61 jobs found in Annapolis

Position Objective: Deliver quality professional nursing care as an expert nurse clinician through evidence-based oncology nursing practice. This practice is accomplished through demonstration of clinical competence, knowledge and understanding of ambulatory and oncology nursing standards and practice in ambulatory infusion and oncology nursing practices. The delivery of care will be consistent with guidelines established in the Nurse Practice Act, the Oncology Nursing Society and the nursing standards of AAMC. The nursing care will be high quality, timely, and directed at meeting or exceeding the needs of patients and internal/external customers. Open communication, high professional standards, and a spirit of inquiry are essential in the care delivery. Essential Job Duties: Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions Delivers evidenced based nursing care consistent with the standards of AAMC, Oncology Nursing and the intravenous nursing standards of care. Responsible for the safe and efficient, administration of biotherapy, chemotherapy, blood transfusions, and other related infusions services. Demonstrates proficiency and competency in use maintenance and troubleshooting of all types of venous access devices and serves as a nurse expert to support care in other departments as requested. Utilizes information technology according to established processes at AAMC to advance care coordination and communication. Uses evidence based guidelines and demonstrates competency for the care of duties according to established standards for age groups late childhood through geriatric. Provides education for patients and family members related to biotherapy, chemotherapy or related infusions, services, expected toxicities and interventions. Uses SBAR communication tools for documentation of all patient interactions both in person and by telephone consultation via the paper or electronic record to maintain communication with the care team. Acts as a resource and consultant for patients and families, and assists in referrals when necessary for both internal and external resources Social Work, Nutrition, Case Management, Financial Coordinators, Nurse Navigators, Home Health, Hospice, Physical Therapy, Wound Care. Responds to inquiries from physicians, nurses, patients and families in established time frames to promote improvement of clinical outcomes and efficiency. Demonstrates competency and continually enhances the practice of oncology nursing and infusion/intravenous therapy by seeking educational opportunities either self-initiated or through formal AAMC Nursing or professional society sponsored education. Presents and participates in nursing rounds, case presentations or nursing committees to maintain and share knowledge of ambulatory oncology practice. Collaborates with and participates in the care of research patients in the identification, education, and documentation and compliance of patients on clinical trials and protocols. Collaborates with leadership including Medical Director, Pharmacy Manger/Director and Nurse Director, in the development and implementation and monitoring of quality/performance and outcomes, improvement activities aimed at continually improving patient outcomes. Actively supports and participates in patient and employee satisfaction programs and activities seeking enhanced outcomes. Nb Develops educational materials and programs to support nurse, patient and family education. Participates in the development of evidenced based nursing practice with the Nurse Practice Council and the other shared leadership councils of AAMC Nursing. Participates as an active member of the AAMC Nursing Strategic Planning Committee. Participates in local, regional and national oncology nursing programs to advance the practice of nursing and delivery of care. Demonstrates cultural competency and sensitivity to caring for multicultural populations. Serves as a mentor, consultant, or preceptor to students, new graduates or RNs new to Oncology nursing. Demonstrates the ability to work in an interdisciplinary team. Educational/Experience Requirements: If serving as a bilingual/multilingual interpreter, certification in Medical Interpretation is required to perform the duties of a qualified interpreter. Minimum of two years nursing experience. Oncology experience preferred. Required to complete and pass the Oncology Nursing Society (ONS) Chemotherapy/Biotherapy Course within the following time frame: Experienced registered nurses (>1 year of experience) within 6 months of hire or Nurses (< 1 year of experience) within 12 months of hire RNs will be required to renew the ONS Chemotherapy/Biotherapy card every 24 months and or per requirements of ONS. Associate Degree in Nursing. Required License/Certifications: CPR- American Heart Association Health Care Provider. Oncology Nursing Certification is highly recommended when eligibility criteria is met. Licensed as Registered Nurse in the state of Maryland. Working Conditions, Equipment, Physical Demands: There is a reasonable expectation that employees in this position will or will not be exposed to blood-borne pathogens. Physical Demands – Medium work. Exerting up to 50 pounds of force occasionally, and/or up to 30 pounds of force frequently, and/or up to 10 pounds of force constantly to move objects. The physical demands and work environment that have been described are representative of those an employee encounters while performing the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions in accordance with the Americans with Disabilities Act. The above job description is an overview of the functions and requirements for this position. This document is not intended to be an exhaustive list encompassing every duty and requirement of this position; your supervisor may assign other duties as deemed necessary.

