Job Specification & Terms and Conditions
Job Title and Grade
Clinical Nurse Specialist in Rheumatology
Specified Purpose only
Campaign Reference
RQ1014
Closing Date
Friday 29th August 2025
Proposed Interview Date
Week of 8th September 2025
Whole Time equivalent hours
37.5 hours 1 WTE, Monday to Friday (No weekends)
Taking up Appointment
To be confirmed
Location of Post
Peamount Healthcare
Reporting relationship
Assistant Director of Nursing / Director of Nursing
Details of service/background to post
Peamount Healthcare is an independent voluntary organisation that provides a range of high-quality health and social care services. We help people return home after a serious illness, we provide safe and homely residential care for those who need it, and we support people to live as independently as possible in the community.
Peamount Healthcare Services include -
Neurological Rehabilitation Services
Neurological Disability Services
Age Related Rehabilitation and Residential Services
Respiratory Services including Rehabilitation and Sleep services
Residential Services for Older adults with an Intellectual Disability
Community Outpatients Services
Specific Clinical Area:
Rheumatology is the medical speciality caring for patients with musculoskeletal disease. The service is a consultant led service that provides expert outpatient and inpatient services in the diagnosis, treatment, management and Rehabilitation of patients.
Inpatient Services:
This service includes a 10 bedded inpatient unit on a Monday to Friday basis. Admissions to the unit are elective, arranged through OPD services or transfers from acute hospital services.
The setting of care is rehabilitative. The ethos of care is rehabilitation, optimisation and access to multidisciplinary services to enhance the quality of life of patients with a musculoskeletal disease.
Outpatient Services:
Consultant led outpatient clinics.
Infusion clinics for Rheumatology patients
Rehabilitation led by the Multidisciplinary Team
Multidisciplinary Team services
Diagnostics including bloods, Xray, Pulmonary Function and Respiratory Services
Aligned to the Rehabilitation services is a Pulmonary Function Laboratory, a Radiology department and Gymnasium for Rehabilitation.
The Service users in Peamount Healthcare present with complex medical, psychological and social care needs that are identified and supported through assessment.
Interventions are developed to prevent, treat, or manage complex symptoms, in keeping with the "Strategic Framework for Role Expansion of Nurses & Midwives Promoting Quality Patient Care" (NMBI 2011). The appointment of the CNSp is an essential element in the provision of effective, high quality, integrated care for patients with A Neurological Condition requiring Rehabilitation.
The application of specialty focused knowledge and skills of the Clinical Nurse Specialist (CNSp.) in Rheumatology will provide for the care and on-going management of patients with Rheumatology and Rheumatology conditions. The post holder will be required to work as a key member of the multi-disciplinary team in the organisation providing physical, psychological and emotional support to patients and their families/carers throughout their rehabilitation and treatment journey. She / he will act as a liaison between Rheumatology Services in Peamount Healthcare, Primary Care, Community services and other agencies.
The CNSp in Rheumatology is supported by the Rheumatology Consultant and the Multidisciplinary team. The CNSp manages a caseload of patients presenting with musculoskeletal disease both as inpatients and on an outpatient basis. This service is delivered in collaboration with the Multidisciplinary Team (MDT) in accordance with best practice standards, (HIQA, 2016)
Purpose of the Post
The purpose of this Clinical Nurse Specialist (Rheumatology) post is to provide pivotal role co-ordinating patient care and managing activity and resources within the clinical area. The main responsibilities are managing a patient case load, planning assessing and treating patients in consultation with the Rheumatology team using best evidence-based practise.
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.
The successful candidate will work as a key member of the multidisciplinary (Rheumatology) team providing a patient / client centred quality service to patients / clients and this specialist practice will encompass a major clinical focus which comprises assessment, planning, delivery and evaluation of care given to patients / clients and their families.
Specific to the role of the Clinical Nurse Specialist in Rheumatology is to provide specialist nursing support and care to adults with Neurological conditions requiring rehabilitation.
The aim is to help them achieve an optimum level of health with Rheumatology and supports.
Provide comprehensive care under the care of the Rheumatology team during inpatient and outpatient attendances.
Provide specialist clinical advice and support to patients attending the service.
Be the key hospital contact person within the Rheumatology service.
Contribute to the evidence-based improvement of the health care experience and outcomes for the individual.
Provide appropriate health and services education to the patient and health professionals.
Liaise with other hospitals, service providers, respite services,
palliative care providers and relevant community services to ensure the patient is linked with necessary, services and supports.
