nurse practitioner

NURSE PRACTITIONER, GERIATRIC TRANSITIONAL OUTREACH (GTO)

Job Description

Ontario Shores requires one (1) temporary (12 months) fulltime Nurse Practitioner (NP) to work in the Geriatric Transitional Outreach (GTO) Clinic.

The Nurse Practitioner (NP) is a nurse who has an advanced level of clinical nursing practice that maximizes the use of advanced educational preparation, in-depth nursing knowledge and expertise in meeting the health needs of individuals, families, groups and populations. The NP brings to patients a holistic approach to care encompassing mental, physical and social. He/she practices independently within their legislated scope of practice. The incumbent will have sound knowledge of clinical issues in the areas of mental health, geriatric psychiatry, geriatric medicine and evidence-based dementia care. In addition to completing mental health and physical assessments, responsibilities include: participating as an advance practice nurse practitioner within a interprofessional team; providing patient centered treatment and support; reviewing referrals in consultation with the team to determine eligibility for admission or programs; prescribing medications and non-pharmacological treatment modalities and assessing effectiveness of these interventions; developing patient centered treatment / rehabilitation goals and plans in collaboration with patients, their families, their support network and the interprofessional team; implementing treatment plans, performing clinical risk assessments and implementing treatment plans to mitigate against risk, assessing for and recognizing signs of decompensation and instituting actions to prevent further decline.

The position is part of a specialized geriatric mental health outreach team providing community-based care to individuals aged 65 and older living with complex and serious mental illness, including dementia with behavioural and psychotic symptoms of dementia (BPSD). The role involves travel to private homes and retirement settings within Durham Region and must have the ability to respond to the unpredictability of home environments. The NP in this position will act as the most responsible provider (MRP) and will work with a team of Registered Nurses (RN) and/or Registered Practical Nurses (RPNs). The NP in this role also manages diagnostic clarification and collaborates with a consulting psychiatrist for more complex presentations. The NP will report to the Administrative Director of the Geriatric program.

Key Duties and Responsibilities

• Acts as Most Responsible Practitioner (MRP) for patients admitted to this outpatient service.
• Practices independently within legislated scope of practice.
• Performs initial and ongoing psychiatric, medical and cognitive assessments.
• Performs initial and ongoing physical assessments.
• May prescribe, initiate, monitor and adjust medications within legislated scope of practice.
• Prescribes medications accurately and safely, monitoring therapeutic responses, reactions, untoward effects, toxicity and potential incompatibilities with other medications or substances.
• Recommends and monitors implementation of non-pharmacological interventions.
• Monitors ongoing conditions and treatment for patients with stable and chronic illnesses.
• Orders appropriate diagnostic treatments/interventions for management of patient presentations and conditions.
• Provides family support, education and counseling on diagnosis, treatment options evaluation outcomes and follow-up plans with focus on health promotion and illness prevention.
• Works with community partners in planning, treatment and establishing supports to maintain the patient in the community.
• Works with internal or community partners to support the patient to access additional services to enhance their wellbeing, such as brain stimulation, addiction services, adult day programs, and home care services.
• Utilizes evidence-based monitoring tools and scales (e.g. NPI, MMSE, MoCA, AIMs etc.).
• Supports the development of behavioural management interventions in collaboration with the consulting psychiatrist and the interprofessional team.
• Collaborates with patient and interprofessional team to develop and maintain treatment goals which meet the needs of the patient.
• Supports the integration, sustainability and evaluation of organizational changes into practice.
• Works with interprofessional team.
• Documents in accordance with professional standards of practice and Centre policies and procedures.
• Identifies the need for change, in the environment or practice system.
• Manages rapidly changing circumstances, implements crisis intervention or critical procedures as necessary.
• Facilitating an inpatient admission to support the patient's physical or mental health when clinically indicated.

• Supports chronic disease management and specialized geriatric medicine expertise and geriatric psychiatry expertise.

• Responsible to recognize and report patient, staff, and environment safety issues, identify and implement preventative and corrective actions, within the scope of this role.

• Implements and models the Recovery philosophy in all aspects of care as a Recovery champion.

• Provides consultation to the treatment, community agencies and other healthcare providers about difficult issues, ethical practice and managing complex care needs.

• Supports professional development opportunities for the members of the interprofessional team.

• Actively participates in nursing, interprofessional and hospital committees.

• Integrates evidence-based research findings into clinical practice.

• Demonstrates a commitment to supporting and participating in and research and education.

• Acts as an advocate for patients, supporting autonomy and other recovery related principles.

• Uses conflict resolution skills to facilitate interprofessional health team interaction and functioning.
• Participates within the interprofessional team in fostering and maintaining effective working relationships.
• Participates in program committees and community organizations.

• Provides education and counselling to staff, patients and their families and/or significant others and community care providers regarding diagnosis, treatment options and evaluation of outcomes and follow-up plans.

• Provides effective communication with the patient and family members which includes engagement and embodies respect and involvement.

• Collaborates with physicians and other health professionals for the implementation of an individualized care plan.

Requirements

• Nurse Practitioner with no practice restrictions, is required with extensive geriatric experience
• Knowledge and experience working with individuals experiencing complex mental health challenges required
• Current registration as a Registered Nurse – Extended Class (RNEC) with the College of Nurses of Ontario in good standing
• Graduate Degree (Master's) (preferred)
• Certification in Mental Health Nursing (preferred)
• Certification in Gerontological Nursing (preferred)
• Certification in Canadian Academy of Geriatric Psychiatry (preferred)
• Current B.C.L.S. (Basic Cardiac Life Support)
• Current CPR – Health Care Provider
• Minimum 2 years Geriatric/Mental Health or related experience required
• Minimum 5 years in a Nurse Practitioner role (preferred)
• Knowledge of general and psychiatric nursing theory and practice, infection risk management, health promotion and health education/teaching activities
• Knowledge in the Dementia Quality Standards, GPA, PIECES
• Demonstrates effective written and verbal communication skills.
• Demonstrates problem solving, decision-making and conflict resolution skills
• Demonstrates clinical and social assessment skills
• Uses critical and analytical thinking skills. The job requires strong organizational, prioritization and time management abilities to ensure that assignments are completed within deadlines and established time frames.

Job Posting Closing: December 23 , 2025. Please note any job applications after the closing date will not be considered

This is a 12 month temporary posting

Number of vacancy 1