Clinical Nurse Specialist

DUTIES AND RESPONSIBILITIES To act as Key Worker for Renal cancer patients, carers and other professionals during the patient pathway at the Christie for non-surgical treatments, from first referral through to end of life or discharge from follow-up To work independently and collaboratively providing assessment, advice, support and symptom/side-effect management for patients, carers and other professionals. To work as a member of the Renal Disease Group with responsibility for the development and review of protocols / guidelines which promote innovative clinical nursing practice and integration of patient care. To be aware of change at national and local level and how it affects the service provided To undertake clinical and organisational audit, promoting the importance and value of undertaking such initiatives through multi professional collaboration. Clinical duties To accept referrals, undertake a Holistic Needs Assessment and formulate the ongoing personalised care plan.

Referring appropriately to services in the acute and community setting. To attend appropriate Renal clinics and liaise closely with the patients, nurses and doctors attending these. To provide continuity of care across the group, particularly with regard to integrating radiotherapy and chemotherapy. To provide information about side effects of treatment and ensure clear and concise documentation is completed.

To be fully conversant with treatment protocols. To communicate effectively and support / counsel patients and carers prior to, during and after treatment. Work in a collaborative manner with the rest of the team to work towards all patients having End of Treatment Summaries and Long-Term Care Plans. When appropriate have conversations with patients about their Preferred Priorities of Care and Advanced Care Planning, document and communicate with the other professionals involved.

Assess out-patients, both face-to-face and via phone, in multi-disciplinary and nurse led clinics, formulating appropriate clinical decisions and management plans through history taking, physical examination and requesting clinical investigations (depending on competency). Provide specialist assessment, support and information around psycho-sexual, fertility and menopause issues. Ensure accurate documentation of patient care in accordance with hospital policies and standards. Non-medical prescribing (within the limits of your competence) to manage treatment toxicity and symptoms for patients with renal cancer.

To attend MDT meetings as appropriate and contribute to the discussion about individual patients. To attend other professional and clinical meetings as appropriate. To be aware of current research protocols and liaise with the Research Nurses from the Renal Research Team and Observational & Supportive Team as appropriate. To act always in accordance with the NMC Code guiding documents.

To be aware of all non-surgical Renal cancer patients admitted as inpatients and liaise with nursing and junior medical staff involved in their care. In collaboration with the Renal Nurse Clinicians to act as a point of contact for patients and their carers in the community. To implement/follow Trust Policies and Procedures to ensure safe and effective delivery of care. Managerial/Clinical Leadership.

To provide specialist, expert clinical knowledge to clinical colleagues, patients and carers/relatives both within and outside the Trust. To provide written evidence of service development and performance. Initiate and support clinical developments / projects to promote excellence in patient care. Promote patient and public involvement activities in the specialist area, leading to service improvement.

Attend and participate in the CNS Forum Act as a role model presenting a professional image at all times Evaluate service delivery; identify areas for improvement to promote excellence in patient care and initiate change. Involve patients and the public in service development as appropriate. To build effective professional relationships with the GM Cancer Alliance and across Acute and Community settings. Provide and receive clinical supervision and mentorship to facilitate reflective practice.

Line manage other nurses or support staff on the team as appropriate. Education and Development 1. To participate in annual appraisal and accept personal responsibility for professional growth and development. Maintain a professional portfolio.

1. Ensure compliance with Trust essential training. 3. To identify training and educational needs of colleagues and develop educational programmes in collaboration with colleagues 4.

To provide specialist input on relevant post registration/graduate courses. 5. Use relevant educational opportunities, including attending local, national and international conferences, to ensure provision of the highest standards of patient care that is evidence based. Provide written and verbal feedback to colleagues.

Together with other professional colleagues develop information and resource packs for patients and their carers. Research and Audit To ensure that clinical practice is based on evidence and current best practice and to disseminate information to staff. To identify opportunities for nursing research and to participate where appropriate in nursing and multi disciplinary research, clinical audit, and benchmarking, in order to improve effectiveness and quality of patient care. Evaluate service delivery; identify areas for improvement and initiate change.

Establish improvements in practice through audit and research and disseminate through presentation at local, regional, national and international conferences and written publication. Contribute to the writing of protocols relevant to own specialty.