Hospice Palliative Care Nurse Practitioner

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Competition Number:
J1122-1651
Job Title:
Hospice Palliative Care Nurse Practitioner
Employee Group:
ONA
Employment status:
Permanent Full Time
Initial FTE Allocation:
1.0
Initial Assignment:
Hospice Palliative Care Nurse Practitioner Team
Department:
Special Programs
Initial Hours of Work (subject to all hours of operation as required):
70
Office Location:
Belleville, Trenton, Picton
Reports To:
Manager, Patient Services
Salary:
$51.34 - $64.63/Hour
# of positions:
1


Home and Community Care Support Services South East is one of 14 Home and Community Care Support Services organizations in Ontario with a focused mandate to deliver local health care services such as home and community care and long-term care home placement.

These organizations were previously known as Local Health Integration Networks (or "LHINs") at a time when they also led local health care planning and funding, and those functions are now part of Ontario Health.

Home and Community Care Support Services South East is dedicated to ensuring the ongoing delivery of local services while Ontario makes changes to improve the health care system to give patients better-connected care with health care providers working as one coordinated team in Ontario Health Teams.
The south east region extends from Brighton on the west, to Prescott and Cardinal on the east, north to Perth and Smiths Falls, and back to Bancroft. The boundaries are for funding and planning purposes only. Residents of the Home and Community Care Support Services South East can seek health care services wherever they prefer, inside or outside these boundaries.

Position Summary

The Hospice Palliative Care Nurse Practitioner (HPC NP) will contribute to excellence in the delivery of care for people of all ages and their families requiring hospice palliative care in Home and Community Care Support Services South East. The HPC NP will collaborate with inter-professional care teams across the health care continuum including (but not limited to) home care, primary care, specialized hospice palliative care, acute care and community supportive care organizations/agencies.

The HPC NP may provide direct care for individuals with hospice palliative care needs when this service would not otherwise be available. Strong collaborative relationships will be built with providers of palliative care in Home and Community Care Support Services South East. The HPC NP will collaborate with these partners to promote integration of inter-professional care across the continuum of health care services, and to advance hospice palliative care support.

The Hospice Palliative Care Nurse Practitioner will:
• Ensure rapid response capacity to provide expert clinical care to complex palliative care patients which will include the management of pain and other symptoms, provision of psychosocial support and therapeutic interventions. A rapid response may require the ability and capacity to respond to urgent patient issues beyond regular working hours.
• Provide expert clinical advice to primary care physicians and community nurses.
• Provide “home” visits to this specific population of patients and their families, for the purpose of conducting comprehensive clinical assessments, contributing to the development of comprehensive shared care plans, taking into consideration any psychosocial, cultural or ethnic factors that may impact on patient care needs.
• Contribute to shared care planning which involves communication, collaboration and consultation with the identified Home and Community Care Support Services South East care coordinator, frontline service providers, primary care providers and other physicians involved in the patient’s care, as necessary.
• Understand and utilize 1)standard palliative care assessment tools, such as ESAS, PPS, MMSE, MOCHA; 2) disease specific classification systems, such as NYHA classification (HF), MRC dyspnea score (COPD, ILD) and dementia functionality scales (FAST [Functional Assessment Staging Tool]).
• Be knowledgeable about the implementation of the Symptom Response Kits (SRKs) in patient “homes”.
• Coordinate an interdisciplinary plan of care and facilitate efficient navigation of the patient through the healthcare system.
• Facilitate ethical decision making consistent with the patient/family goals of care and communicate the plan of care to patients/families and members of the healthcare team.
• Act as a resource to the care coordinator in terms of clinical expertise in the development of palliative care plans for complex patients (shared care plans) and chronic care patients (coordinated care plans), which appropriately balances clinical, family and system needs.
• Assess, monitor, evaluate and document the patient’s response to recommended therapies, interventions and decisions and determine whether care plans need to be modified to ensure achievement of best possible outcomes.
• Develop a shared care partnership with primary care (if mutually agreeable) and support primary care providers in caring for palliative care patients on their roster, in a model that is mutually beneficial for patients and the involved health care providers.
• Coordinate access to specialized/expert palliative care, and when necessary and appropriate to acute care services, including providing advice and support to ensure safe and seamless transitions between care settings.
• Become integral members of designated Health Links within their geographical area and participate in patient-related rounds/ discussions, and participate in an “on-call roster” with family physicians.
• Work in collaboration with Palliative Pain & Symptom Management Consultants to mentor, educate and coach other primary care providers.
• Provide leadership in quality improvement initiatives and program planning for this specified population of patients.
• Identify opportunities to develop medical directives, participate in their development, implementation and evaluation and directly implement aspects of care based on medical directives.
• Educate and recommend interventions in consultation with primary care providers and the care team, to influence the plan of care for the patient and family.
• Participate in Home and Community Care Support Services South East/Regional Palliative Care business meetings as requested, to assist in program development and ongoing monitoring and evaluation of services.
• Participate in systems planning and integration with the overarching goal of ensuring a comprehensive and quality system of care for patients and their families that is available on a 24/7 basis.
• Perform shared responsibilities on a rotational basis, as requested by Home and Community Care Support Services South East, related to committee involvement or palliative care initiatives.
• Participate and provide leadership on intra-and inter-disciplinary committees related to development of policies, protocols, procedures, guidelines, standards, clinical pathways, education and research.
• Provide consultation to nursing service agencies, managers, community practicing physicians and other team members regarding clinical and professional practice issues.
• Ensure policies, protocols, procedures, standards, and pathways are effectively communicated to all individuals involved in the care of the patient/family.
• Deliver, coordinate and participate in education and professional development activities/programs
• Collaborate and works closely with the Palliative Pain & Symptom Management Consultants and South East Palliative Care Educators in: identifying the learning needs of various populations of care providers; planning, implementing and evaluating needs-based continuing education for staff and clinical partners to promote quality palliative and end-of-life care for patients and families
• Serve as an educator and clinical preceptor for nursing students, medical students and other members of the inter-disciplinary care team
• Participate in Queen’s Palliative Medicine Academic regional rounds on a monthly basis
• Interpret, communicate and disseminate research findings to support clinical care and recommend policy change
• Participate in clinical investigations to monitor and improve nursing and patient care practices
• Enhance the scientific base of nursing practice by utilizing and supporting research in nursing and other health care disciplines.

