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JOB DESCRIPTION
Clinical Midwife/ Nurse Specialist – Perinatal Mental Health
Equivalent to Clinical Nurse/Midwife Manager 2
(CNM2/CNM2).
Details of the Service:
Patients are at the heart of everything we do. Our mission, Excellence in the Care of Women &
Babies is to provide high quality and equitable services for all by delivering care based on excellence
in clinical practice, teaching, and research, grounded in kindness, compassion, and respect, whilst
developing our staff and becoming a model employer.
Our hospital is based within the Dublin Midlands Group which comprised of the following:
•
AMNCH, Tallaght Hospital
•
Coombe Women & Infants University Hospital
•
Midland Regional Hospital, Portlaoise
•
Naas General Hospital
•
St James’ Hospital
•
Tullamore Hospital
•
St Luke’s Hospital
Vision:
The formation of the hospital groups, which will transition to independent hospital trusts, will change
how hospitals relate to each other and integrate with the academic sector. Over time, the groups will
deliver:
•
Higher quality service
•
More consistent standards of care
•
More consistent access to care
•
Stronger leadership
•
Greater integration between the healthcare agenda and the teaching, training, research and
innovation agenda
The Coombe Women & Infants University Hospital which opened in 1826 is a voluntary teaching
hospital with national, regional and area responsibilities for ensuring the optimal health of women and
babies within the maternity, neonatal and gynaecology services and caters for up to 10,000 pregnant
women per annum. As such, it is governed by a Board of Guardians & Directors. We have an
approved bed complement of 243 beds and are the largest provider of women’s health care in the
Republic of Ireland.
We are a national, tertiary referral centre for specialised maternal-fetal medicine, neonatal and
gynaecological services.
The Coombe Women & Infants University Hospital also provides the largest gynaecology service in
Ireland. The Neonatal Centre is a provider of the National Neonatal Transport Service.
There is a community midwifery service, which provides outreach clinics and a DOMINO service. The
hospital’s catchment area extends to counties Wicklow, Kildare and Meath as well as the greater
Dublin area, with a population in excess of 1.6 million. The projected population increase in the
greater Dublin area is from 1.5M (2002) to 2M (2021)
Our Academic Partner is the University of Dublin, Trinity College.The offers both pre and
postgraduate midwifery programmes in conjunction with University of Dublin, Trinity College. The
Higher Diploma in Neonatal Intensive Care Nursing course is affiliated with RCSI. In addition, it is the
host hospital for the Hub Centre for Midwifery Education in the Greater Dublin Area.
The hospital also hosts a modern high quality facility that is our Colposcopy department accredited by
the National Cancer Screening Service (NCSS).
The Coombe Women & Infants University Hospital is a member of the Hospital Network of Health
Promoting Hospitals and has a Certificate of Membership for the Baby Friendly Hospital Initiative
(BFHI).
The Coombe Women & Infants University Hospital is committed to supporting personal professional
development for staff.
Recent and Potential Future Developments for the Service:
The hospital has the most modern delivery suite in the State. It is comprised of single rooms for all
labouring and birthing women. Our hospital is unique in the Greater Dublin Area in that we are the
only hospital to have a birthing pool room. We also have a ‘state of the art’ Emergency Operating
Theatre located within the Delivery Suite to facilitate swift transfer for requiring operative deliveries, in
addition to two High Dependency Rooms, a bariatric room and an isolation suite.
Our Neonatal Centre (NNC) is one of 4 tertiary referral centers in Ireland. It participates in an on call
rota to provide a national neonatal transport service. The outcomes for babies cared for in our NNC
are amongst the best in the country.
The Coombe Women & Infants University Hospital offers a combined Obstetric and Peri-Natal Mental
Health service that cares for and supports women who are experiencing mental health issues in the
peri-natal period , which includes the period during pregnancy and for up to six months post-partum. It
is a multidisciplinary team approach comprised of obstetricians, midwives, consultant psychiatrists
and a clinical nurse specialist in perinatal mental health.
The Hospital Board, management and staff are committed to the mission statement and as such, are
constantly seeking ways to improve care women and infants, as well as be the visionaries in the field
of women and infants healthcare. To this end, we embarked on the Productive Ward Initiative
“Releasing Hours to Care”, a type of lean approach to work processes which resulted in greater
efficiencies in work processes thus releasing more time for staff to spend at the bedside with women.
This hospital was the only one in Ireland to receive a Special Commendation by the NHS (UK) in
2013 for achievements in implementation of this initiative. The hospital has embarked on another lean
project in order to streamline processes in our very busy outpatients department.
The Coombe Women & Infants University Hospital participates in national audits and is committed to
the implementation of the National Standars for Safer Better Maternity Services (2016).
Multidisciplinary teams of staff meet weekly to progress quality improvement plans and to re-self
assess our standards against national standards.
The hospital is a 5 storey building and includes the following :
•
Outpatient facilities
•
An Early Pregnancy Assessment Unit
•
Perinatal Ultrasound Department
•
Colposcopy Department
•
Antenatal and Postnatal Wards
•
Neonatal Centre and Special Care Baby Unit
•
Gynaecology Day and Inpatient Wards