Act as the patient's advocate when appropriate
Link with members of MDT in Peamount Healthcare and across the hospital and community services for musculoskeletal disease.
The primary focus of the post holder will be to ensure that Adults with musculoskeletal disease receive timely and appropriate care through assessment, planning, implementation and evaluation of care delivery.
The Clinical Nurse Specialist in Rheumatology's caseload is a broad role covering all aspects of Rheumatology care for patients with a musculoskeletal condition during outpatient and in-patient treatment
Co-ordinating and providing care and support to the patient and their family.
Co-ordinating meetings and follow-up appointments
Discharge planning, and management of waiting lists
Role Responsibilities
The person holding this post is required to support the principle that the care of the patient comes first at all times and will approach their work with the flexibility and enthusiasm necessary to make this principle a reality for every patient to the greatest possible degree.
Maintain throughout the hospital awareness of the primacy of the patient in relation to all hospital activities.
Performance management systems are part of role and you will be required to participate in the Group's performance management programme.
The post holder's practice is based on the five core concepts of Clinical Nurse Specialist (Rheumatology ) role as defined by the NCNM 4th edition (2008) in order to fulfil the role. The concepts are:
Clinical Focus
Patient/Client Advocate
Education and Training
Audit and Research
Consultant
Clinical Nurse Specialist (Rheumatology) 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 Focus:
Clinical Nurse Specialist (Rheumatology) 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.
Direct Care:
Clinical Nurse Specialist (Rheumatology) will:
Provide a specialist nursing service for adults with musculoskeletal conditions who require support and treatment through the continuum of care
Undertake comprehensive individual care needs assessment to include physical, psychological, social and spiritual elements of care using best evidence-based practice in Rheumatology care
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 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 polypharmacy and support medical and pharmacy staff with medication reviews and medication management
Be the key co-ordinator for patients with complex needs who attend the Rheumatology service, whilst they are an inpatient.
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 Rheumatology 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:
The Clinical Nurse Specialist in Rheumatology will:
Identify and agree appropriate referral pathways to Rheumatology services.
Participate in case review with MDT colleagues
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 musculoskeletal care
Take a lead role in ensuring the service for patients with musculoskeletal conditions is in line with best practice guidelines and the Safer Better Healthcare Standards (HIQA, 2012)
Patient Advocate
The Clinical Nurse Specialist in Rheumatology will:
Communicate, negotiate and represent patient's 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, on behalf of the patient, clear patterns for communicating and working together with medical, ward staff and other healthcare professionals such as general practitioners, community health services, area medical officers, community pharmacists, public health
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 and Training
The Clinical Nurse Specialist in Rheumatology will:
Maintain clinical competence in patient management within Rheumatology 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 musculoskeletal condition.
Contribute to the design, development and implementation of education programmes and resources for the patient, family and/or carer in relation to musculoskeletal l conditions.
Provide mentorship and preceptorship for nursing colleagues as appropriate.
Participate in training programmes for nursing, MDT colleagues and key stakeholders as appropriate
Create exchange of learning opportunities within the MDT in relation to evidence-based Rheumatology 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 Rheumatology.
Be responsible for addressing own continuing professional development needs
Audit & Research:
The Clinical Nurse Specialist in Rheumatology will:
Establish and maintain a register of patients requiring Rheumatology specialist services within the Clinical Nurse Specialist Caseload.
Maintain a record of clinically relevant data aligned to National Key Performance Indicators (KPI's) as directed and advised by the DON.
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 Rheumatology care into practice
Contribute to nursing research on all aspects of Rheumatology care.
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
Consultant:
The Clinical Nurse Specialist in Rheumatology will:
Provide leadership in clinical practice and act as a resource and role model for Rheumatology 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 National Rheumatology Clinical Nurse Specialist's/Registered Advanced Nurse/Midwife 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's in Rheumatology care 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.
The Clinical Nurse Specialist in Rheumatology will:
- Participate and cooperate with legislative and regulatory requirements regarding 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 Peamount Healthcare's Complaints Policy
Ensure completion of incident/near miss forms and clinical risk report on Vi Clarity.
Adhere to organisational policies in relation to the care and safety of any equipment supplied and used to carry out the responsibilities of the role of CNS in Rheumatology.
- Contribute to the development of policies, procedures, guidelines and safe professional practice and adhere to relevant legislation, regulations and standards.
- Have knowledge of the Health Information and Quality Authority (HIQA) Standards as they apply to the role.
- Ssupport, promote and actively participate in sustainable energy, water and waste initiatives to create a more sustainable, low carbon and efficient health service.
