Clinical Practice

In all Carefor programs, the RPN provides service consistent with the standards established by Carefor and provincial regulatory agencies/bodies. The nursing process is utilized: assessment, planning, implementation and evaluation.

• Provides complete, relevant assessment of the client
• Develops a care plan with the client based on the General and Diabetic Foot Assessment Tool
• Implements nursing strategies or interventions according to the established care plan
• Describes, evaluates and documents client’s/family’s responses to care plan utilizing established procedures
• Utilizes appropriate interviewing and communication skills to obtain information from the client/family
• Describes and documents nursing processes clearly, concisely, accurately and appropriately, according to Carefor documentation standards
• Evaluates client’s/family’s responses to care plan for the achievement of realistic client-centered outcomes and revises plan as required
• Demonstrates respect for client’s choices and decisions
• Utilizes adult learning principals and established teaching materials to provide health teaching to clients and families
• Analyses and incorporates current research findings into clinical practice (e.g.best practices, products & procedures)
• Sanitization of equipment and instruments according to established regulations, policies and procedures.

Resource Management

• Refers clients to appropriate levels of nursing providers, support providers and to other disciplines (e.g., ET, Leg Ulcer specialist, Physician, etc.)
• Documents rationale for referrals, for increase/decrease in visits
• Provides cost-effective, organized, outcome directed care on an ongoing basis (e.g., supplies, visit utilization)
• Demonstrates effective time management, planning and organizing of days’ work activities
• Promotes client-directed care, self-care and independence through teaching

Leadership

• Works collaboratively within a multidisciplinary team and acts as a clinical resource and mentor for other care providers, staff, and students
• Shares knowledge, enabling clients, family, and community to make informed choices in determining health and service needs
• Promotes involvement of client/family in determining health and service needs

Quality & Risk Management

• Practices in accordance with the quality and risk management framework of the organization (e.g., universal precautions, ergonomics)
• Demonstrates knowledge of components of quality and risk management (e.g., infection control, client safety, medication, incident reports)
• Plans, implements, evaluates, and adjusts care in accordance with customer focused expectations
• Seeks input from clients to assure that service meets expectations (e.g., to ensure client satisfaction)
• Functions as an effective team member (e.g., Collaborating with members of interdisciplinary team).
• Participates in decision-making and follows up to promote continuous quality improvement.

Professional Accountability

• Functions in accordance with the Standards of Nursing Practice from the appropriate provincial regulatory body (College of Nurses)
• Functions in accordance with the Carefor policies, procedures and strategic directions (e.g. health care manual, new technology initiatives)
• Functions in accordance with applicable legislation (e.g. informed consent, client Bill of Rights)
• Maintains competence through continuing education (e.g. In services, CPR, seminars)
• Collaborates with management staff and colleagues in the evaluation of own practice (e.g. CNO Reflective practice)

Health and Safety Accountability

• Functions and reports in compliance with the Occupational Health and Safety legislation, regulations, and Carefor policies and procedures
• Demonstrates and applies knowledge of WHMIS in the workplace (e.g. biohazard)
• Wears or uses any/all protective equipment or clothing provided by Carefor as per guidelines.
• Reports the absence of or defect in any equipment or protective device of which he/she is aware and which may endanger him/herself or another worker
• Recognize and Reports any Health and Safety issue and / or hazards
• Does not use or operate any equipment, machine or device, or work in a manner that may endanger him/herself or any other worker
• Ensures all workplace incidents are reported in a timely manner in accordance with legislation, and Carefor policies and procedures for workplace injuries and incidents (e.g. WSIB injuries).

