Registered Nurse or Registered Practical Nurse – Community Transition (#056-24)

JOB POSTING #056-24                                                                                                                                                                                                                                       POSTING DATE: April 17, 2024

JOB TITLE:   Registered Nurse or Registered Practical Nurse – Community Transition

INITIAL ASSIGNMENT:  High Intensity Supports at Home Program (HISH)

BARGAINING AGENT:   ONA

LOCATION:   Haileybury or Kirkland Lake

LANGUAGE(S):  English and French

EFFECTIVE DATE: Immediately

Home and Community Care Support Services North East offers a wide-range of quality health-care services and resources to support people of all ages at home, school or in community. In addition to planning, delivering and coordinating care for thousands of people each day in Northeastern Ontario, we also manage eligibility and admissions to long-term care homes, short stay respite and assisted living. We need caring, motivated people who are driven to help others and make difference in their community, to join our multi-disciplinary team.

POSITION SUMMARY:

The Registered Nurse (RN) or Registered Practical Nurse (RPN) – Community Transition assists with hospital transition home for Alternate Level of Care (ALC) patients with an imminent long-term care destination and other high-risk patients with similar needs in community who are long-term care waitlisted, meet eligibility criteria, and are at risk of requiring hospitalization and becoming ALC designated. The Community Transition Nurse (RN/RPN) provides individualized patient care through a holistic and collaborative approach, working closely with the High Intensity Supports at Home (HISH) team, patient/family and primary care provider to develop a unique plan of care specific to their needs.

NATURE & SCOPE:

• Assists with hospital discharge and/or environmental transition of high-risk seniors, ensuring the patient is seen in home within 24-48 hours of being admitted to the HISH Program. The RPN will consult with the RN or assigned Care Coordinator when support is required for complex discharges or transitions. 
• Coordinates with HISH or assigned Care Coordinator in the development of care plan necessary to provide patient with wrap-around, holistic nursing support to remain safely at home while waiting for LTC placement.
• Provides ongoing, short-term support to patients’ through education and coaching, clinical assessment, assistance with medication management, and communication with primary care to reduce hospital admission/readmission. This may include daily visits to ensure patients’ needs are being met. The RPN will work in consultation with the RN or assigned Care Coordinator on complex patient files or issues outside of the RPN’s scope of practice.
• Provides in-home nursing visits and manages patients’ care needs as presented, which may also include support with activities of daily living and instrumental activities of daily living (ADL/IADL).
• Collaborates closely with the care team to ensure consistent, aligned communication; participates in weekly huddles as required.
• In collaboration with the care team, works with patient/SDM and family members/caregivers and primary care provider to develop a transition plan that supports the unique needs of the patient.

QUALIFICATIONS:

• Registered Nurse (RN) or Registered Practical Nurse (RPN) in good standing with the College of Nurses of Ontario;
• Minimum 3-5 years clinical experience working as a Nurse (RN or RPN);
• Recent and relevant experience, within the last 2-3 years, providing direct, hands-on nursing care;
• Certification as a Gerontological Nurse (GNC) or Gerontology Practical Nurse (GPNC) an asset;
• Superior clinical assessment skills and care planning skills;
• Strong collaboration skills and ability to provide quality clinical service delivery in conjunction with patients and other stakeholders;
• Ability to work independently;
• Strong critical thinking and problem solving skills;
• Effective interpersonal and communications skills;
• Ability to provide health coaching and disease-specific education to patients;
• Advanced oral and written proficiency in English and French is essential;

• Must have valid driver’s license and access to a vehicle; travel to patient homes will be required;

• Valid Emergency First Aid Certification and CPR.

Less qualified candidates may be considered.  However, candidates who meet all requirements will be given priority for an interview.

Home and Community Care Support Services North East is an equal opportunity employer. Personal information submitted will be used only for the purpose of determining suitability for this vacancy.  All applicants are thanked for their interest in this position.  Only those applicants selected for an interview will be contacted.

Individuals with a disability requiring accommodation during the application and/or the interview process should advise the recruitment contact so arrangements can be made.

Interested persons are invited to submit a cover letter and resume by visiting and applying through the organization website at:

North East Careers | Home and Community Care Support Services (healthcareathome.ca)

Please refer to posting #056-24 when applying.

Home and Community Care Support Services has implemented a mandatory vaccination policy across the province that requires all staff to be fully vaccinated against COVID-19. Applicants being considered for employment will be required to provide proof of vaccination documentation confidentially to Human Resources upon hire. Any medical or human rights exemption requests will be reviewed and validated prior to an offer of employment.