Clinical Nurse Practitioner, Emergency PSU - Full Time (1.0) Temporary (until September 2023)

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 paediatric 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.
The scope of practice and sphere of influence of the NP role has five interrelated components: direct clinical care practitioner, educator, consultant, researcher, and leader. These components are not separate and distinct but are woven into the everyday functioning of the NP role. The balance of these components will continuously vary depending on the setting in which the NP is employed, the needs of the patients cared for in that setting, and the expertise of the nurse as an NP. However, given the focus of NP role, the major sphere of influence and majority of the NP’s time is in the direct clinical practice component of the role. Time, opportunity and other supports are provided for the NP to engage in the full scope of the role.

SCOPE OF PRACTICE & SPHERE OF INFLUENCE: DIRECT CLINICAL PRACTICE & CONSULTATION [60-80%]

As an advanced practitioner working within the auspices of approved medical directives and in collaboration with physician partners, the NP devotes a major portion of his/her time to direct patient care with a family context. The NP manages the patient’s care while within the ED, in conjunction with clinical partners (e.g., bedside nurses, physicians, pharmacists). The NP’s advanced direct care practice is conducted (a) within a holistic framework; (b) through the formation of partnerships with the child, youth and/or family; (c) with the use of expert clinical reasoning and skillful performance; (d) the use of best evidence; and (e) the use of diverse, direct care management and treatment approaches.

• 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 within scope of practice.
• 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 based on scope of practice and/or defined medical directives.
• Performs selected diagnostic and therapeutic intervention and in consultation with the attending physician as necessary.
• Liaises with health care team members regarding patient care progress and outcomes.
• Requests consultation from physicians and health care professionals when indicated.
• 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 within and between various care settings.
• Engages patients, nurses and other team members in anticipating, discussing and resolving moral, ethical, and/or legal issues relevant to patient care at both the individual and corporate level.
• 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 [5-10%]

In the educator component, the NP shares specialized knowledge with other members of the interdisciplinary team to achieve treatment goals and provide continuity of care. As a clinical expert within his/her paediatric subspecialty, the NP partners with nursing colleagues to facilitate the patients’ and/or families’ learning and promote an environment that maximizes their understanding, participation, and control in their health. The NP also acts as a resource person, preceptor, and mentor for nurses, students and other professionals. The NP also advances the education of nurses.

• 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 [5-10%]

As a leader, the NP provides professional leadership in the development of standards, policies, procedures, and outcome measures related to the specialty area and the development of paediatric NP advanced nursing practice. The NP plans, implements, and evaluates changes in clinical practice. The NP provides clinical leadership by acting as a resource, facilitator, coordinator, role model, and advocate. The NP’s leadership responsibilities should enhance the clinical focus of the role.

• 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 related to development, implementation and evaluation of policies, procedures, protocols, guidelines, standards, education and /or research.
• Collaborates with academic/ research institutions through shared projects and/or through joint appointments.
• 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 delivery.
• Takes a lead in the identification, development, implementation and evaluation of medical directives.

SCOPE OF PRACTICE & SPHERE OF INFLUENCE: RESEARCH [5-10%]

The research component strengthens the link between clinical practice and research. The NP has knowledge in research methodology, identifies, conducts, and collaborates in the development of nursing and/or interdisciplinary paediatric research and quality improvement projects. The NP enhances excellence in paediatric nursing in his/her subspecialty by critically appraising research findings and implementing strategies to translate them into practice to improve patient care in the clinical setting.

• 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 and facilitates their understanding of the research process.
• Evaluates and implements clinical research findings to improve patient care in collaboration with the multidisciplinary team.
• 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)

Bilingualism (French/English) will be validated by a language proficiency assessment conducted by a third party provider. Candidates will be required to meet the minimum linguistic profile prior to the date of hire.

CHEO values diversity and is an equal opportunity employer. We are committed to providing an inclusive and barrier-free work environment, starting with the hiring process and welcome interest from all qualified applicants.

Should you require accommodation during any phase in the recruitment process, please contact Human Resources at jobs@cheo.on.ca. All information received in relation to accommodation will be kept confidential and will be handled in compliance with the Accessibility for Ontarians with Disabilities Act.

We thank all those who apply, however, only those to be interviewed will be contacted.