Core Competencies

Communication – Interacts effectively with clients, coworkers, physicians, public, volunteers, other Branches and Organizations by:

• Listening and striving to understand
• Communicating in a clear and effective manner, demonstrating respect, empathy and understanding.
• Using clear, factual, audience appropriate language, avoiding jargon
• Maintaining confidentiality
• Communicates effectively within the organization (e.g. call checks, voice mail, fax, supervisors)

Accountability – Accepts responsibility for achieving the expectations of the job/role by:

• Consistently focuses on the client/customer
• Approaches a task, carrying it out and taking responsibility of how it turns out
• Protects the safety and welfare of others (e.g. use of code 33 & 44)
• Performs in accordance with the mission, vision and values of the organization
• Uses sound knowledge and skill in work/role performance

Client Focus – Places the needs of clients / customers first by:

• Striving to anticipate and exceed the needs of clients / customers
• Involving clients in decision making
• Monitoring and evaluating results / outcomes
• Advocating for the needs of clients

Teamwork – Works cooperatively and respectfully with others to further the goals of the client and the organization by:

• Participates effectively as a team member
• Values and respects individual contributions
• Shares knowledge and experience
• Looking for ways to improve work or care process, based on results and/or evidence

Quality Improvement – Identifies client/customer needs and improves service by:

• On-going care delivery review and evaluation (e.g. verbal reports, care plan updates, caseload Management)
• Looks for ways to improve work or care process, based on results and / or evidence (e.g. sharing results of best practice)

Adaptability to Change – Recognizes and accepts change as a reality by:

• Asking questions until understanding is achieved
• Being receptive to new ideas and willing to try new methods and approaches
• Being able to adapt to change as the job requires
• Accepting the challenge of self-directed learning

Caring/Respect – Demonstrates a concern and caring for clients / colleagues / customers as individuals by:

• Respecting the values and opinions of others
• Demonstrating genuine regard and compassion for others
• Respecting the confidentiality and integrity of others
• Appreciating and celebrating the contributions and successes of other individuals and groups

Continuing Education & Learning

• Maintains Competence and skills required by Carefor
• Maintains the level of competencies and skills required to meet community needs
• Adapts to change in the role by acquiring the appropriate skills and abilities

• Licensed as a Registered Practical Nurse in the province of Ontario
• Advanced Foot Care Certificate, the applicant must be willing to obtain the certificate with support from Carefor
• Experience in foot care clinics preferred
• Previous community experience will be considered an asset
• Minimum of nine (9) months to one (1) year of related experience required
• Excellent skills in assessment, risk identification and management
• Collaboration, consultation and counseling to resolve issues
• Enhanced chronic disease monitoring and management
• Health teaching, increase access for clients for health-related information to support self-management
• Excellent verbal and written communication, ability to work collaboratively as a member of an interdisciplinary team, system navigation
• Interpersonal relationship building

• Defined Pension Plan with the Healthcare of Ontario Pension Plan (HOOPP)
• Paid mileage between clients
• Smartphone provided and Android Tablet
• 24/7 support from on-call Supervisors
• Paid orientation and training
• Flexible Shifts
• All necessary Personal Protective Equipment (PPE)
• Employee and Family Assistance Program
• Professional Development Opportunities
• Leadership team who values innovation, continuous improvement, quality and service excellence while appreciating work-life boundaries
• A collaborative, diverse and inclusive team culture

Job Types: Full-time, Part-time, Permanent

• Assist or provide care according to the Resident Care Plan. Assistance may need to be provided on a short or long term basis to individual residents including but not limited to personal care, lifts and transfers, observing nutritional status, light housekeeping, assist in taking prescribed medication, etc…
• Observe resident for changes in behaviour or signs or symptoms of decreasing health status and report to Care Team leader.
• Chart care given and give verbal/written report to RPN or other team members on any unusual behaviour and observations made with respect to clients/residents
• Evaluate the individual’s need for change in the personal support care plan and make recommendations to RPN or designate.
• Contributes to the development of the personal support care plan by reporting, to the RPN or designate, all observations or information obtained from the resident and/or family regarding needs and the effect of the care he/she provided.
• Plans and organizes each day’s activities, setting priorities for personal support and other activities, to effectively utilize time, energy, supplies and equipment.
• Completes documentation/paperwork according to Carefor policies and procedures
• Reviews all forms of documentation and communication in order to remain current on residence operations and resident care. This may include reviewing care notes, e-mails, memos, communication book, and receiving verbal updates
• Functions and reports in compliance with the Occupational Health and Safety legislation, regulations, and Carefor policies and procedures
• Reports the absence of or defect in any equipment or protective device of which he/she is aware and which may endanger him/herself or another worker
• Reports any violations of the Health and Safety Act or the regulations, or the existence of any hazard
• Ensures all workplace incidents are reported in a timely manner in accordance with legislation, and Carefor policies and procedures for workplace injuries and incidents

