Skin Oncology Clinical Nurse Specialist

Confined Competition - Internal Applicants Only

Position Summary:
Skin Cancer is the most common cancer in Ireland and the incidence of melanoma is Ireland is increasing yearly by 5% in men and 3% in women (DOH 2017). Beaumont Hospital is the designated cancer centre for the diagnosis and surgical management of melanoma and advanced skin cancers in the RCSI Hospital Group incorporating Our Lady of Lourdes Hospital Drogheda; Cavan & Monaghan Hospital; James Connolly Hospital Blanchardstown Louth County Hospital and the Rotunda. Skin cancer care is delivered by the Dermatology and Plastic Surgery services in association with Medical and Radiation Oncology. The pathway for skin cancer patients can be complex and the Skin Cancer Clinical Nurse Specialist (CNS) plays a pivotal role in ensuring a seamless journey for patients through their treatment pathway. The Skin Cancer CNS will deliver care to predominantly high risk melanoma patients followed by a number of other high risk non melanoma skin cancer patients. Care will be delivered by the Skin Cancer CNS in line with the five core competencies as outlined in the Framework for the establishment of CNS/CMS posts 4th Edition National Council for the Professional Development of Nursing and Midwifery 2008.

Principal Duties and Responsibilities:

Clinical Focus
- To work with all members of the Multidisciplinary Team (MDT) to deliver safe high quality effective and efficient care to skin cancer patients within a supportive caring environment.
- To work with local national and international MDTs to improve referral processes communication structures and create a seamless pathway for patients diagnosed with Melanoma and high risk Non Melanoma Skin Cancers referred to Beaumont Hospital and the wider RCSI hospital group.
- To educate counsel and support newly diagnosed patients and their families and explain the implications of this diagnosis.
- To educate counsel and support patients and their families when diagnoised with reoccurrence and/or metastatic disease.
- To actively participate in Skin Oncology Multi-Disciplinary Meetings (MDMs) liaise with the MDM Coordinator and clinical teams to assist in executing MDM recommendations.
- To employ psychological assessment skills to elicit the patients holistic needs to support wellbeing and recovery and self-care.
- To act as a role model for clinical excellence in the delivery of patient care demonstrating knowledge skill and activities at an advanced level.
- To prepare patients and their families for treatment and operative procedures by providing appropriate information/advice guidance and support thus enabling patients to understand and adjust to their diagnosis and participate in their treatment plans.
- To demonstrate competence relating to the diagnostic interventions required in determining the extent (stage) of the skin cancer and to expedite radiology and other tests as required.
- To liaise with Clinical Teams Advanced Nurse Practitioners Cancer Nurse Co-ordinators Clinical Nurse Specialists Ward Nurses and other members of the multidisciplinary team as appropriate and co-ordinate the ongoing care of individual patients identifying potential problems/needs and take appropriate action to resolve or improve these difficulties.
- To work in conjunction with the nursing medical and allied health team formulate discharge plans which ensure continuity of patient care by liaising with health care professionals in the Community Care setting and ensuring appropriate follow up.
- To ensure patients have clear discharge instructions regarding their follow-up care and appointments and provide telephone support post discharge.
- To provide patients with appropriate self-management strategies and escalation pathways on discharge such as self-surveillance advice and rapid access routes in the event of new suspected skin cancer.
- Act as a resource for patients families and community services following discharge and provide telephone & email based links for patients.
- Refer patients to other health care professionals e.g. social worker dietician occupational therapist and physiotherapist as appropriate.
- Attend the Out-Patient Clinic for Dermatology Plastic Surgery and General Surgery when appropriate.
- To identify health promotion priorities for patients families/carers and support self care in line with best evidence.
- To identify patients who may be experiencing high distress levels and direct them to the most appropriate psychological support services in both the hospital and community setting.
- Maintain accurate records ensuring confidentiality and safe keeping of these records in line with hospital policy and GDPR requirements.

Patient/Client Advocate
- Ensure that patients comfort and needs are given priority at all times.
- To respect and maintain the privacy dignity and confidentiality of the patient and family/carer.
- With expert clinical knowledge and experience act as a patient advocate by participating in discussions on patient management issues on behalf of the patient in MDT meetings with ward staff and other healthcare professionals.
- Review and assess referred patients taking into account the patients opinions and guide in their decision making. Communicate negotiate and represent the plan of care for the patient with clinical medical and nursing staff.
- Be aware of existing resources/services which help patients and their families e.g. community services support groups entitlements.
- To facilitate structured patient support groups for skin cancer patients and their families.
- Implements changes in healthcare in response to patient need and service demand.

