Clinical Nurse Specialist

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Overview: Post Title: Clinical Nurse Specialist (CNS), Neurovascular Service Post Status: Permanent Department NeuroCent Directorate, Beaumont Hospital Location: Beaumont Hospital, Dublin 9 Reports to: Directorate Nurse Manager (DNM) Salary: Appointment will be made on CNM 2 Pay scale (€59,661 - €75,389) at a point in line with Government pay policy. Hours of work: 37.5 hours/week Closing Date: Friday 31st January 2025 @ 12noon Position Summary: Subarachnoid haemorrhage is a severe subtype of haemorrhagic stroke that is associated with high morbidity and mortality and occurs when a blood vessel bursts within the subarachnoid space which is part of the brains outer protective lawyers known as the meninges. An alternative form of haemorrhagic stroke, known as intracerebral haemorrhage, involves the bursting of a blood vessel within the brain tissue. These conditions exact a high social and economic cost, causing a potential loss of productive life years, and is a disease of relatively young people (median age 50 years for SAH). Outcomes for these conditions are poor with a significant prevalence of death within the initial months following survival as well as a high likelihood of inability of survivors to independently manage their activities of daily living. The positive impact that specialised nursing care has on the outcomes of patients and families for this cohort group and this is well documented in the contemporary literature. The Beaumont Hospital neurovascular service provides both acute and elective care of patients with cerebral and spinal vascular pathologies (e.g. subarachnoid haemorrhage (SAH), arteriovenous malformation (AVM) and dural arteriovenous fistulas). The majority of the patients in this category are those patients with ruptured or unruptured aneurysms. The clinical nurse specialist acts as a single point of contact for the patient and family through admission, discharge, and recovery. Providing a visible, accessible specialist nurse presence to key stakeholders, using influencing and collaboration skills across different levels of multidisciplinary professionals, optimising key performance indicators, maintaining and developing standards, provision of education and training, and leading a nurse clinic specific to this patient cohort are some of the competencies expected of this role. Please see the information below for a more elaborate description of the job role and responsibilities. Responsibilities: Principle Duties and Responsibilities The post holders practice is based on the five core concepts of the Clinical Nurse Specialist role as defined by the National Council for the Professional Development of Nursing and Midwifery (NCNM 4th edition (2008)) in order to fulfil the role. The concepts are:

• Clinical Focus
• Patient/Client Advocate
• Education and Training
• Audit and Research
• Consultant

Clinical Focus The clinical practice role may be divided into direct and indirect care. Direct care comprises the assessment, planning, delivery and evaluation of care to the patient, family and/or carer. Indirect care relates to activities that influence and support the provision of direct care. Direct Care Clinical Nurse Specialists will:

• Provide a specialist nursing service for patients within their remit who require support and treatment through the continuum of care
• Undertake comprehensive patient assessment to include physical, psychological, social and spiritual elements of care using best evidence based practice
• Use the outcomes of patient assessment to develop and implement plans of care/case management in conjunction with the multi-disciplinary team (MDT) and the patient, family and/or carer as appropriate
• Monitor and evaluate the patients response to treatment and amend the plan of care accordingly in conjunction with the MDT and patient, family and/or carer as appropriate
• Make alterations in the management of patients condition in collaboration with the MDT and the patient in line with agreed pathways and policies, procedures, protocols and guidelines (PPPGs)
• Accept appropriate referrals from MDT colleagues
• Co-ordinate investigations, treatment therapies, and patient follow-up
• Communicate with patients, family and /or carer as appropriate, to assess patients needs and provide relevant support, information, education, advice and counselling as required
• Where appropriate work collaboratively with MDT colleagues across Primary and Secondary Care to provide a seamless service delivery to the patient, family and/or carer as appropriate
• Participate in medication reconciliation taking cognisance of poly-pharmacy and support medical and pharmacy staff with medication reviews and medication management
• Identify and promote specific symptom management strategies as well as the identification of triggers which may cause exacerbation of symptoms
• Provide patients with appropriate self-management strategies and escalation pathways
• Support (where appropriate) clinics with MDT input
• Identify health promotion priorities for the patient, family and/or carer and support patient self-care in line with best evidence. This will include the provision of educational and health promotion material which is comprehensive, easy to understand and meets patients needs.

