Under the general supervision of the Clinical Nurse Manager in Collaboration with the Associate Chief of Ambulatory Nursing Practice the Staff Registered Nurse: Ambulatory Care practices within the Lahey Clinic Professional Practice Model, MA Nurse Practice Act, ANA Standards of Practice and Code of Ethics and demonstrates Lahey Clinic's core values that reflect its Mission. The nurse-patient/family relationship, continuity of care and accountability are central to the delivery of individualized high quality patient care. The Staff Nurse: Ambulatory works in collaboration with the physician(s), other healthcare provider(s) and other ambulatory support staff within the department and with other disciplines to plan and coordinate the delivery of patient care. The Staff Registered Nurse: Ambulatory demonstrates the knowledge and skills necessary to provide expected standards of care based on physical, psychosocial, cultural, educational, spiritual, safety and age-appropriate considerations of patients. The Staff Registered Nurse: Ambulatory, in accordance with the Nurse Practice Act of Massachusetts Rules & Regulations- 244 CMR 3.0, shall bear full and ultimate responsibility for the quality of nursing care he/she provides to individuals and groups. Responsibilities include health maintenance, teaching, counseling, collaborative planning and restoration of optimal functioning and comfort or for the dignified death of those they serve. The Staff Registered Nurse: Ambulatory assumes the responsibility for the plan of care and has the authority to make decisions. The Staff registered Nurse: Ambulatory is held accountable for decisions specific to assessment, planning, implementation and evaluation of the plan. The registered nurse facilitates the coordination of care across the continuum and demonstrates safe practice within the domains of: -Clinical judgment and decision making -Professional relationships -Clinical leadership -Clinical scholarship The delegation and supervision in accordance with the Nurse Practice Act of Massachusetts Rules & Regulations- 244 CMR 3.0 Registered Nurse and Licensed Practical Nurse: Board of Registration in Nursing and the ANA Principles of Delegation is a responsibility and function of the Staff Registered Nurse: Ambulatory. The delegating registered nurse at Lahey Clinic bears the full and ultimate responsibility that includes but is not limited to: -Developing an appropriate patient care assignment -Properly and adequately teaching, directing and supervising the delegate -The outcome of the delegation The Staff Registered Nurse: Ambulatory maintains a current level of knowledge and skill with technical procedures as defined by nursing specialty organization, complies with all regulations and standards of regulatory and accrediting bodies, and is currently licensed in the state of Massachusetts as a registered nurse. Job Description: Essential Duties & Responsibilities: including but not limited to: I. Clinical Judgment and Decision Making: The process by which nurses come to understand the problems, issues or concerns of patients/families, to attend to relevant/critical information, and to respond in concerned and involved ways. A. The Staff Registered Nurse: Ambulatory is expected to and is accountable for providing safe patient care by demonstrating organizational skills that maintain and coordinate safe delivery of quality care for assigned patients/families. B. Performing systematic patient and family assessment relevant to practice settings and record the related health data.. C Analyze and interpret recorded data. Make informed judgements as to the specific problems and elements of nursing care mandated by a particular situation. D. Developing a culturally competent plan of care that identifies patient problems, expected outcomes, and addresses preventative measures.

• Respecting the values (religious/spiritual, ethnic, cultural) of the patient and family.

E. Delivering care that is specific to the age of the patient F. Utilizing listening skills and clinical judgment in decision making to telephonically assess the severity of patient caller signs and symptoms. G. Evaluating effectiveness of care and adapts plan based on patient/family response H. Providing patient care by:

• Providing necessary physical care to appropriate patient populations which include ADL's, positioning, transporting, and treatments
• Utilizing and transporting equipment
• Monitoring and recognizing acute changes in the patient and intervenes appropriately
• Administering medications including blood and blood products

II. Professional Relationship: The professional relationship is based upon Lahey Clinic's guiding principles and positive effective communication. This relationship extends beyond formal assessment to integrate the particular patient's response and his/her religious/spiritual, ethnic and cultural beliefs into the plan of care. A. Establishes professional relationship with nurses, physicians and other colleagues and patients and families.