• Secondary school education preferred
• Personal Support Worker or Health Care Aide certificate
• Current Standard First Aid Certificate, required
• Current CPR level C Certificate, required

• Utilizes appropriate interviewing and communication skills to obtain information from the client/family
• Provides complete, relevant assessment of the client/family and their environment utilizing established procedures
• Describes and documents assessment findings utilizing established procedures
• In collaboration with the health care team, contributes to and updates the clients care plan as necessary
• Documents problem(s) identified using a specified framework and focuses care on appropriate problem areas utilizing established procedures
• Selects and implements strategies or interventions from established care plans in consultation with the client and/or caregiver and health care team
• Describes, evaluates and documents client’s/family’s responses to care utilizing established procedures
• Provides rationale for and documents modifications to the care plan (eg. visit schedule)
• Negotiates with client/family during delivery of care and respecting client’s choices and decisions
• Utilizes adult learning principals and established teaching materials to provide health teaching to clients and families
• Incorporates current research findings into clinical practice
• Documents clearly, concisely, accurately and appropriately according to Carefor standards

• Registered in good standing with the College of Nurses in Ontario (CNO)
• Excellent high tech skills (with IV restart) or a passion to be trained in these skills
• Valid driver’s license (G2 or G) and the use of a reliable vehicle
• Excellent documentation skills
• The ability to work collaboratively as a member of an interdisciplinary practice
• Excellent problem solving skills and the ability to adapt nursing to independent practice
• Wound care Experience Preferred

• Assist or provide care according to the Resident Care Plan. Assistance may need to be provided on a short or long term basis to individual residents including but not limited to personal care, lifts and transfers, observing nutritional status, light housekeeping, assist in taking prescribed medication, etc…
• Observe resident for changes in behaviour or signs or symptoms of decreasing health status and report to Care Team leader.
• Chart care given and give verbal/written report to RPN or other team members on any unusual behaviour and observations made with respect to clients/residents
• Evaluate the individual’s need for change in the personal support care plan and make recommendations to RPN or designate.
• Contributes to the development of the personal support care plan by reporting, to the RPN or designate, all observations or information obtained from the resident and/or family regarding needs and the effect of the care he/she provided.
• Plans and organizes each day’s activities, setting priorities for personal support and other activities, to effectively utilize time, energy, supplies and equipment.
• Completes documentation/paperwork according to Carefor policies and procedures
• Reviews all forms of documentation and communication in order to remain current on residence operations and resident care. This may include reviewing care notes, e-mails, memos, communication book, and receiving verbal updates
• Functions and reports in compliance with the Occupational Health and Safety legislation, regulations, and Carefor policies and procedures
• Reports the absence of or defect in any equipment or protective device of which he/she is aware and which may endanger him/herself or another worker
• Reports any violations of the Health and Safety Act or the regulations, or the existence of any hazard
• Ensures all workplace incidents are reported in a timely manner in accordance with legislation, and Carefor policies and procedures for workplace injuries and incidents

• Secondary school education preferred
• Personal Support Worker or Health Care Aide certificate
• Current Standard First Aid Certificate, required
• Current CPR level C Certificate, required

