Job Description

Full-Time - 1.0 FTE

The Dufferin Area Family Health Team (DAFHT) is currently recruiting for

one (1) full-time

Nurse Educator

to join a collaborative team working in a primary care setting, as well as within the Dufferin Caledon community.


The

Registered Nurse Educator

is a vital part of the Dufferin Area Family Health Team (DAFHT) and will collaborate with the physicians and other interdisciplinary providers to achieve the vision and mission of the organization. The

Registered Nurse Educator

will assist the DAFHT in achieving its strategic objectives by supporting the chronic disease management (CDM) program. This role will primarily focus on coordinating the diabetic management component and providing education and support to patients with their self-management within this program. Additionally, the

Registered Nurse Educator

will support some patients with other chronic health conditions and serve as a resource for team members regarding best-practice guidelines and approaches.

DUTIES AND RESPONSIBILITIES:

Screen, prioritize and process client referrals using information obtained through the physician, laboratory reports and health records. Provide nursing assessment for adult patients living with a chronic disease, considering the patient's level of knowledge, readiness to change, and socio-demographic background. Educate patients and caregivers on chronic disease management, self-management, and lifestyle improvement, for conditions such as diabetes, hypertension, CHF etc. Support some patients with complex needs, including mental health challenges, addictions, homelessness, who also have a medical chronic disease. Develop a health maintenance care plan with patient and health care team by integrating information about the patient's health status, clinical practice guidelines, and available community resources. Be able to identify and prioritize complex health and social issues. Evaluation of the attainment of self-management goals and risk reduction behaviour. Ensure complete, accurate, and timely documentation of program activities and medical records. Communicate information clearly and concisely to clients and healthcare providers regularly. Present health education sessions on various topics related to diabetes and/or CDM in a group setting using established teaching/learning theory principles and lifestyle counselling. Identify and build relationships with various community partners. Present clinical practice guideline updates to healthcare providers and clinical partners. Provide learning opportunities to students, new hires, and colleagues. Recommend improvements to existing procedures/services. Facilitate teamwork and promote group effectiveness. Assist in developing patient programs, identifying priorities, target dates and implementation strategies. Work effectively within an interdisciplinary team. Coordinate the diabetes program, including administration, teaching, clinical responsibilities, collaborating with Pharmaceutical Representatives, evaluation, and continuous quality improvement, using the input of other FHT providers. Manage the inventory of diabetes and CDM supplies. Practice within the scope and according to the standards of practice as outlined by the College of Nurses of Ontario.

SKILLS AND ABILITIES:

Strong knowledge of pathophysiology, related laboratory values, pharmacotherapy, and lifestyle management for various chronic diseases. Strong skills in nursing assessment, evidence-based practice, outreach, health promotion, interdisciplinary collaboration, and problem-solving. Intermediate experience and strength in applying motivational interviewing counselling techniques in an adult population. Extensive experience and strong skills in patient education focused on managing various chronic diseases, including disease overview, lifestyle modifications, medication management, monitoring vital signs, managing blood pressure and cholesterol levels, blood glucose monitoring, medications and insulin management, and maintaining proper hygiene. Experience working under medical directives. Knowledge and proficiency in current, evidence-based methods and practices of primary care delivery. Expertise in developing strategies that successfully meet the needs of diverse patient, family, and provider populations. An understanding of and critical analysis of the determinants of health and social factors. Excellent verbal and written communication skills, with the ability to clearly convey information and ideas. Ability to work effectively with all members of the health care team. Capability to prioritize, manage time effectively and be flexible in a very active work environment. Strong case management skills. Willingness to teach and train other members of the interdisciplinary team or students as required. Exhibit sound clinical judgment concerning treatment recommendations. Superior problem-solving skills and flexibility, with the ability to prioritize, manage time effectively and be flexible in a very active work environment. Work in a manner that preserves privacy and confidentiality. Assist in developing individual patient programs, identifying priorities, target dates and implementation strategies. Manage, review, and make recommendations regarding protocols for the chronic disease education of FHT patients. Understanding and proficiency in developing and conducting educational programs for learners and experience in evaluating learning activities specific to individual performance. Facilitate group educational sessions using established adult teaching/learning theory principles and lifestyle counselling, using principles of adult learning.

EDUCATION/EXPERIENCE:

A Baccalaureate of Science in Nursing (BScN). Current registration in good standing with the College of Nurses of Ontario. Current membership with the Registered Nurses Association of Ontario preferred. Certified Diabetes Educator (CDE) or evidence of working towards attaining preferred. 2 years of experience in supporting and educating adults living with a chronic disease (i.e. hypertension, Diabetes, CHF, etc.) Demonstrated experience in community or primary care settings. Skilled in case management and case coordination with members of the interdisciplinary team and services within the community preferred. Resourcefulness in working with communities and individuals who face barriers accessing traditional health care institutions such as poverty, discrimination, mental health, and substance use issues an asset. Basic CPR certification. Current Ontario Drivers' License. Solid skills and experience using Microsoft applications (Word, Outlook, Excel & PowerPoint). Experience and accuracy using electronic medical records (EMR) (i.e., Telus PS Suites) an asset. Willing to learn new software and to continuously develop technology skills concerning diabetes care is an asset. Up to date COVID vaccination is required.

Working Conditions and Requirements:

This is an in-person, on-site, and community-based role Hours are 37.5 hours per week Current driver's license and reliable vehicle to travel to sites and within community

Why Join Us:

HOOPP Defined Benefit Pension Plan Extended health care benefits including health, dental, vision, critical Illness, and EFAP and EAP program 4 weeks of vacation to start, floater days, paid personal and sick time Organizational commitment to work-life balance

Qualified applicants are asked to forward their cover letter and resume as a combined PDF document to l.barbour@dafht.ca by Friday, October 31st, 2025

We thank all applicants for their interest, however, only those applicants selected for an interview will be contacted.

The Dufferin Area Family Health Team (DAFHT) welcomes and encourages applications from people with disabilities. Accommodations are available on request for candidates taking part in all aspects of the selection process. If you are contacted for a job opportunity, please advise the DAFHT of any accommodations needed to ensure you have access to a fair and equitable process. Any information received relating to accommodation will be addressed confidentially. The DAFHT is committed to an inclusive, barrier-free recruitment and selection process and work environment.