Management
The Clinical Nurse Specialist in Rheumatology will:
- Provide an efficient, effective, and high-quality service, respecting the needs of each service user.
- Effectively manage time and caseload to meet the needs of a changing and developing service.
- Continually monitor the service to ensure it reflects current needs.
- Implement and manage identified changes.
- Ensure that confidentiality in relation to resident /client records is maintained.
- Maintain accurate and up to date statistics of the service provided, including audit of resident / client contacts.
- Represent the specialist service at local, national and international meetings as required.
- Maintain accurate and contemporaneous records / data on all matters pertaining to the planning, management, delivery and evaluation of this service in line with organisational requirements.
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.
Eligibility Criteria
Qualifications and/ or experience
Candidates must, on the latest date for receipt of completed application forms for the post, possess:
1. Professional Qualifications, Experience, etc.
(a) I) Be a registered nurse on the active Register of Nurses or Midwives held by Nursing and Midwifery Board of Ireland or be eligible to be so registered
And
(b) II) Be registered in General Division of the register of Nurses and Midwives in which the application is being made
Or
In exceptional circumstances, which will be assessed on a case by case basis be registered in another Division of the register of Nurses and Midwives
And
III) 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 Rheumatology prior to application.
Or
IV) Can demonstrate in writing that they have achieved the number of ECTS credits equivalent to a Level 8 or higher standard, relevant to the specialist area of Rheumatology prior to application
And
V) 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
And
VI) Have a minimum of 2 years' experience in specialist area of Rheumatology Nursing
And
VII) Demonstrate evidence of continuing professional development
(b) Have the ability to practice safely and effectively fulfilling his/her professional responsibility within his/her scope of practice
2. Health
A candidate 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.
3. Character
Each candidate for and any person holding the office must be of good character.
4. Age
Age restrictions shall only apply to a candidate where he/she is not classified as a new entrant (within the meaning of the Public Service Superannuation 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.
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 Cnaimhseachais na hEireann (Nursing and Midwifery Board of Ireland).
Post Specific Requirements
Demonstrate depth and breadth of nursing experience in the specialist area of Rheumatology Nursing as relevant to this post.
Other requirements specific to the post
Access to appropriate transport.
Skills, competencies and/or knowledge
Candidates must demonstrate:
Practitioner competence and professional credibility - demonstrates a high level of clinical knowledge to effectively carry out the duties and responsibilities of the role.
The ability to lead on clinical practice and service quality.
Promotion of evidence-based decision making; evidence-based clinical knowledge in making decisions regarding patient / client care.
The ability to plan and manage resource effectively.
Effective analytical, problem solving and decision-making skills.
Strong interpersonal skills including the ability to build and maintain relationships.
Effective communication and influencing skills.
Initiative and innovation in the delivery of service.
Resilience and composure.
Openness to change.
Integrity and an ethical stance.
A commitment to continuing professional development.
The ability to relate nursing research to nursing practice.
Knowledge of quality assurance practices and their application to nursing procedures.
Awareness of relevant legislation and policy e.g. legislation relevant to the service area, health and safety, infection control etc.
Awareness of current and emerging nursing strategies and policies in relation to the clinical / designated area.
Awareness of the Health Service Transformation Programme.
A willingness to develop IT skills relevant to the role.
Campaign Specific Selection Process
Ranking/Shortlisting / Interview
A ranking and or shortlisting exercise may be carried out on the basis of information supplied in your application form. The criteria for ranking and or shortlisting are based on the requirements of the post as outlined in the eligibility criteria and skills, competencies and/or knowledge section of this job specification. Therefore it is very important that you think about your experience in light of those requirements.
Failure to include information regarding these requirements may result in you not being called forward to the next stage of the selection process.
Those successful at the ranking stage of this process (where applied) will be placed on an order of merit and will be called to interview in 'bands' depending on the service needs of the organisation.
The reform programme outlined for the Health Services may impact on this role and as structures change the job description may be reviewed.
This job description is a guide to the general range of duties assigned to the post holder. It is intended to be neither definitive nor restrictive and is subject to periodic review with the employee concerned.
Terms & Conditions of Employment
Peamount Healthcare, Newcastle, Co. Dublin.
Tenure
The Current Vacancy available is Full-Time Specified Purpose.
The post is pensionable. A panel may be created from which permanent and specified purpose vacancies of full or part time duration may be filled. The tenure of these posts will be indicated at "expression of interest' stage.
Appointment as an employee of Peamount Healthcare is governed by the Health Act 2004 and the Public Service Management (Recruitment and Appointment) Act 2004.
