Nurse Practitioner; FTE - Eva Rothwell

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The Nurse Practitioner (NP) at the Eva Rothwell Centre is a full-scope primary care provider within Hamilton Family Health Team's NP-led model at this equity-focused site. The NP holds an enrolled patient panel and is responsible for the full continuum of primary care delivery -- from episodic and preventive care through to chronic disease management, care coordination, and patient advocacy -- for a population experiencing significant health and social complexity.

The NP practices in accordance with the College of Nurses of Ontario standards for the Extended Class, HFHT policies and procedures, and applicable Ontario legislation.

• Provide comprehensive, longitudinal primary care to an enrolled patient panel with a high burden of chronic and complex disease
• Diagnose, treat, and manage chronic conditions including but not limited to diabetes, hypertension, COPD, heart failure, chronic pain, and mental health conditions
• Develop and implement individualized care plans in collaboration with the patient and interprofessional team
• Conduct regular reviews of medications, investigations, and care goals for patients with multiple comorbidities
• Support patients in self-management, health literacy, and navigation of the health system

• Provide well-woman care including routine health screening, Pap tests, reproductive health counselling, and contraception management
• Deliver well-baby and well-child visits including growth and developmental surveillance, immunizations, and caregiver education
• Provide prenatal primary care including initial assessment, ongoing monitoring, prenatal education, and coordination with obstetric and midwifery services
• Administer and prescribe immunizations in accordance with Ontario immunization schedules, HFHT medical directives, and CNO standards
• Conduct proactive outreach and recall for overdue preventive screening and immunizations within the enrolled panel

• Assess and manage acute and episodic presentations within NP scope, with appropriate escalation and referral
• Conduct telephone triage and same-day appointments in response to urgent patient needs
• Collaborate with the RPN and clinic team to manage patient flow and ensure timely, appropriate care

• Lead care coordination for high-complexity patients, facilitating communication across HFHT team members, specialists, and community partners
• Initiate and participate in interprofessional care conferences and case reviews
• Facilitate warm handoffs to social work, dietetics, pharmacy, community health workers, and Eva Rothwell Centre community programming
• Support patients in accessing housing, income supports, legal services, and other social determinants resources in collaboration with the social medicine team
• Serve as a clinical point of contact for community partners including the Eva Rothwell Centre, Thrive Group, and McMaster University research collaborators

• Maintain accurate, timely, and complete EMR documentation in accordance with CNO standards and HFHT policies
• Participate in quality improvement activities including chart audits, data collection, and QI project implementation
• Contribute to the development and review of clinical protocols, medical directives, and care pathways relevant to the Eva Rothwell population
• Support students, learners, and new team members as appropriate

• Current registration in good standing with the College of Nurses of Ontario in the Extended Class (NP-EC or NP-PHC)
• Master's degree in Nursing or recognized NP education program
• Current Basic Life Support (BLS/CPR) certification
• Demonstrated…