SAMPLE ROLE DESCRIPTION FOR REGISTERED NURSE IN FAMILY PRACTICE

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1 SAMPLE ROLE DESCRIPTION FOR REGISTERED NURSE IN FAMILY PRACTICE FOR ADAPTATION TO YOUR PRIMARY CARE PRACTICE Preamble This dcument describes the ptential rles fr nurses in primary care. Registered nurses can use this dcument as a guide; hwever, nt all rles may be apprpriate depending n the practice envirnment and the nurse s level f cmpetence. Please adapt fr yur practice setting as needed. JOB SUMMARY The rle f the registered nurse (RN) in family practice partners with and cmplements that f the family physician. The registered nurse fllws the patient thrugh all stages f grwth and develpment, thrugh degrees f wellness and illness, frm ne setting t anther, cllabrating with ther RNs, physicians and expert prviders in varius settings. The registered nurse prvides hlistic assessments and creates linkages with apprpriate cmmunity resurces. The RN wrks in partnership with the family physician(s) and ther members f the healthcare team t prvide care t the entire patient ppulatin. The RN fcuses n prviding assessment, screening, healthy lifestyle supprt, educatin and chrnic disease management with a gal f imprving health utcmes and facilitating access t services. KEY DUTIES A. Health assessment Each interactin with a patient ffers an pprtunity t cmplete a cmprehensive assessment f the presenting prblem as well as a cmplete assessment f the health status, risks and pprtunities that can affect lng-term health. This may be cmpleted during ne visit r ver a series f visits depending n the circumstances and shuld be updated in the patient s recrd n a regular basis. Obtains a histry f the presenting health issue(s). Perfrms a cmprehensive and fcused health assessment that includes health histry and cmplete physical evaluatin; cnsiders the patient s psychscial, emtinal, ethnic, cultural and spiritual dimensins f health, including his r her understanding f their health/illness experience and hw their daily life is affected. Uses and adapts assessment tls and techniques based n the patient s unique needs. Assesses the presence f r the need fr advanced care directives r d nt resuscitate dcuments. Cmpletes and dcuments a thrugh medicatin assessment, including ver-thecunter medicatins, alternative medicatins, intlerances and allergies. Maintains an accurate list f all current medicatins by reviewing at each visit and assessing adherence Assesses access t medicatins and treatment by determining health cverage. Dcuments health assessment and clinical data in visit nte and patient prfile r summary as apprpriate.

2 Synthesizes health assessment infrmatin and uses critical thinking and clinical reasning skills t identify health cncerns and ptential screening issues. Applies recgnized clinical practice guidelines and best practices t screening, mnitring, and assessment f patient s physical and emtinal well-being. Incrprates bjective findings such as labratry and diagnstic findings, specialist reprts and past histry in a cmprehensive assessment. Prvides telephne and in-persn triage accrding t established practice prtcl B. Health-care management and therapeutic interventins The registered nurse prvides care and management fr patients with a wide range f health issues. As an integral member f the health team, RNs prvide care fr cmplex patients and thse that require extra time and attentin t develp a plan f care. Initiates and/r cntributes t the develpment f a health plan in cllabratin with the patient and ther members f the interdisciplinary team. Encurages maximum independence and accuntability fr self-care. Recgnizes the need fr and initiates effective interventins and treatments. Discusses treatment ptins with patients and invlves them in decisin-making and self management. Assists and supprts patients with implementatin f the health plan including interventins and diagnstic testing. This may invlve setting up supprts such as medicatin delivery/adherence prgrams fr medicatins, assisting with transprtatin, arranging in-hme care, etc. Determines the need fr and initiates cnsultatins with ther services and health-care prviders in a timely and supprtive manner. Mnitrs, evaluates and adjusts the health plan based n effectiveness f interventins and/r changes in cnditin r envirnment, in cllabratin with the patient and team members. Prvides telephne care, fllw-up and cnsultatin. Dcuments this care in patient recrd r accrding t agency plicy. Infrms and educates patients regarding the meaning and implicatins f test results and interventins. Cunsels patients n drug therapies, side-effects and interactins. Cunsels and guides patients n symptm management, health maintenance and rehabilitatin strategies, as well as risk factrs and lifestyle changes. C-rdinates services and care with the patient t ensure cntinuity and fllw-up. Initiates r participates in patient care case cnferences t ensure c-rdinated, cmprehensive and hlistic services. Prvides care in cllabratin with family physician fr patients in lng-term care r assisted living, including hme visits as required. Dcuments accurate and pertinent patient infrmatin in a timely manner, including maintaining a cmprehensive health summary r patient prfile. Prepares prescriptins fr signing r facilitates the rdering f medicatins accrding t practice plicy. (Please cnfirm with yur prvincial/territrial prfessinal cllege r assciatin that this practice is within the scpe f nursing practice in yur prvince r territry.) Cmpletes necessary dcuments t access medicatins r treatments that are exceptins t frmulary. Cmmunicates with secndary and tertiary prviders t ensure the cntinuity f care. Netwrks with cmmunity agencies and grups. Cmpletes referrals r cnsults, lab requisitins*, and diagnstic requisitins*.