• Assist or provide care according to the Resident Care Plan. Assistance may need to be provided on a short or long term basis to individual residents including but not limited to personal care, lifts and transfers, observing nutritional status, light housekeeping, assist in taking prescribed medication, etc…
• Observe resident for changes in behaviour or signs or symptoms of decreasing health status and report to Care Team leader.
• Chart care given and give verbal/written report to RPN or other team members on any unusual behaviour and observations made with respect to clients/residents
• Evaluate the individual’s need for change in the personal support care plan and make recommendations to RPN or designate.
• Contributes to the development of the personal support care plan by reporting, to the RPN or designate, all observations or information obtained from the resident and/or family regarding needs and the effect of the care he/she provided.
• Plans and organizes each day’s activities, setting priorities for personal support and other activities, to effectively utilize time, energy, supplies and equipment.
• Completes documentation/paperwork according to Carefor policies and procedures
• Reviews all forms of documentation and communication in order to remain current on residence operations and resident care. This may include reviewing care notes, e-mails, memos, communication book, and receiving verbal updates
• Functions and reports in compliance with the Occupational Health and Safety legislation, regulations, and Carefor policies and procedures
• Reports the absence of or defect in any equipment or protective device of which he/she is aware and which may endanger him/herself or another worker
• Reports any violations of the Health and Safety Act or the regulations, or the existence of any hazard
• Ensures all workplace incidents are reported in a timely manner in accordance with legislation, and Carefor policies and procedures for workplace injuries and incidents

•  Secondary school education preferred
• Personal Support Worker or Health Care Aide certificate
• Current Standard First Aid Certificate, required
• Current CPR level C Certificate, required

• Schedules service providers for client visits in areas assigned by manager
• Provides work schedules to staff that meet client needs and maximize continuity of care.
• Keeps up to date with daily changes such as staff availability, changes in client service
• authorizations and/or care plans
• Ensures client and service provider information is accurate and up to date in the scheduling database
• Provides timely information, through the use of communication technology (telephone, fax, e-mail, voicemail), to field staff, services providers, co-workers, Managers and Supervisors, clients and customers
• Verifies visit confirmations from field staff and processes in a timely manner to be processed by the billing department
• Verifies payroll information for field staff in a timely manner ensuring accuracy of hours, mileage, stats and premiums.
• Contacts LHIN regarding discrepancies in frequency, authorization for extra visits or not seen/ not found visits, extensions to planned review dates
• Works collaboratively as part of a team willing to assist others and mentor new staff
• Contributes to the principles of customer-focused service and continuous quality improvement
• Functions and completes all duties in compliance with Occupational Health and Safety legislation, regulations, and Carefor policies, procedures, and standards

• Defined Pension Plan with the Healthcare of Ontario Pension Plan (HOOPP)
• Employee and Family Assistance Program
• Professional Development Opportunities
• Leadership team who values innovation, continuous improvement, quality and service excellence while appreciating work-life boundaries
• A collaborative, diverse and inclusive team culture
• Wellness program
• Company events
• Work-life balance
• Paid orientation and training
• Flexible Shifts
• All necessary Personal Protective Equipment (PPE)
• Company cell phone and tablet

• Assess, intervene, consult and counsel clients and their families in the community
• Adjustment to illness/disability
• Ability to cope & manage care needs – including caregiver burden
• Ability to access need resources
• Future care needs
• Palliative care options and End of Life issues
• ntergenerational family conflict
• Abuse/neglect situations
• Psychosocial issues and social isolation
• Housing, Income options, Finances and Resources
• Develop a care plan with the client and family based on the assessment
• Document and communicate care plan as well as client care activity per college standards
• Implement strategies or interventions to achieve realistic client-centered outcomes
• Assist with and complete applications and paperwork for needed resources.
• Refer clients to appropriate community resources and programs as well other disciplines as necessary

• Master Degree in Social Work
• Registered with the College of Social Work and Social Services of Ontario
• Excellent oral and written communication skills
• Bilingualism (French/English) required
• Strong skills in critical thinking, decision making and analysis
• The ability to work collaboratively with case managers, clients, families and other caregivers to provide service
• Possession of a valid driver’s license, (G2 level) and use of a reliable vehicle
• 2-5 years’ experience preferred
• Experience in community health and/or palliative care

Client-centred support and assistance with activities of daily living (ADLs), personal care and other care needs assigned. Duties will be carried out under the formal delegation of a registered nursing professional, in accordance with organizational policies, applicable legislation, and within the scope of training and competence. Responsibilities may include, but are not limited to the following:

