NSFHT RN

The North Simcoe Family Health Team (NSFHT) provides education and support services to patients with chronic illness. We strive to promote healthy living and prevention of complications by enhancing self-management practices and care.
The NSFHT (Midland, ON) is seeking a dedicated and compassionate individual to join our Seniors Program. This role involves working with seniors to enhance their quality of life by promoting independence through therapeutic interventions and adaptive techniques.
 

Registered Nurse, Seniors Program
Permanent, Full-time
$74,148.00 annually
Benefits: HOOPP and Health & Dental
 

Key Responsibilities:

Conduct comprehensive health assessments for elderly patients.
Develop and implement individualized care plans.-
Monitor and manage chronic conditions, coordinating with the multidisciplinary team.
Provide health education and support to patients and their families.
Ensure compliance with all healthcare regulations and standards.
Implement treatment programs aimed at improving seniors’ physical, mental, and emotional well-being.
Monitor and document clients’ progress and adjust treatment plans as needed.
Participate in community outreach programs and workshops to promote wellness among seniors.
 

Qualifications:

Baccalaureate of Science in Nursing-
Current registration with the College of Nurses of Ontario.
Experience in geriatric nursing preferred.
Strong communication and interpersonal skills.
Ability to work independently and as part of a team.
CPR and First Aid certification.
 

Benefits:

Competitive salary and benefits package, HOOPP pension plan
Opportunities for professional development and continuing education
Supportive work environment

Job Description

Nurse Educator, Registered Nurse
 

The Nurse Educator, Registered Nurse is a specialist in disease prevention and community development, and is responsible for the planning, coordination, and delivery of services. Working in collaboration with an interdisciplinary team, the Registered Nurse in the Seniors Program will provide services to individuals, families and groups, focusing on the geriatric population.
 

Roles and Responsibilities:
 

Assessment
▪ Screens, prioritizes and processes patient referrals
▪ Assess physical, emotional, and cognitive functioning with environmental considerations
▪ Conducts Activities of Daily Living (ADL) assessments
▪ Conducts complex geriatric assessments
▪ Reviews patient clinical information obtained through physician referral, laboratory reports and health records
▪ Conducts consultations with patients to obtain relevant information and assess patient health learning needs
Planning
▪ Develops and discusses appropriate individualized health care plan with the patient and/or families based on best practices
▪ Based on evidence and best practice and in partnership with other community partners, collaborates in development of goals and objectives, services and activities, outcome measures and evaluation for community, group or population programming
▪ Reviews current literature & resources to support preparation of education materials and tools
▪ Manages reviews and makes recommendations regarding protocols for education of NSFHT patients
 

Implementation
▪ Works in collaboration with interdisciplinary team to safely and effectively provide appropriate primary care to patients
▪ Provides education to support and meet the learning needs of the patient and/or family members
▪ Recommends and adapts teaching to the patient’s identified health needs, revising treatment protocols as required
▪ Participates in community capacity building activities

▪Documentation according to the NSFHT and of their college policy & procedures
▪ Implements and monitors treatment plans and programs including but not limited to home modifications, mobility devices, falls prevention, caregiver support, education and community linkages
▪Refers to recommended programs and services, arranging follow-up as necessary

Evaluation
▪Evaluates patient comprehension and compliance to the care plan by reviewing clinical and learning outcomes
▪Identifies key performance indicators, participates in the measurement of these indicators
▪Participates in the evaluation of outcomes of group, population or community programming and its effectiveness
▪Advocates for the rights and needs of patients and/or caregivers
Reporting
▪ Works in collaboration with management and the Decision Support Specialist on reporting requirements
 

Organizational Role
▪Maintaining current knowledge of policy manuals, reading minutes of meetings and keeping up to date with organizational happenings
▪Contributing to the efficient functioning of the organization and the attainment of goals basing practice on sound theoretical knowledge & adhering to the CNO standards of practice
▪Arranging priorities as necessary to perform tasks within a scheduled day
▪Knowing established work and administrative procedures
 

Team Development
▪Works effectively within an interdisciplinary team, in varied practice settings, to improve access to primary care for patients of the North Simcoe Family Health Team
▪Provides case study, conducts in-services and workshops for team members, other health professionals and community partners as appropriate
▪Promotes awareness of the NSFHT services and programs
▪Actively participates in staff, team and committee meetings as appropriate
▪Participates in the development, planning and evaluation of treatment, education, counselling and health promotion activities of the NSFHT
 

Communication
▪Communicates effectively with health care team members to create a cohesive team and seamless services to the community
▪Communicates effectively with all patients, families, peers, other health care professionals and community partners
▪Consults regularly, when requested, with colleagues and management
Related Duties
▪Models the mission, vision and values of the NSFHT
▪Exhibits a commitment to life-long learning
▪Maintains confidentiality of team, personnel and patient information
▪Facilitates appropriate in-house and external education sessions
▪Assists with planning and attends special events; and
▪Performs other associated duties as required

Education/Experience
▪Minimum Diploma in Nursing, Baccalaureate of Science in Nursing preferred, Master of Science in Nursing preferred
▪Current registration with the College of Nurses of Ontario required
▪Current membership with Registered Nurses Association of Ontario preferred
▪Basic CPR certification
▪Current Ontario Drivers’ License (preferred)
▪Demonstrated experience in Community and/or Primary Care Setting
▪ Demonstrated experience with the geriatric population
 

Skills/Abilities
▪Knowledge and proficiency in current, evidenced-based methods and practices of primary care delivery, with an emphasis on heath promotion and risk reduction
▪Superior leadership, organizaiton, research, evaluation, time management, communication and interpersonal skills
▪Ability to work within a team or independently
▪Proficiency in the use of the computer hardware and software, particulary in Microsoft Word, Excel, Outlook and Electronic Medical Record (EMR)
▪Multi-tasking skills related to the delivery of efficient primary care including the ability to share information and teach while treating a patient
▪Excellent verbal and written communication skills
▪Exhibit an ability to be open and non-judgemental
▪Knowledge of the goals and structure of the organization, the policies and procedures and the programs.