Minimum Qualifications & Position Requirements

• Must hold current registration with the College of Nurses of Ontario in the Extended Class Nurse Practitioner Program with a minimum Baccalaureate in Nursing (Masters level degree in Nursing preferred)
• Must have certification as a hospice palliative care nurse with the Canadian Nurses Association CPHCN(C)
• Must have continuing education in Palliative Care; Hospice Palliative Care Nursing Certification preferred
• Minimum 2 yrs. of experience in Palliative Care Nursing (previous work in the community setting an asset)
• Hold current CPR- Level C & AED certification
• Valid Ontario driver’s license and access to a vehicle

Competencies

• Demonstrated knowledge of the theory and evidence to support advanced clinical practice and appropriate patient care outcomes
• Demonstrated advanced knowledge in palliative and end-of-life care concepts, consultation skills and ethical decision making
• Advanced knowledge of comprehensive and problem based health assessment and diagnosis
• Advanced knowledge to order appropriate screening and diagnostic investigations and interpret reports, or to ensure follow-up on these investigations
• Advanced knowledge of health care management needs and therapeutic intervention for complex palliative care patients, based on the full range of issues categorized in the 8 Domains of Issues Associated with Illness and Bereavement, including Disease Management; Physical; Psychological; Social; Spiritual; Practical (activities of daily living, dependents, pets, telephone access, transportation); End of Life Care/Death Management; and Loss and Grief
• Advanced knowledge of the management of pain and other symptoms, including a range of therapeutic interventions
• Advanced knowledge of pharmacology in selecting, prescribing, monitoring and dispensing drugs
• Awareness of cultural, ethnic and religious diversity
• Understanding of the health care system and complexities of the Hospice Palliative Care Team
• Knowledge and commitment to the Home and Community Care Support Services South East mission, vision, and strategic directions
• Thorough understanding of Home and Community Care Support Services South East relationship with the Home and Community Care Support Services South East and hospitals within the South East, community support service and contracted service providers.
• Practical knowledge of relevant legislation (e.g. Home Care and Community Services Act, 1994 [HCCSA])
• Proven effective interpersonal skills and communication skills, both verbal and written
• Maintains accurate and thorough documentation and provides copies to appropriate care provider
• Establishes and maintains collaborative and effective working relationships with internal Home and Community Care Support Services South East staff and external partners.
• Team building abilities and experience in advancing the clinical practice of multiple health disciplines.
• Effective coaching and facilitation skills
• Ability to assume leadership role in relation to patients’ primary care needs
• Able to communicate with patients, their families, and other relevant individuals to ensure implementation and continuity of care plan directives
• Able to communicate and consult with Most Responsible Primary Care Provider/Specialist Physicians and HPC teams to influence the plan of care for patients and their families
• Skills in mentorship and role modeling to promote increased capacity in hospice palliative care
• Demonstrated ability to practice with discretion and respect confidentiality
• French language is an asset
• Effective organizational and planning skills
• Proficiency with computerized information systems

Equity, Inclusion, Diversity and Anti-Racism Commitment
Home and Community Care Support Services is committed to a culture of equity, inclusion, diversity and anti-racism. We are committed to attracting, engaging and developing a workforce that reflects the diverse communities we serve. We welcome and encourage applications from all qualified applicants. Accommodations for persons with disabilities required during the recruitment process are available upon request. La version française de cette annonce est disponsible sur demande.
We thank all applicants for their interest; however, only those selected for an interview will be contacted.

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, prior to start date. Any medical or human rights exemption requests will be reviewed and validated prior to an offer of employment.