RN/RPN, Early Psychosis Intervention (Epi) - Indigenous

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Reporting to the Clinical Coordinator, works in collaboration with the multi-disciplinary team to provide clinical and liaison services through an Indigenous lens to clients identified as First Nations, Métis and Inuit in community programs throughout the Fraser Salish region who are taking part in the Early Psychosis Intervention (EPI) Program. Incorporates traditional Indigenous models of health and healing into clinical assessment, planning care, treatment, consultation and follow-up, applying the Provincial EPI Standards and Guidelines and the Early Psychosis Carepath in a way that honours and respects cultural practices and protocols. Utilizes the case management model, including assessing clients’ mental, emotional, physical and spiritual health and substance use status, formulating a plan of care, implementing planned care and evaluating outcomes. Provides assertive outreach for clients experiencing vulnerability due to barriers in accessing services. Shares knowledge with team members in caring for Indigenous clients, and provides mental health and substance use education to clients, families and communities. Partners with clients, caregivers, facility managers and staff of relevant community and regulatory agencies, the First Nations Health Authority (FNHA), Métis Nation BC, First Nations communities and Métis Chartered Communities. Participates in program and policy planning and development and research and evaluation to deliver culturally safe mental health and substance use services for Indigenous peoples.

1. Functions as a nurse and case manager as a member of the EPI multidisciplinary team. Practices from an assertive engagement model to manage client cases, formulates treatment plans and goals with the client and their circle of care; reviewing client/family history, conducting physical/psychosocial assessments, assessing vital signs. Implements treatments such as short- and long-term individual, group, and family mental health and concurrent disorder interventions. Uses crisis intervention and outreach as required. Practices in compliance with professional and organisational standards of practice.
2. In consultation and collaboration with local Indigenous communities, acts to enhance, maintain, and/or develop culturally safe and accessible health services for Indigenous clients, including organizing engagement and informational events as needed.
3. Participates in medication management, in partnership with clients, their families and the multidisciplinary team, including medication administration, assessing the efficacy of prescribed medication, monitoring potential emerging side effects. Providing support and education to client and their support team regarding medication as a part of the overall treatment plan. Ongoing assessment of the client physical well being, providing education and guidance on heathy lifestyle and supporting linkage to other health services to address emerging health concerns.
4. Facilitates clients' utilization of appropriate community services and rehabilitative programs by performing duties such as researching available services, liaising with these agencies, providing related advice and consultation to clients, and providing referrals, warm hand-over, and follow-up with appropriate community treatment programs and services. Utilizes available community resources to develop supportive and rehabilitative programs for adult clients and their families. Makes arrangements for clients to be admitted to hospital when required, including on an involuntary basis.
5. Provides client care linkages between community mental health and substance use services and acute care facilities, including liaising with tertiary and acute care hospitals, and the Forensic Psychiatric Hospital to ensure appropriate referrals of clients and to facilitate assessment and care planning for client discharge from hospital. Liaises with community outpatient clinics and treatment programs. Exchanges relevant client information and receives information about the status and background of clients who will be discharged or referred, in order to make necessary preparations for provision of a smooth continuum of care between acute care and community mental health and substance use services.
6. Assesses clients for placement to and discharge from care facilities, including specialized care licensed facilities, family care homes, congregate care homes and semi-independent living units, by determining eligibility and type and level of care required. Makes arrangements for client placement and care in care facilities by liaising with facility operators, placing client names on wait lists, assisting clients to make moving arrangements, and completing necessary referrals and forms. Follows up with clients by visiting them at their accommodation and assessing the appropriateness and cultural safety of the facility and the level of care including access to cultural supports and traditional healing practices. Adjusts placements as required.
7. Provides support and direction to clients requiring enhanced case management by monitoring their mental health and substance use status, assessing their social adjustment and ability to perform routine life activities including managing money and taking medication regularly. Provides follow-up care and services as required, including providing referrals to other healthcare professionals such as Recreational Therapists, Occupational Therapists, and Psychiatrists and providing the option to connect clients with cultural supports and services. Updates the Clinical Coordinator on the status of client treatment and progress, as well as significant and unusual issues, developments, and circumstances.
8. Maintains client records and statistics, prepares reports, and completes forms and clinical documentation as required, in accordance with Fraser Health policies and standards, including clinical record standards of Mental Health & Substance Use Services. Obtains consent forms for release of client information.
9. Through the building of relationships and presence/visibility and delivery of education in local Indigenous communities, supports early identification of potential first episode clients and facilitates subsequent engagement with early psychosis intervention services.
10. Advocates on behalf of clients by performing duties such as providing clients with information about appeal processes, providing information about clients to relevant Ministries, and assisting clients to complete forms. Acts as a resource for clients and their families.
11. Provides education to clients, their families, First Nations and Métis communities, and staff of care facilities and other agencies, regarding mental health and substance use and existing community programs and services.
12. Provides health promotion services to individuals, families, and Indigenous communities to increase awareness of the Early Psychosis Intervention Program, early identification of psychotic disorder, and how to access services and supports.
13. Provides appropriate information and culturally specific materials and resources to staff of the local mental health centres, treatment and care facilities, and other agencies who work with Indigenous clients with mental health concerns.
14. Reviews and adapts relevant information and educational material. Participates in continuing education programs to keep up to date with current trends and research. Assists with orientation of new staff, students.
15. Participates in quality improvement and risk management activities for assigned area by performing duties such as participating in quality initiatives, providing feedback to the Clinical Coordinator about needs and gaps in programs and services, and suggesting solutions and initiatives to assist in the development and maintenance of a coordinated mental health and substance use care system within the community.
16. Participates as a member of local committees and advisory boards to provide and receive information as a representative of the clinical team, as assigned.
17. Participates in clinical research and program evaluation activities relevant to the needs of clients, families, Indigenous communities, and the EPI program, by providing information as requested when in accordance with Ownership, Control, Access and Possession (OCAP) principles and the notion of “nothing about us, without us”.
18. Performs other related duties as assigned.