The Observation Unit is an outpatient setting for patients who require additional monitoring and intervention after their visit to the Emergency Department. Within 24 hours of arrival, patients transition to home. If you are looking for a more challenging pace than an inpatient unit– the Observation Unit is for you. It is also a great entry point from the inpatient setting to an eventual transition into the Emergency Department as a professional nurse. Position Objective: Contributes to the provision of high-quality, cost-effective healthcare as a provider of direct and indirect patient care and by effective of the health care team. Functions as a competent member of the health care team. Essentional Job Duties : Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 1. Clinical Decision Making/Judgment Demonstrates clinical nursing knowledge and skill in the specialization of the unit. Demonstrates the ability to apply the nursing process effectively in the care of culturally diverse patients and families. Demonstrates the ability to utilize all applicable laws, policies, standards, guidelines and evidence-based practice in the provision of patient/family care. Organizes and reprioritizes patient care activities based on subtle and overt and/or environmental changes. Consistently and thoroughly assesses patients to collect data and identify learning needs according to established standards and policies. Utilizes a systematic, continuous and complete analysis of assessment data to develop individualized problem lists for assigned patients. Develops and individualizes a plan of care for each patient in accordance with established standards, appropriate prioritization of problems/needs, and mutually agreed upon goals. Efficiently implements the patient’s plan of care in accordance with applicable standards, policies, procedures and guidelines. Demonstrates proficiency in medication administration, pain management and other unit or initiative specific skills. Continuously evaluates the effectiveness of the plan(s) of care, making revisions and recommendations based on analysis of patient responses to interventions. 2. Nurse-Patient Family Relationships Demonstrates the ability to assess the patient’s/family’s learning needs, readiness to learn, learning style, and presence of barriers to learning. Demonstrates the ability to develop, implement and evaluate teaching plans for patient populations in unit specialty in accordance with applicable standards. Demonstrates the ability to apply knowledge of growth and development across the life span to the care of patients. Provides direct patient care to patients and families in a culturally, developmentally and ethically appropriate manner. Plans of care address the physical, psychosocial, spiritual and learning needs of the patient/family. 3. Clinical Scholarship Participates in QI, CPI and risk management activities at the unit, department or organizational level. Demonstrates the ability to effectively perform and improve all processes in order to achieve excellence with regard to AAMC’s quality standards and benchmarks. Supports the use of evidence based guidelines and organizational policies and procedures to promote safe patient care and a safe practice environment. 4. Clinical Leadership Participates in unit shared governance according to departmental standards. Participates in the education and orientation of new staff. Delegates patient care activities as appropriate; evaluates delegated activities for expected patient care outcomes. Employs real time computer documentation when completing patient record. Educational/Experience Requirements: Graduate of an accredited school of nursing Adherence to the credentialing requirements of AAMC as stated in the nursing bylaws. Required License/Certifications: Current licensure as a registered nurse by the Maryland Board of Nursing. CPR – American Heart Association Healthcare Provider certification ACLS required within one (1) year of hire. Working Conditions, Equipment, Physical Demands: There is a reasonable expectation that employees in this position will be exposed to blood-borne pathogens. Physical Demands – Medium work. Exerting up to 50 pounds of force occasionally, and/or up to 30 pounds of force frequently, and/or up to 10 pounds of force constantly to move objects. The physical demands and work environment that have been described are representative of those an employee encounters while performing the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions in accordance with the Americans with Disabilities Act. The above job description is an overview of the functions and requirements for this position. This document is not intended to be an exhaustive list encompassing every duty and requirement of this position; your supervisor may assign other duties as deemed necessary.