Remuneration
Remuneration is in accordance with the salary scale approved by the Department of Health:
Current salary scale with effect from 1st August 2025: €61,463 (Point 1) to €77,666 (Point 11) (LSI)
Working Week
The hours allocated to this post are 37.5 hours per week as a standard working day. The allocation of these hours will be at the discretion of the Department Head and in accordance with the needs of the service.
HSE Circular 003-2009 "Matching Working Patterns to Service Needs (Extended Working Day/Week Arrangements); Framework for Implementation of Clause 30.4 of Towards 2016" applies. Under the terms of this circular, all new entrants and staff appointed to promotional posts from Dec 16th 2008 will be required to work agreed roster / on call arrangements as advised by their line manager. Contracted hours of work are liable to change between the hours of 8am-8pm over seven days to meet the requirements for extended day services in accordance with the terms of the Framework Agreement (Implementation of Clause 30.4 of Towards 2016
Annual Leave
As per Health Service Executive (HSE)
Probation
All employees will be subject to a probationary period as per the probation policy. This policy applies to all employees irrespective of the type of contract under which they have been employed. A period of 6 months' probation will be served:
On commencement of employment.
Fixed term to permanent contract.
Permanent employees commencing in promotional posts will also undertake a probationary period relating to their new post.
Pension
Employees of Peamount Healthcare are required to be members of the Hospitals Superannuation Scheme. Deductions at the appropriate rate will be made from your salary payment.
If you are being rehired after drawing down a public service pension your attention is drawn to Section 52 of the Public Services Pension (Single and Other Provisions) Act 2012. The 2012 Act extends the principle of abatement to retired public servants in receipt of a public service pension who secure another public service appointment in any public service body.
Maternity
Maternity leave is granted in accordance with the terms of the Maternity Protection Acts 1994 and 2001.
Sick Leave
Peamount Healthcare operates a Sickness Absence Management policy in line with the new Public Service Sick Leave Scheme as introduced in 31st March 2014. An employee cannot avail of paid sick leave during their first 12 months of employment with the hospital.
Pre-Employment Health Assessment
Prior to commencing in this role a person will be required to complete a form declaring their health status which is reviewed by the hospital's Occupational Health Service and if required undergo a medical assessment with this department. Any person employed by Peamount Healthcare 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.
Validation of Qualifications & Experience
Any credit given to a candidate at interview, in respect of claims to qualifications, training and experience is provisional and is subject to verification. The recommendation of the interview board is liable to revision if the claimed qualification, training or experience is not proven.
References
Peamount Healthcare will seek up to two written references from current and previous employers, educational institutions or any other organisations with which the candidate has been associated. The hospital also reserves the right to determine the merit, appropriateness and relevance of such references and referees.
Garda Vetting
Peamount Healthcare will carry out Garda vetting on all new employees. An employee will not take up employment with the hospital until the Garda Vetting process has been completed and the hospital is satisfied that such an appointment does not pose a risk to clients, service users and employees.
Health & Safety
These duties must be performed in accordance with the hospital health and safety policy. 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. Staff must carry out their duties in a safe and responsible manner in line with the Hospital Policy as set out in the appropriate department's safety statement, which must be read and understood.
Quality, Risk & 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 external agencies on safety initiatives as required.
- Participate and cooperate with internal and external evaluations of hospital structures, services and processes as required, including but not limited to:
- National Standards for Safer Better Healthcare.
- National Standards for the Prevention and Control of Healthcare Associated Infections.
- HSE Standards and Recommended Practices for Healthcare Records Management
- Safety audits and other audits specified by the HSE or other regulatory authorities.
- To initiate, support and implement quality improvement initiatives in their area which are in keeping with the hospitals continuous quality improvement programme.
It is the responsibility of all managers to ensure compliance with regulatory requirements for Quality, Safety and Risk within their area/department
Specific Responsibility for Best Practice in Hygiene
Hygiene in healthcare is defined as "the practice that serves to keep people and the environment clean and prevent infection. It involves preserving one's health, preventing the spread of disease and recognizing, evaluating and controlling health hazards."
It is the responsibility of all staff to ensure compliance with hospital hygiene standards, guidelines and practices.
Department heads/ managers have overall responsibility for best practice in hygiene in their area.
It is mandatory to complete hand hygiene training every 2-years and sharps awareness workshops yearly.
Mandatory Training
It is employee's responsibility to ensure that all mandatory training is up to date and completed. This includes online education which should be completed on HSEland.