Ambulatory Registered Nurse -Primary and Specialty Care

When you join the growing BILH team, you're not just taking a job, you’re making a difference in people’s lives. Under the general supervision of the Administrative Director 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.

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

Pay Range:

$34.20 - $73.39

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.

More than 35,000 people working together. Nurses, doctors, technicians, therapists, researchers, teachers and more, making a difference in patients' lives. Your skill and compassion can make us even stronger.

Equal Opportunity Employer/Veterans/Disabled