Start Date: as soon as possible

Hours of Work: 8:00 am – 4:00 pm Monday to Friday

Pay rate, benefits and other terms and conditions are as per the ONA Collective Agreement

Geriatric Emergency Management (GEM) Nurses provide specialized nursing services in Emergency Departments (ED) for older adults living with / at risk of frailty to the ED.

GEM nurses provide expert and targeted geriatric assessment and treatment services in the Emergency Department; they enhance linkage with hospital and community services and are advocates for the older adults living with/at risk of frailty they serve.

GEM nurses also contribute to capacity building among others working in the ED, as well as community partners, by sharing knowledge and skills, acting as resource clinicians, and collaborating with others in the care of older adults. GEM nurses spend time each week teaching, mentoring and coaching, and supporting the implementation of Senior Friendly Care and geriatric protocols in the ED, across acute care organizations and in other environments.

QUALIFICATIONS

Education & Training:

1. Minimum of a four (4) year Bachelor of Science in Nursing (BScN), from an accredited university.

2. Current Certificate of Registration in good standing with College of Nurses of Ontario (CNO).

Experience:

1. Minimum of five (5) years’ experience working within Specialized Geriatric Services and completing assessment and treatment guided by the Comprehensive Geriatric Assessment.

DUTIES

1. Assist in the implementation of standardized protocols to identify, screen and refer the high-risk older adults in the emergency department, including ongoing education and training.

2. Complete GEM assessments that are aligned to the Comprehensive Geriatric Assessment (CGA model and assess all domains including medical/surgical history, medication, continence, social history, falls, function, cognition, mood/mental health, sleep, pain, nutrition, physical assessment.

3. Provide appropriate assessments and consultation to identify acute symptoms, underlying health conditions, physical, functional, emotional and cognitive status, home environment issues and home supports needed for the at-risk elderly identified in the emergency department.

4. Analyze and synthesize findings from geriatric assessment into a comprehensive clinical report identifying client’s priority needs and relevant treatment options designed to optimize their independence.

5. Make recommendations for care for older adults at risk/living with frailty and assist in their implementation within the emergency department, and other hospital services, including specialized geriatric services.

6. Develop a person-centered, goal-oriented and individualized care plan that is aligned with domains of the CGA. This plan should address modifiable biopsychosocial factors and consider medical diagnosis/prognosis and co-morbidities that impact the health goals of older adults.

7. Assist in transition planning including developing linkages with community services (e.g. family physician, Community Care Access Centre, long-term care settings, ambulatory care RGP services), arrange transportation and equipment needs, coordinate appropriate follow up care and provide education and training in the management of health care needs, including guidance on community-based resources, medications and medical equipment.

8. Develop innovative solutions to address concerns with patient transfers between the ER and other community providers (may include education, development of protocols, etc) with a view to building capacity in the system.

9. Educate patients, families, and staff both formally and informally regarding the particular needs of older adults and the specialized care they require in the ED.

10. Recommend and educate compensatory and remedial strategies, activity modification, adaptive equipment, and assistive devices to the older adult and care partner to promote safety and maximize functional independence.

11. Educate client and family in coping strategies, decision-making, and utilization of personal and community resources, and make referrals to community resources as required.

12. Ensure that a senior friendly care approach is implemented within the emergency department and includes processes for screening, prevention, management, and monitoring of functional decline and delirium.

13. Communicate directly with the attending team, clients, families and community partners throughout the intervention process to make clear recommendations and assist in their implementation.

14. Document assessment findings, analysis, treatment plans, client goals, client’s ongoing progress, effectiveness of treatment plan, and government/insurance/legal forms according to Regulatory College Standards and organizational policies.

15. Collaborate with clients, families, interprofessional team members, and community partners throughout the intervention process and advocate to ensure client needs are met.

16. Build geriatric capacity by creating, implementing, and delivering education to medical professionals, nurses, and physicians across the geriatric continuum of care.

17. Maintain current knowledge of best practice and incorporate into clinical practice.

18. Contribute to ED as well as organizational initiatives to improve the care of older adults (ie. Senior friendly hospital initiatives and quality improvement). This includes collecting outcome data for the GEM service.

19. Evaluate patient care and satisfaction on an ongoing basis and formulate solutions for improvement.

20. Participate in program evaluation and reporting requirements.

21. Participate as an active member of the NE Regional GEM Network.

COMPETENCIES / SKILLS / KNOWLEDGE:

1. Demonstrated person and caregiver focused care and supported by best evidence-based clinical practices.

2. Demonstrated knowledge of best practices for dementia, delirium, depression and other mental health issues and their effect on patients, families and service providers.

3. Demonstrated skills in acute management of geriatric syndromes, including delirium, polypharmacy, falls and functional decline, acute/sub-acute cognitive changes, bowel/bladder, and nutrition/hydration problems.

4. Demonstrated clinical knowledge and expertise in both emergency care and geriatric care.

5. Demonstrated knowledge of Comprehensive Geriatric Assessment (CGA) as the standard of care for older adults living with/at-risk for frailty, including skills conducting CGA, analyzing, developing and administering treatment plans based on the comprehensive geriatric assessment.

6. Demonstrated knowledge of best practice assessment tools (e.g. Barthel Index, Confusion Assessment Method (CAM), Mini Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Clock Drawing Test, Phonemic/Semantic Fluency, Trails Making Test, Kingston Standardized Cognitive Assessment (KSCA), Brain Network Activation (BNA), Geriatric Depression Scale, and Cornell Scale for Depression in Dementia).

7. Demonstrated knowledge of Specialized Geriatric Services across the continuum, as well as primary care, community support services (i.e. Alzheimer’s society, Home and Community care, etc.) and other partners in care.

8. Demonstrated experience as a liaison and consultant to other health care facilities/institutions regarding patient care and health services.

9. Demonstrated knowledge of current health care and privacy legislation.

10. Demonstrated knowledge of evidence-based geriatric clinical practice and best practice in geriatric care.

11. Demonstrated ability to exercise professional judgement, clinical reasoning, and critical thinking with the ability to apply ethical frameworks and choose the optimal assessment and treatment intervention.

12. Demonstrated ability to provide consultation to nursing staff, managers, physicians and interdisciplinary team regarding clinical and professional practice issues.

13. Demonstrated experience working collaboratively with clinical staff to assess, plan, implement and evaluate clinical interventions.

14. Demonstrated ability to effectively make decisions, deploy critical thinking and other skills required to organize/prioritize tasks.

15. Demonstrated knowledge of outcome measures and research process/methodology.

16. Demonstrated knowledge of tools to measure the patient and caregiver experience.

17. Demonstrated strong therapeutic communication skills and ability to communicate both verbally and in writing in a clear, concise manner, considering the intended audience.

18. Demonstrated ability to manage routine correspondence, multiple tasks/projects, diversified workload and rapidly changing priorities and challenging deadlines.

19. Demonstrated ability to effectively problem-solve, set priorities, and manage conflict.

Job Type: Full-time

Salary: $34.24-$49.05 per hour

Benefits:

• Employee assistance program
• On-site parking

Flexible Language Requirement:

• French not required

Schedule:

• 8 hour shift
• Day shift

Licence/Certification:

• Registration with CNO (preferred)

Work Location: One location

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