POSITION SUMMARY

The Nurse Practitioner (NP) at CHEO is a nurse in an advanced nursing practice position with additional educational preparation from an accredited NP program and who has clinical expertise in a pediatric nursing subspecialty. The NP integrates the skills and knowledge from nursing and medicine within a broad framework of advanced nursing practice. The NP functions both autonomously and in collaboration with physicians and other health care providers to manage, in a comprehensive manner, the health care needs of patients and families visiting the CHEO Emergency Department (ED). The primary focus of the NP is to stabilize patients with episodes of acute and/or life-threatening illnesses, minimize complications, restore maximal health potential, and provide holistic nursing care to the children and/or youth within a relational ethics and family centered care philosophy in order to implement strategies to minimize or prevent the problems for which the acute care populations are at risk. Within the ED, the NP’s primary strategy will also rapid assessment and disposition of low acuity patients to support redirection to further assessment within the ED or discharge to Primary Care Provider and home.

SCOPE OF PRACTICE & SPHERE OF INFLUENCE: DIRECT CLINICAL PRACTICE & CONSULTATION

• Assesses the health status of the child through advanced physical examination, interview, history and selected diagnostic studies; conducts in-depth comprehensive assessments which integrate a wide range of complex information including: resident, family and/or substitute decision maker perspectives, staff perspectives, nursing and allied health theory and research. Completes holistic health histories, mental status and physical examinations.
• Identifies the patient's health problem and develops a plan of care in collaboration with the child/family and the health care team.
• Orders and interprets laboratory, radiologic, or other tests in consultation with the attending physician, as necessary.
• Formulates medical and nursing diagnoses of acute health / complex patient conditions
• Discusses the diagnosis and prognosis with patient's family.
• Identifies and implements creative strategies for managing complex patients and their families.
• Prescribes pharmacological agents and therapeutic measures
• Performs selected diagnostic and therapeutic intervention and in consultation with the attending physician
• Liaises with health care team members regarding patient care progress and outcomes.
• Requests consultation from physicians and health care professionals
• Facilitates the planning and discharge or transfer of patients.
• Documents assessment, plan, intervention and evaluation of patient care.
• Provides consultation services to nursing staff, managers, physicians and other team members regarding clinical and professional practice issues.
• Applies relevant research and best evidence based on theoretical, empirical, ethical and experiential knowledge to inform critical thinking and decision making when making recommending nursing interventions.
• Promotes and facilitates collaborative interdisciplinary patient & family centered care.
• Uses critical thinking skills and synthesis skills to guide decision-making when participating in complex patient care coordination and in facilitating care navigation
• Engages patients, nurses and other team members in anticipating, discussing and resolving moral, ethical, and/or legal issues relevant to patient care
• Uses clinical exemplars to generate new knowledge and develop new standards of care, programs and policies within the practice environment.
• Monitors, evaluates & documents outcomes of decisions and interventions to facilitate the best possible outcome with no unnecessary exposure to risk of harm for patients and families.
• Identifies opportunities to develop care processes and delivery system to strengthen the provision of patient centered quality care within the practice environment.
• Knowledge of regional health care system in related specialty area.
• Represents nursing in institutional, community & professional forums.
• Acts as a consultant to nursing and other program staff with regard to treatment and care of children.
• Provides consultation to the community to collaboratively develop standards, policies and procedures to ensure seamless care for children and families.

