Nurse Practitioner

About the Job:

The Nurse Practitioner (NP) provides advanced clinical care, crisis intervention, care coordination and transition support to individuals with complex mental health, addiction, cognitive, behavioural and/or neurological needs. The role supports the ACTT (Assertive Community Treatment Team) Step-Down Program and BSO (Behavioural Supports Ontario) Crisis Response.

The NP supports ACTT clients in transitioning to appropriate ongoing services, including William Osler Health System (WOHS), primary care, psychiatry, community mental health and addiction services, case management and other community supports. Through BSO Crisis Response, the NP provides comprehensive assessment, crisis stabilization, risk management and care coordination for older adults experiencing mental health, cognitive or behavioural crises, working collaboratively with clients, caregivers and community partners to promote safety, continuity of care and successful transitions.

Duties and Responsibilities:

A: ACTT Step-Down Program (0.5 FTE)

• Work independently and collaboratively with the multidisciplinary team to provide assess clients' readiness for transition from ACTT and identify appropriate step-down services and support based on their clinical needs, level of functioning and recovery goals.
• Provide primary/preventive health care as well as clinical assessment, nursing assessment, health screening, metabolic monitoring, medication reconciliation and administration, and prescribe medications within the NP's scope of practice
• Develop and implement individualized transition and discharge plans in collaboration with clients, families/caregivers, the ACTT team and receiving service providers.
• Identify and coordinate appropriate next-step services and programs for clients, including transition to William Osler Health System (WOHS), primary care providers, psychiatrists, community mental health services, case management, and other community-based supports.
• Facilitate transitions to William Osler Hospital and other identified services, ensuring timely communication, clinical information sharing and coordination between SHIP, hospital and community providers.
• Support clients in establishing and maintaining ongoing primary care, psychiatric care and other community supports prior to discharge from ACTT.
• Provide psychoeducation, supportive counselling, health teaching and individualized goal planning to support clients in successfully managing their mental health and physical health needs following transition.
• Identify risk factors and establish, implement and review crisis, safety and relapse prevention plans to support safe transitions and reduce the risk of service disruption or crisis following discharge.
• Establish and maintain strong clinical collaboration with WOHS, primary care providers, psychiatrists, community mental health programs and other external service providers to ensure continuity of care.
• Monitor and follow up on transitions to ensure clients have successfully connected with their identified services and supports and address barriers or gaps in care when they arise.

B: BSO Crisis Response (0.5FTE)

• Conduct comprehensive clinical assessments of older adults experiencing mental health, cognitive, behavioural and/or other complex care crises and/ or responsive behaviors, including assessments in clients’ homes and other community settings.
• Conduct risk, safety and crisis assessments and develop, implement and evaluate individualized crisis, safety and care plans to support stabilization, reduce risk and promote continuity of care.
• Administer and interpret appropriate screening and standardized assessment tools, including MOCA, RUDAS, C-SSRS, PIECES and GDS, as appropriate to inform clinical formulation, care planning and referrals.
• Assess and manage mental and physical health needs within the NP scope of practice, including medication review, reconciliation and prescribing, as clinically indicated.
• Provide clinical intervention, supportive counselling, health teaching and psychoeducation to clients, families and caregivers, and identify factors contributing to crisis, including mental health, cognitive impairment, substance use, physical health, medication-related concerns, environmental factors and caregiver needs.
• Determine appropriate service pathways and referrals and coordinate transitions to mental health, addiction, primary care, geriatric, hospital, crisis, community and other specialized services to support continuity of care and reduce service gaps.
• Liaise and collaborate with health and community partners, including mental health and addiction providers, crisis services, BSO networks, geriatric services, family physicians, hospitals, care coordinators, community agencies and families, to facilitate timely intervention, stabilization and coordinated care.
• Provide clinical consultation and expertise to SHIP colleagues and community partners regarding mental health, cognitive impairment, responsive behaviours, crisis management, risk and safety, and support multidisciplinary and cross-sector collaboration.
• Advocate for clients and caregivers, particularly where there are barriers to care or complex system needs, and promote client-centred, recovery-oriented and person-centred approaches that support stability and, where appropriate, enable clients to remain in their preferred place of residence.
• Maintain high-quality clinical documentation, records, statistics and outcome measures in accordance with SHIP standards; participate in team, case consultation and sector meetings; adhere to SHIP’s Health & Safety Program and Client Safety Framework; promote equity, diversity and inclusion; and perform other duties as required or delegated by management.