•
Delivery Suite including High Dependency Unit and 24 hour Assessment Unit
•
Operating Theatre Department
•
Perinatal Centre
•
Emergency Room
•
Paediatric Outpatients
•
Centre for Midwifery Education onsite
•
Laboratory including post mortem and mortuary facilities
•
Maintenance
•
IT department
•
Occupational Health Department
Clinical Midwife/ Nurse Specialist – Perinatal Mental Health
1.0 BACKGROUND & PURPOSE OF THE POST
The evolution of the nursing discipline saw a move to university education and the increasing diversity
of nursing roles and specialist posts. In the Irish context, nursing and midwifery professions have
undergone significant change. The Report of the Commission on Nursing (Government of Ireland
1998) was the catalyst for the introduction of a clinical career pathway that would encompass
progression to CNS/ANP roles (Begley et al, 2010).
The creation and development of this clinical career pathway has taken place against a background of
health service reform. Created by the discipline of nursing to meet the growing complexity of patient
care, the role of the CNS has evolved to meet societal healthcare needs (RCSI, 2010).
Clinical nurse/midwife specialists possess the educational preparation and mobility within healthcare
systems to assess and anticipate trends in healthcare and to respond to ever changing healthcare
environments (Begley et al, 2010). Within the context of perinatal mental health, the perinatal mental
health nurse specialist has as a pivotal role in providing ongoing and specialist support to women
experiencing mental health difficulties during pregnancy and for six months post-partum, thus fulfilling
an essential role within the multidisciplinary team.
The effects of perinatal mental illness
is a significant public health
concerns, both in terms of
healthcare costs, the effect on the developing child and the impact of perinatal mental health on family
relationships. In the U.K. The average society cost of perinatal mental illness, including perinatal
depression, anxiety and psychosis, carries a total long-term cost to society of about £8.1 billion for
each one year cohort of births (Bauer et al, 2014). Currently, there is strong evidence that mental
health difficulties in pregnancy and the post-natal period are associated with adverse outcomes for
the foetus and the baby as well as the mother herself. (NICE Guidelines, 192 – 2014), compromising
the healthy emotional, cognitive and physical development of the child (Brand and Brennan, 2009).
Other studies suggest that maternal mood may have a direct effect on foetal brain development
(O'Connor et al, 2012), and also on obstetric outcome as associations have been found between
depression/anxiety and increased nausea and vomiting, prolonged sick leave during pregnancy and
an increased number of obstetric visits (Anderson et al, 2004). Further, post-natal depression leads to
an increase in marital discord and conflict within families, which can have a deleterious effect on
children (Burke, 2009).
Currently, it is estimated that between 10% and 20% of women develop a mental illness during
pregnancy or within the first year after having a baby, which includes both new episodes and
recurrence of pre-existing conditions (Bauer et al, 2014). Further, psychiatric illness remains one of
the leading causes of maternal deaths (CMACE, 2011). In 2014, there were over 1200 referrals to
Perinatal Mental Health in CWIUH.
The perinatal period offers us a unique window of opportunity for promotion, prevention and early
intervention in mental health (Beyond Blue, 2008). A growing body of evidence demonstrates that
Perinatal Mental Health Specialists can, improve outcomes for women during the perinatal period
(Currid, 2004), and nationally (Cusack & Kiloury, 2012).
The policy document “Maternity Matters: Choice, Access and Continuity of Care” (DH 2007) highlights
the need for women to receive high quality safe care from a midwife and recognises that some
women will also require access and support from the wider maternity / medical team and psychiatric
team. Further, the benefits from improved outcomes for women and their babies are enhanced where
care is specifically designed and delivered to meet the complex needs of women who have or who
may develop mental health difficulties during the perinatal period. Pregnancy and birth is a part of the
health continuum for the majority of women and the role that midwives/nurse specialists play in
supporting and promoting future health should not be underestimated. The introduction of a role of
Clinical Nurse/Midwife Specialist inPerinatal Mental Health offers maternity services the opportunity to
improve the care offered to women and to enhance the long term future health of generations.
The Perinatal Mental Health Nurse Specialist’s role is to support and monitor the woman’s mental
health and well-being during her pregnancy and in the post-natal period, and to guide her and her
family in the promotion and maintenance of mental health during the perinatal period, using the
principles of a recovery-orientated approach as defined by the Mental Health Commission (2008).
With enhanced education, training and experience a Clinical Nurse Specialist in Perinatal Mental
Health, is best placed to provide additional support and guidance to a woman and her family where
her care becomes increasingly complex as a result of mental health issues. The role must be firmly
embedded in the Perinatal Mental Health Care Pathway and clearly recognise the need for the
enhancement of normal midwifery/nurse practice.
The care of the pregnant woman with mental health issues is complex and it requires specialist
knowledge. The benefits of expertise in Perinatal Mental Health can result in improved maternal and
foetal and child outcomes and greater satisfaction with the delivery of care (Morrison et al 2002). The