SCOPE OF PRACTICE & SPHERE OF INFLUENCE: EDUCATION

• Assists in the identification, planning and evaluation continuing education needs for nurses and other clinical partners to promote quality patient and family centered care.
• Participates in professional development activities/ programs both internally and externally.
• Acts as a resource/mentor/role model for nurses, students, and other clinical partners to improve and support nursing practice.
• Supports nurses in professional development and career planning.
• Educates nurses, other health care providers and patients regarding the link(s) between nursing assessment, interventions and patient outcomes to effect health care changes.
• Seizes informal learning opportunities to educate nursing colleagues and health team members.
• Develops and advocates for the design, implementation and evaluation of educational and support programs for the specialty population of patients, families, general public, and health care professionals to promote quality care.
• Participates in the academic community by providing education, clinical supervision and mentorship through a university joint-appointment.
• Provides counseling and education applying advanced knowledge and synthesis of therapeutic counseling modalities.
• Disseminates & profiles nursing knowledge through presentation and/or publication at local, regional, national and international venues.
• Promotes development, critical analysis and refinement of professional nursing practice.

SCOPE OF PRACTICE & SPHERE OF INFLUENCE: LEADERSHIP/CHANGE AGENT

• Provides leadership regarding quality improvement and program planning within area of expertise.
• Leads and/or supports nurses in continuous quality improvement initiatives in the evaluation of the effectiveness of nursing interventions/ care delivery models on patient outcomes and care delivery processes.
• Applies knowledge of risk management, harm reduction and remediation principles within the context of continuous quality improvement.
• Identifies nursing clinical practice issues needing improvement.
• Participates in strategic planning processes at corporate and program level.
• Anticipates emergent/ future issues/ changes and provides leadership and vision in short & long term goal planning.
• Participates and provides leadership on intra/ interdisciplinary and external committees
• Collaborates with academic/research institutions
• Contributes to the broader context of nursing knowledge through scientific, best practice presentations and publications.
• Recommends policy changes based in best available evidence or research outcomes.
• Demonstrates an understanding of legislative and socio/political issues that influence health care decision making and nursing practice.
• Facilitates the development, implementation and evaluation of processes/ pathways to ensure new nursing knowledge/ policies/ standards are effectively communicated to nurses and others within the practice environment.
• Identifies opportunities to incorporate reflective practice into nursing profession activities/ systems.
• Collaborates with the Unit Manager and/or Director by providing recommendations to re-mediate nursing practice to resolve practice concerns.
• Lobbies for development and changes in pediatric health care
• Takes a lead in the identification, development, implementation and evaluation of medical directives.

SCOPE OF PRACTICE & SPHERE OF INFLUENCE: RESEARCH

• Identifies, evaluates, interprets, communicates, and disseminates best practice innovations and research findings to support patient care and recommends policy changes based on research.
• Identifies, and facilitates the implementation of recent best practice innovations and research findings relevant to patient outcomes and nursing practice.
• Assists nurses with implementation of research findings
• Evaluates and implements clinical research findings to improve patient care
• Monitors and evaluates current practice at the individual and system level in light of emerging research findings and best practice guidelines.
• Enhances the scientific base of nursing practice by utilizing and supporting research in nursing and with other disciplines.
• Provides leadership in identifying nursing research opportunities, developing research protocols, conducting and/or participating in nurse led and interdisciplinary research initiatives to monitor, improve or evaluate patient outcomes, nursing services and/or care delivery processes.
• Seeks funding sources to investigations of clinical issues or care delivery models.
• Publishes in clinical, scientific and peer reviewed journals and presents at scientific conferences.
• Actively participates in nurse-related Research Institute activities.

QUALIFICATIONS

• Vulnerable Sector Check (Essential)
• Masters degree in Nursing (preferred) (or equivalent) with subspecialty clinical focus, and completion of Acute Care Nurse Practitioner program, Primary Care Practitioner program, or other academically recognized subspecialty program (i.e., NNP) (Essential)
• Current certification/licensure as a Nurse Practitioner as required in Ontario (Essential)
• Current CNA (or equivalent) certification in subspecialty (Essential)
• Registration Required: Current license with College of Nurses (Essential)
• Three to five years of recent related clinical nursing experience (Essential)
• Current appropriate level of life-support training (e.g., BCLS, PALS, NRP) (Preferred)
• Member of RNAO/Nurse Practitioner Association of Ontario (Preferred)
• Bilingualism (French/English) ( Preferred )