FCHS Upcoming Volunteer Opportunities

Foothills Country Hospice
Upcoming Volunteer Opportunities

The following is a brief summary of upcoming volunteer opportunities. More detailed job descriptions are being developed so duties will change from time-to-time.

The Volunteer Coordinator is responsible for the initial recruitment and screening of volunteers; planning development, assessment and recognition processes for volunteers; and for being a volunteer advocate. Day-to-day supervision will come from the staff or committee members which the volunteer supports.

For more information call the Volunteer Coordinator at (403) 995-4673 x202 or email volunteercoordinator@countryhospice.org

Reception—first contact with callers, patients, families, and visitors. Answering phones, logging visitors, possible clerical work. Reports to hospice management team.
Clerical/admin—typing, filing, special projects (commemorative scrapbook). Reports to hospice management team.
Patient/family orientation tours—introducing prospective and new patients and their families to the hospice home, staff and volunteers. Reports to hospice management team.
Direct patient support—“being present”, listening, reading, helping with personal grooming, cutting up food, reporting patient/family-related concerns to staff, distributing snacks from food/beverage cart as scheduled. Reports to clinical management team.
Patient errands—may include picking up grooming supplies, washing patient’s personal laundry, driving visitors to and from hospice, or other tasks as approved by Volunteer Coordinator and as requested by or on behalf of patient. Drivers require clean driver’s abstract and proof of insurance ($2million liability and endorsement to carry passengers). Reports to hospice management team.
Fund-raising—participate or spearhead fund-raising events on behalf of hospice. Reports to fund development committee.
Landscaping (spring 2009)—assists with completing new landscaping and ongoing maintenance. May include planting, pruning, weeding, etc. as directed. Reports to landscaping committee.
Housekeeping—could include kitchen laundry, linen and towels, dusting, vacuuming, sweeping snow away from doors. Reports to hospice House Manager/Housekeeper.
Kitchen assistance—could include food preparation (chopping, mixing), snack/meal preparation, kitchen/dining area/coffee station restocking, distributing snacks/meals and kitchen clean-up. May require food safety training. Reports to hospice Chef.
Equipment cleaning—items such as wheelchairs, lifts, etc. need to be cleaned and disinfected after use. Reports to clinical management team.

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FCHS Volunteer Requirements

Prior to joining the hospice team, prospective volunteers will be required to:

complete and submit a Confidential Volunteer Application Form, preferably by e-mail.

participate in a confidential interview with the Volunteer Coordinator.

provide two references. Preferred references would be from previous volunteer work, employment or personal reference from a non-relative. The Foothills Country Hospice conducts reference checks and by signing the application form, you grant permission for any named person, agency or employer to be contacted.

provide a current criminal record check (less than 6 months old) which is required of all staff and volunteers. There is no cost for volunteers as long as you have a letter from the hospice. Once I receive your application form, I will send you a letter which you can take with you when you apply for the record check.

submit certification of any qualifications or courses cited on page 1 of the application form.

provide a clean five-year driver’s abstract ONLY IF you are volunteering to do errands for patients, to drive on behalf of the hospice, or to drive landscaping equipment.

review, understand and sign a confidentiality agreement.

review, understand and sign a volunteer code of conduct.

review, understand and sign a role description indicating understanding of and agreement with the role associated with the particular volunteer “job” which you are taking on.

participate in orientation and training sessions as provided by the Society. Participation in and completion of training does not confer the right to be accepted or retained as a volunteer with the Foothills Country Hospice.

obtain written parental/guardian consent for volunteers under 18 years of age.

sign a liability release form only if you are participating in any volunteer activity on behalf of the hospice, which, in the sole judgement of the Foothills Country Hospice Society, may put you at risk of bodily injury or death.

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FCHS Volunteer Confidentiality Form

I, the undersigned, __________________________________ (Name of volunteer) agree that I will hold in confidence the identities of persons utilizing the Foothills Country Hospice services, their client records and will divulge such information, orally or in writing, only to those Hospice Society volunteers or staff as authorized by the Hospice Society whose duties require them to have a "need-to-know."

Without such "need-to-know", such information will not be divulged to any person.

I further agree to conform to the best of my ability to the Foothills Country Hospice Society requirements respecting the marking, control, transmission, reproduction, handling, storage and destruction of records and information.

I agree to allow the Foothills Country Hospice Society to photograph me and allow reproduction of such photographs to further the mission of the society.

Personnel are provided with security privileges in accordance with individual job responsibilities, whereby such authorizations may enable access to confidential personnel, personal or donor information, beyond the scope of their job responsibility and/or geographic area. Any unwarranted review and/or disclosure of confidential information will be considered a breach of this Confidentiality Agreement and subject to consequences including immediate termination as a volunteer of the Foothills Country Hospice Society.

I acknowledge that in the event of my breach of this Confidentiality Agreement, the Society and other third parties may have a claim (for damages) against me.

