CNM 2 Stoma Care

Confined Competition - Internal Applicants Only

Position Summary:

The CNM2 in Stoma Care is a registered nurse who has acquired additional knowledge skills and experience in the specialist area of stoma care. The Stoma Service in Beaumont Hospital comprises of 2 WTE CNM2 posts.

A Stoma CNS provides holistic expert care and the successful candidate will be expected to practice at an advanced level and work autonomously within his/her Scope of Practice to deliver a high standard of evidence based care to patients with or needing a faecal or urinary stoma.

Key responsibilities include performing comprehensive assessments pre-operative stoma siting and post-operative stoma care for colorectal/urology patients providing expert advice running nurse-led clinics and supporting both in-patient and out-patients to meet their stoma needs.

As a key member of the multidisciplinary teams responsible for stoma patients the successful candidate will collaborate with clinicians involved in the diagnosis management and ongoing care of patients attending Beaumont Hospital who require stoma care.
The Stoma CNS has a pivotal role in meeting the psychological emotional and information needs of the stoma care patient and his/her family. The successful candidate will demonstrate a keen awareness and the ability to address the emotional needs of patients relating to body image and anxiety. He/she will offer follow up care for patients in the community families and healthcare professionals and has a central role offering practical and psychological support thereby easing adaptation and adjustment to their altered lifestyle.

The Stoma Care CNS while being autonomous must be cognisant of his/her scope of practice and the need to refer patients to other specialist services as required. The post holder will have an important educational role within the interdisciplinary team and will be expected to participate in auditing activities aimed at ensuring the service is meeting national quality guidelines e.g. HIQA and NCCP. The Stoma CNS is also expected to engage with and promote the professional development and ongoing skills development of nursing staff and students across Beaumont Hospital. The Stoma CNS is required to maintain a database for stoma patients treated.

Principal Duties and Responsibilities

Responsibilities:

Ensure a seamless specialist service for stoma patients
Help meet the psychological emotional and informational needs of stoma patients at the time of diagnosis and throughout his/her treatment both as an inpatient and outpatient.
Provide information and support to stoma patients prior to surgery during the patients hospital stay following discharge into the community and on follow up visits.
Provide a nurse led outpatients stoma care service as per the Irish Stoma Care and Colorectal Association Practice Standards
Assess patients in relation to their need for referral to specialist services and refer appropriately
Include pre-operative assessment information and education for patients undergoing elective including those being managed on the Colorectal Enhanced Recovery pathway
Site stomas according to best practice guidelines
Work as part of multidisciplinary teams within the hospital providing optimal nursing care
Liaise with other stoma care nurses and ward staff relating to patient care and follow up
Liaise with relevant support groups including The Ostomy Association of Ireland and participate in meetings as appropriate
Provide post-operative stoma care and identify prevent and manage stoma complications
Provide stoma dilatation as required
Educate the patient/family/staff in relation to alternative stoma management techniques including colostomy irrigation and colostomy plug
Provide a wound/fistula management service for complicated wounds and stomas
Give information and ongoing support to patients undergoing ileo-anal pouch procedure
Promote health education for stoma patients in relation to diet exercise travel returning to work family planning and pregnancy
Advise patients on abdominal support prevention and treatment of parastomal hernia
Keep up to date with new ostomy appliances/equipment through liaison with manufacturers and suppliers as per guidelines
Prescribe ostomy appliances and supply details and information to the patient/family and the pharmacy
In conjunction with nursing medical and allied health teams formulate discharge plans which ensure continuity of care by liaising with health care professional in the community/primary care setting and ensuring appropriate follow up.
Ensure that patients have clear instructions regarding their follow up appointments and named person to contact in the event of problems post discharge from hospital
Act as a resource for patients families and community services following discharge
Refer patients to other health care professionals as appropriate

