Hepatology Clinical Nurse Specialist

• The Hepatology Clinical Nurse Specialist (CNS) role requires practice that is informed by higher levels of judgement, decision-making and discretion.
• The Hepatology CNS will work as part of the multidisciplinary team, using clinical, communication and interpersonal skills to identify the needs of patients to ensure a co-ordinated quality service and will be actively involved in education, audit, and research.
• The Hepatology CNS will work as an integral member of the hepatology team providing specialist nursing advice and support to patients and families from the time of diagnosis and throughout care.
• The Hepatology CNS role involves demonstrating leadership, education, and management to ensure a seamless service for patients, carers, and staff.
• The Hepatology CNS will be responsible for the duties of a clinical nurse specialist, including facilitating face-to-face and telephone clinics and remote surveillance of patients.
• The Hepatology CNS will continue to develop, implement, monitor, and review standards/policies and guidelines. 
• The Hepatology CNS will aim to undertake paracentesis after appropriate training. 

Main duties of the job

• Run independent nurse led clinics for patients being assessed for liver transplantation and post-transplant surveillance. 
• Streamline the service to ensure transplant patients can access prompt imaging and follow-up, and ensure that imaging is coordinated such that transplant work up is achieved in a timely manner. 
• Co-ordinate and manage an independent nurse led clinic for the viral hepatitis B patient cohort using the existing model of FibroScan support.
• Liaise with UBHW for the care of NBT patients with hepatitis C undertaking viral
• Aim to complete a non-medical prescribing (NMP) course within the first year of CNS role.
• Prescribe and review medication for therapeutic effectiveness, in accordance with evidence-based practice, national protocols, legislation (non-medical prescriber or under Patient Group Directions) and within scope of practice.
• Undertake an IRMA course at NBT within 12 months of starting the post, to request relevant imaging.
• To undertake FibroScans.
• Demonstrate the pathways and data collection from clinics and innovations for audit and service development.
• Participate in regional and national training and updates within their field and be an active participant in relevant associations such as BASL BLNS and BSG.
• Outpatient paracentesis service: with support the CNS should aim to undertake paracentesis for outpatient patients with decompensated cirrhosis.

Working for our organisation

NBT Cares. It’s a very simple statement; one which epitomises how everybody across our organisation goes the extra mile to ensure our patients get the best possible care.

NBT Cares is also an acronym, standing for caring, ambitious, respectful, and supportive – our organisational values.

And our NBT Cares values are underpinned by our positive behaviour’s framework – a framework that provides clear guidance on how colleagues can work with one another in a constructive and supportive way.

Detailed job description and main responsibilities

The hepatology CNS will provide liaison between NBT, Kings College Hospital and other transplant centres. To coordinate the transplant assessment pathway, coordinating the necessary investigations in a timely and efficient manner. The successful applicant will work with the NBT MDT to identify potential liver transplant candidates and support the patient through the listing process up to the time of transplantation. Once listed the applicant will coordinate care both pre- and post-transplant.

Person specification

Knowledge

Essential criteria

• Advanced knowledge of the care and management of hepatology patients in the outpatient setting.
• Up-to-date knowledge and understanding of national and local cancer issues and developments
• Sound knowledge of liver care bundles and clinical guidelines.
• Understanding of the concepts of clinical governance and shared governance.
• Understanding of quality strategies.

Training

Essential criteria

• Registered non-medical prescriber (desirable) or willingness to undertake NMP course.
• Physical assessment and clinical reasoning skills qualification (desirable) or willingness to undertake.
• Evidence of relevant ongoing professional development and including leadership and management
• RCN registration.

Experience

Essential criteria

• Significant post-registration hepatology experience of which 3 years includes recent experience.
• Experience of change management and project development.
• Experience of undertaking audit and the planning and implementation of research.
• Relevant experience in facilitation and negotiation.

Clinical skills

Essential criteria

• The ability to provide clinical leadership and be a role model for excellence in hepatology care.
• Excellent interpersonal and communication skills in dealing with patients, relatives, and colleagues.
• Expert diagnostic and assessment skills.
• Ability to cope with emotional issues presented in the course of work and provide support for others.
• The ability to communicate bad news to patients and families in a highly sensitive manner and to support and guide staff in the breaking of bad news

Leadership and management skills

Essential criteria

• Leadership skills to ensure effective, efficient, and safe team-working.
• Skills in judgement and decision-making.
• Ability to evaluate services on order to improve team effectiveness and patient care.
• Ability to work effectively within a team.
• Ability to lead and influence change.
• Excellent organisational skills.

Desirable criteria

• Motivational, negotiating, and mediating skills.
• Excellent presentation and teaching skills.
• Project management skills.
• The ability to self-motivate and to encourage others
• Computer literate, able to use databases and other relevant programmes.