Registered Nurse Community Mental Health

Unity Health Toronto, comprised of Providence Healthcare, St. Joseph's Health Centre and St. Michael's Hospital, works to advance the health of everyone in our urban communities and beyond. Our health network serves patients, residents and clients across the full spectrum of care, spanning primary care, secondary community care, tertiary and quaternary care services to post-acute through rehabilitation, palliative care and long-term care, while investing in world-class research and education. Join our team in our mission to continue to put patients and families at the centre of everything we do, in the role of Registered Nurse, Community Mental Health.

The Community Connections Program is a program of St. Michael's Hospital Mental Health Service. The program provides service to clients with serious and persistent mental illness, homelessness, and concurrent substance abuse disorders. Community Connections is based on intensive case management model. This model relies on individual case managers to assist clients to identify, secure, and mobilize the personal and environmental resources required to be successful and satisfied in the community. Flexible and person-centered services are provided in collaboration with other community agencies to enable individuals to harness their own personal strengths and abilities.

The RN works within a changing environment and in inter-professional teams to advocate for and promote wellness while ensuring the delivery of safe, effective and ethical nursing care. The RN shares his/her knowledge and expertise with others and contributes to the advancement of nursing practice excellence. The RN continually enhances his/her practice and competencies through ongoing learning, education, experience and reflective practice.

RESPONSIBILITIES:
The primary role of the RN is to provide holistic, evidence-based, culturally appropriate, patient-centred quality care in accordance with the College of Nurses of Ontario standards and SMH¿s mission, vision, values and policies. The RN optimizes the patient's experience and care outcomes by:

• Being accountable for one's decisions and professional practice;
• Establishing a therapeutic relationship with the patient;
• Collaborating with other members of the patient's care team; and,
• Coordinating and communicating patient care activities.

The RN has 4 key areas of responsibility:

Patient Care:

• Acquires information to assess patient care and learning needs
• Develops a plan of care and integrates nursing activities with other inter-professional activities
• Engages in critical inquiry and reflection to select evidence-based interventions
• Organizes nursing care and assigns or changes nursing care activities where appropriate
• Evaluates the effectiveness of the plan of care and adjusts the plan as needed
• Anticipates, recognizes and addresses rapidly changing situations
• Provides health education to patients and their families using effective teaching strategies
• Documents observations, assessments and care provision
• Contributes to discharge and transition planning
• Refers patient to other agencies or services as needed

Collaboration & Coordination

• Serves as the primary resource for organizing and coordinating patient care activities
• Establishes and maintains respectful, collaborative, therapeutic and inter-professional relationships
• Coordinates and communicates patient care activities for a safe and seamless transition and appropriate transfer of accountability
• Participates in hospital committees and other groups

Leadership

• Aligns behavior with SMH's vision, mission and values and Code of Conduct
• Supports the advancement of professional practice
• Utilizes effective judgment in assigning patient care activities
• Engages in self-reflection, performance review and ongoing learning
• Participates in mentoring, teaching and /or coaching students, co-workers and other regulated and unregulated health professionals
• Embraces change that leads to improved nursing practice and better patient outcomes
• Advocates for a safe and healthy work environment

Research

• Participates in or supports research projects
• Supports and participates in evidence based practice implementation and quality improvement initiatives

The Community Connections RN will:

• Utilize assertive outreach strategies, to locate, engage and maintain clients in a helping relationship. Deliver service and supports in the client's environment of choice in the community (e.g. home or other community setting).
• Perform assessments and complete the biopsychosocial history for the purpose of case planning. Identify client's strengths, existing supports and prior successes. Identify needs related to health care, mental health, substance use/abuse, income, housing, daily living skills, meaningful activity, family relationships, social relationships, recreation and leisure, legal difficulties. Appraise the capacity of the client and informal support to address clients¿ needs.
• Provide clients with information regarding community resources. Select appropriate community resources based on client needs and goals in the medical therapeutic, substance use/abuse, living, learning, working, social environments. Complete referrals and liaise with community agencies. Use assertive outreach to support the client's utilization of community resources.
• Provide support to family and extended family. Educate families about diagnosis, medication and symptoms of mental illness. Assist family members with crisis management.

QUALIFICATIONS:

• Must have Current General Class (Practicing) Registration with the College of Nurses of Ontario
• BLS Certification
• Must have Crisis prevention certification or willing to take within 6 months
• Canadian Psychiatric Mental Health Nursing certification preferred
• Minimum three years recent experience in a community mental health setting
• Knowledge of psychosocial rehabilitation as it applies to community mental health settings
• Knowledge of case management models and case management functions
• Knowledge of community resources
• Demonstrated knowledge and application of the Mental Health Act of Ontario
• Demonstrated knowledge of and skill in the care of patients with severe mental illness and substance abuse disorders
• Excellent assessment and crisis intervention skills
• Excellent attendance record is required
• Ability to work collaboratively with other professions / disciplines in a team environment
• Excellent communication skills
• Proven planning, time management, organization and coordination skills

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