RCSI Hospital Group HQ

Clinical Nurse Specialist - Plastics / Dermatology

Job Locations Our Lady of Lourdes Hospital & Louth County Hospital
Posted Date 1 week ago(14/10/2021 11:57)
Job ID
# of Openings
Nursing & Midwifery
Closing Date


The purpose of this Clinical Nurse Specialist Plastics/ Dermatology  post is to:


Deliver care in line with the five core concepts of the role set out in the Framework for the Establishment of Clinical Nurse Specialist Posts, 4th edition, National Council for the Professional Development of Nursing and Midwifery (NCNM) 2008


This post supports the Dermatology and Plastic surgery Consultants and members of the Skin Service in the development, management and operational delivery of the services. The purpose of the role is to provide nursing leadership and the effective management of a defined caseload of patients; assessing needs, setting priorities, planning, delivering and monitoring appropriate care. The post holder will provide specialist clinical advice and teaching to support the multidisciplinary team, patients, their carers and families. The post holder will proactively undertake clinical audit to monitor standards of care and service delivery and undertake nursing research to further progress the service


The post holder will be responsible for coordinating all patients with Melanoma, other skin cancers and skin conditions between Dermatology, Plastic Surgery and Oncology Services, ensuring that all patients are supported clinically and holistically during the treatment process.

Organisational Context

Approximately 50% of referrals to Dermatology are for skin cancer and Ireland has one of the highest incidence of skin cancer in the world, with 10,089 cases of non-melanoma skin cancer and 1067 cases of Melanoma diagnosed in 2017(NCRI).

Our Lady of Lourdes Hospital has recently established a Plastics Surgery Service providing Outpatient Clinics, Minor Surgery sessions and Day case sessions for the Louth and Meath catchment area.

The CNS (Plastics and Dermatology) role is pivotal in providing and ensuring a streamlined and seamless journey for skin cancer and associated skin conditions for patients from referral to discharge.

Key Responsibilities

Clinical Focus


Clinical Nurse Specialist (Plastics/Dermatology) will have a strong patient focus whereby the specialty defines itself as nursing and subscribes to the overall purpose, functions and ethical standards of nursing.


The clinical practice role may be divided into direct and indirect care. Direct care comprises the assessment, planning, delivery and evaluation of care to the patient, family and/or carer. Indirect care relates to activities that influence and support the provision of direct care.


The CNS in Plastics/Dermatology will:


  • Articulate and demonstrate the concept of nursing specialist practice within the framework of Nursing legislation and the regulatory body of An Bord Altranais agus Cnáimhseachais na hÉireann.
  • Provide safe, comprehensive care for patients and their families within the scope of practice guidelines set out by An Bord Altranais agus Cnáimhseachais na hÉireann.
  • To work with local, national and international MDT’s to improve referral processes, communication structures and to create a seamless pathway for patients diagnosed with Melanoma and high risk Non Melanoma Skin Cancers referred to Our Lady of Lourdes Hospital and the wider RCSI hospital group.
  • Attend the Out-Patient Clinic for Plastic Surgery.
  • Plan and initiate care and treatment modalities within agreed interdisciplinary protocols to achieve patient/client centred outcomes and evaluate their effectiveness.
  • Utilise evidence based assessment and treatment skills and techniques to determine and manage each patient/family needs.
  • Develop, document and update care, discharge and teaching plans as necessary
  • Act as a resource for patients, families and community services following discharge and provide a telephone based link for patients.
  • Complete and maintain relevant documentation in a thorough and accurate manner
  • Plan all care in collaboration with the patient
  • Liaise as appropriate with other members of the multidisciplinary team (MDT) regarding any aspect of patient care.
  • Implement changes in health care service in response to patient/client need and service demand.
  • To identify health promotion priorities for patients, families/carers and support self care in line with best evidence.
  • Maintain effective and appropriate communication and collaboration with other departments, members of the multidisciplinary team, other agencies, colleagues, personnel, patients and their relatives/carers.