Position Objective: Contributes to the provision of high-quality, cost-effective healthcare as a provider of direct and indirect patient care and by effective of the health care team. Functions as a competent member of the health care team. Essential Job Duties : Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 1. Clinical Decision Making/Judgment Demonstrates clinical nursing knowledge and skill in the specialization of the unit. Demonstrates the ability to apply the nursing process effectively in the care of culturally diverse patients and families. Demonstrates the ability to utilize all applicable laws, policies, standards, guidelines and evidence-based practice in the provision of patient/family care. Organizes and reprioritizes patient care activities based on subtle and overt and/or environmental changes. Consistently and thoroughly assesses patients to collect data and identify learning needs according to established standards and policies. Utilizes a systematic, continuous and complete analysis of assessment data to develop individualized problem lists for assigned patients. Develops and individualizes a plan of care for each patient in accordance with established standards, appropriate prioritization of problems/needs, and mutually agreed upon goals. Efficiently implements the patient’s plan of care in accordance with applicable standards, policies, procedures and guidelines. Demonstrates proficiency in medication administration, pain management and other unit or initiative specific skills. Continuously evaluates the effectiveness of the plan(s) of care, making revisions and recommendations based on analysis of patient responses to interventions. 2. Nurse-Patient Family Relationships Demonstrates the ability to assess the patient’s/family’s learning needs, readiness to learn, learning style, and presence of barriers to learning. Demonstrates the ability to develop, implement and evaluate teaching plans for patient populations in unit specialty in accordance with applicable standards. Demonstrates the ability to apply knowledge of growth and development across the life span to the care of patients. Provides direct patient care to patients and families in a culturally, developmentally and ethically appropriate manner. Plans of care address the physical, psychosocial, spiritual and learning needs of the patient/family. 3. Clinical Scholarship Participates in QI, CPI and risk management activities at the unit, department or organizational level. Demonstrates the ability to effectively perform and improve all processes in order to achieve excellence with regard to AAMC’s quality standards and benchmarks. Supports the use of evidence based guidelines and organizational policies and procedures to promote safe patient care and a safe practice environment. 4. Clinical Leadership Participates in unit shared governance according to departmental standards. Participates in the education and orientation of new staff. Delegates patient care activities as appropriate; evaluates delegated activities for expected patient care outcomes. Employs real time computer documentation when completing patient record. Educational/Experience Requirements: Graduate of an accredited school of nursing Adherence to the credentialing requirements of AAMC as stated in the nursing bylaws. Required License/Certifications: Current licensure as a registered nurse by the Maryland Board of Nursing. CPR – American Heart Association Healthcare Provider certification ACLS – Required within one year of hire from the American Heart Association Healthcare Provider PALS – Required within one year of hire from the American Heart Association Healthcare Provider Working Conditions, Equipment, Physical Demands: There is a reasonable expectation that employees in this position will be exposed to blood-borne pathogens. Physical Demands – Medium work. Exerting up to 50 pounds of force occasionally, and/or up to 30 pounds of force frequently, and/or up to 10 pounds of force constantly to move objects. The physical demands and work environment that have been described are representative of those an employee encounters while performing the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions in accordance with the Americans with Disabilities Act. The above job description is an overview of the functions and requirements for this position. This document is not intended to be an exhaustive list encompassing every duty and requirement of this position; your supervisor may assign other duties as deemed necessary.

Ideal candidate will have 3+ years of recent Cardiac O.R. experience Start date for this position will be January 2020 in preparation of the opening of our Cardiac Surgery program. Position Objective : Contributes to the provision of high-quality, cost-effective healthcare as a provider of direct and indirect patient care and by effective of the health care team. Functions as a competent member of the health care team. Essential Job Duties : Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 1. Clinical Decision Making/Judgment Demonstrates clinical nursing knowledge and skill in the specialization of the unit. Demonstrates the ability to apply the nursing process effectively in the care of culturally diverse patients and families. Demonstrates the ability to utilize all applicable laws, policies, standards, guidelines and evidence-based practice in the provision of patient/family care. Organizes and reprioritizes patient care activities based on subtle and overt and/or environmental changes. Consistently and thoroughly assesses patients to collect data and identify learning needs according to established standards and policies. Utilizes a systematic, continuous and complete analysis of assessment data to develop individualized problem lists for assigned patients. Develops and individualizes a plan of care for each patient in accordance with established standards, appropriate prioritization of problems/needs, and mutually agreed upon goals. Efficiently implements the patient’s plan of care in accordance with applicable standards, policies, procedures and guidelines. Demonstrates proficiency in medication administration, pain management and other unit or initiative specific skills. Continuously evaluates the effectiveness of the plan(s) of care, making revisions and recommendations based on analysis of patient responses to interventions. 