• Personal Care & ADLs: Assist clients with bathing, grooming, dressing, toileting, mobility, and safe transfers (including use of lifts and mobility aids).
• Health Monitoring: Observe and report changes in client condition to the supervising nurse or care team.
• Medication Assistance: Provide medication reminders or assistance as per care plan.
• Environmental Support: Perform light housekeeping, laundry, and meal preparation to maintain a safe and clean environment.
• Social & Emotional Support: Engage clients in conversation and activities to reduce isolation and promote well-being.
• Documentation & Communication: Accurately document provided care and communicate effectively with clients, families, and team members.
• Safety & Infection Control: Follow Personal Protective Equipment (PPE) protocols, infection prevention practices, and health and safety regulations.
• Team Collaboration: Work collaboratively with nurses, supervisors, and other health care professionals to ensure continuity of care.
• Specialized care: provide basic ostomy and catheter care; assist with end of life care and respite care where appropriate
• Acts in compliance with the Occupational Health and Safety legislation, regulations, and Carefor policies and procedures
• Other related duties/tasks as assigned by the Supervisor, Personal Support Services

• Personal Support Worker Certificate (or equivalent qualification) (essential)
• Strong interpersonal, communication, and problem-solving skills (essential)
• Clear vulnerable sector police check (essential)
• Experience in home care, retirement homes, or long-term care (asset)
• Ability to work independently and manage multiple tasks in a fast-paced environment (asset)
• Ability to service clients in any geographical area when the need arises (asset)
• Demonstrate ability to be flexible in accepting a variety of assignments (asset)
• Gentle Persuasive Approach (GPA) (asset)
• Enhanced Palliative Care certificate (asset)
• Current CPR and First Aid certification (asset)
• Valid driver’s license and full access to a vehicle (essential for Full -Time and Part Time Community setting only – otherwise asset)
• Registered PSW with Health and Supportive Care Providers Oversight Authority (HSCPOA) (asset)
• Bilingualism (English & French) (asset)

• Competitive wages (in addition to the Provincial government wage enhancement)
• Defined Pension Plan with the Healthcare of Ontario Pension Plan (HOOPP)
• Paid professional development and training
• Employee Assistance Program

• Supports the care management and home care assessment responsibilities of clients transitioning out of hospital within the atHome Program;
• Delivers nursing care to clients within the atHome Program;
• Acts as a resource to the atHome Program care team, providing coaching, education, and instruction to encourage individual and operational performance objectives. Encourages and models evidence-informed practice;
• Supports the performance management process with assigned staff and engages with appropriate managers regarding any performance issues;
• Contributes to human resources management including employee relations, health and safety, continuing education, performance development, recognition of staff and orientation, as required;
• Assists the Manager in identifying areas for recruitment, anticipates and monitors staffing needs and initiates appropriate action to obtain/maintain an adequate compliment staff for the atHome program;
• Investigates and evaluates client and staff concerns/complaints and implements appropriate resolutions, as required

Operational And Organizational Responsibilities

• Leads by example and promotes continuous quality improvement;
• Understands, promotes, and communicates the value, purpose, and goals of the atHome Program;
• Working with the Allied Health Services Manager in the evaluation and revision of atHome Program policies and procedures, based on changes in practice and requirements from funder or partner organization;
• Ensures that the quality of client care delivery is consistent with Carefor’s mission, vision, values and strategic plan;
• Meets the contractual terms set forth by external/funding partners and maintains communication with these partners as needed;
• Assists with operation of the program; provision of direct client care as required;
• Collaborate to address quality, safety and risk management issues, including the creation of professional development and performance improvement plans to address shortfalls;
• Contributes to the improvement of client outcomes (quality of life and quality of care) based on best available evidence and efficient utilization of resources;
• Contributes to business development initiatives, as required;
• Support the atHome Program team through regular meetings, orientation, mentorship, consultation, and guidance with complex clinical situations. Participate in internal and external case conferences or meetings as required; and
• Operates within as well as monitors individual, staff, and program compliance to Occupational Health and Safety Legislation, standards, and Carefor Policies & Procedures.