Patient / Client Advocate
Ensure that the patients comforts and needs are given full priority at all times
Provide an efficient effective and high quality service respecting the needs of each patient
With expert clinical knowledge and experience act as a patient advocate by participating in discussion on patient management issues on behalf of the patient in MDT meetings with ward staff and the MDT
Review and assess referred patients taking into account their opinions and guide them in their decision making processes. Communicate negotiate and represent the patients input within clinical medical and nursing staff discussions
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
Be aware of existing resources /services which help patient and their families e.g. community services support groups entitlements
Implement changes in healthcare in response to patient need and service demand

Education and Training
Provide education session for patient families medical and nursing staff students and allied health professional
Promote patient/carer independence through relevant teaching and support
Identify the needs of staff patients and carers in relation to stoma care
Provide educational programmes to health care workers including nurses eg Colorectal Module/Post Graduation Courses in Urology/Theatre/Medical and Surgical Nursing/bedside clinical instruction
Engage with local study days arranged to improve general nurses stoma skills
Facilitate nurse placements in the stoma care department for nurses/student nurses/post graduate nurses/adaptation nurses and other allied healthcare professionals
Make available relevant published articles teaching videos and teaching aids to the wards and the centre of education
Play an active role in providing teaching in a variety of settings including hospital community colleges universities and incorporates
Be available to give expert advice as required on developments and best practice in stoma care
Develop review and distribute information leaflets to patients and family members

Audit and Research
Participate in the audit of clinical care
Participate in and be aware of best practice recent research and new developments in Stoma Care 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 results
Participate in relevant collaborative research as appropriate and promote awareness of evidence based practice among staff
Ensure that statistical and management information is provided to the Directorate Nurse Manager as required
Participate in external audits of services by HIQA the NCCP and other external agencies
Produce an annual report for the Directorate Nurse Manager outlining:

1. The number of patients seen
2. Frequently occurring issues within the service
3. Patient satisfaction within services
4. Action plan for the following 6 months
5. Progress reports on the development of the role
6. Services development initiatives

Consultant
Play a leading role in the design development and evaluation of the stoma care service in Beaumont Hospital
Promote and provide holistic care for patients
Recognise the importance of health promotion
Develop and promote positive attitudes towards stoma care and adjustment to altered lifestyle
Respect culture and diversity
Work as an innovator and change agent within the speciality
Provide leadership in clinical practice and act as an expert role model for health care professional
Work in a complimentary role to medial colleagues and other members of the MDT

Professional Development
In conjunction within the Directorate Nurse Manager Surgical Directorate CNM3 the surgical cancer service manager agree learning objectives designated to meet professional development goals
Maintain professionalism at all times and work within 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)
Accept responsibility for own professional development and be aware of current trends and strategies in nursing particularly in relation to the specialist area of practice
Attend relevant conference workshops and seminars and disseminate changes in practice within implications for nursing practice
Develop and maintain nursing practice skills in relation to stoma care 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

The job description indicates the main functions and responsibilities of the post and is subject to review and amendment.

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) Are registered in the relevant division of the Register of Nurses & Midwives
maintained by the Nursing and Midwifery Board of Ireland NMBI (Bord
Altranais agus Cnáimhseachais na hÉireann) or entitled to be so registered.

(ii) Have at least 5 years post registration experience (or an aggregrate of 5 years
fulltime post registration experience) of which 2 years must be in the speciality
or related area.

(iii) Have the clinical managerial and administrative capacity to properly discharge
the functions of the role.

(iv) Candidates must demonstrate evidence of continuous professional development.

(b) Candidates must possess the requisite knowledge and ability including a high standard of
suitability and clinical managerial and administrative capacity to properly discharge the
functions of the role.

2. Annual registration
(i) On appointment practitioners must maintain live annual registration on the relevant
division of the Register of Nurses and Midwives maintained by the Nursing and
Midwifery Board of Ireland (Bord Altranais agus Cnáimhseachais na hÉireann).

(ii) Confirm annual registration with NMBI to the HSE by way of the annual Patient
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 course

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