2. Nurse-Patient Family Relationships Demonstrates the ability to assess the patient’s/family’s learning needs, readiness to learn, learning style, and presence of barriers to learning. Demonstrates the ability to develop, implement and evaluate teaching plans for patient populations in unit specialty in accordance with applicable standards. Demonstrates the ability to apply knowledge of growth and development across the life span to the care of patients. Provides direct patient care to patients and families in a culturally, developmentally and ethically appropriate manner. Plans of care address the physical, psychosocial, spiritual and learning needs of the patient/family. 3. Clinical Scholarship Participates in QI, CPI and risk management activities at the unit, department or organizational level. Demonstrates the ability to effectively perform and improve all processes in order to achieve excellence with regard to AAMC’s quality standards and benchmarks. Supports the use of evidence based guidelines and organizational policies and procedures to promote safe patient care and a safe practice environment. 4. Clinical Leadership Participates in unit shared governance according to departmental standards. Participates in the education and orientation of new staff. Delegates patient care activities as appropriate; evaluates delegated activities for expected patient care outcomes. Employs real time computer documentation when completing patient record. Educational/Experience Requirements: Graduate of an accredited school of nursing Adherence to the credentialing requirements of AAMC as stated in the nursing bylaws. Required License/Certifications: Current licensure as a registered nurse by the Maryland Board of Nursing. CPR – American Heart Association Healthcare Provider certification Working Conditions, Equipment, Physical Demands: There is a reasonable expectation that employees in this position will be exposed to blood-borne pathogens. Physical Demands – Medium work. Exerting up to 50 pounds of force occasionally, and/or up to 30 pounds of force frequently, and/or up to 10 pounds of force constantly to move objects. The physical demands and work environment that have been described are representative of those an employee encounters while performing the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions in accordance with the Americans with Disabilities Act. The above job description is an overview of the functions and requirements for this position. This document is not intended to be an exhaustive list encompassing every duty and requirement of this position; your supervisor may assign other duties as deemed necessary.

Join our busy Women’s and Children’s Service line! This is an opportunity to show your versatility as a float nurse. You will be required to work 2 of 4 areas (L&D, Mother Baby, NICU, Peds) and receive premium pay! Position Objective: Contribute to the provisions of high-quality, cost-effective healthcare as a provider of direct and indirect patient care and by effective collaboration with other members of the health care team. Functions as a competent member of the health care team. Essential Job Duties: Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions Demonstrates clinical nursing knowledge and skill in the specialization of the unit as a flex nurse. Demonstrates the ability to apply the nursing process effectively in the care of culturally diverse patients and families. Demonstrates the ability to utilize all applicable laws, policies, standards, guidelines and evidence-based practice in the provision of patient/family care. Organizes and reprioritizes patient care activities based on subtle and overt and/or environmental changes. Consistently and thoroughly assesses patients to collect data and identify learning needs according to established standards and policies. Utilizes a systematic, continuous and complete analysis of assessment data to develop individualized problem lists for assigned patients. Develops and individualizes a plan of care for each patient in accordance with established standards, appropriate prioritization of problems/needs, and mutually agreed upon goals. Efficiently implements the patients plan of care in accordance with applicable standards, policies, procedures and guidelines. Demonstrates proficiency in medication administration, pain management and other unit or initiative specific skills. Continuously evaluates the effectiveness of the plan (s) of care, making revisions and recommendations based on analysis of patient responses to interventions. Demonstrates the ability to assess the patients/family’s learning needs, readiness to learn, learning style, and presence of barriers to learning. Demonstrates the ability to develop, implement and evaluate teaching plans for patient populations in unit specialty in accordance with applicable standards. 10. Demonstrates the ability to apply knowledge of growth and development across the life span to the care of patients. Educational/Experience Requirements: Required License/Certifications: NRP certification within one year of hire. Adherence to credentialing requirements of AAMC as stated in the nursing bylaws. Working Conditions, Equipment, Physical Demands: There is a reasonable expectation that employees in this position will or will not be exposed to blood-borne pathogens. Physical Demands – The physical demands and work environment that have been described are representative of those an employee encounters while performing the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions in accordance with the Americans with Disabilities Act. The above job description is an overview of the functions and requirements for this position. This document is not intended to be an exhaustive list encompassing every duty and requirement of this position; your supervisor may assign other duties as deemed necessary.