Indirect Care Clinical Nurse Specialists will:

• Support and facilitate agreed referral pathways for patients
• Participate in case review with MDT colleagues
• Use a case management approach to patients with complex needs in collaboration with MDT in both Primary and Secondary Care as appropriate
• Ensure that practice is evidence based and guided by policy or local protocols
• Take a lead role in ensuring the service for patient is in line with best practice guidelines and the Safer Better Healthcare Standards (HIQA, 2012)

Patient/Client Advocate Clinical Nurse Specialists will:

• Communicate, negotiate, and represent patients family and/or carer values and decisions in relation to their condition in collaboration with MDT colleagues in both Primary and Secondary Care as appropriate
• Develop and support the concept of advocacy, particularly in relation to patient participation in decision making, thereby enabling informed choice of treatment options
• Respect and maintain the privacy, dignity and confidentiality of the patient, family and/or carer
• Establish, maintain and improve procedures for collaboration and cooperation between Acute Services, Primary Care, and Voluntary Organisations as appropriate
• Proactively challenge any interaction which fails to deliver a quality service to patients

Education & Training Clinical Nurse Specialists will:

• Maintain clinical competence in patient management within nursing, keeping up-to-date with relevant research to ensure the implementation of evidence based practice
• Provide the patient, family and/or carer with appropriate information and other supportive interventions to increase their knowledge, skill and confidence in managing their condition
• Contribute to the design, development, and implementation of education programmes and resources for the patient, family and/or carer thus empowering them to self-manage their condition
• Provide mentorship and preceptorship for nursing colleagues as appropriate
• Participate and lead training programmes for nursing/midwifery, MDT colleagues and key stakeholders as appropriate
• Be responsible for addressing own continuing professional development needs

Audit & Research Clinical Nurse Specialists will:

• The post holder will maintain a register of patients with within the CNS remit
• Maintain a record of clinically relevant data aligned to National Key Performance Indicators (KPIs)
• Support and/or lead audit and research projects relevant to the area of practice
• Utilise and disseminate current relevant research to advise and ensure the provision of informed evidence based practice

Consultant Clinical Nurse Specialists will:

• Provide leadership in clinical practice and act as a resource and role model
• Use specialist knowledge to support and enhance generalist nursing practice
• Develop collaborative working relationships with local Clinical Nurse Specialists/Registered Advanced Nurse/Midwife Practitioner/MDT colleagues as appropriate, developing person centred care pathways to promote the integrated model of care delivery
• With the support of the Director of Nursing, attend integrated care planning meetings as required
• Develop and maintain collaborative networks with specialist services in voluntary organisations which support patients in the community
• Liaise with other health service providers in the development and on-going delivery of the National Clinical Programme model of care

Health & Safety These duties must be performed in accordance with local organisational and the HSE (Health Service Executive) health and safety polices. In carrying out these duties the employee must ensure that effective safety procedures are in place to comply with the Health, Safety and Welfare at Work Act (2005). Staff must carry out their duties in a safe and responsible manner in line with the local policy documents and as set out in the local safety statement, which must be read and understood. Quality, Risk and Safety Responsibilities It is the responsibility of all staff to:

