Nurse Practitioner

POSITION SUMMARY

The Nurse Practitioner (NP) is an integral member of the LTCH interprofessional health care team. The Nurse Practitioner will be responsible for the planning, coordination and delivery of care to LTCH residents in collaboration with the Most Responsible Practitioner (MRP). Nurse Practitioners are accountable for their own practice and provide comprehensive health assessment, diagnose health/ illness conditions, and treat and manage acute and chronic illness within a holistic model of care. Nurse Practitioners order and interpret screening and diagnostic tests, perform procedures and prescribe medications in accordance with federal & provincial legislation and policy. The Nurse Practitioner will provide clinical and educational support to residents, staff and family members and facilitate community care connections across the health care sectors for residents requiring complex care services. The NP will work in collaboration with the LTCH nurse leadership and the medical director(s).

DUTIES AND RESPONSIBILITIES (not listed in order of priority)

Clinical Practice

1. Practise in accordance with federal and provincial legislation, professional and ethical standards, and policy relevant to the nurse practitioner practice.

2. Incorporate knowledge of diversity, cultural safety and determinants of health in the assessment, diagnosis and therapeutic management of residents and in the evaluation of outcomes.

3. Incorporate knowledge of developmental and life stages, pathophysiology, psychopathology, epidemiology, environmental exposure, infectious diseases, behavioural sciences, demographics and family processes when performing health assessments, making diagnoses and providing overall therapeutic management.

4. Incorporate knowledge of the clinical manifestations of normal health events, acute illness/ injuries, chronic diseases, comorbidities and emergency health needs, including the effects of multiple etiologies in the assessment, diagnosis and therapeutic management of residents and in the evaluation of outcomes.

5. Provide resident diagnostic information and education that are relevant, theory-based and evidence informed, using appropriate teaching/learning strategies.

6. Promote safe resident care by mitigating harm and addressing immediate risks for residents and others affected by adverse events and near misses.

7. Disclose the facts of adverse events to residents, and report adverse events in keeping with relevant legislation and organizational policies.

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

9. Adhere to federal and provincial legislation, policies and standards related to privacy, documentation and information management (this applies to verbal, written or electronic records).

Collaboration, Consultation and Referral.

10. Consult with and/or refer residents to other health-care providers at any point in the care continuum when the residents’ condition is not within the nurse practitioner scope of practice or the individual nurse practitioner’s competence.

11. Collaborate with members of the home interprofessional health care team to provide and promote interprofessional resident-centred care.

12. Apply advanced knowledge and skills in communication, negotiation, coalition building, change management and conflict-resolution, including the ability to analyze, manage and negotiate conflict.

Research.

13. Engage in evidence-informed practice by critically appraising and applying relevant research, best practice guidelines and theory when providing health-care services.

14. Identify and implement research-based innovations for improving resident care at the individual & organizational levels.

15. Identify, collect data on, and evaluate the outcomes of, nurse practitioner practice for residents and the health-care system.

16. Collaborate with other members of the health-care team or the community to identify research opportunities and to conduct and/or support research.

Leadership.

17. Integrate the principles of resource allocation and cost-effectiveness into clinical decision-making.

18. Provide leadership in the management of clinical care and is a resource person, educator and role model.

19. Act as a preceptor, mentor and coach to nursing colleagues, other members of the health-care team and students.

20. Advocate for and participate in creating an organizational environment that supports safe resident care, collaborative practice and professional growth.

21. Guide, initiate and provide leadership in the development and implementation of standards, practice guidelines, quality assurance, education and research initiatives.

22. Participate in LTCH care conferences, Medical Advisory & Program Advisory Committee meetings.

23. Engage in ongoing professional development and accept personal responsibility for maintaining nurse practitioner competence.

Health Assessment and Diagnosis.

24. Perform a focused health assessment and/or an advanced comprehensive health assessment, using and adapting assessment tools and techniques based on resident needs and relevance to resident stage of life.

25. Perform a complete or focused health history appropriate to the resident’s situation, including physical, psychosocial, emotional, ethnic, cultural and spiritual dimensions of health.

26. Synthesize health assessment information using critical inquiry and clinical reasoning to diagnose health risks and states of health/illness.

27. Order and/or perform screening and diagnostic investigations, interpret results using evidence-informed clinical reasoning and critical inquiry, and assume responsibility for follow-up.

28. Diagnose diseases, disorders, injuries and conditions, and identify health needs, while considering the resident’s response to the health/illness experience.

29. Communicate with residents, health care team and/or family caregivers as appropriate about health assessment findings and/or diagnosis, including outcomes and prognosis

Therapeutic Management.

