Registered Nurse - Hospice at Home

at  St Peters Hospice

Job Purpose The Hospice at Home Registered clinician is an expert in ensuring high quality palliative care is delivered to patients in the last weeks of life and their families. They can work independently, and as part of the wider health care team. The role includes Providing symptom control, psychological, personal, social and spiritual care and initial after death guidance and bereavement support Support and line management of Band 5 nurses and healthcare assistants The triage, assessment and prioritisation of referrals Coordinate, manage and allocate HCA teams to deliver Hospice at home care Working with a multi-professional approach to care Participation in quality initiatives Key Relationships Internal Director of Patient Care Deputy Director of Patient Care Head of Community Nursing Hospice at Home, Team Leader St Peters Hospice Clinical Teams Fundraising, Marketing and Communication Team Learning and Development Team and Clinical Quality Improvement Teams External Patient and family Community Nursing Teams and other Allied Health Care Professionals General Practitioners Key Responsibilities Independent assessment of the patients needs, identifying their priorities and working with the patient and family towards achieving them Demonstrate an in-depth knowledge of the options for achieving control of symptoms in the last weeks of life and ability to advise the primary and community health care teams Responsibility for the planning and supervision of delivery of care Support and coach carers at home in managing a relative whose condition is deteriorating Recognise the impact of caring for dying patients on yourself, internal and external colleagues and offer / seek support Safely administer medication in the community including setting up syringe pumps once competent to do so Recognise and manage palliative care emergencies Bring closure to the clinician -patient relationship and provide for a safe transition to another care provider as appropriate Deputise for team leader Work within own scope of practice, taking professional accountability for clinical competence. Potential Additional Clinical Responsibilities The post holder may undertake additional responsibilities when they have passed the relevant module and are using the skills in current practice, as below.
Use physical assessment and clinical reasoning skills as part of patient assessment and to support clinical advice, professional communication and documentation Perform Non-Medical prescribing within area of competence and practice according to local policy. In addition, to practice Non-medical Prescribing, the post holder must be registered as a Non-Medical Prescriber with the Nursing and Midwifery Council (NMC)or Health and Care Professional Council(HCPC) Governance, Quality and Clinical Practice KSF 3 Contribute to improving quality Promote care that is effective, safe and provides as positive an experience as possible. Promote quality approaches making others aware of the impact of quality Understand own role, its scope and how this may change and develop over time in developing a high quality organisation Work to support the team and help and enable others to work as a team Prioritise workload and manages own time in a manner that maintains and promotes high quality and offers flexibility in response to changing situations Evaluate the quality of own and others work in own area and raises quality issues and related risks with the appropriate people Support changes in own area that improves the quality of systems and processes Take appropriate action when there is a persistent problem with quality. Communication KSF 3 Can develop and maintain communication with people about difficult matters and/or in difficult situations Maintain high standards of integrity when communicating with patients and the wider public Manage complex communication issues with patients and families as a lone worker in the community Structure an interview using appropriate questioning, avoid jargon, using familiar language, at patients own pace Record concisely, accurately, confidentially and legibly the appropriate elements of patient assessment, results of investigations, problems identified and management plan Break bad news in steps appropriate to the understanding of the individual and be able to support distress and have discussions around prognosis and future care options Demonstrate an understanding of the need to involve patients and carers in decision making, offering them informed choices, respecting their views Use the Recommended Summary Plan for Emergency Care and Treatment (ReSPECT plus) process and form to support the documentation and communication of the patients preferences and clinical recommendations for emergency care and treatment Demonstrate skill in working with families facing loss Manage dissatisfied patients/relatives, anticipating potential problems and managing expectations Communicate with patients whose first language may not be English in a manner that they understand, using interpreters appropriately Present cases clearly, consistently and professionally to the multidisciplinary team (MDT) meeting contributing effectively in patient management Provide feedback to others on their communication where appropriate Communicate effectively with the wider multidisciplinary team Demonstrate negotiation and diplomacy skills and partnership working with external agencies Demonstrate competent use of Electronic Patient Records and IT systems Write and maintain accurate notes/documentation and input computerised data, keeping all information up to date.
Personal & people development KSF3 Develop oneself and contribute to the development of others Take responsibility for identifying and meeting own development needs Generate and use appropriate learning opportunities and apply own learning to development of practice Assess how well last years objectives were met and helps set new ones for the year ahead Enable opportunities for others to apply their developing knowledge and skills Actively provides learning and development opportunities to others including mentoring new staff and clinical placements Apply evidence to patient care Use strategies to develop own resilience Practice effectively by reflecting to support practice improvement, this maybe with colleagues and/or be engaging with clinical supervision. Health Safety and Security KSF 2 Monitor and maintain health, safety and security of self and others Look for potential risks to self and others in work activities, environments and processes including issues specific to lone working Manage identified risk in the best way possible Work in a way that complies with legislation and hospice policies and procedures on health, safety and risk management Demonstrate safe mobilisation, transfer and movement of patients in the community and how and where to obtain appropriate equipment Take action to manage an emergency, calling for help immediately when appropriate Report actual or potential problems that may put health, safety or security at risk and suggest solutions Support and challenge others in maintaining health, safety and security at work Work within the guidance policy for the protection of vulnerable adults Understand specific risks associated with lone working and follow lone working policy. Service Improvement KSF 2 Contribute to the improvement of services Discuss with the team the likely impact of changing policies, strategies and procedures on practice and changes the team can make and how to make them effective Take on new work and make changes to own work when agreed, requesting relevant help if needed Support colleagues in understanding and making agreed changes to their work Evaluate own and others work when needed including engaging in audit Make suggestions to improve the service Constructively identify where new ways of working, polices or strategies are having a negative impact on the service given to users or the public. Equality and Diversity KSF 2 Support equality and value diversity Challenges bias, prejudice and intolerance if appropriate or brings it to the attention of a manager Aware of the impact of own behaviour on others Demonstrate sensitivity and respect for people from different religious and cultural background and sexual orientation

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