Direct Care


Clinical Nurse Specialist (Dermatology) will:


  • Manage a caseload of patients as agreed by Consultant Plastic Surgeon


  • Provide a specialist nursing service for patients with a diagnosis of any skin condition who require support and treatment through the continuum of care
  • Undertake comprehensive patient assessment to include physical, psychological, social and spiritual elements of care using best evidence based practice in Plastics/Dermatology care.
  • To identify the specific nursing needs of patients with complex and non-complex wounds.
  • Use the outcomes of patient assessment to develop and implement plans of care/case management in conjunction with the multi-disciplinary team (MDT) and the patient, family and/or carer as appropriate.
  • Monitor and evaluate the patient’s response to treatment and amend the plan of care accordingly in conjunction with the MDT and patient, family and/or carer as appropriate.
  • Make alterations in the management of patient’s condition in collaboration with the MDT and the patient in line with agreed pathways and policies, procedures, protocols and guidelines (PPPG’s).
  • Accept appropriate referrals from Multi-Disciplinary Team (MDT) colleagues
  • Co-ordinate investigations, treatment therapies and patient follow-up
  • Communicate with patients, family and /or carer as appropriate, to assess patient’s needs and provide relevant support, information, education, advice and counselling as required
  • Where appropriate work collaboratively with MDT colleagues across Primary and Secondary Care to provide a seamless service delivery to the patient, family and/or carer as appropriate
  • Participate in medication reconciliation taking cognisance of poly-pharmacy and support medical and pharmacy staff with medication reviews and medication management
  • Identify and promote specific symptom management strategies as well as the identification of triggers which may cause exacerbation of symptoms.
  • Provide patients with appropriate self-management strategies and escalation pathways.
  • Manage nurse led clinics with MDT input
  • Identify health promotion priorities for the patient, family and/or carer and support patient self-care in line with best evidence. This will include the provision of educational and health promotion material which is comprehensive, easy to understand and meets patients’ needs


Indirect Care


Clinical Nurse Specialist( Plastics/Dermatology) will:


  • Identify and agree appropriate referral pathways for patients with skin lesions and associated conditions
  • Participate in case review with MDT colleagues both on site and via appropriate on-line portal for off site meetings.
  • Use a case management approach to patients with complex needs in collaboration with MDT in both Primary and Secondary Care as appropriate
  • Take a proactive role in the formulation and provision of evidence based PPPGs relating to Plastics/Dermatological care
  • Take a lead role in ensuring the service for patients with skin cancer or other associated skin conditions is in line with best practice guidelines and the Safer Better Healthcare Standards (HIQA, 2012)


Patient/Client Advocate

Clinical Nurse Specialist (Plastics/Dermatology)will:


  • Communicate, negotiate and represent patient’s family and/or carer values and decisions in relation to their condition in collaboration with MDT colleagues in both Primary and Secondary Care as appropriate
  • Develop and support the concept of advocacy, particularly in relation to patient participation in decision making, thereby enabling informed choice of treatment options
  • Respect and maintain the privacy, dignity and confidentiality of the patient, family and/or carer
  • Establish, maintain and improve procedures for collaboration and cooperation between Acute Services, Primary Care and Voluntary Organisations as appropriate
  • Proactively challenge any interaction which fails to deliver a quality service to patients




Education & Training:

Clinical Nurse Specialist (Plastics/Dermatology) will:


  • Maintain clinical competence in patient management within Plastics/ Dermatology nursing keeping up-to-date with relevant research to ensure the implementation of evidence based practice.
  • Provide the patient, family and/or carer with appropriate information and other supportive interventions to increase their knowledge, skill and confidence in managing their
  • Contribute to the design, development and implementation of education programmes and resources for the patient, family and/or carer in relation to their skin condition thus empowering them to self-manage their condition.
  • Provide mentorship and preceptorship for nursing colleagues as appropriate.
  • Participate in training programmes for nursing/midwifery, MDT colleagues and key stakeholders as appropriate
  • Create exchange of learning opportunities within the MDT in relation to evidence based plastics/dermatology care delivery through journal clubs, conferences etc.
  • Develop and maintain links with Regional Centres for Nursing & Midwifery Education (RCNMEs), the Nursing and Midwifery Planning and Development Units (NMPDUs) and relevant third level Higher Education Institutes (HEIs) in the design, development and delivery of educational programmes in plastics and dermatology
  • Be responsible for addressing own continuing professional development needs


