Candidate Advanced Nurse Practitioner (c/ANP) in Breast Cancer Survivorship and Family History

Overview:

Post Title:

Candidate Advanced Nurse Practitioner (c/ANP) in Breast Cancer Survivorship and Family History

Post Status:

Permanent

Department

Surgical Directorate

Location:

Beaumont Hospital, Dublin 9

Reports to:

Professional Reporting Relationship: Professionally reporting to Director of Nursing (Operationally reports to Directorate Nurse Manager, Hospital Breast Surgeon’s (where appropriate).

Salary:

Appointment will be made on cANP grade at a point in line with Government pay policy (€70,025 - €79,081)

Hours of work:

Full Time, 37.5 Hours

Closing Date:

Tuesday 3rd June 2025 @ 12 noon

Position Summary

The Symptomatic breast service at Beaumont Hospital has expanded exponentially over the past 12 years since the amalgamation of cancer services into the eight designated cancer centers.

The role will also take responsibility for the surveillance of a defined cohort of patients considered at high risk of developing symptomatic breast disease.

The post holder will endeavour to improve patient experience and satisfaction while promoting health and wellbeing and improve the quality of service patients receive within Beaumont Hospital.

Responsibilities:

• Take a holistic approach to patient care and promote health and wellbeing
• Improve the quality of service patients receive and Improve patient experience and satisfaction
• Assess, diagnose, treat, discharge and evaluate patients autonomously as appropriate
• Provide continuity of care and timely access to services
• Assist in the reduction of the breast care service/family history waiting list
• Work effectively as part of the multi-disciplinary team in the Breast Service
• Be actively involved in the continued evaluation of services through ongoing clinical audit and research
• Identification and management of treatment related side effects
• Support and empower patients to self-manage their own health needs
• With the Breast MDT, collaboratively agree and develop local policies, procedures, protocols and guidelines
• Organise, interpret and follow up on all investigations required as part of the pathways for their agreed cohort of patients (breast surveillance patients), ensuring they are performed in a timely manner
• Participate in the development of the breast cancer family history service. Triaging referrals, categorising risk assessment of patients with high familial risk, discussing consent, family history assessment questionnaires, requesting reports, collating information and referrals to other services where indicated
• Establish Nurse led outpatient services, utilising telehealth and other ICT measures to facilitate more effective and efficient delivery of care
• Provision of community based clinics and group sessions
• Act as a communication link between the wider MDT in the management of patient issues, ensuring the appropriate services are referred to in a timely fashion
• Attend multidisciplinary team (MDT) meetings and breast service out-patient clinics
• Manage a specific cohort of patients with Breast cancer
• Coordinate survivorship programme against latest up-to-date national guidelines
• Develop the interface between primary and secondary care services (General Practice, External Hospitals, Public Health Nurses (PHN)s, Practice Nurses) through clinical work, education, research and leadership
• Contribute to the continuous improvement of the quality of care experienced by patients accessing the breast care service
• • Advance the theory and practice of advanced nursing practice through demonstrating expert practice, autonomy in practice clinical leadership, research and audit
• Work with the healthcare team contributing to meeting health service quality/patient safety and resource needs at local and national level and within a patient-centred philosophy
• The cANP engages in on-going clinical supervision as per a Service Level Agreement.
• The cANP Breast Cancer Survivorship and Family History maintains a record of clinical supervision in his/her professional practice portfolio.
• The cANP Breast Cancer Survivorship and Family History must develop a professional practice portfolio, incorporating evidence of learning from continuing professional development, clinical supervision, reflective practice and review of his/her own scope of practice in accordance with regulatory requirements and service need
• Surveillance of breast cancer patients from time line of 1 year post diagnosis or post completion of treatment onwards for lifelong follow up and detection of recurrent cancers including ordering of surveillance procedures and scans etc.

The duties detailed above are not intended to be a comprehensive list of all the duties involved and consequently, the post holder may be required to perform other duties as appropriate to the post which may be assigned to him/her from time to time and to contribute to the development of the post while in office

1. 0 Key Working Relationships (to include but not limited to):

• Directorate Nurse Manager
• RANPs and other nursing grades
• Nurse Practice Development Co-ordinator
• Centres of Nursing and Midwifery Education
• Other relevant statutory and non-statutory organisations
• National Clinical and Integrated Care Programme
• National Leadership and Innovation Centre
• Prescribing site co-ordinator(s)
• Medical colleagues

1. 0 Purpose of the Post:

The main purpose of the post is to develop the job description and supporting documentation under the direction of the Health Care Provider’s Advanced Practice Stakeholder Governance Group, to enable the individual nurse to meet the Nursing and Midwifery Board of Ireland (NMBI) Criteria for Registration as an Advanced Nurse Practitioner as set out in Advanced Practice (Nursing) Standards and Requirements (NMBI, 2017).