• The relationship includes the patient and family as a partner in care and is based upon Swanson's Theory of Caring.

B. Educates the patient and family about the patient's illness and treatment including preventative measures appropriate to the patient. C. Supports Lahey Clinics commitment to community based activities both within the Lahey community and beyond. D. Collaborates, cooperates and communicates with other healthcare providers to ensure quality and continuity of care. III. Clinical Leadership: The Staff Registered Nurse: Ambulatory supports the development of others and creates a practice climate of responsiveness and learning based on Benner's Novice to Expert skills acquisition model. This supports the retention and recruitment of clinically competent nurses. The ability to lead and influence the reasoning of colleagues in the patient's best interest depends on skillful comportment, authoritative clinical knowledge and wisdom, the conviction to act as an ethical agent despite adverse consequences, and the ability to listen and enhance others' strengths. A. Demonstrates professional behavior by adhering to unit policies and procedures, practice guidelines specific to the setting and the ANA Code of Ethics. B. Demonstrates skills as a responsive team member. C. Demonstrates role of nurse as teacher. D. Demonstrates ability to fulfill role in regulatory compliance and readiness. E. Achieves and maintains ACLS certification as required by departmental standards F. Serve as patient advocate, within the limits of the law. IV. Clinical Scholarship: The Staff Registered Nurse: Ambulatory Care achieves clinical scholarship through experiences with patients, through collaboration with colleagues and leadership and through formal education. Learning is transformed into knowledge through self-reflection and analysis. A. Upholds standards of quality nursing care. B. Demonstrates a commitment to life long learning. C. Demonstrates evidenced based practice (EBP) in nursing. Organizational Requirements: • Maintains strict adherence to the Lahey Clinic Confidentiality Policy. • Incorporates Lahey Clinic Guiding Principles, Mission Statement, and Goals into daily activities. • Complies with all Lahey Clinic Policies. • Complies with behavioral expectations of the department and Lahey Clinic. • Maintains courteous and effective interactions with colleagues and patients. • Demonstrates an understanding of the job description, performance expectations, and competency assessment. • Demonstrates a commitment toward meeting and exceeding the needs of our customers and consistently adheres to Customer Service standards. • Participates in departmental and/or interdepartmental quality improvement activities. • Participates in and successfully completes Mandatory Education. • Performs all other duties as needed or directed to meet the needs of the department. Minimum Qualifications: Education: Graduate of a state approved and/or accredited School of Nursing BSN preferred Licensure, Certification, Registration:

• Current license to practice professional nursing from the Massachusetts Board of Registration
• BLS certification with American Heart Association

Skills, Knowledge & Abilities: Clinical Skills/Technical Knowledge

• Demonstrates the necessary clinical skills and technical knowledge to provide care for patients according to Nursing Policy and Procedures. See Skill Record.
• Demonstrates the necessary clinical skills and knowledge to provide care for patients according to the clinic specific competencies. See Skill Record.
• Excellent interpersonal and organizational skills.

Experience: Acute care medical-surgical experience Pay Range: $37.00 - $95.37 The pay range listed for this position is the base hourly wage range the organization reasonably and in good faith expects to pay for this position at this time. Actual compensation is determined based on several factors, that may include seniority, education, training, relevant experience, relevant certifications, geography of work location, job responsibilities, or other applicable factors permissible by law. Compensation may exceed the base hourly rate depending on shift differentials, call pay, premium pay, overtime pay, and other additional pay practices, as applicable to the position and in accordance with the law. As a health care organization, we have a responsibility to do everything in our power to care for and protect our patients, our colleagues and our communities. Beth Israel Lahey Health requires that all staff be vaccinated against influenza (flu) as a condition of employment.