3 Cmpletes insurance, Wrker s Cmpensatin Bard dcuments r ther frms. Mnitrs and maintains infectin cntrl practices accrding t established standards. Examples f types f interventins can include: lifestyle cunselling, chrnic disease management, medicatin management, referrals r links t cmmunity resurces, wund care, suture/staple remval*, insulin starts, specimen cllectin, INR adjustment*, injectins, dressing changes, immunizatins*, crdinating services, ear syringing*, wart treatment*, ft care*, assisting with prcedures, etc. In sme prvinces the fllwing interventins are als pssible with apprpriate dcumentatin r use f best practice guidelines. Please check with yur prvincial cllege r assciatin t ensure that these interventins are apprved: Recmmending ver-the-cunter medicatin Prescribing cntraceptives r ther medicatins Adjusting insulin dses Suturing minr laceratins INR management (adjustment f warfarin) * May be subject t prvincial cllege r assciatin standards f practice r scpe f practice guidelines (link t r require additinal educatin r dcumentatin such as medical directives.r best practice guidelines C. Health educatin The registered nurse prvides educatin that is respnsive t the needs f the patient t ptimize health, enhance understanding f health status, and engage the patient in managing their wn health while anticipating challenges and barriers. Assesses health educatin requirements and readiness f the patient as a cmpnent f an verall health assessment. Assesses current knwledge, educatin and literacy levels, scial supprts, learning preferences and ther factrs that may affect the educatin apprach and plan. Acquires, develps, and evaluates teaching materials and tls, with cnsideratin fr cultural, language, physical, intellectual, and envirnmental factrs. Emplys educatin strategies and mtivatinal interviewing skills t supprt behaviur changes t enhance health (e.g., smking cessatin, physical activity, and healthy eating). Prvides educatin related t healthy living, preventin f injury, illness and cmmunicable diseases, care and treatment, individual and family adjustments, and supprt systems as apprpriate t the patient situatin. Engages patients in educatin regarding chrnic illnesses such as diabetes, chrnic bstructive pulmnary disease, hypertensin, cardiac disease, cancer, and chrnic pain. Utilizes all health-care encunters as an pprtunity t identify educatinal needs and prvide health educatin (e.g., immunizatins, screening, health lifestyle, smking) Develps and prvides a variety f educatinal appraches t address health tpics, including individual and grup sessins, and ffers these in a variety f settings t enhance accessibility. Uses a variety f cmmunicatin strategies, e.g., written, verbal, nn-verbal, visual, Internet, and grup educatin.

4 Creates r advcates fr an envirnment that facilitates patients learning and maximizes their participatin and cntrl in meeting their health-care gals. Examples f areas f health educatin that can be prvided: diabetes, chlesterl, COPD, hypertensin, insulin starts, cardivascular health, medicatins, inhaler use, sexual health cunselling, smking cessatin, health screening, cmmunity resurces, nutritin, medicatin, tests and prcedures, INR educatin, etc. D. Health prmtin and preventin f illness, injury and cmplicatins Screening and mnitring is cmpleted t ensure early identificatin f health issues and cmplicatins assciated with chrnic r cmmunicable diseases. The RN can play a key rle in the preventin f illness and prmtin f health by ensuring screening mechanisms are in place and patient-management f health is encuraged. Plans t prevent the nset f health issues and minimize cmplicatins arising frm disease. Assesses the cmmunity fr strengths and pprtunities t enhance health and mnitrs trends that may have an impact n health. This may be dne in cnjunctin with the cmmunity health nurse r ther cmmunity health prviders. Cnducts risk assessments in cllabratin with the patient and ther service prviders and develps apprpriate health plans t prmte health and prevent illness and cmplicatins. Assesses the immunizatin status f all patients and ensures immunizatins are current. Plans and participates in a strategy t recall patients fr mnitring and screening (e.g., planned recall fr diabetes, cervical screening, hypertensin) Builds n patient and cmmunity resurces in planning health prmtin and illness preventin strategies. Cllabrates with patients, interdisciplinary teams and cmmunities t develp, implement and evaluate health prmtin and illness preventin prgrams. Prvides and c-rdinates screening fr health issues such as diabetes, hypertensin, chlesterl, cancer screening, cardivascular health, mental health, cgnitive functin and steprsis. Prvides cunseling n health prmtin and illness preventin strategies. Assists and supprts the patient in life transitins, including palliatin and death. Wrks as a navigatr t ensure the apprpriate referrals and cnnectins t ther services and prgrams that wuld enable the patient t achieve their health gals. Mnitrs patient prgress with respect t risk reductin and self management plans. Participates in the maintenance f an accurate cmprehensive health recrd. Dcuments accrding t standards fr cmpleting electrnic medical recrds where applicable. E. Prfessinal rle and respnsibility The registered nurse wrks in an ever-changing envirnment and, as such, invests cnsiderable time in maintaining their prfessinal expertise and maintaining a strng evidence-based apprach. The RN acquires and maintains a cmprehensive understanding f health and scial services as well as referral prcesses, including diagnstic services, specialists, hspital care, rehabilitatin and supprt prgrams, educatinal prgrams, and cmmunity-based health agencies. They are als invlved in many initiatives aimed at imprving the health-care practice, identifying risk and safety issues and facilitating reslutin. They are strng and visible rle mdels fr their prfessin.

