RN/RPN, Substance Use Services

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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 nursing care services to clients experiencing problematic substance use, such as assessment, referrals, counselling, client and family teaching and follow-up as required and health promotion activities. Demonstrates nursing expertise and provides clinical leadership in evidence based practice through direct care activities including nursing assessments, crisis intervention, treatment and group facilitation.

1. Plans and provides direct nursing care to clients in compliance with standards of practice by performing activities such as reviewing client/family history, conducting physical/psychosocial assessments, developing a care plan specific for the client and collaborating with other members of the health care team to discuss and review the care plan.
2. Processes physician or nurse practitioner orders through methods such as initiating unit standing orders, administering medications, carrying out treatments and monitoring and documenting the effects.
3. Manages emergencies including drug overdose, heart attack, assaultive behaviour and seizures through methods such as by responding in a manner appropriate to the emergency and in accordance with established policies and procedures such as initiating CPR and/or alerting ambulance and/or police.
4. Consults and collaborates with interdisciplinary team members and other health care professionals/providers in the identification and resolution of a variety of client/family issues by participating in client care conferences, rounds and staff meetings and contributing information.
5. May be required to provide general and crisis counselling to clients who present to the Emergency Department, IPU, and medical wards, including short term follow-up in accordance with approved treatment plans authorized by the Physician, Nurse Practitioner or consulting psychiatrist. Teaches clients and family members as required and/or other care-givers about illness prevention, health maintenance and health promotion strategies by assessing the learning needs of individuals, providing and explaining information, demonstrating procedures and use of equipment, checking the learners use of procedures, techniques and equipment, and evaluating the overall effectiveness of the selected teaching methods and outcomes of learning.
6. As assigned: in accordance with BCCNM standards, limits and conditions, demonstrates and articulates the responsibility of the authorized RN/RPN prescriber to the interprofessional team and when interacting with the client. Identifies when client needs exceed RN/RPN scope of practice.
7. Participates in quality improvement and risk management activities such as identifying and reporting high risk situations, evaluating effect of changes in nursing practice, generating recommendations for alternative approaches to nursing practice, conducting safety audits and identifying needs for corrective action and changes to selected practices, procedures or protocols.
8. Acts as a clinical resource/support person to client and family as required and nursing and health care professionals by explaining the theoretical rationale for nursing decisions and providing clinical consultation to Health Care Detox Workers. Participates in the training and orientating and continuing education of nursing staff and students through mentoring, preceptoring and role modelling.
9. Maintains clinical records through methods such as collecting and documenting information including electronic health care information regarding clients and their families, nursing observations, telephone communications, progress notes, interventions, themes worked on during interventions, teaching, care evaluations, patient outcomes and discharge summaries to ensure that client/family records are current and complete.
10. Performs intake functions, conducts mental health assessments, develops, implements, maintains and adjusts comprehensive treatment plans based on client needs and best practices, administers prescribed medications, and monitors and assess client's mental state, response to medications and efficacy of treatment plan to ensure optimum use of resources and to facilitate client-centered care, as assigned.
11. Maintains a safe environment for clients, visitors and employees by adhering to established safety and emergency practices and procedures and reporting any risks and anomalies to the Client Care Coordinator.
12. Participates in program development and in the delivery of clinical services through methods such as actively participating in internal conferences and by participating in the development, implementation and evaluation of new or existing client program activities and treatment approaches.
13. Identifies own learning needs/goals, reviews these with the Client Care Coordinator and engages in a variety of activities to meet these needs/goals.
14. Participates in the development, implementation and evaluation of policies/procedures and interpreting same to clients, other agencies and the public and referring unusual inquiries to Client Care Coordinator.
15. (If applicable) Plans, coordinates, and delivers educational sessions to clients and their family members, other service providers, and community agencies on topics such as detoxification, relapse prevention, stress management, wellness, self care, problem solving and coping skills. Facilitates group sessions utilizing psychodynamic, cognitive/behavioural, interpersonal, and supportive interventions in conjunction and consultation with other interdisciplinary team members.
16. (If applicable) Provides outreach nursing care to clients in their home setting or suitable alternative performing nursing functions such as assessing substance use/dependence, determining physical and mental status, monitoring withdrawal symptoms and evaluating response to medications administered. Formulates and explains plan of care to client/family or supportive care persons. Transports and/or accompanies clients to physician appointments for assessment to determine suitability for program or to designated safe bed for withdrawal management support.
17. Performs other related duties as required.

Education, Training & 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).

Completion of approved addictions or substance use training, or substance use certificate program, and one year's recent related experience working in an addictions environment with individuals with substance use disorders, or an equivalent combination of education, training and experience. May require: current approved Standard First Aid Certificate and current Cardiopulmonary Resuscitation Certificate (CPR) level C. May require: skills and experience in facilitating psycho-educational groups. May require: Valid Class 5 Driver's License and access to personal vehicle with appropriate insurance coverage. May require: eligible for completion of BC Provincial Opiate Addiction Treatment Support Program course and approved related preceptorship.

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 including crisis intervention.
• Knowledge of mental illness and substance use treatment.
• Knowledge of psychopharmacology (indications and side-effects).
• Knowledge of 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/care givers, 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.