Registered Nurse – Vulnerable Populations (Job ID: 20190502)

Status: Full-time, Permanent Vacancies: Two  | FTE: 1.0  | Schedule: Monday to Friday, 8:30 a.m. to 4:30 p.m.

Reporting to the Clinical Program Manager of the Calgary West Central Primary Care Network (CWC PCN), the Registered Nurse – Vulnerable Populations (RN) is responsible for providing comprehensive nursing services to vulnerable populations who are patients of CWC PCN member clinics.  

The RN provides an advanced level of nursing practice that maximizes the application of in-depth nursing theory, knowledge and skills to meet the complex healthcare needs of individuals, families and communities.  The RN functions as a nursing practice leader and an expert practitioner and educator focusing on complex vulnerable populations.



The RN will use critical thinking and clinical judgement to coordinate and facilitate the assessment and management of patients within the CWC PCN. Specifically, the RN will use a case management approach when assessing, planning, implementing and evaluating patient care needs. The RN will utilize the Electronic Medical Record (EMR) in maintaining accurate and timely records, documenting all phases of patient care.

Responsibilities include providing clinical expertise to patients of CWC PCN physician members. The RN works to full scope of practice delivering evidence-based care, assessments and interventions with an emphasis on providing comprehensive care, education and guidance to patients and their families. They are accountable for facilitating the transition of a patient’s care between and across services and providers, including the transitions between acute, primary and community-based services. The RN will work collaboratively with all members of the Patient Care Team.

Clinical role

  • Works collaboratively within a multidisciplinary team under the direction of the physician of record to enhance the delivery of primary care services to vulnerable populations, including but not limited to: medically complex patients, indigenous patients, immigrants, refugees and other new Canadians, people experiencing social isolation, homelessness and those of low income or the working poor.
  • Performs and documents a comprehensive history and in-depth assessment of the health status according to practice protocols, including physiological, psychosocial, economic, learning, cultural and spiritual factors affecting health and well-being. Initiates and implements management strategies and provides appropriate evaluation, followup and modifications to care plans.
  • Integrates scientific theories and current research and evidence from nursing and allied healthcare professions. Identifies and articulates the rationale for selecting interventions, and implements innovative approaches to support the health, learning and transitional needs of the individual, family and community.  
  • Works in collaboration with family physicians and other members of the collaborative care team, or independently as appropriate, to assess and evaluate the needs of patients. Home visits and providing care in community settings, for example Alpha House and Sunalta House, are key elements of this role.
  • Provides chronic disease management, meeting the patient where their needs require it, incorporating monitoring progress and response to treatment, and promoting the preventive aspects of patient care. Provides necessary interventions within the scope of practice.
  • Initiates appropriate investigations, community referrals and navigates community resources to broaden the base of support for patient, family and caregiver. Liaises with community resources, agencies and stakeholders to improve health outcomes.
  • Advocates for patients without family or caregiver supports, ensuring they have access to the right resources to meet their health needs.
  • Supports, fosters and implements evidence-based practice.
  • Works with CWC PCN member clinics with a special focus on vulnerable populations.
  • Employs consulting skills with nurses and other professionals in various community settings to directly and indirectly influence patient care in accordance with CWC PCN policies, procedures and established standards.
  • Works with the Clinical Program Manager to implement the CWC PCN primary care vision, outcomes, operational plans, systems, policies, protocols and metrics.
  • Supports family physicians by keeping abreast of current trends in nursing within primary care.

Professional development

Responsible for personal professional development through a variety of strategies highlighted in the performance management/personal development plan. Participates in the CWC PCN education programs, clinical review meetings and multidisciplinary team meetings.


The ideal candidate is a Registered Nurse who has an advanced level of nursing expertise to maximize the application of in-depth nursing theory, knowledge and skills to meet the complex healthcare needs of vulnerable populations and communities.

Education: A minimum of a Bachelor’s degree in Nursing from an accredited post-secondary healthcare program with an equivalent combination of training and experience with vulnerable populations is required. A Master’s degree in Nursing is an asset. Current Basic Life Support for Health Care Providers is required.

Functional knowledge: Demonstrated clinical skills in primary care nursing with evidence of continued professional development. Knowledge of and ability to use EMR system. Demonstrated ability to use equipment and supplies according to established standards and procedures.

Experience: A minimum of five (5) years of broad clinical nursing practice is required and a minimum of three (3) years’ nursing experience in primary care. Minimum of two (2) years’ acute care experience preferred. Experience in management of chronic disease and mental health is preferred. Minimum two (2) years’ recent experience working with vulnerable populations, chronic pain, addictions, mental health and wound care management. Must have the ability to work independently with minimal supervision in a professional manner.

Organizational and problem-solving skills: Ability to multi-task and prioritize. Strong organizational skills. Proven ability to work under pressure and meet deadlines in a highly challenging environment. Ability to work with fixed deadlines, cope with frequent interruptions and changes.

Communications and customer-relations skills: Strong communication, interpersonal and relationship-building skills; able to handle requests and complaints in a professional, non-confrontational manner. Proven ability to build good working relationships with healthcare professionals, patients and other members of the community. Excellent followup and problem-solving skills with ability to make intuitive decisions. Discretion and ability to handle sensitive information and material appropriately.

Background check: A clear Criminal Background check, inclusive of a vulnerable sector search, is required to start. If you have resided outside of Calgary in the past 12 months, you will need to contact the local police or RCMP detachment in your previous residential municipality to be able to obtain a full report.

Technical: Proficiency in computers, Microsoft Office Suite and Electronic Medical Record systems.

Why Work for Us?

Employees of the CWC PCN enjoy a competitive salary and benefits package that includes employer-paid premiums for health and dental benefits, healthcare spending or wellness account, learning account, eligibility to contribute to our group RRSP plan and receive an employer match, flexible working options, generous vacation and personal time off allowances, and education days, as well as professional development opportunities.

The CWC PCN is a leader in the provision of primary care through collaboration, innovation and teamwork, creating healthy patients and satisfied providers.


Due to the high volume of applications we receive, only those who apply through the CWC PCN website will be moved forward in the recruitment process. This is a necessary step as we require some important information from our online application form. Please include your cover letter and resume when submitting your application.

We thank all applicants for their interest; however, only shortlisted candidates will be contacted.

Posting will remain open until a suitable candidate is found.



CWC PCN Physicians
If you are a CWC PCN member physician and you have questions about any of the services provided to our membership, or require access to our physician-only website, please email us at memberservices [at] cwcpcn [dot] com.