Reports to Advanced Clinical Practitioner/Hospice Outreach Service manager Scope & Job Purpose Hospice in the Weald are committed to supporting and developing its workforce. We recognise and value the importance of individual development and want our nurses and paramedics to train and develop into Clinical Nurse Specialists or Clinical Paramedic Specialists. These roles are demanding, and require a broad range of skills and competencies, however, they are very rewarding and will provide you with both skills and learning to meet the needs of our community and our organisational strategies. Primary Job Purpose To work as part of the multi-disciplinary team in HOS (Hospice Outreach Service) to deliver high quality care to patients with a life limiting illness in the community. To offer the patient and those who care for them, the skills of a dedicated palliative care service which encompasses symptom control, social, emotional and spiritual care. To offer advice, support and education to the primary health care team and other healthcare professionals on palliative care issues. Giving appropriate medications when immediate need is identified on community visits and supporting other community healthcare professionals with advice about safe medication administration when needed To strive to help us extend our hospice reach to ensure we have the right people, providing right care at the right time You will provide clinical advice and specialist support to other professionals on palliative care issues and play a significant role in helping patients to achieve their preferred place of care and their preferred place of death. To participate in quality initiatives within the department. Key Responsibilities Deliverables/Outcomes Take and analyse a clinical history in a relevant succinct and logical manner Record concisely, accurately, confidentially and legibly the appropriate elements of the history, examination, results of investigations, differential diagnosis and management plan Present cases clearly, consistently and professionally to the MDT contributing effectively in patient management Assess the patients needs. Identify their goals and work with the patient and family towards achieving them Interpret the results of investigations and discuss and liaise with colleagues to order them appropriately Develop knowledge of the options for achieving control of symptoms and ability to advise the primary health care team Develop an ability to explore the personal resources of families/carers in order to ensure patients are cared for in the place of their choice Support, advise and coach carers at home in managing a relative whose condition is deteriorating Recognise the impact of caring for dying patients on primary health care team colleagues and offer support Demonstrate sensitivity and respect for patients and families from different religious and cultural background and sexual orientation Demonstrate safe mobilisation, transfer and movement of patients in the community and how and where to obtain appropriate equipment Recognise and manage palliative care emergencies Bring closure to the nurse-patient relationship and provide for a safe transition to another care provider To be involved with and support the Gold Standard Framework (GSF) meetings with GPs and in Care Homes and Nursing homes. Attend weekly MDT meetings Management and Leadership Liaise closely with HOS Manager and wider team on control, distribution and management of clinical workload. Be cognisant of the Hospice in the Wealds Three-Year Strategy and Operational Business Plan. Work to maintain a high level of risk awareness about self and patient safety Assist in the development of policies, procedures, and guidelines to continuously improve ways of working. Support and empower our volunteers Communication and Teamwork Develop skills in managing complex communication issues with patients and families as a lone worker in the community; Anticipate barriers to communication, and take action to improve the communication skills and strategies of the team Seeks out different styles and methods of communicating to assist longer term needs and aims Develop advanced communication skills Write and maintain accurate notes/documentation and input computerised data, keeping all information up-to-date Develop presentation skills, both oral and written. Structure an interview using appropriate questioning, avoid jargon, using familiarlanguage, at patients own pace Communicate both verbally and in writing to patients whose first language may not be English in a manner that they understand, using interpreters appropriately Break bad news in steps appropriate to the understanding of the individual and be able to support distress Demonstrate an understanding of the need to involve patients and carers in decision making, offering them informed choices, respecting their views Manage dissatisfied patients/relatives, anticipating potential problems Demonstrate negotiation and diplomacy skills and partnership working with external agencies Demonstrate competent use of Electronic Patient Records and Hospice in the Weald IT systems Education and Training Education and Training Participate in all learning opportunities offered and expected as part of the development programme, and apply own learning to the future development of practice Share, articulate and reflect palliative care skills, enabling others to learn Participate in planned teaching programmes Develop teaching skills Support new staff and clinical placements Use relevant AV equipment; Utilise experiential learning methods; Consistently draw on research and literature to influence specialist palliative careteaching Obtain evidence based literature from various sources; Apply evidence to patient care; Training and Development Within 2 years to have completed the ACNS/ACPS framework and consolidated performance and practice at a CNS/CPS level. Actively participate in the provision of supervision/reflective practice to colleagues to support engaging development opportunities. Undertake Hospice mandatory training and participate in wider training and development opportunities Act as a role model and mentor to colleagues and to be an ambassador to neighbouring health and social care providers, providing informal education and support to staff in their provision of palliative care. Work collaboratively with the multi-professional team to provide training to care homes on End of Life Care as required. Working with Due Diligence Assist with the development of policies and procedures Participate in forums for discussion on research and audit programmes Support quality initiatives in local area Participate in clinical governance initiatives e.g. clinical review Engage in clinical supervision and self-reflection, and use this to improve care andPractice Maintain professionalism through adherence to recognized Codes (e.g. NMC, GMC, HPC, HCPC) and work within the boundaries of Hospice in the Weald policies Maintain professional development though the Hospice Annual Review process to continuously update and improve knowledge and competencies General All employees are required to undertake the following: To make positive contributions to all internal and external quality and/or best practice measures/processes. To fully participate in the annual appraisal process, to agree targets and objectives with line managers and to report on activity against agreed targets on a regular basis. To fully comply at all times, with Hospice in the Weald policies and procedures and to take responsibility for own actions/inactions. To fully comply with all mandatory and HITW role specific training requirements To act in accordance with workplace legislation/requirements including Health and Safety, Equality and Diversity and Data Protection. To share and model HITW values and expected behaviours at all times. To participate in all employee engagement activities including team, departmental or other staff meetings as required THIS JOB DESCRIPTION IS NOT EXHAUSTIVE AND IS SUBJECT TO REVIEW IN CONJUNCTION WITH THE POST HOLDER AND ACCORDING TO FUTURE CHANGES/DEVELOPMENTS IN THE SERVICE PERSON SPECIFICATION Qualifications Registered Nurse (Level 1) or Registered Paramedic (HCPC)with 3 years post registration experience. Evidence of ongoing Professional Development. Experience Proven track record of contemporaneous clinical practice. Experience in Palliative and End of Life Care and Bereavement Support in a community setting (desirable) Prepared and delivered education programmes to other healthcare professionals. (desirable) Essential Skills Ability to motivate and inspire others to achieve in a fast paced and challenging environment. Takes the initiative and responds flexibly to change. Delegates tasks appropriately. Ability to develop rapport with a wide range of people and to act with credibility, tact and diplomacy. High level of computer literacy skills including the use of mobile technology. Ability to interpret situations from different angles and identify opportunities for improvement. Forward thinking and proactive in decision making and in assessing risks and its mitigation. Applies personal organisation strategies to prioritise and effectively manage workload within a team environment. Personal Attributes Passionate about providing individualised care Dedicated to making a difference and changing peoples lives Compassionate High levels of enterprise, innovation and dedication Maintains a calm disposition and positive outlook Proactive team player Ability to work well within and adapt to a changing environment Willingness to travel to varying work locations Forward thinking