clinical midwife/nurse specialist post is to meet an identified service need and to improve quality of
patient/client care. This area of specialist midwifery practice shall (and does) require the application of
specially focused knowledge and skills within a major clinical focus incorporating assessment,
planning, delivery and evaluation of care given to women and their families in hospital and outpatient
settings.
As women with mental health difficulties during the perinatal period require the care of a wide range of
healthcare professionals in a diversity of settings, it is essential that healthcare professionals work
together to ensure that the right care be provided to the right person at the right time. Mental Health
Midwife/Nurse Specialists advocate for an individual to experience seamless and ongoing interactions
with a range of healthcare professionals in a healthcare system designed around the needs of the
individual patient rather than the service or the professionals.
The future for effective team working lies with medical and midwifery/nursing staff realising the
inherent power through complementary knowledge held by each group (Reeves et al, 2013).
Collaboration can improve job satisfaction, help overcome fragmentation of service delivery and
improve patient outcomes.
The complexity of delivering effective patient care means that no one profession can meet the needs
of patients. The need for a flexible collaboration between professions is central to the delivery of
effective patient care (Reeves et al, 2013).
Client Group: Women with mental health needs and their families
Team Structure: The Clinical Nurse/Midwife Specialist in Perinatal Mental Health works as part of a
larger multidisciplinary team that comprises of psychiatrists, obstetricians, midwives, dieticians,
physiotherapists and medical social workers. S/he is responsible for the provision of specialist mental
health/nursing care for pregnant and postnatal women attending the Coombe Women & Infants
University for their pregnancy care.
Working Relationships: The CNS/CMS – Perinatal Mental Health will work closely with the following:
•
Obstetricians – All Consultants and NCHD
•
Psychiatrists
•
Midwife colleagues
•
Perinatal Centre Midwives
•
Assistant Director of Midwifery & Nursing – Maternity
•
Director of Midwifery & Nursing
•
Dieticians
•
Physiotherapists
•
Medical Social Workers
•
All patient related services including ADMIN
•
Ultrasound sonographers
•
Laboratory staff
•
Phlebotomy
•
All support staff
2.0 PERSON SPECIFICATION
POST
Clinical Midwife/ Nurse Specialist – Perinatal Mental Health Equivalent to
Clinical Nurse/Midwife Manager 2 (CNM2/CNM2Clinical Midwife/Nurse
Mental Health
Department
Obstetric Division
Location:
Coombe Women & Infants University Hospital
Factors
Essential
Desirable
Qualifications
RM or RGN or RPN
Cognitive Behavior
Training or Relevant
Counseling
Qualification
** PgDip in Mental Health training **
Evidence of continuous professional
development.
Experience
(length and type)
Healthcare Knowledge
Five years post midwifery/nursing registration
experience
National Maternity Strategy (2016)
National Standards for Safer Better Maternity
services (HIQA 2016)
Demonstrable
experience of
improving quality.
Health, Safety & Welfare Work Act
Hygiene & Decontamination Standards
Relevant health and safety regulations
Involvement in
accreditation
process.
Child Protection Legislation and Requirements
Service planning knowledge
Clinical governance & Risk Management
Professional
Knowledge
Up to date knowledge of models of midwifery and
nursing care.
Understanding and application of research
Clinical/nursing audit methods.
Nursing & Midwifery Board of Irelamd (NMBI)regulatory function.
Knowledge of Midwifery/Nursing Educational
Programmes
Knowledge of workload measurement tools and
skill mix
Scope of professional practice.
Mandatory training, BLS, Fire, Manual Handling.
Experience in preceptoring students / new staff.
Attendance at
relevant
seminars/study.
Knowledge of hospital information systems
Core Competencies
Leading on Clinical practice and service Quality
Communication & Influencing Skills
Practitioner Competence & Professional
Credibility
ECDL or equivalent
course.
Clinical Supervision
Planning & Organising
Special Competencies
Generally Monday to Friday ( flexibility may be
required)
*Candidates for CMS /CNS in Perinatal Mental Health must be a registered Midwife /Nurse with
an additional qualification at a minimum level 8 in the area of mental health and 5 years post
qualification experience.
However, if a candidate has demonstrated an active interest in this area and/or has had specific
work placements in perinatal mental health care they may be considered for appointment to the
post while working towards and completing the academic requirements.
The Appointment to the CMS post is subject to attaining the required qualification and will be on a
two year fixed term contract. Remuneration during this period will be on the CMM2 Consolidated
Salary Scale.
The appointment is subject to satisfactory completing a level 8 post registration Quality and
Qualifications Ireland (QQI), National Framework of Qualifications (NQF)8 major academic award
relevant to the specialist area or equivalent –in Pregnancy loss/ Bereavement Care There after
the candidate upon acquiring the qualification may apply to the NMPDU for their CMS status to be
ratified.
PARTICULARS OF OFFICE
The appointment is fulltime, permanent.
Character:
A candidate for and any person holding the office must be of good character.
Duties:
The Clinical Midwife / Nurse Specialist will perform such duties as are outlined in this job description.
Hours of work:
The standard working week applying to the post is 39 hours per week worked over a 5 day week,
Monday to Friday (flexibility may be required). As per Hospital policy internal rotation will be applied to
all posts, which may involve allocation to day units such as OPD etc.
