NursingNetUK

Key Result Areas:

Main Duties and Responsibilities

To act as keyworker for inpatients and outpatients with confirmed Colorectal and Upper GI malignancies providing specialist Colorectal and Upper GI oncological nursing advice to support patients and their family / carers from the time of diagnosis and throughout their cancer care pathway.

Working with and liaising with other specialist teams as needed.

Assessing and assisting in the management of acutely unwell Colorectal and Upper GI oncology patients admitted to South Warwickshire, working with the Acute Oncology Service and or Oncology Consultants.

Providing expert knowledge to enhance optimum care, including the reduction of the inpatient stay and furthermore work as necessary in close collaboration with the Specialist Acute oncology and Specialist Palliative Care Team(s).

To further develop the weekly Colorectal and Upper GI oncology nurse led outpatient / ReSPECT clinics to provide follow up for patients following treatment (predominately this will be oncological treatments) for Colorectal and Upper GI cancer.

As part of these clinics a physical and psychological assessment will be completed aiding the provision of holistic needs assessment, care planning and treatment summaries as required.

Within clinics a variety of clinical skills will need to be performed including:

Observations as most drugs require monitoring.

Urinalysis for patients with urinary symptoms.

Wound swabbing as needed

Checking Blood glucose levels.

Phlebotomy when urgent blood are required (Nurse can work towards this skill).

Requesting pre-clinic bloods and completing the blood form.

Health assessment - assessing patients health needs pre and during treatment.

Interpreting disease staging and explaining this to the patient.

This post does not administer drugs but will explain in detail the potential side effects of these drugs.

Non-medical prescriber

To work as the patient advocate, to help negotiate the patient pathway and ensure optimum care is provided to each patient.

To provide telephone support to patients, discussing symptoms and advising on management often preventing admission to secondary care and liaising with primary care providers.

To provide patients and staff with specialist advice to manage complex symptoms of both disease and potential treatment side effects.

To develop and share expertise within the multidisciplinary team. 

To request and negotiate relevant radiology and pathology investigations ensuring correct staging and assessment is provided and will monitor investigations results, initiating further assessment / review of treatment pathway as required.

Adopt and maintain a flexible approach to patient care, recognising the changing needs of patients throughout their cancer pathway.

To undertake individual holistic assessments at key stages in each patient’s pathway, this information will be available in the patient’s medical records and on the cancer register. Where appropriate copies will be sent to the patient and her GP.

To participate in the Living Well and Beyond Cancer agenda and actively support the Personised Stratified follow up pathway for all eligible Colorectal cancer patients.

To have an understanding of treatment regimens and side effects.

To ensure safe and high standards of nursing care are maintained in accordance with hospital policies and procedures and National Cancer Service Guidelines and acts at all times in accordance with the NMC Code of Conduct and within the principles of the scope of Professional Practice and ensures other members of the team also work within these.

Manage patients within speciality and prioritise workload to meet patient and service need. 

Use and apply technical knowledge of the speciality and treatment to define, oversee and personalise care pathways for individuals through holistic needs assessment, planning and evaluation of care and all care interventions.

Effectively manages pathways of care, adapting to patients’ emerging needs by ensuring a planned and co-ordinated approach to care, supporting enhanced recovery and reducing inappropriate admissions to improve patient experience and safety.

Act as a patient advocate to facilitate the process of shared decision making in respect to health, choice of treatment and care.  Use interpersonal and communication skills where there may be significant barriers in order to build confidence.  Ensure that patients’ individual needs are expressed and valued and individual care plans are understood.

Advise on the complex disease and symptom management for patients within the speciality in both inpatient and outpatient settings.  Evaluate the response to interventions and advise on the adaptation of management.

Empower patients to self-manage their condition, undertaking risk stratification to determine those who can self-manage following education, those who will need guided support to self-manage and those who will need ongoing face to face support.

Work autonomously in the development and delivery of nurse led or parallel clinics in line with National guidance and local service need.

Responding to patient calls, GPs and advice given to medics within the trust for inpatient advice and referring to:-

Direct referrals to clinical psychology if required.

Palliative care

District nurses

Myton Hospice

Shakespeare Hospice

Macmillan Information Centre

Wheelchair Services

Management & Leadership:

Act as a role model demonstrating high standards of holistic cancer care and provide expert clinical leadership to others across the organisation.

Teaching staff on the wards and outpatient areas regarding Colorectal and Upper GI oncology treatment and pathways.

Determine measurable outcomes for the service and demonstrate continuous evaluation of practice making changes where necessary.

Carry out audits and development of patient surveys.

Participate in operational and strategic planning for the development and delivery of the specialist service.  Implement service improvements and efficiencies.

Attend Trust senior nurse meetings and contribute to the agenda and the strategic nursing vision.

Represent the Trust by contributing to and participating in meetings locally, regional and nationally relating to the speciality.

Attendance relevant events at the British Society of Gastroenterology (BSG).

Investigate complaints and untoward incidents in accordance with Trust policies and procedures. Provide accurate, timely and professional statements. 

Communication:

Take personal responsibility for ensuring effective communication between all service providers.

Act as a role model for excellent advanced communication skills and expertise.

Demonstrate advanced empathetic interpersonal and communication skills in supporting, informing and advising patients and carers through diagnosis, treatment, disease progression, prognosis and supportive and palliative care where applicable.  This will involve frequently imparting significant news or supporting patients and carers during and following such consultations.

Effectively and sensitively communicate highly complex and sensitive information to emotionally distressed patients and family / carers at key points along the care pathway on a frequent basis.

As a core member of the MDT provide professional advice to all members of the MDT / nursing team / Physiotherapy / Pharmacy / Consultant.

Refer to other health professionals and outside agencies to ensure optimum care and ongoing support for individual patients / carers, and to ensure the seamless transition from primary to secondary care appropriate to patients’ individual needs and circumstance.

Maintain links with local and national organisations, which support the care of patients within this speciality.

Education:

Identify and use advanced educational strategies to deliver complex information to patients and carers.

Lead the development of patient focused education including training to support self-management and health promotion activities.

Influence the development of other professionals by leading or contributing to Trust wide specialist education and training.

Act as a mentor / clinical supervisor as appropriate.

Take personal responsibility for life-long learning and personal development through clinical supervision and appraisal.  Actively engage with learning and development opportunities needed to work as an advanced practitioner and take appropriate action to ensure these needs are met.

Quality, Audit, Innovation & Research:

Develop written patient information and use existing appropriate resources to inform users, according to individually assessed need.

Work within the NMC code of professional conduct.

Influence and develop policy and clinical guidelines to support the specialist service.

Collaborate with other MDT members to develop and update multi-professional Trust operational policies and guidelines.

Maintain patient records and ensure an effective documentation system to reflect the activity and delivery of specialist nursing care.

Promote the service and clinical excellence by publishing and presenting innovations, audit and research locally and nationally.

Use creative reasoning, experience and vision to advance care.