Audit & Research:

Clinical Nurse Specialist (Dermatology) will:


  • Maintain a record of clinically relevant data aligned to National Key Performance Indicators (KPI’s) as directed and advised by the Director of Nursing
  • Identify, initiate and conduct nursing and MDT audit and research projects relevant to the area of practice.
  • Identify, critically analyse, disseminate and integrate best evidence relating to management of skin lesions into practice
  • Contribute to nursing research on all aspects of Plastics/Dermatology c
  • Use the outcomes of audit to improve service provision
  • Contribute to service planning and budgetary processes through use of audit data and specialist knowledge
  • Monitor, access, utilise and disseminate current relevant research to advise and ensure the provision of informed evidence based practice


Audit expected outcomes including:


  • Collate data agreed locally which will provide evidence of the effectiveness of Clinical Nurse Specialist (Plastics/Dermatology) interventions undertaken. These will include a clinical nursing focus as well as a breakdown of nurse led activity ie. patient’s seen and treated.
  • Evaluate audit results and research findings to identify areas for quality improvement in collaboration with nursing management and MDT colleagues (Primary and Secondary Care).



Clinical Nurse Specialist (Dermatology) will:


  • Provide leadership in clinical practice and act as a resource and role model for Plastics/Dermatology Nursing practice.
  • Generate and contribute to the development of clinical standards and guidelines and support implementation
  • Use specialist knowledge to support and enhance generalist nursing practice
  • Develop collaborative working relationships with local Clinical Nurse Specialist’s/Registered Advanced Nurse Practitioner/MDT colleagues as appropriate, developing person centred care pathways to promote the integrated model of care delivery.
  • With the support of the Director of Nursing, attend integrated care planning meetings as required
  • Where appropriate develop and maintain relationships with specialist services in voluntary organisations which support patients in the community.
  • Liaise with other health service providers in the development and on-going delivery of the National Clinical Programme model of care.
  • Network with other Clinical Nurse Specialist in Dermatology and in related professional associations.


Health & Safety:


These duties must be performed in accordance with local organisational and the HSE health and safety polices. In carrying out these duties the employee must ensure that effective safety procedures are in place to comply with the Health, Safety and Welfare at Work Act (2005). Staff must carry out their duties in a safe and responsible manner in line with the local policy documents and as set out in the local safety statement, which must be read and understood.


Quality, Risk and Safety Responsibilities

It is the responsibility of all staff to:


  • Participate and cooperate with legislative and regulatory requirements with regard to quality, risk and safety
  • Participate and cooperate with local quality, risk and safety initiatives as required
  • Participate and cooperate with internal and external evaluations of the organisation’s structures, services and processes as required, including but not limited to, The National Hygiene Audit, National Decontamination Audit, Health and Safety Audits and other audits specified by the HSE or other regulatory authorities
  • Initiate, support and implement quality improvement initiatives in their area which are in keeping with local organisational quality, risk and safety requirements
  • Contribute to the development of PPPGs and safe professional practice and adhere to relevant legislation, regulations and standards
  • Comply with Health Service Executive (HSE) Complaints Policy
  • Ensure completion of incident/near miss forms and clinical risk reporting
  • Adhere to department policies in relation to the care and safety of any equipment supplied and used to carry out the responsibilities of the role of Clinical Nurse Specialist (Plastics/Dermatology) in the department.


Specific Responsibility for Best Practice in Hygiene

Hygiene is defined as: “The practice that serves to keep people and environments clean and prevent infection. It involves the study of preserving one’s health, preventing the spread of disease, and recognising, evaluating and controlling health hazards. In the healthcare setting it incorporates the following key areas: environment and facilities, hand hygiene, catering, management of laundry, waste and sharps, and equipment“(HIQA, 2008; P2) It is the responsibility of all staff to ensure compliance with local organisational hygiene standards, guidelines and practices. 