The individual will undertake the academic preparation and develop the clinical and leadership skills, competencies and knowledge required to meet the criteria to be registered as a Registered Advanced Nurse Practitioner (RANP) with NMBI. The scope of the cANP role must reflect the incremental development of expertise and as such, the cANP cannot deliver care as an autonomous practitioner.

Furthermore, the cANP will develop and submit their personal portfolio and all other necessary documentation to NMBI in order to register as a RANP.

The value of the nursing contribution as a distinct profession must be safeguarded and articulated in the development of new services led by advanced nurse practitioners, complementing rather than replacing current services delivered by doctors (NMBI 2017 p.9).

The overall purpose of the post is to provide safe, timely, evidenced based nurse-led care to patients at an advanced nursing level. This involves undertaking and documenting a complete episode of patient care (assess, diagnose, plan, treat and discharge patients) according to collaboratively agreed protocols and scope of practice in the clinical setting; demonstrating advanced clinical and theoretical knowledge, critical thinking, clinical leadership and decision making skills.

The advanced practice role demonstrates a high degree of knowledge, skill and experience that is applied within the nurse-patient/client relationship to achieve optimal outcomes through critical analysis, problem solving and accurate decision-making (NMBI, 2017).

Central to this is the provision of quality care, a safe environment and processes for patients using evidence based clinical guidelines that address patient expectations, promote wellness and evaluate care given.

The role will provide clinical leadership and professional scholarship in order to develop nursing practice and health policy at local, regional and national level.

The key responsibilities of the cANP will be to develop a higher level of capability across the six domains of competences as defined by Bord Altranais agus Cnáimhseachais na hÉireann Advanced Practice (Nursing) Standards and Requirements (NMBI 2017).

The domains are:

• Professional Values and Conduct
• Clinical Decision Making Competences
• Knowledge and Cognitive Competences
• Communication and Interpersonal Competences
• Management and Team Competences
• Leadership and Professional Scholarship Competences

Domain 1: Professional Values and Conduct

The cANP for Breast cancer Survivorship and Family History will gain increased competence in applying ethically sound solutions to complex issues related to individuals and populations by:

• Demonstrating accountability and responsibility for professional practice as a lead healthcare professional in the care of patients undergoing diagnosed with breast cancer.
• Collaborating with his/her supervisor and local stakeholder group to determine the caseload, scope of practice and the inclusion and exclusion criteria for the RANP (Breast Cancer Survivorship and Family History)
• Articulating safe boundaries and engaging in timely referral and collaboration for those areas outside his/her scope of practice, experience, and competence by establishing, in collaboration with key stakeholders, referral pathways and locally agreed policies, procedures, protocols and guidelines to support and guide the Breast Cancer service.
• Demonstrating leadership by practising compassionately to facilitate, optimise, promote and support the health, comfort, quality of life and wellbeing of persons whose lives are affected by altered health, chronic disorders, disability, distress or life-limiting conditions.
• Selecting a professional practice model that provides him/her latitude to control his/her own practice, focusing on person centred care, interpersonal interactions and the promotion of healing environments.
• The chosen professional practice model for nursing will emphasise a caring therapeutic relationship between the cANP/RANP (Breast Cancer Survivorship and Family History) and his/her patients, recognising that cANPs/RANP (Breast Cancer Survivorship and Family History) work in partnership with their multidisciplinary colleagues.
• Articulating and promoting the advanced practice nursing service in clinical, political and professional contexts {for example presenting key performance outcomes locally and nationally; contributing to the service’s annual report; participating in local and national committees to ensure best practice as per the relevant national clinical and integrated care programme}.

Domain 2: Clinical-Decision Making Competences

The cANP (Breast Cancer Survivorship and Family History) will enhance his/her advanced knowledge, skills, and abilities to engage in senior clinical decision-making by increasing his/her capability to:

• Conduct a comprehensive holistic health assessment using evidenced based frameworks, policies, procedures, protocols and guidelines to determine diagnoses and inform autonomous advanced nursing care.
• Synthesise and interpret assessment information particularly history including prior treatment outcomes, physical findings and diagnostic data to identify normal, at risk and subnormal states of health.
• Demonstrate timely use of diagnostic investigations / additional evidence-based advanced assessments to inform clinical-decision making.
• Exhibit comprehensive knowledge of therapeutic interventions including pharmacological and non-pharmacological advanced nursing interventions, supported by evidence-based policies, procedures, protocols, and guidelines, relevant legislation, and relevant professional regulatory standards and requirements.
• Initiate and implement health promotion activities and self-management plans in accordance with the wider public health agenda.
• Discharge patients from the service as per an agreed supporting policy, procedure, protocols, guidelines and referral pathways.
• Domain 3: Knowledge and Cognitive Competences

The cANP Breast Cancer (Survivorship and Family History) will actively contribute to the professional body of knowledge related to his/her area of advanced practice by enhancing his/her capability to:

• Provide leadership in the translation of new knowledge to clinical practice (for example teaching sessions; journal clubs; case reviews; facilitating clinical supervision to other members of the team).
• Educate others using an advanced expert knowledge base derived from clinical experience, on-going reflection, clinical supervision and engagement in continuous professional development.
• Demonstrate a vision for advanced practice nursing based on service need and a competent expert knowledge base that is developed through research, critical thinking, and experiential learning.
• Demonstrate accountability in considering access, cost and clinical effectiveness when planning, delivering and evaluating care (for example key performance areas, key performance indicators, metrics).

