Renal Palliative Care Clinical Nurse Specialist

NHS; London; On-site; GBP 54,000 - 61,000; Full time

Job description

Renal Palliative Care Clinical Nurse Specialist

Guy's and St Thomas' NHS Foundation Trust

A Renal Supportive Care Clinical Nurse Specialist (CNS) plays a key role in providing palliative and end-of-life care to patients with advanced chronic kidney disease (CKD), particularly those in stage 5 CKD, across various care settings. This role is essential for patients who either choose not to undergo dialysis, are receiving dialysis, or have undergone a kidney transplant. The CNS ensures the holistic care of these patients, addressing their physical, emotional, psychological, and spiritual needs as they approach the end of life.

Due to increasing patient numbers, higher levels of complexity, and growing frailty, we are expanding our team to better meet the needs of this population, both in renal care and within the broader local community.

This is a full-time post (1.0 FTE) based within Guy's & St Thomas' NHS Foundation Trust and also includes our satellite sites.

Interview date: 01/05/2025

Main duties of the job

Lead nurse clinics at the Guys site and satellite units, where you will assess patients and prescribe treatment with their care plans. Offer advance care planning discussions, help manage symptoms of CKD and dialysis, and provide end-of-life care to patients across a wide geographical area. Coordinate care ensuring close collaboration with community colleagues and palliative care teams to avoid unnecessary hospital admissions and facilitate out-of-hospital end-of-life care. Work with the MDT teams to deliver holistic care.

Provide palliative care to inpatients on renal wards. Assist in difficult discussions regarding treatment withdrawal and ensure that decisions align with the patient's preferences, avoiding overmedicalization of death. Support staff in delivering excellent end-of-life care to patients with renal disease, ensuring they are competent in managing sensitive end-of-life conversations and providing care that aligns with patient priorities.

Implement effective symptom management strategies. Ensure patients receive person-centred care that supports their physical comfort and emotional well-being during the final stages of their illness. Collaborate with nephrologists, palliative care teams, and other healthcare providers to ensure patients receive seamless, coordinated care tailored to their needs. Participate in discussions that consider all aspects of patient care, ensuring decisions made are in line with patient values and goals.

About us

The role sits within the Directorate of Transplant, Renal and Urology under the speciality of Renal. The successful candidate will be welcomed into the team and given the appropriate training to succeed in this vital role.

We offer a range of in-house training to enhance your clinical, research and managerial skills. The management team will support you to have a clear plan and support additional external training if required for your role, development and future career objectives.

Job responsibilities

The JD and main responsibilities for this role are but not exclusively:

1. Lead nurse-led clinics at the Guys site and satellite units, assessing patients, developing care plans, and prescribing treatments.
2. Provide advanced care planning and guidance, especially for patients with stage 5 CKD, those receiving dialysis, and those with kidney transplants.
3. Symptom Management and End-of-Life Care ensuring comfort in the final stages of life.
4. Supporting staff with patients with complex needs, liaising with community colleagues and palliative care teams. Ensure that patients are supported with holistic care.
5. Inpatient Care: Provide palliative care to inpatients on the renal wards, particularly focusing on treatment withdrawal and ensuring that death is not overly medicalized.
6. Support difficult communication around end-of-life decisions and facilitate care that aligns with patient wishes and values.
7. Multidisciplinary Team Work: Collaborate with the wider MDT.
8. Patient and Family Support: Guide patients and families through the process of advance care planning, offering options for care based on their values and wishes.

By managing these responsibilities, you will ensure that patients receive the best possible care throughout their journey with advanced kidney disease, especially during their final stages.

Please also see the attached detailed JD and expectations for a CNS at GSTT.

Person Specification

Education and training

• Degree
• Leadership course
• Renal Course
• To have or working towards a non-medical prescribing course
• To have or working towards an advanced assessment course
• To have or working towards a master's degree

Professional Registration

• Registered Nurse on the NMC register.
• Extensive experience of working autonomously at an advanced level within the specialist area delivering effective patient-focused care.
• Proven evidence of management / leadership skills and autonomous practice.
• Proven listening / counselling skills with the ability to manage complex situations and appropriately deliver sensitive and difficult outcomes.

Disclosure and Barring Service Check

This post is subject to the Rehabilitation of Offenders Act (Exceptions Order) 1975 and as such it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service (formerly known as CRB) to check for any previous criminal convictions.

Guy's and St Thomas' NHS Foundation Trust

Head of Nursing Transplant, Renal and Urology

£54,320 to £60,981 a year inclusive of HCA