30. Create an environment in which effective communication of diagnostic and therapeutic intervention can take place.

31. Explore therapeutic options, considering implications for residents through the integration of resident information and evidence-informed practice.

32. Determine care options and initiate therapeutic interventions in collaboration with residents, care givers and SDM’s while considering resident perspectives, feasibility and best outcomes.

33. Support, educate, coach and counsel residents regarding diagnoses, prognoses and self-management, including their personal responses to diseases, disorders, conditions, injuries, risk factors, lifestyle changes and therapeutic interventions.

34. Perform invasive/non-invasive procedures for the clinical management and/or prevention of disease, injuries, disorders or conditions.

35. Prescribe pharmacotherapy based on the resident’s health history, disease, disorder, condition and stage of life, and individual circumstances.

36. Counsel residents and care givers on medication therapy, benefits, potential side effects, interactions, importance of compliance and recommended follow-up.

37. Intervene, as appropriate, when potential or actual problematic substance use and/or misuse of drugs, including complementary and alternative therapies, is identified.

38. Prescribe and/or dispense drugs in accordance with provincial and/or federal standards and legislative requirements.

39. Monitor, evaluate and revise the plan of care and therapeutic intervention based on current evidence-informed practice and on resident goals, preferences, health status and outcomes

Health Promotion and Prevention of Illness and Injury.

40. Assess, identify and critically analyze information from a variety of sources to determine resident and/or population trends and patterns that have health implications.

41. Initiate or participate in the development of strategies to address identified resident and/or population health implications.

42. Initiate or participate in the design of services/interventions for health promotion, health protection, and the prevention of injury, illness, disease and complications.

43. Initiate or participate in the development and implementation of evaluation processes, including identification of indicators for ongoing monitoring of strategies, services and interventions.

44. Work in compliance with Health & Safety laws adhering to safe work practices and procedures established by the County of Simcoe.

45. Other duties as assigned.

CORPORATE COMPETENCIES

Has knowledge of and demonstrated ability in our corporate competencies:

• Acts with the Customer in Mind

• Ensures Accountability

• Continuously Seeks to Improve Work Processes

• Collaborates

• Communicates with Impact

• Is Resilient

EDUCATION, TECHNICAL SKILLS AND CERTIFICATION

• Baccalaureate Degree in Nursing.

• Nurse Practitioner Diploma (Primary Care or Adult).

• Current registration with the College of Nurses of Ontario as an RN-EC (extended class) Adults or Primary Care.

• Affiliation with Registered Nurses Association of Ontario (RNAO) or Nurse Practitioner Association of Ontario (NPAO) with PLP or equivalent.

• Certification in CPR (BLS-C).

• Post graduate Nurse Practitioner certification for Palliative Care and Gerontological care preferred.

• Current Ontario Driver’s License and access to reliable vehicle for travel.

• Able to work flexible hours including evenings and weekends if required.

• Criminal Records Check with Vulnerable Sector Screening that is less than six (6) months old at time of hire.

• As a condition of employment, candidates are required to submit documented results of TB testing, as per Public Health requirements.

• As a condition of employment, candidates are required to submit documented proof of the necessary vaccinations to protect against infection of COVID-19 or any similar infectious diseases, which may be recommended by governmental and public health authorities.

EXPERIENCE

• Preference will be given to candidates with 2-3 years clinical experience as a Nurse Practitioner, preferably with the geriatric population.

• Highly experienced with therapeutic management, health assessment and diagnosis, and competence in emotional assessment to assist MRP with developing an appropriate plan of care as per resident or substitute decision maker (SDM) wishes.

• Experience with Point Click Care an asset.

• Wound Care specialization an asset.

• Demonstrated ability to work effectively as a member of an inter-professional team, with excellent interpersonal and communication skills.

• Exceptional documentation skills and attention to detail.

• A positive and professional attitude.

• Excellent time management skills with an ability to multi-task and effectively set priorities.

• Demonstrated and comprehensive understanding of ethical decision-making principles, palliative care philosophy, and quality end of life care planning.

• Demonstrated working knowledge of community resources, specifically for older adults and palliative care.

EFFORT

• Some physical effort is required when assessing/diagnosing/caring for residents.

• Frequent walking, standing.

• Visual and mental effort required when assessing residents and completing charts.

WORKING CONDITIONS

• This position is located in a long-term care facility, exposure to illnesses is possible on a daily basis.
• Work schedule to be determined; shifts may include days, evenings, nights and weekends.