JOB PROFILE Specialist nurses can work in isolation or as part of a multidisciplinary team to provide high quality, patient-centred, timely and cost-effective care. All specialist nurses provide tailored care depending on the patients level of need. They also provide education and support for patients to manage their symptoms, particularly patients with long term conditions and multiple morbidities. RCN (2014) Senior Specialist Nurses will be able to; Use their expert knowledge and clinical judgement to decide whether to refer patients for investigations and discuss potential or make diagnoses with members of the wider MDT. Decide on and carry out treatment, which may include advice on the prescribing of medicines (if a qualified non-medical prescriber, within their scope of practice), advice patients and related health care professionals on MDT recommendations or referring patients to an appropriate specialist. Assess individuals, families and populations holistically using a range of different methods, some of which may not be usually exercised by nurses such as Holistic needs assessments, history taking, ordering and interpreting diagnostic tests or specialist health needs assessments. Ensure the provision of continuity of care. Assess and evaluate, with patients and /or carers, the effectiveness of the treatment and care provided and make changes as needed. Work autonomously within a wider health care team and as a lone practitioner. Work across professional, organisational and system boundaries and proactively develop and sustain new partnerships and networks to influence and improve health, outcomes and healthcare delivery systems. KEY RESULT AREAS: Clinical Practice: Senior Specialist Nurses will: Work at a highly specialised level, practicing autonomously as well as within a multi-disciplinary team and are self-directed. Work clinically to optimise health and wellbeing, demonstrate autonomous decision making related to comprehensive history taking and physical assessment of patients, working within defined protocols and competency frameworks and scope of practice. Work at a highly specialized level drawing on a diverse range of specialist knowledge in complex decision making to determine evidence-based therapeutic interventions, which may include advising the wider MDT. Plan, prioritise and manage complete episodes of care, working in partnership with others, delegating and referring as appropriate to optimise health outcomes and resource use, providing direct support to patients and clients. Act as key worker where this model exists. Use professional judgement in managing complex and unpredictable care events. Draw upon an appropriate range of multi-agency and inter-professional resources in their practice. Appropriately define boundaries in practice. Promote a high standard of highly specialist nursing by initiating and coordinating the assessment, planning, delivery and evaluation of the holistic needs of patients/families through evidence-based practice following agreed policies, protocols and guidelines. Practice a high standard of communication including highly sensitive and complex information to develop and sustain partnership working with individuals, groups, communities and agencies. Utilise evidence-based information through a variety of communication media. Maintain adequate patient documentation to NMC requirements for all patients seen and advice given in any practice setting and contribute to clinical activity/data collection as required. Adhering to legal requirements and to professional organisational and national policies and guidelines, to undertake to prescribe for patients in the care of the post holder Leadership/Management: Senior Specialist Nurses will: Collaborate with the multi-professional team to develop a shared vision of the service. Act as a role model and resource in expert clinical evidence-based practice. Work collaboratively with colleagues to develop effective documentation, pathways, protocols and guidelines for care. Demonstrate a commitment to share expertise and disseminate information. Initiate the development of their team and service, contribute to wider service development to continuously improve patient care Participate in implementing national standards and frameworks at a local level. Network locally, regionally, nationally and internationally and seek opportunities to develop the specialist role. Have an understanding of budgetary constraints and may be required to manage budgets. Use effective change management skills to initiate and implement service and practice development, making the best use of resources to improve practice and health outcomes. Participate in the selection, interviewing, appraisal and professional development of team members. Line manages members of the team where appropriate Maintain involvement and active input in multidisciplinary meetings and appropriate local bodies / forums to contribute to practice and service development Education/Training: Senior Specialist Nurses will: Maintain, advance and develop personal theoretical knowledge, high standards of clinical competence and professional development through ongoing self-education and attendance at relevant courses of study. Develop and maintain a peer network of support, information and learning with other nurse specialists at a local and National level. Maintain own professional portfolio. Contribute to the development and acquisition of specialist nursing knowledge and skills to enhance and extend the practice of other nurses and health care professionals within the service and beyond Identify and address the educational needs of patients, families, carers and staff involved in the delivery of this service. Contribute to the teaching and support of students and other members of the multi professional team within relevant educational programs. Provide an appropriate learning environment, including mentorship, coaching and preceptorship. Organise and contribute to relevant educational programs and in house study days. Improving quality and developing practice: Senior Specialist Nurses will: Coordinate and participate in ongoing service review and evaluation, including seeking and monitoring patient experience and outcomes Participate in research / audit to generate new evidence in area of speciality. Evaluate clinical practice in relation to its evidence base and clinical effectiveness including policy and guidance Identify areas of risk and poor quality, and address these through appropriate governance structures and forums. Participate and actively seek peer review in practice and sound evidence for assurance purposes Have responsibility to ensure annual appraisal, agree objectives which reflect local and national service needs and develop personal development plans. Develop personal and professional knowledge through critical self-appraisal, clinical supervision and networking with other health care professionals locally, nationally and internationally. Advocate and contribute to a working environment that promotes continuous learning and development, evidence-based practice and succession planning, as well as identifying learning opportunities at local and national levels. Have a high level of communication skills to enable the participation in the dissemination of practice through conferences and professional publications. Ensure statutory and mandatory training updates, as well as role /specialty updates are completed, and necessary records maintained.