Hospice Patient Navigator

**Requisition Details**:
Employment Status: Temporary, Full Time (1.0 FTE)
Program Name: Hospice Services
Number of Hours Bi-Weekly: 75
Work Schedule: Days
Union/Bargaining Unit: ONA
On-Call: No
Anticipated End Date: 02/03/2024
Location(s): Whitby

**Join our Palliative Care Community Team**

VON Durham Hospice Services optimizes supports and linkages in both health and social care for clients and their families with a life threatening illness. This wholistic team collaborates with primary and care providers, and community services implementing a shared-care model, through referral and assessment to palliative, psycho-social-spiritual care and grief and bereavement support services and supports.

The model promotes early engagement and connection, and builds on existing areas of caregiving expertise and supports providing a continuum of care from diagnosis, through active treatment, at end of life and through grief and bereavement.

**Key Accountabilities**:

- Provides client and family centered care that optimizes quality of life of clients with a life limiting illness and their families and friends
- Conducts assessments/reassessments
- Coordinates complex clinical care
- Develop, coordinate, and assist with the implementation of the care plan based on the client's goals
- Supports clients and families with Advanced Care Planning
- Active role in symptom management in conjunction with other members of the interdisciplinary team and the Palliative Pain and Symptom Management Consultant (PPSMC)
- Links clients with appropriate resources internally and externally
- Advocates for clients with respect to access to services and client driven care
- Enhances communication between client, family and the interdisciplinary members of the care team
- Helps clients interpret medical information and with system navigation
- Attends Community Rounds as directed
- Relationship building with interdisciplinary team and community agencies
- Advocate transforming the care and culture of life limiting illness through education, competency, advocacy, leadership and research
- Assists clients and families through the decision-making process associated with care options
- Relationship building with client, family, primary and community providers, interdisciplinary teams to facilitate transitions of care and service supports across multiple settings of care
- Be a part of the 24/7 on-call team coverage rotation when available
- Contributes to program development, implementation, and evaluation within the community and health care systems
- Assumes responsibility for ongoing personal and professional development

**Tasks**:

- Attends initial home visit assessments as assigned by the Team Lead, all service documentation, tracks and prioritizes care requests to ensure all clients/families receive timely response, including follow-up calls to clients/families to ensure care needs have been met
- Completes regular and timely documentation
- Manages client files, ensuring information is up-to-date at all times
- Attends Client Rounds
- Notifies team members and updates files when situations change
- Assists with the development and provision of community education and awareness programs
- Contributes to a culture of sharing, openness, education and mentoring to team members, volunteers and students
- Facilitates an environment and attitude where values and beliefs regarding shared care coordination are clearly articulated
- Works with partners in needs identification and delivery of palliative care education

**Key Competencies Required for this Position**
- Registered Nurse in good standing with the College of Nurses of Ontario
- Advance Care Planning certification an asset
- Comprehensive Advanced Palliative Care Education (CAPCE) or equivalency; LEAP an asset
- CNA Certification in Hospice Palliative Care Nursing/CHPCN(C); Oncology Nursing/CON(C) an asset
- RNAO Membership
- Current BCLS
- Minimum of five (5) years recent experience in hospice palliative care
- Minimum of five (5) years of community nursing experience
- Demonstrates respectful, courteous, caring attitude in all interactions
- Solid experience in care planning and communicating with multiple providers
- Proven history of working well within an interdisciplinary team
- Excellent interpersonal skills
- Critical thinking and problem solving skills
- Proven leadership abilities with effective verbal, non-verbal and oral communication skills
- Administrative skills with computer proficiency and accuracy for all documentation and record keeping, and attention to detail
- Valid driver’s license and willingness to travel throughout Durham Region for home visits and meetings
- Car required
- Flexible and supportive to clients and Team needs
- Adheres to all standards, practices, policies and procedures regarding privacy and confidentiality of information, and ethical practices as set forth by employer and regulating College
- Other skills include conflict management and