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WESTERN ISLES NHS BOARD JOB DESCRIPTION 1 JOB IDENTIFICATION JOB TITLE: Prostate Cancer Nurse Specialist (0.6 WTE) DEPARTMENT(S): Hospital and Community JOB HOLDER REFERENCE: NO OF JOB HOLDERS: 1 2 PURPOSE To facilitate access to specialist cancer advice and support for patients with prostate cancer at all stages in their post-diagnostic treatment journey. To develop and provide training and education for primary care practitioners, including GPs, and local hospital services To enhance the links between primary and secondary care locally, and with the mainland specialist hospital services thereby synchronising and smoothing the patient pathway To increase the understanding of the rights of patients with cancer and the specific needs of those with prostate cancer. JOB SUMMARY It is estimated that there are approximately 20 men diagnosed annually with prostate cancer. These men, together with cancer survivors, form the core target for the project. With a high cancer survival rate at 5, 10 and 15 years, these numbers may reach as many as 200 or more men and their families living with the disease in the Western Isles. The focus of this post is on connecting with men, their families and their health professionals around new diagnoses and treatment, there will also be emphasis on recurrent cancer, side effects of treatment and managing longer term complications such as continence, sexual functioning and relationships. The postholder will provide direct patient contact through face to face and remote methods (telephone, videoconferencing, Jabber). There will also be the potential to maintain a locally-delivered chemotherapy service to enable men to remain on the islands for their chemotherapy and not require them to attend Inverness or Glasgow for this. The post holder will signpost patients and families to further resources to support them, e.g. benefits advice. JD v2 --> GJ 18 May 2015 The post holder will link to the Cancer Services Steering Group, as the overarching committee developing and monitoring cancer services across the islands. (S)he will work alongside the Macmillan nursing team and participate fully in their meetings, together with appropriate training and development. Managed by the Macmillan team leader, the post holder will have clear objectives, a personal development plan and regular review meetings. 3 ORGANISATIONAL CHART Nurse Manager (Macmillan Team leader) Macmillan nursing team 4 Prostate Cancer Nurse Specialist MAIN DUTIES AND RESPONSIBILITIES OF THE POST to ensure high quality holistic specialist nursing care is provided for patients with prostate cancer throughout their cancer experience, including for those who are terminally ill and dying to develop and sustain support for families affected by a diagnosis of prostate cancer, including bereavement care to act as an expert resource for clinical staff across local hospital and community settings involved in caring for men with prostate cancer to provide education and training in prostate cancer and wider urological diseases and cancers to health professionals, caregivers, patients and families to lead on educational initiatives for the recognition and initial management of people with suspected malignant spinal cord compression and after care following treatment to lead on the provision of advice, guidance and support to patients and partners in sexual health, fertility and post-treatment matters such as erectile dysfunction, continence management and relationship guidance. JD v2 --> GJ 18 May 2015 The desired outcomes for the project are as follows: Better patient-reported experience of their cancer journey from prediagnosis to discharge, including end of life and bereavement care Having an advocate in their corner helping them navigate the complexities of the NHS systems locally and on the mainland (see section 2 below) Personal concerns, e.g. sexual functioning, addressed and advice given. Appropriate referrals for specialist care made Better communication between healthcare professionals with input to the patient's care Improved support available for partners of patients with prostate cancer, regardless of sexuality Positive reports on Cancer Patient Experience Quality Performance Indicators (Healthcare Improvement Scotland, 2013) around communication and involvement in decision-making. Measures of success will include: a rise in referrals from Primary Care to the project, indicating awareness and visibility clear care pathways identified and agreed for patients, regardless of place of treatment and stage of disease improved patient experience (self-assessed) along the care pathways early identification and referral from primary to secondary care resulting in earlier diagnosis and earlier staging of disease, with better prospects of greater survival higher levels of repatriation to the Western Isles and greater proximity to the home, for patients requiring therapies that have the potential to be delivered locally (eg chemotherapy) improved service availability and sustainability through cross cover across the specialist cancer nursing team increasing the breadth and range of peer support through the number of contacts with members of the Hebridean Men's Cancer Support Group and the membership of this and the related groups in the Uists and Barra. KNOWLEDGE, TRAINING AND EXPERIENCE: First level Registered Nurse (RN). At least 5 years post-registration experience. At least 2 years of urological experience, preferably prostate cancer linked. Evidence of continuing professional development to meet NMC requirements. Specialist education at diploma/degree/post graduate level. Extended, independent and supplementary nurse