment of patients and their carers needs following referral, which realistically minimises physical symptoms and the social, financial, emotional and spiritual implications of the disease process. In negotiation with the patient, their carers, and the wider multidisciplinary team, formulate a plan of care using specialist knowledge and skills dependent on the level of specialist intervention required. Provides highly specialist care and advice for patients and carers, and assists the multidisciplinary team in delivering and evaluating the interventions/ plan of care, reviewing and amending this care as appropriate.

Frequently acts as a primary resource for site-specific specialist nurses, nursing/medical teams and the multi disciplinary team. Acts as a key-worker in co-ordinating care across different professionals and agencies. Facilitates and assists with complex discharge planning to home, hospice or other facility. Regularly assesses patient for inpatient admissions to specialist palliative care level 2 bedded units.

Has admission rights to palliative care inpatient unit in liaison with Consultant in Palliative Medicine. Frequently elicit and analyse complex patient/carer/ family reaction, needs, dynamics occurring throughout the patient/carers journey. Instigate action to facilitate the development of a therapeutic relationship between the patient/carer and members of the MDT to enhance intra-family communication. Frequently initiates and participates in highly sensitive and complex communication issues with patients, carers, nursing/medical teams; including pre-bereavement support, advice and imparting life changing news, e.g a terminal illness.

Regularly participates and contributes to relevant site-specific multidisciplinary team meetings. Regularly reviews and develops appropriate patient documentation in line with Trust policy and Department of Health recommendations. Participates and contributes to cancer network meetings to ensure the profile of palliative care is maintained. An understanding of the National Cancer Agenda and its impact on cancer service delivery in practice.

Be involved in the consultation of a 24 hour palliative care advice service in line with Department of Health guidelines. To offer a nurse prescribing service to palliative care patients in line with Department of Health and Acute Trust guidelines which will reduce patient and carers distress by being able to prescribe immediately and appropriately in response to patient needs. Uses a palliative care database that includes patient registration, clinical details and interventions that are shared with the community palliative care team, the consultant in Palliative Medicine, the Primrose Hospice and the inpatient palliative care unit. To participate in a 7 day palliative care visiting service that includes weekends and bank holidays.

Education Constantly acts as a resource for information on specialist palliative care within the Worcestershire Acute Hospitals NHS Trust, disseminating evidence based knowledge and skills to clinical staff at levels. Effectively utilises informal education opportunities with patients, carers and professionals. Educates patients and their carers in the understanding of their illness, treatments and provides other sources of information, help and support. Plan and coordinate formal and informal educational programmes to involve all aspects of generic and specialist palliative care within the acute and community trust, and for other agencies e.g The Primrose Hospice, St Richards Hospice.

Specifically identifies the educational needs of multi-professionals and delivers programmes to meet these needs, locally and as part of a county wide network. Participates in county wide palliative education initiatives and development, e.g the Palliative Education Strategy. Works in conjunction with the Consultant in Palliative Medicine to provide education and training to rotational specialist registrars and the induction of medical and surgical house officers. Provides placements/mentorship for professionals studying palliative care/oncology at undergraduate and postgraduate level.

Regular audit of issues relevant to current service provision, reviewing and amending practice as a result. To be involved in clinical effectiveness issues, particularly the introduction of patient pathways e.g. working with the End of Life team Co-ordinates the development, implementation and review of relevant nursing policies, procedures and documentation, ensuring a consistent evidence based approach to patient care. Personal and Professional Responsibilities Maintains a programme of personal and professional development by attending in-



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