ADULT Volunteer Application Package

Transcription

1 Oakville Trafalgar Memorial Hospital Site 327 Reynolds Street, Oakville, ON L6J 3L7 ADULT Volunteer Application Package Thank you for your interest in becoming a member of our team! Volunteering with the Oakville Trafalgar Memorial Hospital is a great opportunity to make a difference in someone s life, be part of a team, share your experience, learn new skills and develop lasting friendships. The hospital places a high value on its volunteers who play a vital role within the hospital as valued members of our team. Attached you will find information outlining the many functions performed by our volunteers to assist you in identifying those areas of interest to you. The following forms are required to volunteer: Application Form: Please complete in full, sign, and return this application form as soon as possible to the Volunteer Services Department. You must include contact information for THREE references. Immunization Clearance Form: Please begin the process of completing this form as soon as possible, as it needs to be completed and signed by your medical practitioner before you can start. It may take a month or so to complete, requiring a series of visits to your doctor and/or a walk in clinic. Once completed, please return it to the Volunteer department. This form can be submitted after your interview. Completion of health screening does not guarantee a volunteer placement. If you have any questions regarding this process, please contact the Volunteer Services Department at (905) or us at lparente@haltonhealthcare.on.ca

2 VOLUNTEER SERVICES APPLICATION FORM Date: HALTON HEALTHCARE SERVICES CORPORATION Oakville-Trafalgar Memorial Hospital site 327 Reynolds Street, Oakville, Ontario L6J 3L7 Tel: (905) Fax: (905) Name: (Surname) (First) Address: (Street) (Apt./Unit No.) (City) (Province) (Postal Code) Telephone: Home: ( ) Other: ( ) How did you hear about our volunteering opportunities? Why do you want to volunteer at O.T.M.H? Which Volunteer services are you interested in? List both employment and/or volunteer experience: List any skills, experiences, interests, education or training that would assist you in your choice of service: When are you available to Volunteer (times are approximate)? (Please check all that apply) Time Available Mon Tues Wed Thurs Fri Sat Sun Mornings Afternoons Evenings

3 References: (Please provide volunteer, employment and/or personal references not including immediate family or physicians) Name Relationship Address Phone # (preferred) As a Volunteer: 1. I understand I am required to comply with the confidentiality regulations of Halton Healthcare Services. 2. I understand that proof of an up-to-date Tuberculin skin test or chest x-ray and record of updated inoculations are required BEFORE beginning a volunteer assignment. 3. I understand that I must wear my I.D. badge and uniform while on duty, and that these must be returned to the Volunteer Department within 4 weeks of termination of appointment. A fully refundable deposit for the uniform is required. 4. I understand that there will be a three-month probationary period during which time either party may terminate the partnership with minimal explanation. 5. I understand that to obtain a credit or a letter of reference, I must volunteer for a minimum of 50 hours. 6. I hereby give my permission for Halton Healthcare Services or its agent to check references, as provided above. 7. I understand that the Hospital s insurance coverage will protect me from personal liability while I am serving as a volunteer, provided that I am acting in accordance with such directions or instructions as are given to me by the volunteer management, and I am acting reasonably, honestly and in good faith. Signature: Witness: FOR OFFICE USE ONLY Interview Date: Interview by: Health Clearance Date: Comments:

4 VOLUNTEER SERVICES DEPARTMENT Halton Healthcare Services Oakville-Trafalgar Memorial Hospital site 327 Reynolds Street, Oakville, Ontario L6J 3L7 Phone (905) Fax (905) SERVICE Asthma Clinic Book appointments over the telephone; related clerical work. Breast Feeding Clinic Assist in office while lactation consultants visit mothers. Crutch Preparation Size and adjust crutches; stock supplies. Cardiac Rehabilitation Filing, clerical work, patient reminder calling. Cardiology Filing. Chart Group Assemble and deliver new charts for hospital departments. Chiropody & Orthotic Clinic (located off-site) Reminder calling and clerical assistance in office. Coordinate patient visits with staff while at local nursing homes. ConnectCARE Friendly calling, installing equipment in clients homes, or office assistance. Diabetic Clinic (located off-site) Help staff and patients with weekly clinics. Diagnostic Imaging Reception and escort assistance among modalities. Reminder calls to patients regarding appointments. Dialysis Unit (Oakville and Burlington Clinics) Visit with patients during treatment; transport patients; help stock supplies; occasional filing. 9:00 - Noon SHIFT RANGE 9:00 a.m. - 3:00 p.m. Sat/Sun 9:00 a.m. 1:00 p.m. days Morning or afternoon Friday 8:30 a.m. - 11:30 a.m. Occasional weekends Mon - Fri 7:45 a.m. - 11:30 a.m. Mon - Fri Days Mon Sat Shifts between 9:00 a.m. and 9:00 p.m.