• Participate and cooperate with legislative and regulatory requirements with regard to quality, risk, and safety
• Participate and cooperate with local quality, risk, and safety initiatives as required
• Participate and cooperate with internal and external evaluations of the organisations structures, services and processes as required, including but not limited to, The National Hygiene Audit, National Decontamination Audit, Health and Safety Audits and other audits specified by the HSE or other regulatory authorities
• Support and implement quality improvement initiatives in their area which are in keeping with local organisational quality, risk, and safety requirements
• Support the MDT in the development of PPPGs and safe professional practice and adhere to relevant legislation, regulation, and standards
• Comply with Health Service Executive (HSE) Complaints Policy
• Ensure completion of incident/near miss forms and clinical risk reporting - lead investigations and disseminate findings to key stakeholders where appropriate
• Adhere to department policies in relation to the care and safety of any equipment supplied

Management/Administration Clinical Nurse Specialists will:

• Provide an efficient, effective and high quality service, respecting the needs of each patient, family and/or carer
• Effectively manage time and caseload in order to meet changing and developing service needs
• Continually monitor the service to ensure it reflects current needs
• Support and lead change and quality improvement initiatives with the support of the wider MDT and other stakeholders
• Ensure that confidentiality in relation to patient records is maintained
• Represent the specialist service at local, national and international forums
• Maintain accurate and contemporaneous records and data on all matters pertaining to the planning, management, delivery and evaluation of care and ensure that this service is in line with HSE requirements
• Have a working knowledge of the Health Information and Quality Authority (HIQA) Standards as they apply to the role
• To support, promote and actively participate in sustainable energy, water and waste initiatives to create a more sustainable, low carbon and efficient health service.

Skills, Competencies, and Knowledge Professional Knowledge Clinical Nurse Specialists will:

• Practice in accordance with relevant legislation and with regard to The Scope of Nursing & Midwifery Practice Framework (Nursing and Midwifery Board of Ireland, 2015) and the Code of Professional Conduct and Ethics for Registered Nurses and Registered Midwives (Nursing and Midwifery Board of Ireland, 2021)
• Maintain a high standard of professional behaviour and be professionally accountable for actions/omissions.
• Take measures to develop and maintain the competences required for professional practice
• Adhere to the Nursing & Midwifery values of Care, Compassion, and Commitment (DoH, 2016)
• Adhere to national, regional, and local HSE PPPGs
• Adhere to relevant legislation and regulation
• Adhere to appropriate lines of authority within the nurse/midwife management structure

Clinical Nurse Specialists will demonstrate:

• In-depth knowledge of the role of Clinical Nurse Specialist
• A commitment to developing in-depth knowledge of the pathophysiology for the conditions they are supporting
• Ability to support nursing assessments for patient caseloads
• Critical thinking with regards to referral onto specialist teams or agencies
• The ability to formulate a plan of care based on findings and evidence based standards of care and practice guidelines
• The ability to follow up and evaluate a plan of care
• Knowledge of health promotion principles/coaching/self-management strategies that will enable people to take greater control over decisions and actions that affect their health and wellbeing
• An understanding of the principles of clinical governance and risk management
• Evidence of teaching in the clinical area
• A working knowledge of audit and research processes
• Evidence of computer skills including use of Microsoft Word, Excel, E-mail, PowerPoint

Communication and Interpersonal Skills

• Effective communication skills
• Ability to build and maintain relationships particularly in the context of MDT working
• Ability to present information in a clear and concise manner
• Ability to manage groups through the learning process
• Ability to provide constructive feedback to encourage future learning
• Effective presentation skills

Organisation and Management Skills

• Evidence of effective organisational skills including awareness of appropriate resource management
• Ability to attain designated targets, manage deadlines and multiple tasks
• Ability to be self-directed, work on own initiative
• A willingness to be flexible in response to changing local/organisational requirements

Building & Maintaining Relationships including Team and Leadership skills

• Leadership, change management, and team management skills including the ability to work with MDT colleagues

Commitment to providing a quality service

• Awareness and respect for the patients views in relation to their care
• Evidence of supporting quality improvement programmes
• Evidence of conducting audit or service evaluation initiatives
• Evidence of motivation by ongoing professional development