5 Recgnizes persnal attitudes, beliefs, feelings and values abut health in their interactins with patients and their families. Maintains and applies evidence-based knwledge t the nursing prcess. Leads r participates in research initiatives. Leads r participates in cnference presentatins. Demnstrates the ability t reflect n persnal and team practice thrugh a systematic evaluatin f prfessinal cmpetencies, acceptability, quality, efficiency, and effectiveness f practice. Participates in the develpment, implementatin, and maintenance f medical directives, and plicies and prcedures that guide practice. Uses research findings and evidence t guide the delivery f services. Seeks prfessinal develpment pprtunities cnsistent with current primary care practice, new and emerging issues, changing needs f patient ppulatins, and research. Advances primary care nursing thrugh participatin in prfessinal develpment and practice develpment activities, mentring students, rientating staff and participating in research and quality assurance initiatives. Prvides supervisin, mentrship, rientatin, bservatinal and teaching pprtunities t students ensuring that prgram gals and bjectives are met. Demnstrates leadership in areas such as chrnic disease management, reprductive health, shared care mdels, safety and health. Participates in relevant meetings and cmmittees. Establishes and maintains effective prfessinal relatinships and partnerships with ther rganizatins t benefit system integratin, efficient service utilizatin, effective cllabratin and ptimal patient care Identifies and cllects perfrmance and quality imprvement data and initiates r participates in a prcess t address identified issues. Cmpletes dcumentatin, accurate statistical data, and reprts. Participates r leads quality imprvement prgrams r initiatives in the practice. Maintains a membership with prfessinal rganizatins and interest grups.

6 STATEMENT OF (MINIMUM) QUALIFICATIONS Educatin: Baccalaureate degree in nursing r diplma entry registered nurse Current CPR and BCLS Experience: Certificate/ Licence: Minimum f five years experience as a registered nurse Current nursing registratin with the prvincial/territrial prfessinal cllege r assciatin Knwledge: Knwledge f primary health care and the scial determinants f health Knwledge f cncepts f health prmtin, disease preventin, behaviur change cunselling, prgram planning, individual and grup cunselling Knwledge and awareness related t cultural cmpetence Nursing care knwledge related t primary care/cmmunity health/chrnic disease management Knwledge f the principles f the Stanfrd mdel f self management Understanding f the principles f cllabratin In-depth knwledge f health assessment and interventins in the family practice cntext Knwledge f acts r legislatin that gvern practice: Persnal Health Infrmatin Prtectin Act Prtectin fr Persns in Care Act Mental health act Wrkplace Hazardus Material Infrmatin System (WHMIS) Principles f rutine practices (universal precautins) Child prtectin act Cmpetencies/ Skills & Abilities: Ability t wrk independently and be self-directed Ability t wrk well with ther health-care prfessinals Ability t delegate care apprpriately Ability t be an effective change agent Effective rganizatinal, critical thinking, prblem-slving and decisinmaking skills Excellent cmmunicatin skills and ability t adapt cmmunicatin styles t meet the needs f patients, health team members and cmmunity partners Desirable Qualificatins: Language: Cmpletin f a pst entry primary health care/family practice nurse educatin prgram Certificatin in the administratin f immunizatins (r demnstratin f cmpetency) Specialty certificatin Experience wrking in a family practice, cmmunity r primary health care setting Experience in wrking within a cllabrative interdisciplinary team Experience in a variety f clinical areas English French

7 Desirable Key Relatinships: Other: Sign language Other Other primary care teams and nurses in family practice Other prfessinal team members within centre and in the cmmunity (e.g., public health, hme care, pharmacists) Cmmunity resurces (e.g., cmmunity health bards, cmmunity grups r centres, lcal service clubs) Health-care institutins and specialty prgrams Lng-term care r nursing care facilities Educatin facilities, including schls, clleges, and universities If hme visiting r cmmunity wrk is part f the nursing rle, a valid driver s licence and access t a vehicle may be required

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