Framework for Implementation of Clause 30.4 of towards 2016” applies. Under the terms of this
circular, all new entrants and staff appointed to promotional posts from Dec 16th 2008 will be required
to work agreed roster / on call arrangements including rotation as advised by their line manager.
Contracted hours of work are liable to change between the hours of 7.30am until 8.30pm over seven
days to meet the requirements for extended day services in accordance with the terms of the
Framework Agreement.
Remuneration:
Remuneration is in accordance with the salary scale approved by the Department of Health &
Children effective from 1st April 2017. Current remuneration for Clinical Midwife / Nurse Specialist
(CMM2 grade) ranges from €48,089 to €56,852 pro rata per annum.
Annual Leave:
Annual Leave will be given in accordance with the Department of Health and Children/Hospital
Regulations and under the terms of the Organisation of Working Time Act, 1997.
The Hospitals annual leave year is from 1 April to 31 March. Annual leave entitlement for part-time
staff will be on a pro rata basis.
Years of Service
Annual Leave entitlement
0-5
25 days
5-10
26 days
10+
28 days
Garda Vetting:
The National Vetting Bureau (Children and Vulnerable Persons) Acts 2012 to 2016 provide a statutory
basis for the vetting of persons carrying out relevant work with children or vulnerable persons. Given
the specialised nature of the services provided by the Coombe Women and Infants University Hospital,
your appointment is subject to satisfactory Garda Vetting and revetting in circumstances where the
Hospital deems it appropriate. You are obliged to disclose previous and any criminal convictions acquired
during the course of your employment. Should the Hospital obtain information from the Garda Vetting
Unit to indicate that your Garda clearance report is not satisfactory and / or if you have supplied the
hospital with false or misleading information in relation to your Garda clearance status, the Hospital may
terminate your contract with immediate effect.
Health:
A candidate for and any person holding the office must be fully competent and capable of undertaking
the duties attached to the office and be in a state of health such as would indicate a reasonable
prospect of ability to render regular and efficient service.
Sick Leave:
Payment of salary during illness will be in accordance with arrangements as approved from time to
time by the Department of Health and Children.
Probation:
The successful candidate will be appointed initially for a probationary period of six months. During the
probationary period progress or otherwise will be monitored and at the end of the probationary period
the service will (a) be certified as satisfactory and confirmed in writing or (b) if not satisfactory, the
probationary period may be extended by 3 months.
Termination of Office:
The employment may be terminated at any time by three months’ notice on either side except where
circumstances are dictated by the Minimum Notice and Terms of Employment Act 1973/2005. The
Management’s right under this paragraph shall not be exercised save in circumstances where the
Management is of the opinion that the holder of the office has failed to perform satisfactorily the duties
of the post or has misconducted himself/herself in relation to the post or is otherwise unfit to hold the
appointment.
Age Restrictions In Relation To Applications:
Age restriction shall only apply to a candidate where he/she is not classified as a new entrant (within
the meaning of the Public Service Superannuation (Miscellaneous Provisions) Act 2004). A candidate
who is not classified as a new entrant must be under 65 years of age on the first day of the month in
which the latest date for receiving completed application forms for the office occurs.
Pension arrangements and retirement age:
The person appointed will be required to join the relevant Superannuation Scheme and will be required to
contribute to the employing authority at the appropriate rate of gross annual superannuable remuneration
as determined by the Minister responsible for the Scheme.
There are three superannuation schemes currently in operation for staff in The Coombe Women &
Infants University Hospital:
(a)
Voluntary Hospital Superannuation Scheme (Non-New Entrant)
(b)
Voluntary Hospital Superannuation Scheme (New Entrant)
(c)
Single Public Service Pension Scheme
Please read carefully the summary of the criteria for the three superannuation schemes below. This
will assist you in identifying which scheme membership is applicable to your employment
circumstances.
If you have been continually employed in the public service prior to the 1st April 2004 and you
(a)
have not had a break in service of more than 26 weeks, you will be included in the Voluntary
Hospital Superannuation Scheme (Non-New Entrant) with a Minimum Retirement Age of 60
and a Maximum Retirement Age of 65.
If you have been continually employed in the public service post the 1 st April 2004 and you
(b)
have not had a break in service of more than 26 weeks, you will be included in the Voluntary
Hospital Superannuation Scheme (New Entrant) with a Minimum Retirement Age of 65. There
is no Maximum Retirement Age.
The compulsory retirement age of 65 has been removed enabling staff to remain longer in
work should they wish, subject to suitability and health requirements:
(c)
If you have commenced employment in the public service as a new entrant or you are a
former public servant, returning to the public service after a break of more than 26 weeks, you
will be included in the Single Public Service Pension Scheme effective from the 1 st January
2013 with a minimum retirement age of 66 (rising to 67 and 68 in line with state pension
changes). The maximum retirement age under this scheme will be age 70.
Pension benefits made to part-time staff will be on a pro-rata basis.
The person chosen will:

