Clinical Nurse Specialist (CNS) (RN) - Oncology Inpatient

A Brief Overview
The Clinical Nurse Specialist (CNS) is a direct care clinician who also collaborates with members of the health care team to enhance patient care by developing and supporting nursing staff and providing care to patients and families within an identified specialty. This model describes the CNS's practice competencies within three spheres of influence: the patient/client, nursing and nursing practice and the organization/system sphere with the patient being the most important sphere. The CNS's clinical expertise arises from competencies inherent within a specialty of nursing practice and are used to address nursing issues within the patient/client, nursing and nursing practice, and the organization/system spheres. The essential roles of the CNS: expert clinician, interdisciplinary consultant, educator, researcher, and leader help to:

1. Provide direct patient and family care,
2. Direct specialty knowledge and skill acquisition,
3. Shape core competencies of clinical practice,
4. Promote evidence-based outcome-guided nursing care,
5. Integrate quality patient care across SHC practice sites,
6. Promote promoting an environment of mentoring and system change that empower the nurse to experience professional growth and development.

• The CNS is accountable to and evaluated by a Nursing Administrator at the Director, Nurse Manager, or Clinic Manager level.
  This job description covers all classifications for CNSs within the organization. All CNSs must meet all elements of the Essential Functions, Qualifications, and Supervision. There is a voluntary Career Ladder for CNSs who are interested in promotions for clinical expertise and contributions to the institution as well as the profession. Promotion is determined based on the Center for Advanced Practice Career Ladder Handbook.

What you will do

• The essential functions of the clinical nurse specialist are derived by the CNS Core Competencies delineated by the National Association of Clinical Nurse Specialists (NACNS, 2010). The Core Competencies are listed below.
• Direct Care Competency:
• Direct interactions with patients, families, and specialty patient populations to promote health/well-being and improve quality of life. Care is provided with a holistic perspective in the advanced nursing management of health, illness, and disease states.
• Conducts advanced comprehensive assessments of patients, families, communities and social systems using evidence-based techniques.
• Formulates and prioritizes differential diagnoses based the needs of each individual.
• Develops evidence-based clinical interventions and systems to achieve defined outcomes.
• Recommends therapeutic interventions and treatments to meet the needs of patients, families, and specialty patient populations.
• Assists staff in the development of innovative, cost-effective programs or protocols of care.
• Evaluates nursing practice that promotes patient-centered and evidence-based care.
• Evaluates patient outcomes that considers safety, timeliness, effectiveness, and efficiency.
• Other duties as assigned.
• Additional Direct Care Competencies (Privileging required through Medical Staff Office to perform; activities below are performed according to Standardized Procedure: Assessment and Management of Patients):
• Evaluates and treats patients with acute, and chronic health complaints as well as health maintenance concerns related to specialty according to written standardized procedures Obtains complete histories and performs pertinent physical exams with assessment of normal and abnormal findings on new and return patients, according to written standardized processes Performs or requests and evaluates diagnostic studies as indicated upon evaluation of the patients, according to written standardized procedures Administers and orders medications Orders and collects specimens for routine laboratory tests, screening procedures and therapeutic procedures, including blood and blood products.
• Orders physical therapy, occupational therapy, respiratory therapy, radiology examinations and nursing services.
• Performs designated procedures after demonstrated competency, according to written standardized procedure where applicable.
• Obtains informed consent, as indicated.
• Initiates arrangements for hospital admissions and discharges and completes appropriate paperwork.
• Recognizes and considers the age specific needs of patients.
• Recognizes situations which require the immediate attention of a physician, and initiates lifesaving procedures when necessary.
• Performs discharge summaries.
• Systems Leadership:
• Manages change and empowers others to influence clinical practice and political processes both within and across systems.
• Facilitates, leads, and evaluates system change to improve health outcomes and foster evidence-based practice.
  Identifies variables that influence nursing practice and patient care outcomes.
• Promotes clinical excellence through education, role modeling, team building, and quality.
• Develops and applies clinical standards, policies, and procedures using evidence-based practice.
• Coordinates care with use of system and community resources to optimize patient, family, and community outcomes.
  Evaluates fiscal implications of practice and system modifications.
• Participates in and evaluates impact of Quality initiatives on Nurse Sensitive Indicators.
• Provides leadership through the use of advanced communication skills to improve patient outcomes.
• Consultation:
• Provides specialized expertise to consult on patients, staff, and systems-focused problems. Using the consultation process implements and evaluates evidence-based practice changes within a clinical specialty.
• Provides consultation to staff nurses, physicians and to other health care professionals on patient care issues.
• Communicates consultation findings to healthcare team, and identifies resources to improve patient care outcomes.
• Analyzes consultation outcomes to implement evidence-based practice changes within a clinical specialty.
• Provides and coordinates patient teaching and counseling.
• Collaboration:
• At an advanced level, collaborates by committing to authentic engagement and constructive problem-solving to optimize clinical outcomes for the patient, family, system, and patient population.
• Utilizes leadership, team building, negotiation, and conflict resolution skills to build interdisciplinary collaboration within and across systems to meet optimal outcomes.
• Effectively communicates and interacts with patients, families, staff and members of the community from diverse backgrounds.
• Facilitates the collaboration between providers and coordination of community resources.
• Facilitates the coordination of inpatient and outpatient care and services as needed.
• Coaching:
• Provides skillful guidance and teaching to advance the care of patients, families, groups of patients, and professional nursing.
• Uses coaching and advanced communication skills to facilitate the development of effective clinical teams.
• Designs education for individuals, families, and specialty patient populations to promote knowledge, understanding and optimal functioning across the wellness-illness continuum.
• Promotes professional development of staff nurses and continuing education activities.
• Contributes to the advancement of the nursing profession as a whole by disseminating outcomes of CNS practice through presentations and publications.
• Research:
• Evidence based practice underlies all aspects of the CNS role and incorporates analysis, application, and evaluation of research/evidence related to a clinical practice specialty.
• Mentors nurses to translate research into practice.
• The CNS role allows for independent and/or multidisciplinary involvement in research within a supportive clinical environment.
• Publication or presentation of evidence-based outcomes or research findings.
• Ethics:
• Promotes a practice climate conducive to providing ethical care.
• Fosters professional accountability.
• Facilitates patient and family understanding of the risks, benefits, and outcomes of proposed healthcare regime to promote informed decision making.
• Ensures compliance with legal, regulatory and clinical policies and procedures.

Education Qualifications

• Master's degree in Nursing from an accredited university.
• Graduate of a CNS program accredited by the National League of Nursing Accrediting Commission (NLNAC) or the Commission on Collegiate Nursing Education (CCNE).
• Doctoral degree in Nursing preferred.

Licenses and Certifications

• RN - Registered Nurse - California State Licensure
• CNS - Clinical Nurse Specialist and
• BLS - Basic Life Support from the American Heart Association

Additional Requirements

• Oncology Experience
• Chemo Certification

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