Working Conditions

• Combined regular office environment with some flexibility of remote work.
• A vehicle for travel within the Ottawa region to support Nursing staff working in various community settings (e.g. individual homes, retirement homes, Carefor clinics) will be required.
• Ability to work flexible hours to support client needs may be required.

• Registered Practical Nurse (RPN) in good standing with the College of Nurses of Ontario; required.
• Three (3) years recent experience of working within the adult home health care sector with related experience to support the provision of restorative care to older adults.
• Knowledge of the related regulatory and legislative requirements within Ontario; required.
• Certification in clinical specialties and chronic disease management (e.g., GPNC(C) Gerontology Practical Nurse Certified (C) Canada or CMSN(C) Medical-Surgical Nursing (C) Canada); an asset.
• Ability to promote and facilitate evidence-based practice within a community setting with a demonstrated expertise and ability to apply, teach, coach and mentor individuals and teams.
• Superior communication skills and ability to communicate effectively to direct and motivate others while maintaining a persuasive and credible presentation style at all levels of the organization.
• Demonstrated effective analytical, and problem-resolution skills.
• Excellent organizational, planning and time management skills.
• Proficiency in using Microsoft Office applications (e.g., Outlook, Word, Excel, etc.).
• Experience in a unionized environment; an asset.
• Certified RAI Assessor; preferred
• Active member of RPNAO; an asset.
• Bilingualism (French/English), an asset

• Defined Pension Plan with the Healthcare of Ontario Pension Plan (HOOPP)
• Employee and Family Assistance Program
• Professional Development Opportunities
• Leadership team who values innovation, continuous improvement, quality and service excellence while appreciating work-life boundaries
• A collaborative, diverse and inclusive team culture
• Wellness program
• Company events
• Work-life balance
• Paid mileage between clients
• Smartphone provided
• 24/7 support from on-call Supervisors
• Paid orientation and training
• Flexible Shifts
• All necessary Personal Protective Equipment (PPE)

Job Types: Part-time, Permanent

Hrs: 37.5

As a Registered Practical Nurse in Carefor’s Visit Nursing Program, you will make a difference in the lives of your clients in the community by utilizing your excellent communication skills to obtain relevant information from your clients and their families. You will implement nursing strategies or interventions according to the established care plan in consultation with the client and/or caregiver and the health care team. You will utilize adult learning principals and teaching materials to provide guidance to clients and their caregivers. You will incorporate your research findings into your daily clinical practice while demonstrating your exceptional time management and advance planning skills that will promote client-directed care, self-care and independence.

• In our fast-paced, responsive, and caring environment, we are looking for a self-starter who has the experience and ability to jump in on day one with energy and enthusiasm. The following items describe important experience and competency areas you have demonstrated in your current or previous roles in order to be successful in this role:

• You are registered in good standing with the College of Nurses in Ontario (CNO)
• You have excellent high-tech skills (with IV restart) or a passion to be trained in these skills
• You possess a valid driver’s license and use of a reliable vehicle
• You have excellent documentation skills
• You have the ability to work collaboratively as a member of an interdisciplinary practice
• You have excellent problem-solving skills and the ability to adapt nursing to independent practice
• You take initiative and you are passionate about caring for your clientsIf you have the following, it would be considered an additional asset:

• Ability to converse in both official languages (English and French)
• Experience in palliative care
• You have LEAP training or are willing to take part as a requirement to palliative care provision
• Experience in community health care
• Current skills in Foot Care

• Defined Pension Plan with the Healthcare of Ontario Pension Plan (HOOPP)
• Employee and Family Assistance Program
• Professional Development Opportunities
• Leadership team who values innovation, continuous improvement, quality and service excellence while appreciating work-life boundaries
• A collaborative, diverse and inclusive team culture
• Wellness program
• Company events
• Work-life balance
• Paid mileage between clients
• Smartphone provided
• 24/7 support from on-call Supervisors
• Paid orientation and training
• Flexible Shifts
• All necessary Personal Protective Equipment (PPE)