5 SERVICE Emergency Offer comfort measures and companionship in waiting room and treatment areas; tidy waiting room; help stock supplies as needed. Floor Service Assist patients with menus and meals; provide helping hands and comfort to patients; assist staff with stocking and filing. Foundation (located off-site) o Assemble mailings, photocopy, material preparation o Special events committees; clerical support for fundraising drives ** Fundraising -- A COMMITTEE develops and implements ideas for regular and special fundraising activities throughout the year. SHIFT RANGE Mon - Sun Days, Afternoons, Evenings 8:00 a.m. - 11:00 a.m. and 4:15 6:15 p.m. hours BINGO - Assist in the operation of games at Mayfair Bingo Hall. H.E.L.P.P. Lottery -- Sell instant win lottery tickets in the hospital to help raise money for hospital equipment purchases. Gastro-Intestinal Suite Coordinate patients and families before and after treatment. Geriatric Assessment Clinic Assist staff with client flow and office assistance. Gift Shop [This is a major source of revenue for the Auxiliary] Salespeople and cashiers (training provided). -- Tuck Cart Sell sundries (newspapers, personal hygiene items, snacks) from mobile Gift Shop Cart to patients and staff throughout the Hospital. Buyers Select merchandise for sale in the Gift Shop. Display Designers Arrange items for display in the gift shop and display cases. Knitting/Crocheting Group Create items for sale in the Gift Shop and for patients. Alternate Wed. Afternoons 9:00 a.m. 3:00 p.m. 9:00 a.m. 2:00 p.m. Alternate Tuesday or Wednesday afternoons Mon Sun Days, Afternoons, and Evenings 10:00 a.m. - 12:00 noon Tues 1:00 p.m. - 3:00 p.m.

6 SERVICE SHIFT RANGE Health Promotion Restock information displays throughout the Hospital. Assist with special events and promotional projects. Heart Function Clinic Assist with telephone calls; setting up charts and filing. Information Desk Assist in directing patients and visitors within the hospital, answer telephone and print patient s for distribution. Direct visitors to second floor departments (weekdays only). Information Systems E-Learning assist staff with on-line education modules. Other computer projects as required. Intensive Care Unit (ICU) Provide information and comfort to families and liaise among patients, visitors and staff. Kailo (Wellness Program) Assist with special events, projects Deliver tea and snacks to staff by cart Library Book Cart Offer donated books and magazines to in-patients and waiting areas throughout the hospital from the mobile library cart. Maternal Child Program Assist staff with preparing clerical materials and other supplies. Coordinate patient visits to weekly Endocrine clinic or prenatal classes. Assist with the organization and promotion of Child Life equipment and supplies. Outpatient Clinics (Orthopaedic, Ophthalmology, Pacemaker; Mental Health is off-site) Greet and coordinate patients, pull charts, file, make reminder calls, book appointments. Days and/or Evenings Mon Sun Days, 8 12; 12-4 Evenings, 4-7 Weekends, 9 11:30; 11:30-2 Mon Sun 12-4 and 5:30 8 pm approx. Days and/or Evenings Mornings preferred Mornings Mornings and Afternoons

7 SERVICE SHIFT RANGE Palliative Care Provide companionship and support to long-stay and terminally ill patients and their families. Patient Surveys or Reminder Calling (Various Departments) Conduct patient satisfaction surveys or call patients to remind them of pending appointments. May include data entry functions. Patient Visitation Spend time with non-palliative patients who desire company. May include walks on the grounds, reading, playing games etc. Pre-Admission Clinic Coordinate patient visits with staff, assist with clerical functions. Joint Replacement Clinic co-ordinate patient visits with staff Public Relations Assist staff with distribution of information throughout the hospital. Pulmonary Rehabilitation (COPD) Provide assistance and encouragement to patients during therapy. Quilting Work in a group making quilts for fund-raising raffles. Recreation Programs Assist with daily programs & special events on nursing units and/or one to one visiting. Rehabilitation (Physiotherapy, Pre-Hab, Occupational Therapy, Falls Prevention and Hand Clinics) Greet patients; assist staff before and after treatment. Respiratory Therapy Assist with reminder calls, coordination of records. Mon Sun Varied Day and Evening hours, as required., 8:30-3:30 Wed. mornings or afternoons Wed and Fri. 10:30 am 12:00 noon Thurs 9:00 a.m. - 11:30 a.m. Tues - Sat Days and Evenings Monday through Friday Days Tues and Thurs/Fri 9:00 a.m. 11:00 a.m.

