Nurse Practitioner; FTE - Eva Rothwell

Position: Nurse Practitioner (1.0 FTE) - Eva Rothwell )
Together, we do amazing things every day.
Imagine a supportive employer, a career that fits your lifestyle, and many learning opportunities. With the Hamilton Family Health Team, you can have all of that, and more. We work hard to create an innovative and diverse workplace that values the contributions of our employees. No matter what your role, working with us is about making a difference – every day!
Your Opportunity:  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.

Roles and Responsibilities:

Primary Care and Chronic Disease Management   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
Preventive Care, Well‑Woman, Well‑Baby, and Prenatal Care   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
Episodic and Urgent Care   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
Care Coordination and Navigation   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
Documentation and Quality   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

Qualifications and Skills:

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)…