Domain 4: Communication and Interpersonal Competences

The cANP (Breast Cancer Survivorship and Family History) will negotiate and advocate with other health professionals to ensure the beliefs, rights and wishes of the person are respected by gaining increased competence and capability to:

• Communicate effectively with the healthcare team through sharing of information in accordance with legal, professional and regulatory requirements as per established referral pathways.
• Demonstrate leadership in professional practice by using professional language (verbally and in writing) that represents the plan of care, which is developed in collaboration with the person and shared with the other members of the inter-professional team as per the organisation’s policies, procedures, protocols and guidelines.
• Facilitate clinical supervision and mentorship through utilising one’s expert knowledge and clinical competences.
• Utilise information technology, in accordance with legislation and organisational policies, procedures, protocols and guidelines to record all aspects of advanced nursing care.

Domain 5: Management and Team Competences

The cANP (Breast Cancer Survivorship and Family History) will manage risk to those who access the service through collaborative risk assessments and promotion of a safe environment by:

• Promoting a culture of quality care.
• Proactively seeking feedback from persons receiving care, families and staff on their experiences and suggestions for improvement.
• Implementing practice changes using negotiation and consensus building, in collaboration with the multidisciplinary team and persons receiving care.

Domain 6: Leadership and Professional Scholarship Competences

The cANP (Breast Cancer Survivorship and Family History) will lead in multidisciplinary team planning for transitions across the continuum of care by enhancing his/her competence and capability to:

• Demonstrate clinical leadership in the design and evaluation of services (for example findings from research, audit, metrics, new evidence).
• Engage in health policy development, implementation, and evaluation (for example key performance indicators from national clinical and integrated care programme/HSE national service plan/ local service need to influence and shape the future development and direction of advanced practice in Breast Cancer.
• Identify gaps in the provision of care and services pertaining to his/her area of advanced practice and expand the service to enhance the quality, effectiveness and safety of the service in response to emerging healthcare needs.
• Lead in managing and implementing change.

Advanced Practice Performance Management and Evaluation:

In addition, they identify areas of good practice that must be recognised and celebrated (HSE 2015).

The Department of Health (2017) Framework for National Performance Indicators for Nursing and Midwifery provides a guiding framework for the development of Nursing and Midwifery PI’s.

In collaboration with the Director of Nursing, the cANP will identify and develop Nursing PI’s for their area of practice, collect and collate data which will provide evidence of the impact and effectiveness of the interventions undertaken.

The cANP (Breast Cancer Survivorship and Family History) will evaluate audit results and research findings to identify areas for quality improvement in collaboration with nursing management and multidisciplinary team colleagues (primary and secondary care).

Professional / Clinical

The cANP (Breast Service) will practise nursing according to:

• Professional clinical guidelines
• National Health Policy
• Local policies, procedures, protocols and guidelines
• Current legislation
• Values for Nursing and Midwifery – Care, Compassion and Commitment (DoH, 2016).

Education and Training:

The cANP (Breast Cancer Survivorship and Family History) will:

• Contribute to service development through appropriate continuous education, research initiatives, keeping up to date with nursing literature, recent nursing research and new developments in nursing practice, education and management.
• Provide support and advice to those engaging in continuous professional development in his/her area of advanced nursing practice.

The cANP must develop a professional practice portfolio, incorporating evidence of learning from continuing professional development, clinical supervision, reflective practice and review of his/her own scope of practice in accordance with regulatory requirements and service need.

The cANP (Breast Services) practises nursing according to:

• The Code of Professional Conduct and Ethics for Registered Nurses and Registered Midwives (NMBI 2014);
• Scope of Nursing and Midwifery Practice Framework (NMBI 2015);
• Values for Nurses and Midwives in Ireland – Care, Compassion and Commitment (Department of Health 2016);
• Advanced Practice Nursing Standards and Requirements (NMBI 2017);
• National Health Policies and Procedures (latest versions) {list as relevant to the service for example: HSE (2013, revised 2016) National Consent Policy;
• Local policies, procedures, protocols and guidelines
• Current legislation as relevant to the service

Qualifications:

Professional Qualifications, Experience, etc

(a) Eligible applicants will be those who on the closing date for the competition: (i) Be a registered nurse with the Nursing and Midwifery Board of Ireland

practicum.