Clinical Nurse Specialist (Plastics/Dermatology) will:


  • Provide an efficient, effective and high quality service, respecting the needs of each patient, family and/or carer
  • Effectively manage time and caseload in order to meet changing and developing service needs
  • Continually monitor the service to ensure it reflects current needs
  • Implement and manage identified changes
  • Ensure that confidentiality in relation to patient records is maintained
  • Represent the specialist service at local, national and international fora as required
  • Maintain accurate and contemporaneous records and data on all matters pertaining to the planning, management, delivery and evaluation of care and ensure that this service is in line with HSE requirements.
  • Contribute to the service planning process as appropriate and as directed by the Director of Nursing
  • Have a working knowledge of the Health Information and Quality Authority (HIQA) Standards as they apply to the role for example, Standards for Healthcare, National Standards for the Prevention and Control of Healthcare Associated Infections, Hygiene Standards etc and comply with associated HSE protocols for implementing and maintaining these standards as appropriate to the re.
  • To support, promote and actively participate in sustainable energy, water and waste initiatives to create a more sustainable, low carbon and efficient health service.

The above Job Description is not intended to be a comprehensive list of all 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

Essential Criteria

  1. Professional Qualifications, experience etc


Be a registered nurse on the active Register of Nurses and Midwives held by An Bord Altranais agus Cnáimhseachais na hÉireann (Nursing and Midwifery Board of Ireland) or be eligible to be so registered




Be registered in General Division of the register of Nurses and Midwives





Have successfully completed a post registration programme of study, as certified by the education provider, which verifies that the applicant has achieved a Quality and Qualifications Ireland (QQI), National Framework of Qualifications (NFQ) major academic Level 8 or higher relevant to the specialist area of Plastics/Dermatology prior to application.




Can provide written evidence from higher education institute that they have achieved the number of ECTS credits equivalent to a Level 8 or higher standard, relevant to the specialist area of Plastics/Dermatology prior to application.




Have a minimum of 5 years post registration full time experience or an aggregate of 5 years full time in the general division of the register in which the application is being made.




Have a minimum of 2 years’ experience in specialist area of Plastics/ Dermatology care




Demonstrate evidence of continuing professional development.



Have the ability to practice safely and effectively fulfilling his/her professional responsibility within his/her scope of practice


2. Annual registration

(i) Practitioners must maintain live annual registration on the appropriate/relevant Division of the register of Nurses and Midwives maintained by the Nursing and Midwifery Board of Ireland (Bord Altranais agus Cnáimhseachais na hÉireann) for the role


(ii) Confirm annual registration with NMBI to the HSE by way of the annual Patient Safety Assurance Certificate (PSAC).

 3. Age

Age restriction shall only apply to a candidate where s/he is not classified as a new entrant (within the meaning of the Public Service Superannuation (Miscellaneous Provisions) Act, 2004). A candidate who is not classified as a new entrant must be under 65 years of age on the first day of the month in which the latest date for receiving completed application forms for the office occurs.


4. Health

Candidates for and any person holding the office must be fully competent and capable of undertaking the duties attached to the office and be in a state of health such as would indicate a reasonable prospect of ability to render regular and efficient service.


5. Character

       Candidates for and any person holding the office must be of good character.


Please note that appointment to and continuation in posts that require statutory registration is dependent upon the post holder maintaining annual registration in the relevant division of the register maintained by Bord Altranais agus Cnáimhseachais na hÉireann (Nursing & Midwifery Board of Ireland) by way of the Patient Safety Assurance Certificate (PSAC)


Post Specific Requirements:


  • Have undertaken or agree to undertake, within an agreed timeframe, the Nurse Midwife Medicinal Products Prescribing Education Programme.
  • Have undertaken or agree to undertake, within an agreed timeframe, the Nurse Referrer of Radiological Procedures Certificate.