prescribing. JD v2 --> GJ 18 May 2015 ANALYTICAL AND JUDGEMENT SKILLS: Skills for assessing complex patient and family need i.e. symptom control, emotional, psychological, physical, spiritual, financial, psychosocial and informational. Skills for interpreting facts and expectations held by the patient/family, which may disagree with clinical facts or lack evidence or understanding and to discuss the resulting range of options. Risk assessment for equipment provision, domiciliary oxygen therapy and storage of drugs in the home. Recognising the need for appropriate onward referral. Diagnosing for prescribing medication from Nurse Prescribers Formulary PLANNING AND ORGANISATIONAL SKILLS Prioritise and manage patient caseload. Plans provision of service for prostate cancer within the Western Isles. Assist with planning chemotherapy provision for this patient group within the Western Isles. Liaison between primary and secondary care to ensure effective discharge planning. Development and review of individual patient care plans Plans travel between islands for visits to patients. Plans and delivers educational programmes on prostate cancer and health promotion. Plans for meetings with colleagues and organises travel or video-link. Plans development of the service within the locality in conjunction with Macmillan Lead Cancer Nurse (Line Manager), NHSWI Cancer Steering Group and other professionals. Involvement in monthly oncology outpatient clinic and implementation of nurse led clinics. PHYSICAL SKILLS: Moving and handling skills — occasional use. Dexterity for phlebotomy and occasional cannulation. Occasional care and maintenance of central venous catheters. Competent in the use of specialised equipment for patient care. Provide instruction and demonstration to other staff, patients, relatives and carers in the use of specialised equipment. Car driving skills. IT skills. RESPONSIBILITY FOR PATIENT /CLIENT CARE JD v2 --> GJ 18 May 2015 Responsible for the use of evidence based care and the provision of information and advice to empower the patient to exercise informed consent and regain control of their lives. Regular patient and family contact in all care settings to assess and monitor patient's condition and provide appropriate interventions. Manages own caseload of patients with prostate cancer and family members. Assessing, developing, implementing and evaluating specialist individual patient care plans in line with national recommendations as set out by Cancer Quality Improvement Indicators and HIS. Responsible for record keeping in both nursing and medical notes. Responsible for prescribing decisions as qualified Non-Medical Prescriber. Risk assessment for safe storage and use of drugs and oxygen therapy in the home and infection control. Responsible for assessing and co-ordinating highly complex care packages within the patient's home in partnership with social care colleagues. Responsible for advocacy and liaison with mainland colleagues to ensure coordination of patient visits. Provide specialised nursing input into weekly surgical clinics and monthly oncology clinic. COMMUNICATION AND RELATIONSHIP SKILLS Effective communication skills to maintain a pivotal communication role between multidisciplinary teams locally and with mainland specialist centres. Responsible for communicating sensitive information regarding diagnosis, prognosis and treatment to patients and to families in understandable language. The post requires strong relationship and counselling skills to establish a rapport, which facilitates patients and family members to discuss sensitive issues. Breaking bad news. Responsible for finding an interpreter using the Language Line, for example a Gaelic speaker, if and as required. Attending meetings with colleagues to co-ordinate cancer care strategy in the Western Isles. Write service reports as required. Communicate relevant data in verbal, written and electronic format. RESPONSIBILITY FOR POLICIES/SERVICE DEVELOPMENT Develops and implements nursing standards and protocols for specialised areas of practice. Participates with and contributes to NHS Western Isles Cancer Steering Group in order to implement national clinical standards and JD v2 --> GJ 18 May 2015 quality of service requirements within the North of Scotland Cancer Area Network (NoSCAN). Specialist advisor to local initiatives to develop prostate disease services. RESPONSIBILITY FOR FINANCIAL AND PHYSICAL RESOURCE Refer patients to the Macmillan Benefits Advisor for benefits advice and applications for government benefits Order supplies Post has no budget RESPONSIBILITY FOR HUMAN RESOURCES Planning and delivery of training to the following: Nursing colleagues; paid carers; college students; nursing and medical students; doctors and other health care professionals. Guiding and supporting self help groups. Informal clinical support for health professionals and carers. Empowering community and hospital nurses to effectively care for prostate cancer patients through forward planning and education. Undertake and participate in PDP. RESPONSIBILITY FOR INFORMATION AND RESOURCES Have current information available in multimedia format about prostate cancer, treatments and different problems that patients encounter. Knowledgeable of other information and support resources and how to access these as required. Keep patient records in accordance with NMC requirements. RESPONSIBILITY FOR RESEARCH AND DEVELOPMENT Audit clinical effectiveness of service. Participate in research and audit projects as agreed. (Occasional). Produce service reports as necessary. FREEDOM TO ACT Free to act on own initiative to meet the needs of the service within the constraints of the NMC Code of Conduct, national