Cashier/customer Service
7 months ago
Position Summary
CARE AND BE CARED FOR - THIS IS YOUR HOME
Are you an experienced registered nurse, with recent acute or clinical experience, seeking a rewarding career that cares for others, in a professional practice that cares for you? You're looking in the right place.
As a Transition Support Nurse, you will be responsible for ensuring effective transitions from acute care to home care for target populations defined as complex, high risk and/or populations with high emergency department utilization. You will work directly with Rapid Response Nurses, Regional Palliative Care Leads and Service Provider Organizations (SPOs) to support patients in need, supported by primary care, pharmacists and community support agencies
Whether you work in our office, in the community, or a health care facility - you will play a lead role in providing connected, accessible, patient-centred care - and be supported by our collaborative team that includes over 8,000 regulated health care and other professionals.
As a valued team member, your mission will be to help our patients be healthier at home, while you benefit from our supports for professional growth, personal wellness and work-life balance.
What will you do?
Plan, organize and provide timely and effective care. Confirm hospital discharge plan and liaise with hospital staff and Care Coordinator in regards to patient discharge if required
Complete a nursing physical assessment in the patient's home and provide health teaching to the patient and/or family regarding their illness/symptom management and avoidance of re-occurrence of acute episode.
Review the discharge care plan and confirm outstanding medical tests are scheduled, coordinating family/friends supports as needed.
Complete a Best Possible Medication History (BPMH) and provide teaching and medication management as required with the patient and/or caregiver. In partnership with a pharmacist, the TSN ensures new prescriptions are filled and facilitates a medication reconciliation to confirm no drug interactions or contraindications
Ensure contact with primary care provider, providing an update on the patient's acute care event and post discharge regime.
Recommend and facilitate a follow up visit as appropriate
Identify patient's requiring an accelerated Care Coordination home assessment for home care services and work with the Care Coordinator to facilitate the home assessment visit.
Inform and support the Care Coordinator in developing the client's care plan and ensuring a smooth transfer of the primary care physician and pharmacist to the ongoing care team.
Provide health teaching and information to the patient/caregiver and ensure they have Home and Community Care Support Services Agora South Inc contact information
Direct nursing care with non-complex skills for a short stay or until discharge or transition to another Direct Care Provider.
Assess for and promote a safe environment for clients, caregivers, family members, and staff.
Participates in and demonstrates an understanding of quality, risk and patient safety principles and practices
Assists with the orientation of new staff/students and carries out preceptor responsibilities
What must you have?
Minimum of five (5) years of relevant experience as a Registered Nurse, with recent clinical/acute experience preferred
Holds current appropriate unrestricted registration as a Registered Nurse with the College of Nurses of Ontario
University Degree in Nursing preferred
Working knowledge of community resources and roles of multi-disciplinary health care professionals
Working knowledge of the nursing process, the consultation process, program planning and crisis management
Emergency/critical care and community nursing experience an asset
Completion of critical care course in area of specialty an asset
Demonstrate knowledge, experience and ability to care for patients with the following would be an asset: Initiation and maintenance of IV therapy, Intermate/CADD pump, Vascular Access Device management, Palliative pain and symptom management, wound management skills
Hold current CPR- Level C & AED certification
Vehicle and valid Ontario driver's license is required
Proficient in a Windows environment
We have a mandatory COVID-19 vaccination policy. As a condition of employment, all employees are required to submit proof of COVID-19 vaccination status prior to start date.
What would give you the edge?
Knowledge of direct care / case management models used in community health care organizations.
Knowledge of health care related legislation and practices
Significant understanding of relationship with Home and Community Care Support Services Agora South Inc and Agora South Inc LTCHs, hospitals, community support service and contracted service providers.
Practical knowledge of relevant legislation (e.g. Long-Term Care Act)
Ability to deliver information effectively, verbally and in writing, in a variety of settings
Ability to spe
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