Job Specification

Purpose of Position :

To assess, diagnose, prescribe treatment and manage a spectrum of illnesses in the inmate population of a large detention centre. To provide health care services with a strong emphasis on health promotion and disease prevention in collaboration with the inmate, and other health care professionals. The Health Care Unit operates 24 hours per day, 7 days a week.

Duties / Responsibilities :

In Ontario's largest maximum security detention centre with an operational capacity of 1650 and 320 in the Toronto Intermittent Centre, housing male inmates with diverse needs and security requirements, the incumbent will provide comprehensive Nurse Practitioner (NP) services within the scope of practice as outlined by relevant legislation, i.e. Regulated Health Professions Act, Nursing Act. As such, responsibilities include:

1. Assessing, diagnosing, prescribing treatment and evaluating an inmate's health status, including contributing to the development of inmate specific care plans. Providing ongoing and follow-up assessment and care of inmates with a spectrum of health care issues; including evaluation of prescribed treatments and consultation with physicians and specialists, as required. Prescribing medication, laboratory and diagnostic tests, referrals to a physician specialist, X-Rays and ultrasounds. Interpretation of the laboratory and diagnostic test results considering the inmate presentation and consulting with the physician, as required. Communicating the diagnosis made by the NP to the inmate, ensuring the inmate understands of the diagnosis and treatment options to aid the inmate in decision making regarding their treatment plan.

2. Providing consultation to regulated and non-regulated health care professionals. Contributing to the planning, implementing and evaluating of educational sessions for employees and conducting research of new techniques and best practices when necessary.

3. Encouraging inmates to take responsibility for their own health by involving them in risk factor and health problem identification, goal setting, and the choices of intervention for illness prevention and treatment. Collaborating with the health care team members to implement strategies that promote health and prevent illness. Acting as a resource to inmates, other health care professionals, and providing leadership in the advocacy for inmates.

4. Ensuring confidentiality and security of all personal health information in accordance with the Personal Health Information Protection Act (PHIPA) by complying with MCSCS approved health care record management systems. Ensuring inmate consent before release of personal health information, compliance with court orders, and responses to corporate, legal branch, client complaint resolution unit and ombudsman inquiries.

5. Assisting the Manager, Health Care Services in the planning, development, implementation and evaluation of business continuity and crisis management plans for health care services, in collaboration with administration and Corporate Health Care in the event of operational disruptions. Business continuity and crisis management plans should ensure an adequate inventory of medical and pharmaceutical supplies and equipment are available and in working order and procedures to provide inmate care.

6. Administering health care services in accordance with relevant legislation, i.e. Regulated Health Professions Act, Nursing Act, Health Promotion & Protection Act, Ontario Public Service and MCSCS policies, procedures and Collective Agreements. Providing professional expertise and consultative
advice to the Director, Deputy Superintendent and other managers involved in operation of the Institution, with respect to relevant legislation, professional standards and inmate health care needs. Participating on relevant institutional, corporate and community committees as management/clinical representative.

Staffing and Licensing :

Registered Nurse Extended Class (Nurse Practitioner) with the College of Nurses of Ontario.
Extended class speciality certificate in Primary Health Care or Adult.

Knowledge :

Registered Nurse Extended Class (Nurse Practitioner) with the College of Nurses of Ontario is required. Knowledge of illness/disease theory, pharmaceuticals, diagnostic and laboratory testing, evidence based practice and current treatment modalities acquired through completion of post degree NP specialty certificate in primary health care or adult care, and supplemented by continuing education in their designated specialty
Knowledge of institutional and health care policies and procedures to ensure safety of inmates, security of health care areas and equipment/supplies/pharmaceuticals and to report precautions that may affect inmate's ability to participate in programs and work activities e.g. advising of options on how to best approach an inmate. Job requires CPR at BCLS level certificate. Knowledge of the CNO scope of practice for Registered Nurses, Registered Practical Nurses and Nurse Practitioners to provide nursing services effectively and to each disciplines full scope of practice. Knowledge of relevant sections of related legislation; e.g. Public Service Act, Ministry of Correctional Services Act, Freedom of Information and Protection of Privacy Act, Mental Health Act, Regulated Health Professions Act, Health Care Consent Act, and Personal Health Information Protection Act, Collective Agreements. Working knowledge of computers and related software to prepare correspondence and reports, and utilize email.

Skills :

Clinical assessment and critical thinking skills to elicit and interpret information from inmates and other sources, evaluate diagnostic information and draw conclusions to initiate and manage the care of inmates and/or monitor the ongoing prescribed treatment of inmates with a spectrum of illnesses through assessment, diagnosis and prescription of treatment for their specific illness. Analytical skills to evaluate response to prescribed treatment and to modify treatment prescribed in collaboration with the multidisciplinary health care team to achieve established inmate goals, considering for example, therapeutic measures and success levels, inmate motivation, family feedback, alternative therapy. Strong oral and written communication skills to present ideas and develop rationales (e.g. to collaborate with inmate and/or advocate on the inmate's behalf), to the multidisciplinary team, significant others, community agencies regarding offender care and discharge plans; to document inmate care and progress; to contribute to care plans and prepare clinical/administrative summaries and explain diagnoses. Interpersonal skills to negotiate elements of treatment plan with inmate; to counsel inmates; to advise inmates and significant others about therapies, explaining possible side effects and expected outcomes to promote education and achievement of inmate goals. Demonstrated experience in planning along with conceptual skills in order to develop and implement strategies to promote health and to prevent disease. Tact and discretion to interpret or clarify information about illness and treatment to inmate and significant others to deal with problems, complaints or concerns and to encourage inmate compliance with recommended care plans. Ability to assess emergency situations to implement appropriate therapeutic interventions. Administrative and leadership skills to plan, organize, coordinate and direct day-to-day delivery of health care services.

Freedom of Action :

Work is performed under general direction of the Manager, Health Care Services, and within the health care services policies and procedures and other relevant legislation and guidelines such as the Regulated Health Professions Act, the Narcotics Control Act, the Federal Food and Drug Act, College of Nurses Professional Standards, the institution's Standing Orders. Incumbent exercises judgement in making decisions in the absence of and/or with limited on-site access to physicians in a correctional environment. Incumbent has access to other Ministry professionals and specialists and community professionals for advice and consultation in order to make critical decisions. Developing plans of care, prescribing drugs, laboratory tests, diagnostic tests, x-rays and ultrasounds, etc. within the Nurse Practitioner scope of practice and Ministry procedures. Collaborating with the multi-disciplinary team and health care professionals to address issues that affect health care. Incumbent ensures individual and institutional health care issues are identified and resolved.
Judgement is required to ensure a consistent standard of health care is provided to inmates and staff, that professional standards are maintained and that procedures are followed, by providing professional direction. Ensuring follow-up and feedback is provided to staff that fail to follow professional standards, best practices and procedures, as well as identifying when policies and procedures, professional standards and practice expectations are not met. Judgement is required to provide direction and to point out failure to follow professional standards, best practices and procedures as well as identifying when policies and procedures are not met. Provides guidance in areas related to professional development. Acting as a Ministry representative in matters related to community agencies/specialists, telemedicine contacts, and when arranging for community care and/or services. Assessing inmate health problem/symptoms/emergencies and making sound decisions surrounding continued health care needs such as transfers to local hospital for further treatment, emergency care, supervising the provision of care.