Chronic Disease Management Specialist

2 weeks ago


Surrey, British Columbia, Canada Fraser Health Full time
Job Summary

We are seeking a skilled Chronic Disease Nurse, Diabetes to join our team at Fraser Health. As a key member of our interdisciplinary team, you will play a vital role in the planning, implementation, and evaluation of individual care plans for clients with diabetes.

Key Responsibilities
  • Develop and implement individualized care plans based on established assessment processes, in collaboration with other healthcare professionals.
  • Enhance patient self-management of diabetes and co-morbidities through various teaching and education methods, including individual counseling and group facilitation.
  • Write timely and accurate patient reports of relevant observations, including patient and/or family teaching and evaluation of nursing care.
  • Participate in clinical case reviews, program development and evaluation, education materials and delivery, and other clinical resources.
  • Provide orientation and mentoring to new staff, and participate as a preceptor to students.
  • Act as a resource to other healthcare professionals and provide information sessions on diabetes, as needed.
  • Participate in quality improvement and risk management activities by participating in research and special projects related to diabetes.
  • Maintain client records, documentation, and related statistics, as required.
  • Participate on local, regional, program, and professional committees, as assigned.
Qualifications
  • Graduation from an approved school of Nursing.
  • Two years' recent related clinical experience assessing and treating patients with diabetes within a chronic disease management framework, including supporting self-management and accreditation as a certified Diabetes Educator (CDE), or an equivalent combination of education, training, and experience.
  • Current practicing registration as a Registered Nurse with the British Columbia College of Nurses and Midwives (BCCNM).
  • Current CPR certification.
Skills and Abilities
  • Demonstrated knowledge of current standards for diabetes management.
  • Demonstrated understanding of the principles of adult/child/youth learning, including strategies around empowerment and motivation.
  • Ability to communicate effectively, both verbally and in writing.
  • Ability to work independently and as a member of an interdisciplinary team.
  • Demonstrated ability to teach and implement a diabetes education program for patients/clients/families, in both an individual and group setting.
  • Ability to create and maintain rapport with the patient/client/family and with other healthcare providers.
  • Ability to plan and prioritize work in a continuously changing environment.
  • Ability to operate related equipment, including related software applications.


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