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Community Health Nurse - Registered Nurse- New West Hh
Company | Fraser Health Authority |
Address | New Westminster, British Columbia, Canada |
Employment type | FULL_TIME |
Salary | |
Category | Hospitals and Health Care |
Expires | 2023-07-10 |
Posted at | 11 months ago |
Posted per NBA Article 17.02
- Provides direct client care and identifies other care services required in accordance with applicable guidelines, policies and evidence-based best practice; provides comprehensive explanations of care to the client and family, as appropriate.
- Participates in the orientation and ongoing education of nursing staff and students by providing information and acting as a preceptor as appropriate.
- Establishes a therapeutic relationship with the client through the use of interpersonal and interviewing techniques, in person and/or over the telephone, to ensure the client's choice and autonomy in decision-making and care planning including the client's right to dignity and privacy.
- Provides health counseling to clients including education, self-management, self-monitoring and wellness/health promotion/prevention through a combination of clinic, telephone or home visits; collaborates with other healthcare professionals in clinics, community programs and services to facilitate the flow of information through a variety of settings within the primary & community care network.
- Supports clients and their families before, during and after interprofessional conferences and clinic visits by providing information through their decision-making process regarding treatment options; advocates on behalf of the client/family to support their choices and needs and provides direct care to client within the clinic/community/home as they transition to another program, service or healthcare provider.
- Discusses clinical findings with client/family, in collaboration with the interprofessional team to develops action plans and sets goals directed at clinical needs, self -management, self-care and improved health-related quality of life; accesses system information and resources to review client data such as medical history, progress notes, consultation reports, lab reports and incorporates findings into the care plan; plans, organizes and establishes priorities by using resources effectively and efficiently; responds to unanticipated events and/or changing client or service assignment needs, as needed.
- Develops a comprehensive shared patient/client care plan, in collaboration with the interprofessional team, primary care provider, client and/or family, other healthcare providers and/or referring clinics; facilitates and supports the transition of the client care plan to the referring source, primary/community care provider and/or community agencies.
- Performs other related duties, as assigned.
- As required based on the local community model, makes decisions on client specific direct care tasks; assigns direct client care tasks to Community Health Workers and when appropriate delegates client specific direct care tasks to Community Health Workers; provides in-home demonstrations and training to standards of practice for assigned and delegated client specific tasks; ensures that the Community Health Worker has the necessary knowledge, skills and support to perform the delegated tasks within the clearly defined limits; collaborates with the Community Health Nurse - Licensed Practical Nurse in the monitoring of Community Health Workers performing clients specific delegated direct care tasks.
- Arranges and participates in joint home visits to clients and/or families with other healthcare professionals, as required; provides advice to the client and/or caregiver about available community resources.
- Facilitates care conferencing to review client care plans, in collaboration with the interprofessional team and primary care provider to determine timing and referral to other services and/or interventions to improve client outcomes; initiates, monitors and evaluates the appropriateness and effectiveness of the short and long term care plan to meet specific client goals; develops next steps in collaboration with the client and family; develops and supports a transition process for achieving client care goals across the care continuum including discharge and/or transfer to other services, as required.
- Maintains clinical records such as intake screens, client assessments, clinical interventions, treatment formulations, care plans and progress notes; maintains statistical information on clients in accordance with established policies, standards, and procedures.
- Screens referrals, provides individualized client assessments, interprofessional care planning and interventions including clinical care, when appropriate and referral services for clients with multiple complex chronic conditions; assists clients to achieve an optimal level of function by facilitating timely and appropriate health services and utilizing a variety of resources and services; collaborates with the primary care provider, client, the family/supports/caregivers, other health care professionals, clinics, hospitals and other community resources to identify and resolve client care issues and coordinate the integration of care and services.
- Provides input in the development and revision of standards of care, policies and procedures and advocates for improvements in clinical practice, health care and health care services; participates in the development, implementation and evaluation of quality improvement initiatives within the program by providing recommendations to the Manager.
- Participates in department quality improvement and risk management activities by identifying client care issues and collecting data; participates in research opportunities, as required.
- Maintains professional practice growth, knowledge and expertise to reflect current standards of practice by reviewing relevant literature, attending educational workshops and in-services, consulting and networking with other health care professionals.
- Demonstrated ability to communicate effectively, both verbally and in writing
- Demonstrated ability to complete initial and ongoing client assessments and provide nursing care through therapeutic interventions
- Ability to independently manage and prioritize clients with diverse healthcare issues
- Ability to teach clients and others about topics essential to health care, health promotion and care self-management using care management principles
- Demonstrated knowledge, skills and competence in the areas such as gerontology and adults living with complex frailty and chronic illnesses
- Demonstrated ability to integrate and evaluate pertinent data from multiple sources to problem-solve effectively
- Ability to work effectively in a dynamic environment with changing priorities
- Knowledge of broad health care services, community resources agencies and their role in providing a continuum of care
- Ability to operate related equipment including applicable software applications
- Physical ability to perform the duties of the position
- Ability to work independently and as a member of an interprofessional team
- Ability to promote client-focused care including sensitivity to diverse cultures and preferences
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