Transcript Development of practice and career pathways in marginalised

Nursing in Contexts
of
Marginalised Health
Conference DCU 2015
‘Development of practice and career
pathways in marginalised health nursing’
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Definition?
Who/What is a Marginalised group?
those with no recourse to public funds
asylum seekers and refugees
care leavers
people who experience homelessness (particularly rough
sleepers)
people living in remote rural areas
people with mental health problems
people with learning disabilities
people with physical disabilities
substance mis users
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Irish travellers, Roma travellers
ethnic or religious minorities
sex workers
non-English speaking linguistic minorities
those in severe and persistent poverty
migrant workers
those in severely deprived neighbourhoods
old people
men/women suffering domestic violence
Prisoners and ex-offenders
Health management
• Outreach and case finding & management
• Develop trusting non judgemental relationships
that conveys compassion, respect, dignity and
value
• Physical & Psychosocial assessment
• Illicit drug use, risky sexual behaviours
• Mental health issues
• Counselling
• Identify their talents and strengths to enable
recovery
Nurse led health services
• Clinical care: working in outreach and case
management (direct & indirect)
• Acting as a liaison between homeless and all
others (consultant)
• Provides screening, prevention, early intervention
clinical interventions, medications & health
promotion
• Advocacy : be their voice
• Care planning, Discharge planning, care pathways
Professional Accountability &
Scope of Practice
• The scope of nursing practice is the range of
roles, functions, responsibilities and
activities which a registered nurse is
educated, competent and has authority to
perform (ABA 2000).
Core Concepts of the CNS/CMS Role
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Clinical Focus (Direct/Indirect Care)
Patient/Client Advocate
Education & Training
Audit & Research
Consultant
Criteria for posts
• The post must arise from an identified health service need
• The post must have a major clinical focus, incorporating
assessment, planning, delivery and evaluation of care given
to patients and their families in hospital, community and
outpatient settings
• The post will allow for its holder, in consultation where
necessary with the interdisciplinary team, to make clinical
decisions based on agreed protocols
• The post will involve working closely with medical,
paramedical and other colleagues
Criteria for Posts
• The post requires that practice should be research and
evidenced based and dissemination of research be
paramount
• The post involves participation in nursing/midwifery
research and audit
• The post involves being an advocate for the patient
• The post involves being a consultant to interdisciplinary
colleagues
• The reporting relationship on professional nursing &
midwifery manager
Criteria for individual CNS/CMS
• The person must be a registered nurse or midwife
• The person must be registered in the division in which the
application is being made
• The person must have extensive experience and clinical
expertise i.e. a minimum of 5 years post registration
experience including a minimum of 2 years experience in
the specialist area
• The person must provide evidence that they engage in
CPD
• The person must have undertaken formal recognised postregistration education relevant to his/her area of specialist
practice at level 8 or above on NQAI framework
Process for Approval of a CNSp/CMSp Post
Identification of
Need for
CNSp/CMSp
Development
of
job description
Patient/client need
Service need
Inclusion in service
Plan to secure
funding
Role description
Level of decision
Making
Outline case load
Scope of Practice
Core Competencies
Send application
form,
Job description and
person specification
Send financial
approval form
Director of Nursing/
Midwifery
Service manager
Director of
Nursing/
Midwifery
Service manager
Director of Nursing/
Midwifery
Director of NMPD
Service manager
Submission of
application to
regional NMPD
NMPD
reviews
application
Review by NMPD
Does this fit with regional plans?
If criteria met Director of
NMPD approves, signs and forwards
to ONMSD designated Area Director
NMPD
Director of NMPD
Application sent to
ONMSD
Review of application by ONMSD
Designated Area Directors NMPD
details entered in record if criteria
met. If details missing or incorrect
further information sought via
NMPD
ONMSD
Process for Approval of the Person into a Post
Advertise approved post
according to local policy
Director of Nursing/Midwifery
ensures individual fulfils all the
criteria outlined by the NCNM
Director of
Nursing/Midwifery
Service Manager
Submission of application
to regional NMPD
Send post holder details to NMPD
Director of
Nursing/Midwifery
NMPD reviews application
Review by NMPD
If criteria met Director of NMPD signs and
forwards to ONMSD
Designated Area Directors NMPD
Director of NMPD
Review of applications by ONMSD
Review application by ONMSD
Designated Area Director NMPD
Details entered in record if criteria met
If details missing or incorrect further
information sought via NMPD
ONMSD