Qualifications:

• Current registration in good standing with the College of Nurses of Ontario (CNO) as a Registered Nurse in the Extended Class (Nurse Practitioner).
• Completion of a Primary Health Care Nurse Practitioner Program and a Master's degree in Nursing.
• Current membership with RNAO, NPAO/NPAI or equivalent professional association, as applicable.
• Minimum three (3) years of relevant clinical experience, with strong experience in community mental health and addiction care. Experience with older adults, dementia, responsive behaviours, crisis services and/or complex care is an asset.
• Experience supporting clients through care transitions, including discharge planning, community integration and connection to primary care and community services.
• Demonstrated competency in mental health, addiction, cognitive and behavioural assessments, crisis intervention and risk assessment.
• Knowledge of Community Support Services, Primary Care and Mental Health systems and related legislation.
• Knowledge of, or experience with, the P.I.E.C.E.S. framework and/or other evidence-informed approaches to responsive behaviours is an asset.
• Excellent skills in assessment, health teaching, counselling, psychoeducation, crisis intervention and clinical communication.
• Ability to work collaboratively with multidisciplinary teams and external partners, including hospitals, police, community agencies and other health and social service systems; and ability to build effective partnerships across sectors.

Reporting Function:

The Nurse Practitioner reports directly to the Director of Clinical Mental Health and Wellness and works closely with the ACTT Program Manager, IST Program Manager, ACTT Psychiatrist, SHIP Medical Director and other clinical teams and community partners. They are responsible for overseeing and managing a small team and have the authority to hire/fire/discipline and manage accordingly.

The NP interacts with internal and external stakeholders at all levels, serving as a clinical resource, support and advocate for clients, families, the team and SHIP.

Working Conditions and Physical Requirements:

• Day shifts (Monday – Friday) with the ability to work excess/overtime hours where required
• Contract position until September 30, 2027
• Able to work well with internal and external clients
• Able to drive, walk (site locations) regularly
• Able to sit for prolonged periods of time
• Able to answer and communicate telephone calls and general computer use
• Computer screen use (multiple screens if applicable) for prolonged periods of time
• Able to lift up to 20lbs (product, documents, etc.)
• Travel by vehicle to community sites for client support as required

Ship Values:

• Compassion, Hope, Inclusive, Respect, Professional

About Us

Services and Housing In the Province (SHIP) is a Provincial leader in the broader public sector that builds strategic partnerships and programs that support the fundamental rights for Housing and Health Services throughout the Peel Region, Dufferin County, Region of Waterloo and surrounding areas.

Our commitment to increase quality of life through health services and housing supports that promote mental and physical health and wellness is at the forefront of every employee we hire. We value compassion, hope, inclusiveness, respect, and professionalism.

Our organization has supported the region for over 35 years and employs over 550 passionately engaged employees ranging from office administration, nurses, and service health specialists to housing specialists all dedicated to the community, clients, and families.

Accessibility

“SHIP strives to be equitable and inclusive in all that we do. Equity is a core value, and we are committed to providing an inclusive selection process. We encourage applicants from equity deserving communities including women, Black, Indigenous, other racialized groups, 2SLGBTQ+ persons, individuals with disabilities and others who will contribute to and enrich the organization and its values. We are committed to inclusive, barrier-free recruitment, selection processes, and work environments. Please advise the People and Culture Department of any accommodations needed in accordance with the Accessibility for Ontarians with Disabilities Act, 2005 and the Ontario Human Rights Code to ensure you have access to a fair and equitable process”.

Application Instructions

Interested candidates are encouraged to apply before November 13, 2026

Why Work For Us?

Work-Life Balance

SHIP believes a healthy work-life balance is essential for both professional success and personal well-being. We strive to create a company culture that values and supports the well-being of our employees, while also pushing innovation in our organization

Our Vision
Quality Housing, Quality Services, Quality Lives

Our Mission
To increase quality of life through health services and housing supports that promote mental and physical health and wellness

Our Culture
Leader and innovative partner in the community. Our programs welcome employees into our caring, compassionate, and innovative culture. We listen; we know what it means, and why it matters.

Our Commitment
People are at the forefront of our success. Below are just a few ways our full-time permanent staff have personal and professional success:

• Competitive Salaries with Annual Performance Reviews
• Comprehensive Health Plans
• Group RRSP (5% Employer Contributions)
• 12 Paid Health, Wellness, and Sick Days
• 10 Paid Vacation Days
• 3 Paid Personal/Floating Holidays
• Generous Parental and Family Leave
• Learning and Development Opportunities
• Travel Allowances
• Employee Assistance Program
• Company Culture to be Proud of
• Possibility to Create a Real Impact

35+

Years focused on Clients, Tenants, Staff, and Families

5,000+

Clients and Residents served annually

20+

Programs and Service offerings in Southern Ontario

500+

Dedicated, Respectful, Compassionate and Professional Employees

Monday - Friday | 8:30am - 4:30pm
Non-Union | 37.5 hours per week