CharityVillage

POSITION SUMMARY

The attending NP works with residents, family/caregivers, and the health care team in the development, implementation and evaluation of the resident’s plan of care; provides leadership and mentorship to the Home’s staff to enhance their knowledge, assessment skills and ability to care for residents in place; and leads and collaborates in research, education and evidence-based practice initiatives to optimize resident, Home and health system outcomes.

MAJOR RESPONSIBILITIES

• Provide comprehensive primary care to residents (including Substitute Decision-Makers (SDMs) as appropriate) as part of the multidisciplinary health care team.

• Increase the continuity of care through collaboration, consultation and referral as appropriate:

• Collaborate and consult with attending physicians, the DOC, nursing department staff, multidisciplinary team members and external resources regarding resident plan of care

• Assist, support, guide and provide consultation to the DOC, registered nursing staff and multidisciplinary team members regarding challenging clinical situations

• Make referrals to specialized consultants, services and other health providers

• Accept referrals from multidisciplinary team members.

• Perform a person-centred health assessment of residents on admission, annually, and as needed (including quarterly medication reviews).

• Conduct person-centred comprehensive health histories.

• Engage in regular dialogue with the resident about their care plan.

• Participate in resident care conferences.

• Order or perform appropriate screening and diagnostic investigations, interpret results, and provide follow-up care.

• Diagnose acute and chronic health conditions.

• Manage the care of residents by providing pharmacological, complementary or counselling interventions, and perform procedures within the NP scope of practice.

• Advocate for and provide palliative and end-of-life care.

• Document clinical data, assessment findings, diagnoses, plans of care, therapeutic interventions, resident responses and clinical rationale in a timely and accurate manner.

• Utilize communication and counselling skills to engage residents in dialogue to determine what is important to them for health and quality of life, and to provide person-focused health education.

• Collaborate with the resident to develop a person-centred plan of care.

• Provide outreach and transitional services to residents who return to the community.

• Liaise with discharge planning services for hospitalized residents to ensure a smooth transition back to the Home.

• Participate in providing after hours and on-call coverage in accordance with the Home’s on-call policy.

• Identify, develop and implement practice innovations in collaboration with the Home’s senior leadership team.

• Provide leadership and involve the multidisciplinary team in quality improvement initiatives.

• Provide leadership in developing and implementing strategies to optimize the integration of illness and injury prevention, health promotion, health maintenance, rehabilitation and restorative care activities.

• Provide formal and informal teaching and coaching in the management of clinical care to multidisciplinary team members, serving as a resource person, educator and role model, and contributing to the performance appraisals of registered nursing staff.

• Identify and implement research-based innovations for improving resident care.

• Collaborate with members of the multidisciplinary team or community to identify research opportunities and to conduct or support research.

QUALIFICATIONS

• Current College of Nurses of Ontario registration in the Extended Class (EC) as an NP (adult) or NP (primary health care) required.

• Master’s Degree in Nursing/Nurse Practitioner (MN-NP) or Masters of Science in Nursing with successful completion of a post Master's Nurse Practitioner Diploma from a recognized school of graduate studies required.

• Minimum 2 years of relevant experience in either home/community care, acute care, chronic disease management, health promotion, palliative care or mental health.

• The ability to work independently in an autonomous and self-directed manner within the NP scope of practice.

• Demonstrated clinical leadership experience to manage complex patient and family needs in complex settings with need to liaise with multidisciplinary team and primary care providers.

• Critical thinking, problem solving and analytical skills to navigate challenging situations.

• Ability to be flexible and adaptable with excellent organizational skills.

• Excellent interpersonal and communication skills.

• Ability to work in a team environment.

• Vulnerable sector check (current).

• Post-graduate education and experience in gerontology is an asset.