Maintain throughout the Hospital awareness of the primacy of the patient in relation to all
Hospital activities.

Demonstrate behaviour consistent with the Values of the Hospital.

Ensure the provision of a consistently high service that is satisfactory to management and the
patient.

Reports to; professionally accountable to: Director of Midwifery/Nursing. Reports to:
Assistant Director of Midwifery/Nursing on all clinical and operational matters
3.0 GENERAL ACCOUNTABILITY
The successful candidate will be primarily be assigned as required as per service needs in order to
maintain service delivery requirements. As a key team member of the department will be responsible
for the delivery of an efficient, effective and high quality service to meet hospital service requirements.
4.0 DUTIES & RESPONSIBILITIES
Research demonstrates how the CNS/CMS role is multifaceted: being a named contact person, a
coordinator of care, a confidant, a person to talk to, a person who listens, and importantly, a person
who empowers the patient through education and knowledge about their condition (Lewandowski and
Adamle, 2009). The growing body of knowledge suggests that the nurse specialist has a positive
impact on patient outcomes through the provision of patient-centered education, advice and support,
decreasing length of hospital stay and expensive complications, which results in decreased health
care use and lower patient mortality rates (RCSI, 2010).

The post holder is required to support the principle that the care of the woman and her baby
comes first at all times. S/he will approach her/his work with the flexibility and enthusiasm
necessary to make this principle a reality for every woman accessing our services to the greatest
possible degree.

Maintain throughout all aspects of care, awareness of the primacy of the woman, her baby and
her family in relation to all hospital activities.

Demonstrate behavior and attitudes that support the mission statement of the hospital Excellence in the Care of Women & Babies

Place kindness and compassion at the core of daily work.
Clinical Focus
The CNS/CMS – Perinatal Mental Health

Will articulate and demonstrate the concept of nursing and midwifery specialist practice within the
framework of relevant legislation, the Scope of Nursing and Midwifery Practice Framework (An
Bord Altranais, 2000a), The Code of Professional Conduct (An Bord Altranais, 2014), and
Guidelines for Midwives (An Bord Altranais, 2001)

Will demonstrate a strong woman/family centered focus. S/he will provide direct care by
assessing, planning, delivering and evaluating care for women experiencing mental health
difficulties during the perinatal period. S/he will provide indirect care by supporting and advising
others on the care and management of women experiencing mental health issues in pregnancy.

Identifies health promotion priorities and implements strategies in accordance with the public
health agenda as agreed at a departmental level in conjunction with the line manager.