Education and training
- Provide education sessions for patients families medical and nursing staff students and allied health professions.
- To contribute to the design development and implementation of education programmes and resources for patients and families/carers in relation to the management of skin cancer.
- Promote patient /carer independence through relevant teaching and support.
- Play an active role in ward based teaching for staff in relation to skin cancer and provide education based on relevant surgical clinical competencies
- Provide support to student nurses and registered staff who do not have prior experience of Skin Cancer
- Is available to give expert advice as required on developments and best practice in skin cancer.

Professional development
- In conjunction with the Directorate nurse manager and/or the CNM3 for Surgical Oncology agree learning objectives designated to meet professional development goals.
- Maintain professionalism at all times and work within the Professional Code of Conduct and scope of Practice framework from Nurse and Midwifery Board of Ireland.
- Accept responsibility for own professional development and be aware of current trends and strategies in nursing particularly in relation to specialist area.
- Attend relevant conferences workshops and seminars and disseminate changes in practice with implications for nursing practice.
- Develop and maintain nursing practice skills in relation to skin cancer nursing.
- Discuss present performance with line manager using job performance review.
- Maintain a personal record of professional development using a portfolio.
- Maintain membership of relevant specialist associations in relation to all aspects of specialist practice.

Audit and research
- Participate in the audit of clinical care and formulate action plans based on the audit results to continuously improve service delivery and patient care.
- Establish and maintain a register of patients with skin cancer referred to the CNS service.
- Participate in/ be aware of best practice recent research and new developments in Melanoma and non-melanoma skin cancer from a Nursing perspective.
- Identify and highlight gaps in the service to improve quality of care.
- Evaluate education sessions given and amend programme in line with the result.
- Participate in relevant collaborative research.
- Ensure that statistical and management information is provided to the Directorate Nurse Manager as required.
- Participate in external audits of service by H.I.Q.A the NCCP and other external agencies.
- Maintain records of clinically relevant data aligned with National Key Performance Indicators and produce an annual report for the Directorate Nurse Manager outlining:

o A breakdown of clinical CNS activity.

o Areas for improvement within the service and relevant quality improvement plans
o Patient satisfaction within the service.
o Action plan for the following six months
o Progress report on the development of the role

Consultant
- Play a leading and participating role with the design and evaluation of the skin cancer service in Beaumont Hospital as a designated cancer centre.
- Promote and provide holistic care for patients.
- Recognise the importance of health promotion.
- Develop and promote positive attitudes towards skin cancer conditions.
- Respect culture and diversity.
- Work as an innovator and change agent within the speciality.
- Act as an expert role model for health care professionals and contribute to the development of relevant policies procedures protocols and guidelines.
- Work closely with the CNM3 for Surgical Oncology/Surgery and the Directorate Nurse Manager
- Work in a complementary role to medical colleagues and other members of the multidisciplinary team.

The job description indicates the main functions and responsibilities of the post and is subject to review and amendment. Other specific work not covered in this job description may also be assigned by your nominated manager from time to time.

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.

(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 Skin Oncology care.

(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). Skin Oncology of
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.

5. Other Requirements Specific to the Post

Demonstrate depth and breadth of nursing experience in the specialist area of Skin Cancer
Professional Knowledge

Clinical Nurse Specialist 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 2014).
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 midwife management structure.

Clinical Nurse Specialist will demonstrate:
In-depth knowledge of the role of Clinical Nurse Specialist
In-depth knowledge of the pathophysiology of Oncology malignancies
The ability to undertake a comprehensive assessment of the patient experiencing complications of Systemic Anti-Cancer Therapies including taking an accurate history of their condition and presenting problem.
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 as they apply directly to Clinical Nurse Specialist/Clinical Nurse Cancer role and the wider health service.
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 providing quality improvement programmes.
Evidence of conducting audit.
Evidence of motivation by ongoing professional development.

Analysing and Decision Making
Effective analytical problem solving and decision making skills.

If an appointee has previously been employed in the Civil or Public Service and that appointee is entitled to or in receipt of a pension from the Civil or Public Service or where a Civil/ Public Service pension comes into payment during the appointees re-employment that pension will be subject to abatement in accordance with Section 52 of the Public Service Pensions (Single Scheme and other Provisions) Act 2012.

Please note: In applying for this position you are acknowledging that you understand that the abatement provisions where relevant will apply. It is not envisaged that the employing Department/ Office/ Body will support an application for an abatement waiver in respect of appointments to this position