Job Description

Position:

Permanent Full-Time (1.0 FTE) Registered Nurse - Geriatric Outreach Team

Reports To:

Manager of Specialized Programs & Services

Position Summary:

As a key member of the Couchiching Family Health Team (CFHT), and an integral part of an interdisciplinary health care team, you will deliver nursing care in accordance with FHT policies and professional practice standards.

The Geriatric Nurse is a specialist in geriatric care and is responsible for the planning, coordination and delivery of services to patients who are seniors and their families and caregivers. Working in collaboration with an interdisciplinary team, the Geriatric Nurse will share expertise and knowledge of health promotion and disease prevention, helping to connect patients with appropriate services and professionals.

Roles and Responsibilities: Assessment:

Screen, prioritize and process client referrals to the designated program

Review client clinical information obtained through the physician or IHP referral, laboratory results and health records

Conduct consultations with clients/family to obtain relevant information and assess client/family learning's and

needs

Conduct home visits

Complete Comprehensive Geriatric Assessments (CGA's)

Complete Coordinated Care Plans for clients in the program

Planning:

In collaboration with the Family Physician and other members of the interdisciplinary team, develop and discuss appropriate individualized care plan with the client/family/caregiver based on best practices

Partner with community resources in developing goals and objectives and help guide the family and client to the necessary services available

Provide ongoing case management for patients identified as at risk and enrolled in the geriatric program

Collaborate with the Geriatrician to deliver effective primary care

Recommend and teach client's treatment protocols and education as required

Document all health notes into the EMR daily and arrange necessary follow up

Reporting:

The Geriatric RN will report directly to the Team Lead, Complex Care Team

Prepare monthly statistical reports to be submitted to Ontario Health as needed

Team Development:

Work effectively within an interdisciplinary team

Promote awareness of the FHT's program and services

Actively participate in staff, team, and committee meetings, if appropriate

Participate in the development, planning and evaluation of treatment, education, counselling, and health promotion activities of the FHT

Professional Development:

Maintain and develop professional competence through ongoing professional development

Fully participate in the Quality Assurance Program of the College of Nurses of Ontario

Stay current and aware of opportunities to implement new, evidenced based methods of client assessment, treatment, and programming

Participate in clinical projects as required

Skills/Knowledge Requirements:

Team player, demonstrated ability to engage in truly collaborative practice with Interprofessional colleagues both across the FHT, multidisciplinary members and the physician office teams

Superior leadership, organization, evaluation, time management, communication, and interpersonal skills

Proficiency in the use of computer hardware and software, particularly in Microsoft word, excel, outlook and electronic medical records

Works in compliance with Health and Safety laws adhering to safe work practices and procedures established by the CFHT

Excellent verbal and written communication

Demonstrated ability to work well autonomously

Adaptable to change

Knowledge in current, evidence-based methods and practice of primary care delivery

Excellent oral/written/interpersonal skills

Other duties as required

Education/Specific Job Requirements:

Baccalaureate of Science in Nursing required

Current registration with the CNO

Gerontological Nursing Certification preferred

Current membership with the RNAO preferred

Basic CPR

Current Ontario Driver's License and access to reliable vehicle for travel to various communities

Provide evidence of a clean driver abstract and proof of insurance

Able to work flexible hours including evenings if required

Police Record/Vulnerable Record Check

It is a condition of employment that you receive 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 from time to time

Experience:

Minimum 3-5 years experience in a community and/or Primary Health Care setting with a focus on geriatric care

The Couchiching Family Health Team supports diversity, equity and a workplace free from harassment and discrimination. The CFHT is committed to an inclusive, barrier- free recruitment and selection process and workplace. If you are contacted to participate in our recruitment process, please advise the interview coordinator of any accommodations. The CFHT has an Accommodation Policy and Procedure to ensure you have access to a fair and equitable process. While we thank all applicants, only those contacted for an interview will be acknowledged.

Please submit cover letter and resume including position title in subject line to careers@cfht.ca

Job Types: Full-time, Permanent

Pay: $73,000.00-$78,000.00 per year

Work Location: In person