Skills & Competencies

Technical & Professional Expertise


'Has command over the technical / professional skills and knowledge required within the job holder's role and continues to upskill to maintain high professional standards and continuous professional development requirements'. 


Clinical Nurse Specialist (Dermatology) will:


  • Practice in accordance with relevant legislation and with regard to The Scope of Nursing & Midwifery Practice Framework (Nursing and Midwifery Board of Ireland, 2015) and the Code of Professional Conduct and Ethics for Registered Nurses and Registered Midwives (Nursing and Midwifery Board of Ireland, 2014)
  • Maintain a high standard of professional behaviour and be professionally accountable for actions/omissions. Take measures to develop and maintain the competences required for professional practice
  • Adhere to the Nursing & Midwifery values of Care, Compassion and Commitment (DoH, 2016)
  • Adhere to national, regional and local HSE PPPGs
  • Adhere to relevant legislation and regulation
  • Adhere to appropriate lines of authority within the nurse/midwife management structure.


Clinical Nurse Specialist (Dermatology) will demonstrate:


  • In-depth knowledge of the role of Clinical Nurse Specialist (Plastics/Dermatology)
  • In-depth knowledge of the pathophysiology of the skin.
  • The ability to undertake a comprehensive assessment of the patient with dermatological condition, including taking an accurate history of their skin condition and presenting problem
  • The ability to employ appropriate diagnostic interventions including: Phototherapy skin testing and biological medication administration to support clinical decision making and the patients’ self- management planning.
  • The ability to formulate a plan of care based on findings and evidence based standards of care and practice guidelines
  • The ability to follow up and evaluate a plan of care
  • Knowledge of health promotion principles/coaching/self-management strategies that will enable people to take greater control over decisions and actions that affect their health and wellbeing
  • An understanding of the principles of clinical governance and risk management as they apply directly to Clinical Nurse Specialist (Plastics/Dermatology) role and the wider health service
  • Evidence of teaching in the clinical area
  • A working knowledge of audit and research processes
  • Evidence of computer skills including use of Microsoft Word, Excel, E-mail, PowerPoint


Communication and Interpersonal Skills


'Speaks and writes clearly, fluently and effectively to both individuals and groups; communicates in a manner that will persuade, convince and influence others, in order to motivate, inspire or encourage them to follow a particular course of action'.


  • Effective communication skills
  • Ability to build and maintain relationships particularly in the context of MDT working
  • Ability to present information in a clear and concise manner
  • Ability to manage groups through the learning process
  • Ability to provide constructive feedback to encourage future learning
  • Effective presentation skills.


Resource Management


'Manages and utilises the organisations resources in the most effective manner to maximise the value for money proposition and to identify costs cavings where posible'. 


  • Evidence of effective organisational skills including awareness of appropriate resource management
  • Ability to attain designated targets, manage deadlines and multiple tasks
  • Ability to be self-directed, work on own initiative
  • A willingness to be flexible in response to changing local/organisational requirements.


Leadership & Management 


'Manages performance to deliver team goals; demonstrates accountability for leading, directing, monitoring and evaluating RSCI Hospital Group services. Creates a climate in which people want to do their best. Promotes confidence and positive attitude; influences others to follow a common goal'.

  • Leadership, change management and team management skills including the ability to work with MDT colleagues.


Commitment to Quality & Risk Management


'The ability to focus on understanding stakeholder's needs and expectations and to respond effectively and efficiently to them. Has a good knowledge and is committed to offer a quality service through the achievement of goals, accreditation standards, other organisation / department standards and risk management frameworks and guidelines'. 


  • Awareness and respect for the patient’s views in relation to their care
  • Evidence of providing quality improvement programmes
  • Evidence of conducting audit
  • Evidence of motivation by on-going professional development.


Analytical Skills


'Uses a logical reasoning process to break down and analyse information and data to support effective decision making and other related processes'


  • Effective analytical, problem solving and decision making skills


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