8 SERVICE Surgical Day Care Liaise between staff and families to coordinate patient visits before and after surgery. Transport Perform in-hospital transport of patients and materials by wheelchair, stretcher and cart. Clerical and other odd jobs as time allows. Volunteer Services Department Assist with office reception, clerical functions, and projects as required. Assist with the maintenance of computerized volunteer database. Wheelchair Maintenance Inventory control and maintenance for hospital wheelchairs and walkers. SHIFT RANGE 8-11, 11-2, 2-5 8:30 a.m. - 12:00 noon 12:00 noon - 3:30 p.m. Tues and Thurs, afternoons Youth Volunteers Youth (aged years) provide help in various areas of the hospital; primarily nursing units. Summer and year-round programs LEGEND: ** Recruited/placed by the relevant service or department, independent of the Volunteer Services Department. S:\1. Services\Volunteer Services List

9 Dear Volunteer: Before you start volunteering you will need to provide us with some information about your immunity. Some basic information is outlined below TUBERCULOSIS (TB) This test involves an injection into the skin of the forearm, with results being read 48 to 72 hours later. If the test is positive it is because you have received BCG vaccine for Tuberculosis or you have been exposed to someone with Tuberculosis. Your doctor will further assess this with a Chest x-ray and discuss any symptoms. If the first test is negative, a second test is performed in the other arm, one to four weeks later. This is followed by another reading in 48 to 72 hours. The second test is taken as the final result. If you are a returning volunteer and have been previously cleared by HHS, you do not have to repeat this process. MEASLES, MUMPS, RUBELLA (German Measles) and VARICELLA (Chicken Pox) If your vaccinations are up to date and you have had Chicken Pox or shingles, you are considered immune, and nothing further has to be done. If your immunity status is unknown, your doctor will do some blood tests (the results take about a month) and follow up with you if necessary. Please take the attached information sheet and form to your doctor to initiate appropriate testing. Your doctor will give you the Immunization Clearance Form as soon as the TB testing (or x-ray if required) is done. Please be sure to follow up with your doctor to complete additional immunization, if required. Return this form to Volunteer Services as soon as possible, as they must keep accurate records. If you don t have a family doctor, you can take the information sheet and form to a Walk-In Clinic. Note that TB tests are not covered by OHIP. We have asked your doctor to waive the fee but charges still may apply. Health screening may take several weeks. Volunteers are encouraged to initiate this process as soon as possible and should be aware that completion of health screening does not guarantee a volunteer placement. We hope you enjoy your experience as a volunteer. Volunteer Services Halton Healthcare Services

10 Dear Doctor: Your patient has applied to be a volunteer which has some surveillance requirements. Please waive any fees if possible. Tuberculosis Status: Unless your patient has a previously documented positive Mantoux test he/she will require testing. The two-step test requires an initial 5 TU skin test even in those persons with a previous history of BCG vaccine. If the result is 0-9 mm of induration (not erythema), the test is repeated one to four weeks later. Readings are performed 48 to 72 hours following the testing. If the initial test is positive (10 mm or greater), the second test is not done. Evaluation of any positive tests must be carried out. This includes a chest x-ray, unless contraindicated, and review of symptoms. Measles, Mumps, Rubella and Varicella Status: If immunizations are up to date and there is a positive history of Chicken Pox, no further follow up is required. If immunity status is uncertain, send blood work to Provincial Health Lab for assessment of immunity to all four diseases. Please give your patient the completed Immunization Clearance Form (attached, or on the back of this letter) as soon as the Tuberculosis status is determined. FAX TO: OAKVILLE (905) MILTON (905) (905) GEORGETOWN (905) Please follow up with your patient if any additional immunization is required after receiving results of the blood work. We appreciate your cooperation in this matter. Do not hesitate to contact us if any clarification is required. Volunteer Services Halton Healthcare Services 327 Reynolds Street Oakville, Ontario L6J 3L7 PHONE: OAKVILLE (905) ext. 1 MILTON (905) ext GEORGETOWN (905) ext. 8153

11 Immunization Clearance Form To: Halton Healthcare Oakville Volunteer Services Milton Georgetown Volunteers Name:.D.O.B:. My patient has had a two step TB test and/or Chest X-Ray and is free of disease. My patient has known immunity to Measles, Mump, Rubella and Varicella OR My patient s MMRV status is unknown at this time, as titre results are pending. I will administer appropriate immunization when results are known. Physician Signature: Date:. Phone number: Stamp if available: Please give this completed form to your patient as soon as TB testing or X-ray results are available OR Fax to Volunteer Services at: OAKVILLE: (905) MILTON: (905) GEORGETOWN: (905)