Analysing and Decision Making Effective analytical, problem solving and decision making skills The above Job Description is not intended to be a comprehensive list of all duties involved and consequently, the post holder may be required to perform other duties as appropriate to the post which may be assigned to him/her from time to time and to contribute to the development of the post while in office. Qualifications: Selection Criteria: Selection criteria outline the qualifications, skills, knowledge and/or experience that the successful candidate would need to demonstrate for successful discharge of the responsibilities of the post. Applications will be assessed on the basis of how well candidates satisfy these criteria. Mandatory: 1. Statutory Registration, Professional Qualifications, Experience, etc (a) Eligible applicants will be those who on the closing date for the competition: (i) Be a registered nurse/midwife on the active Register of Nurses and Midwives held by An Bord Altranais and Cnáimhseachais na hÉireann (Nursing and Midwifery Board of Ireland) or be eligible to be so registered. (ii) Be registered in the division(s) of the Nursing and Midwifery Board of Ireland (Bord Altranais agus Cnáimhseachais na hÉireann) Register for which the application is being made or be entitled to be so registered. OR (iii) In exceptional circumstances, which will be assessed on a case by case basis be registered in another Division of the register of Nurses and Midwives. (iv) Have a minimum of 1 years post registration full time experience or an aggregate of 1 years full time experience in the division of the register in which the application is being made (taking into account (ii) (iii) if relevant) (v) Have a minimum of 1 years experience or an aggregate of 1 years full time experience in specialist area of Multiple Sclerosis. (vi) Have successfully completed a post registration programme of study, as certified by the education provider which verifies that the applicant has achieved a Quality and Qualifications Ireland (QQI), National Framework of Qualifications (NFQ) major academic Level 9 or higher award that is relevant to the specialist area of care (equivalent to 60 ECTS or above), and in line with the requirements for specialist practice as set out by the National Council for Nursing and Midwifery 4th ed (2008). Alternatively provide written evidence from the Higher Education Institute that they have achieved the number of ECTS credits equivalent to a Level 9 or higher standard, relevant to the specialist area of care (equivalent to 60 ECTS or above), and in line with the requirements for specialist practice as set out by the National Council for Nursing and Midwifery 4th ed (2008). Epilepsy Surgery care prior to application* (See **Note 1 below). (vii) Be required to demonstrate that they have continuing professional development (CPD) relevant to the specialist area. (viii) Have the ability to practice safely and effectively fulfilling his/her professional responsibility within his/her scope of practice **Note 1: For Nurses/Midwives who express an interest in CNS/CMS roles and who currently hold a level 8 educational qualification in the specialist area (equivalent to 60 ECTS or above), this qualification will be recognised up to September 2026. (b) Candidates must possess the requisite knowledge and ability, including a high standard of suitability and clinical, leadership, managerial and administrative capacity for the proper discharge of the duties of the office. 2. Annual registration (i) Practitioners must maintain live annual registration on the appropriate/relevant Division of the register of Nurses and Midwives maintained by the Nursing and Midwifery Board of Ireland (Bord Altranais agus Cnáimhseachais na hÉireann) for the role. (ii) Practitioners must confirm annual registration with NMBI to the HSE by way of the annual Service user Safety Assurance Certificate (PSAC). 3. Health Candidates 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. 4. Character Candidates for and any person holding the office must be of good character. Desirable

• Management or leadership experience
• Project management
• Policy development

Further Information for Candidates: The Hospital www.beaumont.ie

Management Unit:

www.beaumont.ie/hr

Informal Enquiries ONLY to:

Name:

Cam Salcedo and Deirdre Coffey

Title:

Directorate Nurse Manager and Clinical Nurse Specialist respectively

Email address:

camilosalcedo@beaumont.ie deirdrecoffey@beaumont.ie

Telephone:

0873859439 or internal extension 8337

Information :

• Company : Beaumont Hospital
• Position : Clinical Nurse Specialist
• Location : Dublin, County Dublin
• Country : IE

How to Submit an Application:

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