RN/RPN - Mental Health & Substance Use Services - CRESST (Fraser East)

Fraser Health is responsible for the delivery of hospital and community-based health services to over 1.9 million people in 20 diverse communities from Burnaby to Fraser Canyon on the traditional territories of the Coast Salish and Nlaka’pamux Nations.

Our team of 43,000 staff, medical staff and volunteers is dedicated to serving our patients, families and communities to deliver on our vision: Better health, best in health care.

Effective October 26, 2021 all new hires to Fraser Health will need to have full COVID 19 vaccination (have received a full series of a World Health Organization “WHO” approved vaccine against infection by SARS-COV-2, or a combination of approved WHO.

Job Classification for CRESST (South Fraser): CH1, Bargaining Unit: HSA

Job Classification for CRESST (Fraser Valley): CH1, Bargaining Unit: BCNU & UPN

In accordance with the British Columbia College of Nurses and Midwives (BCCNM) standards of practice and the Mission and Values of Fraser Health, and working collaboratively and in partnership with the interprofessional care team in the provision of person-centered and recovery oriented care, the Registered Nurse/Registered Psychiatric Nurse provides and coordinates the delivery of psychiatric nursing care services to clients. that are in an acute psychiatric crisis or situational crisis that could lead to psychiatric de-compensation. The RN/RPN sets priorities, and assigns and delegates tasks to support staff through direct care activities including assessments, crisis intervention, client and family education and health promotion activities.

1. Intervenes to stabilize clients, who are in acute psychiatric or situational crisis, by utilizing supportive counselling, therapeutic interventions and providing a safe and supportive environment.
2. Screens potential admissions for appropriateness as required, by using screening tool and admission criteria policy and procedure to ensure clients fit the CRESST mandate and that the facility can provide safe care for them.
3. Provides assessment, planning, implementation and evaluation of nursing care of assigned clients by performing activities such as reviewing client/family history, conducting physical/psycho-social/mental status assessments, monitoring of medical and psychiatric conditions, providing psycho-education, performing planned interventions, and evaluating outcomes.
4. Completes admission process by interviewing client and documenting information in clients'' chart including clients' history, current status and identification of potential safety risks.
5. Collaborates with Program Coordinator and Psychiatrist regarding clients' mental/medical status, response to treatment, including medication and readiness for discharge, by communication through scheduled and unscheduled meetings/phone calls. Communicates with primary therapist/case manager by faxing confirmation of admission and discharge summaries. Obtains collateral information from, and provides status and progress reports to, primary therapist/case managers, doctors and other related agencies through meetings or telephone contacts.
6. Identifies clients' mental/medical needs on an ongoing basis by methods such as observing, interviewing and completing a physical assessment. Makes clinical decisions and takes action based on these assessments.
7. Makes necessary arrangements and facilitates hospital admission, as required, for psychiatric or medical emergencies that can not be dealt with at CRESST.  Uses methods such as obtaining directions from an authorized prescriber, phoning the hospital to advise emergency room staff of pending arrival, conveying proper collateral information, calling ambulance, police or family to transport client, and completing transfer records. For medical client concerns of a less urgent nature, facilitates a doctor's appointment.
8. Empowers clients in their illness or life stressors by educating clients in group, one on one counselling and family meetings, alternate ways of coping, life skills and education, regarding illness and medications.
9. Ensures consistent safe care by completing and reviewing client focussed care plans. Ensures that legal documentation requirements are met by reviewing the client's chart, kardex and medication administration record (MAR) for accuracy and completion. Provides necessary documentation for charts by photocopying necessary paperwork.
10. Provides discharge support to client by providing them with community resource information and assisting them in the decision making process, relative to appropriate support.
11. Ensures that client gets the necessary medication or treatment by obtaining, clarifying and following prescriber's orders and communicates same with pharmacy.
12. Ensures appropriate client treatment interventions by consulting with primary therapist/case manager and/or doctors regarding client history and treatment modes.
13. Ensures that steps are taken to keep at risk clients safe, and ensure compliance with the Community Care Facility Act and Adult Care Regulations, by reporting, as required, AWOL clients to police, Program Coordinator, primary therapist/case manager and family.
14. Ensures that client concerns, especially safety issues and serious incidents, are addressed by taking appropriate clinical action such as completing serious incident reports and reporting same, and seeking direction from Program Coordinator or Manager.
15. Communicates facility concerns and client issues, with an emphasis on safety, by reporting same to the team, verbally and in writing in the chart, kardex, group book, serious incident report, MAR, and log book. Relays information to the next shift by providing a brief verbal report highlighting safety issues and any other issues and situations that may need to be immediately addressed.
16. Facilitates client recreation activity by connecting them with community resources and encouraging them to participate in facility recreation activity programs. Ensures that client receives required service by accompanying and/or driving them to appointments, as warranted.
17. Contributes to interprofessional team participation by setting priorities, and assigning and delegating tasks to care aides.and other support staff.
18. Calls in staff as required, based on predetermined guidelines. Seeks prior approval for overtime, through management fan-out list, and confirms availability of staff for coverage.
19. Performs other related duties as assigned.

Education and Experience

Graduation from an approved Nursing Program with current practicing registration as a Registered Nurse and/or Registered Psychiatric Nurse with the British Columbia College of Nurses and Midwives (BCCNM). One (1) year of recent, related mental health and substance use experience in an acute/sub-acute/community setting, or an equivalent combination of education, training and experience. Standard First Aid and CPR level C (or equivalent). Valid Class 5 BC Drivers License and access to personal vehicle with appropriate insurance coverage.

Skills and Abilities

• Ability to complete initial and ongoing mental health and substance use client assessment and provide nursing care through appropriate/prescribed technical, therapeutic, safety type interventions.
• Applied knowledge of crisis intervention, de-escalation techniques and suicide-risk assessments.
• Knowledge of mental illness and substance use treatment.
• Knowledge of psychopharmacology (indications and side-effects).
• Counselling and group facilitation skills.
• Knowledge of legislation and government policies and procedures that relate to mental health and substance use practices.
• Ability to communicate effectively verbally and in writing with clients, families/caregivers, the public, medical staff and members of the interprofessional care team.
• Ability to promote person-centered care that demonstrates empathy for clients/families/care givers, sensitivity to diverse cultures and preferences, including advocacy for special populations.
• Ability to educate clients and families/care givers about topics essential to their health care and well-being.
• Ability to organize and prioritize work.
• Ability to collaborate with and promote cooperation among members of the interprofessional care team.
• Ability to use factual information and basic principles and procedures to support nursing decisions and actions with relevant research-based evidence/evidence-informed practice.
• Ability to operate related equipment including relevant computer applications.
• Physical ability to perform the duties of the position.