The Perinatal Mental Health Service plays an integral role in the provision and development of
women and infant services with the CWIUH. Within its remit, it is committed to providing high
quality, woman and family centered mental health care both antenatally, intrapartum and
postnatally.
Direct Care:

The CMS/CNS provides a multidimensional role within the perinatal mental health service and
multidisciplinary team.

Direct care encompasses a vast variety of tasks and duties including:

Coordination of the assessment, planning, implementation and re-evaluation of pathways of care
for women and their families experiencing mental health issues during their pregnancy. This role
acts foremost within its primary assessment of the client to make clinical decisions based on
agreed hospital protocols.

Ensure that the needs of women with pre-existing mental health issues or women at high risk of
developing mental health issues in pregnancy and the post-natal period, who access midwifery
services, receive appropriate co-ordinated care.

The CNS/CMS is the central and initial contact point in the maternity services for all women
experiencing mental health difficulties in the Perinatal Period and easier access to maternity
service, recognising the local referral pathways via the CNS/CMS or mental health services.

As part of a wider team the CNS/CMS needs to make contact with the maternity care network,
G.Ps and the primary health care providers of mental health services, including Community
Mental Health Teams, and other non-statutory agencies and care providers of mental health
services to develop and build relationships enabling easy referral and access to maternity
services.

The CNS/CMS needs to be involved in planning proactive services to support and empower
women with mental health issues to have early engagement with maternity services.

The complexity of care for the pregnant woman experiencing mental health difficulties will mean
that she receives care from a number of different professionals; the role of the CNS/CMS is to
ensure that there is seamless continuity in the provision and delivery of care.

Act as an advocate for a pregnant woman and with enhanced skills and knowledge in mental
health/mental illness to contribute to the multidisciplinary team in ensuring delivery of optimum
care.

The CNS/CMS in her role will enhance the normalisation of the pregnancy, birth and postnatal
experience for these women and their babies.

The CNS/CMS will be able to provide education for women tailored to her specific individual
needs, optimising self care skills.

Provide daily inpatient mental health care/assessment in conjunction with ward staff and the
multidisciplinary team

Coordinate the weekly combined perinatal mental health/psychiatry clinic.

Practice as an autonomous health professional at the daily nurse/midwife managed perinatal
mental health clinic offering care to both antenatal and postnatal women and their families.

Provide in-depth education sessions for women who receive a psychiatric diagnosis, educating
them about mental health/mental illness, the effect of this in pregnancy, and the management of
the condition and the promotion of self-care practices.

Provide in-depth education sessions for women with mental health issues in the perinatal period
on first contact with the maternity services to ensure optimal management of mental health during
pregnancy and the post-partum period.

Arrange onward referral to the Consultant Psychiatrist and the Community Mental Health Teams
where required.

Provide education sessions for women commencing the importance of managing their mental
health and self-care practices as an outpatient or inpatient, and encouraging active participation
from the woman in her care.

Provide a service for special needs groups with experiencing mental health difficulties such as
adolescents, ethnic minorities, to those where language barriers and those with learning
difficulties (unable to read/write).

Set realistic treatment and educational goals.

Liaise with the psychiatrists and obstetricians on a daily basis.

Follow up on clinic duties.

Provide telephone support for all patients attending the mental health service through an
assigned mobile number.

The CNS/CMS will provide educational material, advice on supportive networks and models of
mental health care that promote empowerment and life-long learning about mental health for
women and their families.

The CNS/CMS will engender a philosophy of care founded on normalising the experience of
pregnancy and birth, in the face of increased monitoring and intervention.

The CNS/CMS will provide education for women tailored to her specific individual needs,
optimising self-care skills.

The CNS/CMS will act as a knowledgeable resource for other health care professionals and refer
as necessary within the team.

Women with pre-existing mental health issues and those with a history of psychiatric diagnosis
are at higher risk of obstetric complications, including pre-term labour and lower birthweight
(Hedegaard et al, 1993; Lout et al, 1994). A clear pathway for women with mental health issues
from preconception to the postnatal period will optimise the plan of care to improve outcomes for
the woman and her baby.

Ensure that the needs of women with pre-existing mental health issues or women at high risk of
developing mental health issues in pregnancy who access midwifery services receive appropriate
co-ordinated care.
Indirect Care:

The CNS/CMS must be proactive and responsive to maintain the risk management policy and
adverse incident reporting framework that governs the safe and effective delivery of care for
women experiencing mental health issues in pregnancy and their babies.

The CNS/CMS will act as a knowledgeable resource for other health care professionals and refer
as necessary within the team.

