TB Nurse Clinical Prevention Services

Job Summary:

In accordance with the Mission, Vision and Values, and strategic directions of Provincial Health Services Authority patient and employee safety is a priority and a responsibility shared by everyone at PHSA, and as such, the requirement to continuously improve quality and safety is inherent in all aspects of this position.
The TB Nurse, using specialized nursing skills, expert communication and interpersonal skills, provides assessment, case management, treatment and counseling of clients presenting with risk of Tuberculosis (TB) and/or related diseases, and any necessary contact tracing. The incumbent participates in the training of other healthcare providers in the specialty of TB management; acts as a resource, coordinates client referrals, and participates in program planning and research within the service line of Clinical Prevention Services.

Duties/Accountabilities:

1. Provides nursing care, education and counselling using a health promotion, harm reduction and trauma informed approach.
2. Provides nursing services related to the assessment of clients presenting with or at risk for TB by methods such as interviewing clients and taking history, gathering data appropriate to clinical assessment and diagnosis, involving client in a risk assessment for TB, determining appropriate timing of tests to produce valid test results, and assessing client’s anxiety related to their risks and their ability to deal with positive test results.
3. Performs nursing procedures to assist physician in diagnosis including tuberculin skin testing and reading, obtaining specimens and preparing requisitions for laboratory testing such as sputum, serology, urine, cytology and visual acuity; assisting physician with physical examination and dressing change; examines clients for signs and symptoms of infection, lymph node and skin exam and chest auscultation; uses aseptic technique and accepted safety measures to collect specimens required for diagnostic confirmation which may include venipuncture.
4. Administering appropriate treatment according to appropriate clinical guidelines and Decision Support Tools by methods such as assessing the information gathered to determine action required regarding treatment and client follow-up, interpreting test results to clients. Arranges for referral of clients to private physicians, clinics, support services or specialists as necessary which may require clinic physician consultation, assisting clients to locate community resources appropriate to their needs, and ensuring client is aware of and understands any need for follow-up.
5. Provides education and counseling using a health promotion approach to clients and their families regarding topics such as risk behaviours with a goal of reducing risk behaviours, the transmission and treatment of tuberculosis both at home and/or admission to hospital.
6. Administers prescribed medications and performs medication reconciliation by methods such as ensuring doctor’s orders are met in regard to medication, return examinations and follow-up; distributing anti-tuberculous medications as ordered, and monitoring for compliance and counselling for side-effects.
7. Prepares and maintains client records by methods such as documenting client assessments, interventions, evaluations, modifications and client goals, charting client information, documenting significant events/unusual occurrences, noting referrals, recording contact with client/family and health care staff, preparing progress notes and reports in accordance with established standards, policies and procedures to regulatory requirements and provide evidence and rationale that support findings and intervention plan.
8. Carries out contact tracing duties for all clients with TB to ensure contact notification and document adequate treatment or arranging follow up by Interviewing clients in person or by telephone to collect all available information regarding contacts for a specific period of time, using information collected and investigative skills when information is limited to find named contacts, and informing named contacts by telephone or visit what infection they may have been exposed to and what action is required of them, ensuring that confidentiality is maintained at all times. Follows up with contacts to document required testing and treatment, and contacting healthcare providers of clients with lab reported TB to document adequate treatment and offer assistance with contact tracing as necessary and or arrange follow up.
9. Participates in the training of healthcare providers in the specialty of TB management as required by assisting others in developing and delivering education sessions in a classroom setting, demonstrating clinical skills required for assessment and management of TB in a hands on client care setting, supervising inexperienced healthcare professionals in a hands-on practice setting for the purpose of skill development, and providing a role model and guiding the inexperienced learner in collection of very sensitive information.
10. Acts as an TB information resource to the general public, private physicians and other health personnel by answering telephone inquiries related to TB information; interpreting recommended treatment guidelines to healthcare professionals; consulting with clients and private physicians regarding specific concerns, assisting callers to identify needs and community resources available to meet those needs, and making telephone contact with healthcare workers who submit positive TB tests, consulting with designated nurses around the province about newly reported TB cases and maintaining surveillance records of cases.
11. Participates in program planning and research within the service line of Clinical Prevention Services as needed by working on committees and teams to identify problems, solve problems, and develop strategies; participating in quality and safety initiatives, accreditation and other PHSA initiatives; providing input into research planning; implementing research activities, and assisting in review of research results.
12. Performs other related duties as assigned.

Qualifications:

Education, Training and Experience
• Current practicing registration as a Registered Nurse with the British Columbia College of Nursing Professionals (BCCNP).
• Graduation from a certified School of Nursing program.
• One (1) year of recent related experience in Public Health, Communicable Disease or Tuberculosis.
• Valid Class 5 driver’s license to operate a vehicle within the Province of British Columbia. Ability to access fleet vehicles or access to a vehicle for local area travel to Chilliwack, and Abbotsford.

Skills and Abilities
• Broad knowledge in the field of tuberculosis or respiratory diseases or out-patient clinic setting.
• Good working knowledge of infection control concepts to prevent risk to self and others of exposure to infection.
• Expert communication and interpersonal skills.
• Demonstrated ability to manage difficult clients who may be upset, angry, uncooperative, intoxicated, or mentally or physically impaired.
• Sensitivity to the implications and potential stigma of a TB diagnosis to clients with a variety of ethnic origins and beliefs.
• Ability to work with an interpreter.
• Demonstrated ability in making decisions based on independent judgment.
• Demonstrated ability to plan, problem solve, and adjust to new or unexpected events.
• Demonstrated ability to operate related equipment.