Education, Training and Experience

Current practicing registration as a Registered Nurse and/or Registered Psychiatric Nurse with the British Columbia College of Nurses and Midwives (BCCNM). Graduation from approved School of Nursing or Psychiatric Nursing. Two (2) years recent related experience providing treatment services to individuals with mental health and/or concurrent disorders, including experience and/or training working with indigenous individuals, families and communities, and youth and young adults with psychosis, or an equivalent combination of education, training and experience.

Valid Class 5 BC Driver's License and access to personal vehicle with appropriate insurance coverage.

Skills and Abilities

• Demonstrated knowledge and understanding of Indigenous cultural practices, beliefs and values, particularly as they relate to mental health, wellness and healing. Demonstrated knowledge and practice of cultural safety and humility.
• Demonstrated knowledge and ability to practice with humility, cultural competence, and a trauma-informed clinical perspective.
• Effective interpersonal and communication skills, including ability to respectfully, empathetically and effectively engage with Indigenous clients, families and communities, and liaise and collaborate appropriately across the clinical team and health continuum.
• Demonstrated comprehensive knowledge and understanding of early psychosis and associated pharmacological issues.
• Comprehensive knowledge of community resources including Indigenous-specific programs and services and methods of access, networking and collaboration.
• Demonstrated ability to incorporate and apply government and health region policies, standards, and protocol requirements.
• Comprehensive knowledge of crisis and clinical risk management approaches to community mental health care, mental health status assessment, clinical diagnoses and medication management.
• Demonstrated clinical skills including supportive, counseling and cognitive-behavioural interventions, client assessment, family intervention, psychosocial rehabilitation and case management skills.
• Demonstrated knowledge in the area of concurrent disorders.
• Ability to set priorities, organize work and manage caseload independently and effectively under pressure and during times of change.
• Ability to learn new methodologies, ideas, and concepts.
• Ability to communicate effectively in English, both verbally and in writing.
• Demonstrated ability to operate related equipment.
• Physical ability to carry out the duties of the position.