The CNS/CMS can act as a resource for other health care professionals within Primary and
Secondary care and assist in the design and delivery of educational programs and study days as
a member of the perinatal mental health team.

The CNS/CMS is required to be active in developing and implementing the guidelines, policies
and procedures within the team.

The CNS/CMS will liaise with midwives, obstetricians and paediatricians/neonatologists to ensure
that the evidence based care pathways are implemented as appropriate for women experiencing
mental health issues during the perinatal period.

The CNS/CMS will monitor and audit standards for women experiencing mental health issues
during the perinatal period, linking with the wider public health network.

The CNS/CMS will assist in the development and implementation of policies and guidelines with
respect to, and in line with National and international recommendations that deliver a high
standard of care through the childbirth continuum.

A locally agreed protocol must exist to support the CNS/CMS in their role as non-medical
prescriber or supplementary prescriber; this will include the consideration to education, training
and clinical governance structures.
Patient/Client Advocate

The role of the CNS/CMS involves communication and negotiation, and represents the
patient/client values and decisions in collaboration with other professionals and community
resource providers.

The CNS/CMS acknowledges meets the particular needs of each woman and her partner,
enhancing and promoting effective communication between the woman/couple and health care
professionals

The CNS/CMS should utilise her expertise to act as an advocate for the pregnant woman and
with enhanced skills and knowledge in mental health to contribute to the multidisciplinary team in
ensuring delivery of optimum care.

The CNS/CMS enables women to fully participate in decisions about their care.

Ensures the dignity of the woman is maintained at all times, upholds the ethics and philosophy of
the Coombe Women & Infants University Hospital.

Using specialist knowledge and skills, the CNS/ CMS facilitates the woman/ couple receiving
whatever information is made available to them by identified counseling concepts and core
conditions e.g. empathy, transparency, authenticity and non-judgmental caring.
Education and Training

The CNS/CMS would be in a position to provide an advisory role to other midwifery colleagues
and demonstrate advanced levels of clinical decision-making and responsibility.

The CNS/CMS needs to continue with her personal and professional development to enhance
her specific knowledge and skills on pregnancy and mental health, above that of a midwife/nurse
at the point of registration.

Sustained clinical competencies are achieved by the CNS/CMS, in accordance with the Nursing
& Midwifery Board of Ireand (NMBI) by:

Regular attendance in relevant educational programmes, including Cognitive Behavioural
Therapy Training and Nurse Prescribing.

Attendance at national and international multidisciplinary conferences on perinatal mental
health

Facilitate dissemination of recent research findings/practice within the Perinatal Mental
Health Team.

Education and training will support practitioners to ensure that care is delivered from an evidence
based practice to ensure safe and competent workforce.

Provide structured education and training for staff as required. The aim of training is to empower
staff and facilitate development by enhancing existing knowledge, insights, understanding, skills
and sensitivity in caring for women/couples attending the Perinatal Mental Health Service.

A local staff education programme should:

Enhance knowledge of the aetiology of the condition

Knowledge of therapeutic management of mental health in the perinatal period.

Knowledge of condition specific monitoring and clinical care of pregnancy, birth and
postnatal period

Provide mentorship, preceptorship, teaching, facilitation, and professional supervisory skills for
students, midwives and medical staff.

Develops competency programmes in accordance with recommendations advocated by the
national guidelines and/or evidence based best practice.

To liaise with the training and academic departments to deliver ongoing programmes of mental
health education.
Audit & Research

Identifying women’s experience of their maternity care is fundamental to the development and
delivery of quality healthcare (Ten Thousand Voices: Make Your Voice Heard and Improve
Healthcare, 2013).

It is imperative that healthcare professionals evaluate the care they offer to women to ensure that
it is responsive to the needs and preferences of women.

The CNS/CMS will monitor and audit standards for women with diabetes during childbirth, linking
with the wider public health network.

Audit is integral to clinical governance processes; the CNS/CMS has a role in both the audit of the
multidisciplinary team care pathway and her own practice audit.

Evaluate the effectiveness of education programmes on an on-going basis

To improve the standards of care by promoting midwifery/diabetes research and developing
expertise

Identify, critically analyses, disseminates and integrates midwifery and medical research into the
area of specialist practice

Contributes to service planning and budgetary processes through use of audit data and specialist
knowledge

Instigates and participates in clinical audits and prepares appropriate reports

Maintains accurate statistical data and prepares an annual report
Consultant

Practice as a vital member of the Perinatal Mental Health Multidisciplinary Team within the
Coombe Women and Infants University Hospital.

Provide leadership in clinical practice and acts a resource and role model for specialist practice

Consult with and act as a consultant to allied health professionals at a local and national level,
seeking and providing guidance and advice, ensuring best patient care and practice.