standards, local protocols and Health Board financial constraints. Accountable for own clinical practice. JD v2 --> GJ 18 May 2015 5 SUPPORTING EVIDENCE PHYSICIAL DEMANDS OF THE JOB Fit to carry out role. This requires extensive travel by car, ferry and plane throughout the Islands to meet patient needs and both inter-island and to the mainland to meet professional and educational requirements. Provide specialist nursing tasks, e.g urostomy care. Transporting equipment to and from patient's homes. MENTAL EFFORT Multiple assessment, implementation and evaluation of patient symptoms and family situations on a daily basis. Effective forward planning and a degree of lateral thinking to devise solutions to problems. Extensive reading of evidence based research and practice developments. Monitoring, adjusting and prescribing medication as appropriate, in situations where complex drug regimes are the norm. . Extensive car driving and travel, sometimes during adverse weather conditions. EMOTIONAL EFFORT In remote and rural communities the emotional aspects of the post are unique i.e. patients may be friends, neighbours, relatives or colleagues. Anxious or distressed patients/relatives or grieving and bereaved relatives are frequently encountered in social settings. Continuously involved in caring for patients with prostate cancer in different stages, in dealing with stressful situations and delivering or confirming bad news. Must be able to empathise with emotional impact of disease and treatment on patients and family members. Must be able to recognise stress in oneself and others and offer strategies to keep stress within acceptable levels. Sensitive communication with grieving relatives. Personal grief following a patient’s death. WORKING CONDITIONS Generally normal working hours and weekends off, although work flexibly at times to meet the needs of the service. Frequent contact with body fluids. Carrying out procedures at patient's home in confined and unpredictable working conditions JD v2 --> GJ 18 May 2015 6 STANDARD ELEMENTS NHS staff must comply with all approved NHSWI Policies and Procedures. NHS staff must comply with NHSWI Communication Strategy and Media Strategy. Confidentiality This involves taking the necessary precautions when transmitting information only disclosing it to those who have the right and need to know it. All personal health information is held under strict legal and ethical obligations of confidentiality. NHS staff must follow guidance (NHS Code of Practice on Protecting Patient Confidentiality) before disclosing any patient information. All staff must respect confidentiality of all matters that they may learn relating to their employment, other members of staff, patients and their families. Health and Safety: Assist in maintaining own and others’ health, safety and security. This involves: a) Complying with Board health and safety policies, procedures and participating in mandatory training. b) Maintaining a safe working environment and reporting any issues of concern as appropriate. NHS Western Isles attaches the greatest importance to the health and safety of its employees. It is the Board policy to do all that is reasonable to prevent personal injury and hazard to health by protecting staff and others including the public from foreseeable hazards compatible with the provision of proper services to patients. The Board expects its entire staff to take reasonable care of their own health and safety and that of others who may be affected by their acts or omissions at work. More detailed information is given in departmental safety policies where appropriate. Ensure own actions support equality, diversity and rights. This involves: a) Acting in ways consistent with the Board’s policies and procedures. b) Treating those you come into contact with equitably and with respect. c) Recognising the need for aids or adaptations. JD v2 --> GJ 18 May 2015 JOB DESCRIPTION AGREEMENT I, (Print Name) .............................................................. confirm that the job description(s) /person specification(s) attached have been discussed with me and are an accurate and up-to-date account of the duties and responsibilities and skills/qualifications required to undertake the post. Job Holder's Signature: Date Head of Department Signature: Date JD v2 --> GJ 18 May 2015 NHS Elleanan Siar Western Isles WESTERN ISLES NHS BOARD PERSON SPECIFICATION Job Title: Prostate Cancer UK Nurse Specialist Department: Location: Hospital and Community FACTOR EXPERIENCE QUALIFICATIONS, TRAINING, RESEARCH PUBLICATIONS KNOWLEDGE AND SKILLS JD v2 --> GJ 18 May 2015 ESSENTIAL DESIRABLE Minimum 5 years post Experience of oncology registration of which nursing two have been in urological nursing. Evidence of continuing professional development to meet NMC requirements. First level Registered nurse (RN). Bachelor of Nursing Degree. Urological Nursing Course. Non-medical Prescribing Course. Chemotherapy Course. Good communications Previous experience in skills. venepuncture, IV Ability to plan and organise cannulation, I.T. Skills own workload. Ability to learn quickly and display understanding. Education of patients, family, carers and colleagues. Training in Immediate Life Support. Training in Moving and Handling. Training in Infection Control. Training in Health and Safety. DISPOSITION OTHER JD v2 --> GJ 18 May 2015 Pleasant outgoing personality. Good interpersonal skills. Enthusiastic and able to effectively flexibly manage working time. Able to work autonomously and within team. Leadership skills. Car driver with current, full licence. Available vehicle for work. Flexible approach to work. Ability to travel as required using car, ferry and/or planes.