(Signature) and (Date)

(Witness) and (Date)

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FCHS Confidential Volunteer Application Form

Name: _ Date: _

Daytime phone: ___________________________ Evening phone: __________________________

Street/mailing address: _______________________________________________________________

Town/Postal code: _____________________ e-mail: ______________________________________

Best time to contact you: ___ morning ___ afternoon ___ evening ___ weekend

Attach your resumé or complete the following two sections:

Are you currently: ___ employed ___ self employed ___ student ___ semi-retired ___ retired ___ volunteer ___ other (please specify)

Employer/Organization (begin with most recent) Title/Position Employee/ Volunteer Start/End Dates

_________________________________________ ____________ ___________________ _______________

Relevant certification: ___ palliative care ___ bereavement care ___ first aid (level ) ___ CPR (level ) ___ cross-cultural training ___ mediation/conflict resolution ___ valid driver’s license ___ other (please specify)

Please list any hobbies, skills or special interests which you would be willing to share with patients, families, staff and/ or other volunteers.

________________________________________________________________________________________________

Are there languages in addition to English which you would be willing to utilize to assist patients or their families who do not speak English? If so, please specify.

________________________________________________________________________________________________

What experience have you had with death? Have you experienced a life-threatening illness in, or bereavement of, a family member or close friend within the past 2 years? Please describe.

_________________________________________________________________________________________________

In this community, there are many organizations which are seeking volunteer assistance. What factors contributed to your desire to volunteer at the Foothills Country Hospice?

_________________________________________________________________________________________________

Our hospice home is fully accessible and smoke-free. Do you have any other physical requirements we should be aware of which will help us to assist you in your volunteer work? If so, please describe.

_________________________________________________________________________________________________

Which of these categories of hospice volunteer work do you want to assist us with:

___ reception ___ clerical/admin ___ patient/family orientation ___ patient support

___ patient errands ___ fund-raising ___ landscaping ___ housekeeping ___ kitchen assistance

___ childrens room ___ cleaning equipment (wheelchairs, walkers, etc.) ___ other (please specify)

___________________________________________________________________________________________________

When would you typically be available to volunteer (please check all that apply)

Day 6 – 9 am 9 am - noon noon – 3 pm 3 – 6 pm 6 – 9 pm 9 pm - midnight Midnight – 6 am

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Frequency ___ daily ___ weekly ___ biweekly ___ monthly ___ flexible

Holidays (please specify) ___________________________________________________________________________

Are you legally entitled to work/volunteer in Canada ___ yes ___ no

I understand that the information provided in this application to volunteer with the

Foothills Country Hospice Society is part of the permanent volunteer file which will be kept confidential and used only to assist in completing the volunteer screening process and in matching my skills and interests with the needs of the hospice.

___ I have read and understand the Volunteer Requirements document. I hereby certify that all the information included in this application form is true and complete.

Signature __________________________________________ Date __________________________________________

The Foothills Country Hospice conducts reference checks and by signing above, you grant permission for any named person, agency or employer to be contacted. Please list references here:

Name:	Name:
Phone number:	Phone number:
Title:	Title:
Organization:	Organization:
Relationship:	Relationship:
Time known:	Time known:

For office use only:

Reference #1 Checked by Date

Reference #2 Checked by Date

Criminal record check received date

Certicates (list)

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FCHS Parental Guardian Consent Form

Dear Parent/Legal Guardian,

Young people who have not reached the age of majority who are interested in volunteering for the Foothills Country Hospice Society must have the written consent of a parent or legal guardian. We ask that you please read and sign this form acknowledging your understanding and approval of your child’s volunteer responsibilities. By completing this form, we will can complete the volunteer intake process on behalf of the applicant. If s/he is accepted by the volunteer program, your continued involvement and support will help us in providing a fun and rewarding experience for your family member.

I understand that (please print applicant’s name) , wishes to be considered for a volunteer opportunity at the Foothills Country Hospice and I hereby give my permission for him/her to serve in this capacity, if/when accepted. I understand that necessary orientation and training will be provided to ensure the safe and responsible performance of his/her duties. S/he will be expected to meet all the requirements of the position (role description attached), including regular attendance and adherence to the agency policies and procedures.

If you have any questions/concerns regarding this form or your child’s volunteer involvement, please contact Anne Bouscal, volunteer coordinator, at (403) 995-4673 X202 or volunteercoordinator@countryhospice.org.

Volunteer position
Parent/guardian name
Address
Relationship to prospective volunteer			Phone
Signature			Date

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Name: ___________________________________ Date: ___________________________________

Day 6 – 9 am 9 am - noon noon – 3 pm 3 – 6 pm 6 – 9 pm 9 pm - midnight Midnight – 6 am

I understand that the information provided in this application to volunteer with the

Name: _ Date: _