Collaborate with health professionals within the wider diabetes services to develop effective,
patient responsive services.

The CNS/CMS will raise awareness amongst health professionals of the additional screening and
assessment required for women experiencing mental health difficulties in the perinatal period.

The CNS/CMS will assist in the development and implementation of policies and guidelines with
respect to mental health/mental illness, in line with National and international recommendations
that deliver a high standard of care through the childbirth continuum.

The CNS/CMS can act as a resource for other health care professionals within Primary and
Secondary care and assist in the design and delivery of educational programmes and study days
as a member of the perinatal mental health team.

The CNS/CMS will engage with primary and voluntary organisations to maintain a positive
environment for the woman’s ongoing health needs and ensuring early access to health care as
required.

In the promotion of a quality service the CNS/CMS acts in an advisory capacity to the clinical
management team in the planning and development of service needs.
Professional

Actively participate in the management of the Perinatal Mental Health Service making decisions
for which they are personally accountable.

Professionally responsible in conjunction with the Consultant Psychiatrist for the provision of the
perinatal mental health service.

Demonstrate responsibility for professional growth by ensuring personal and professional
development.

To demonstrate a knowledge of and work within the Nursing & Midwifery Board of Ireland Code of
Professional Conduct.

Comply with all Nursing & Midwifery Board of Ireland guidelines, Code of Conduct and Scope of
Practice.

Comply with hospital policies, procedures and guidelines.

Comply with the requirements of the Health, Safety and Welfare at Work Act.

To be accountable for nursing decisions and actions.

To be a member of a supportive multidisciplinary team and to be able to assist persons with
mental health difficulties with their self-management.

To be actively involved in research that is relevant to clinical practice.

Ensure professional practice is research based and clinically effective.
The principal duties and responsibilities as outlined above indicate the main functions and
responsibilities of the post and are subject to review and amendment in light of changing
circumstances and may include other duties and responsibilities as may be determined from
time to time by the Director of Midwifery & Nursing.
5.0 GENERAL GUIDELINES
Information Technology
Ensure that you make the most effective and efficient use of developments in technology for both
patient care and IT support in a manner, which integrates well with systems throughout the
organisation, actively assisting in the integration of new technology and systems.
Hygiene/Infection Control
All employees have responsibility for Hygiene awareness. Hygiene is defined as “The practice that
serves to keep people and environments clean and prevent infection.” All employees also have a
responsibility under their terms of employment to prevent transmission of infection and to follow the
hospital infection control policies and guidelines as outlined in the Infection Control Manual. All
employees must be aware that they work in an area where there is potential for transmission of
infection. All employees have a responsibility to follow hand hygiene guidelines as this is the single
most important intervention to prevent the transmission of infection.
Quality, Safety and Risk Management
Support the delivery of the Quality, Safety and Risk Management Programme, including the
appropriate identification and management of risks and incidents throughout the hospital.
Confidentiality
You will be aware of the confidential nature of Hospital work and in particular, the right of patients to
confidentiality. To this end, you will not discuss workings of the Hospital or its patients or disclose any
information of a confidential nature except as required to do so in the course of your work. No
records, documents or property of the Hospital may be removed from the premises of the Hospital
without prior authorisation. You must return to the Hospital upon request and, in any event, upon the
termination of your employment, all documents or other property of the Hospital which are in your
possession or under your control.
Data Management
Ensure compliance with the obligations required by the Data Protection Act 2003.
Trust in Care Policy
The Coombe Women’s Hospital is committed to the principles of the Trust in Care Policy and all
employees have a duty to report concerns for the safety and welfare of patients with in the procedures
detailed in this policy.
Note: This job description is an outline of current broad areas of responsibility and accountability and
should not be regarded as a comprehensive listing. As the role develops in the hospital this job
description may be reviewed in light of possible new structures and/or changing needs of the hospital.
The extent and speed of change in the delivery of health care is such that adaptability is essential at
this level of appointment. The incumbent will be required to maintain, enhance and develop their
knowledge, skills and aptitudes necessary to respond to a changing situation. The Job Description
must be regarded as an outline of the major areas of accountability at the present time, which will be
reviewed and assessed on an on-going basis.
Short-listing
Applicants will be subject to short listing based on information provided in their application, whereby
only those who meet set criteria shall be called to interview
GENERAL
Applications must be submitted by e-mail only to [email protected]
Before 8pm on the 12th May 2017
All candidates should note that, in order to maintain a timely process, the closing date and
time for receipt of applications will be strictly adhered to