Salary

The salary range for this position is CAD $41.42
- $59.52 / hour

Job Summary

We are currently hiring for a Relief Full Time Community Health Nurse
- Registered Nurse to join the Specialized Community Services Program
- Complex Medically Frail team at Fraser Health Community South Fraser located in Surrey, B.
C. This position is available until approximately January 2027 or until the return of the incumbent.

Detailed Overview

In accordance with the British Columbia College of Nurses and Midwives (BCCNM) standards of practice and the Mission and Values of Fraser Health, the Community Health Nurse (CHN)
- Registered Nurse works independently in the community setting. Works collaboratively and as a member of an interprofessional team in the management of an assigned client caseload including assessments, coaching, interventions, client care services and follow up to enable clients and their families to live confidently and safely at home and/or community; emphasizes the promotion, maintenance and restoration of health such as the treatment of chronic diseases through teaching, counselling and direct client care; facilitates and manages client transitions across the healthcare continuum utilizing the provincial Primary & Community Care model to optimize recovery or adapting to changes in the client's condition to minimize avoidable admission to residential and/or acute care facilities; collaborates and ensures linkages with acute, primary and community care healthcare providers including the client's primary care provider (Nurse Practitioner, Physician, other specialist(s)) and family/supports regarding client care planning; supports clients and families, as client care is transitioned to primary/community care provider including FH and non-FH community services.





Responsibilities

1. Establishes a therapeutic relationship with the client through interpersonal and interviewing techniques, in person and/or over the telephone, to ensure the client's choice and autonomy in decision‑making and care planning including the client's right to dignity and privacy.
2. Screens referrals, provides individualized client assessments, interprofessional care planning and interventions including clinical care, when appropriate and referral services for clients with multiple complex chronic conditions; facilitates timely and appropriate health services and utilizes resources and services to assist clients in achieving optimal function; collaborates with the primary care provider, client, family/supports/caregivers, other health professionals, clinics, hospitals and community resources to identify and resolve client care issues and coordinate care integration.
3. Develops a comprehensive shared patient/client care plan in collaboration with the interprofessional team, primary provider, client and/or family, other healthcare providers and/or referring clinics; facilitates and supports the transition of the client care plan to the referring source, primary/community care provider and/or community agencies.
4. Provides direct client care and identifies other care services required in accordance with applicable guidelines,



policies and evidence‑based best practice; provides comprehensive explanations of care to the client and family, as appropriate.
5. As required based on the local community model, makes decisions on client‑specific direct care tasks; assigns direct client‑care tasks to Community Health Workers and, when appropriate, delegates tasks to them; provides in‑home demonstrations and training; ensures that the Community Health Worker has the necessary knowledge, skills and support to perform delegated tasks within defined limits; collaborates with the Community Health Nurse – Licensed Practical Nurse in monitoring Community Health Workers performing client‑specific tasks.
6. Facilitates care conferencing to review client care plans with the interprofessional team and primary provider to determine timing and referral to other services; initiates, monitors and evaluates the appropriateness and effectiveness of the short and long‑term care plan to meet specific client goals; develops next steps in collaboration with the client and family; supports a transition process for achieving client‑care goals across the care continuum including discharge and/or transfer to other services, as required.
7. Discusses clinical findings with client/family, collaborates with the interprofessional team to develop action plans and set goals directed at clinical needs, self‑management, self‑care and improved health‑related quality of life; accesses system information and resources to review client data such as medical history, progress notes, consultation reports, lab reports and incorporates findings into the care plan; plans, organizes and establishes priorities by using resources effectively and efficiently; responds to unant

📌 Community Health Nurse (Surrey)
🏢 Fraser Health
📍 Surrey