Position Objective: Deliver quality professional nursing care as an expert nurse clinician through evidence-based oncology nursing practice. This practice is accomplished through demonstration of clinical competence, knowledge and understanding of ambulatory and oncology nursing standards and practice in ambulatory infusion and oncology nursing practices. The delivery of care will be consistent with guidelines established in the Nurse Practice Act, the Oncology Nursing Society and the nursing standards of AAMC. The nursing care will be high quality, timely, and directed at meeting or exceeding the needs of patients and internal/external customers. Open communication, high professional standards, and a spirit of inquiry are essential in the care delivery. Essential Job Duties: Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions Delivers evidenced based nursing care consistent with the standards of AAMC, Oncology Nursing and the intravenous nursing standards of care. Responsible for the safe and efficient, administration of biotherapy, chemotherapy, blood transfusions, and other related infusions services. Demonstrates proficiency and competency in use maintenance and troubleshooting of all types of venous access devices and serves as a nurse expert to support care in other departments as requested. Utilizes information technology according to established processes at AAMC to advance care coordination and communication. Uses evidence based guidelines and demonstrates competency for the care of duties according to established standards for age groups late childhood through geriatric. Provides education for patients and family members related to biotherapy, chemotherapy or related infusions, services, expected toxicities and interventions. Uses SBAR communication tools for documentation of all patient interactions both in person and by telephone consultation via the paper or electronic record to maintain communication with the care team. Acts as a resource and consultant for patients and families, and assists in referrals when necessary for both internal and external resources Social Work, Nutrition, Case Management, Financial Coordinators, Nurse Navigators, Home Health, Hospice, Physical Therapy, Wound Care. Responds to inquiries from physicians, nurses, patients and families in established time frames to promote improvement of clinical outcomes and efficiency. Demonstrates competency and continually enhances the practice of oncology nursing and infusion/intravenous therapy by seeking educational opportunities either self-initiated or through formal AAMC Nursing or professional society sponsored education. Presents and participates in nursing rounds, case presentations or nursing committees to maintain and share knowledge of ambulatory oncology practice. Collaborates with and participates in the care of research patients in the identification, education, and documentation and compliance of patients on clinical trials and protocols. Collaborates with leadership including Medical Director, Pharmacy Manger/Director and Nurse Director, in the development and implementation and monitoring of quality/performance and outcomes, improvement activities aimed at continually improving patient outcomes. Actively supports and participates in patient and employee satisfaction programs and activities seeking enhanced outcomes. Nb Develops educational materials and programs to support nurse, patient and family education. Participates in the development of evidenced based nursing practice with the Nurse Practice Council and the other shared leadership councils of AAMC Nursing. Participates as an active member of the AAMC Nursing Strategic Planning Committee. Participates in local, regional and national oncology nursing programs to advance the practice of nursing and delivery of care. Demonstrates cultural competency and sensitivity to caring for multicultural populations. Serves as a mentor, consultant, or preceptor to students, new graduates or RNs new to Oncology nursing. Demonstrates the ability to work in an interdisciplinary team. Educational/Experience Requirements: If serving as a bilingual/multilingual interpreter, certification in Medical Interpretation is required to perform the duties of a qualified interpreter. Minimum of two years nursing experience. Oncology experience preferred. Required to complete and pass the Oncology Nursing Society (ONS) Chemotherapy/Biotherapy Course within the following time frame: Experienced registered nurses (>1 year of experience) within 6 months of hire or Nurses (< 1 year of experience) within 12 months of hire RNs will be required to renew the ONS Chemotherapy/Biotherapy card every 24 months and or per requirements of ONS. Associate Degree in Nursing. Required License/Certifications: CPR- American Heart Association Health Care Provider. Oncology Nursing Certification is highly recommended when eligibility criteria is met. Licensed as Registered Nurse in the state of Maryland. Working Conditions, Equipment, Physical Demands: There is a reasonable expectation that employees in this position will or will not be exposed to blood-borne pathogens. Physical Demands – Medium work. Exerting up to 50 pounds of force occasionally, and/or up to 30 pounds of force frequently, and/or up to 10 pounds of force constantly to move objects. The physical demands and work environment that have been described are representative of those an employee encounters while performing the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions in accordance with the Americans with Disabilities Act. The above job description is an overview of the functions and requirements for this position. This document is not intended to be an exhaustive list encompassing every duty and requirement of this position; your supervisor may assign other duties as deemed necessary.

Anne Arundel Medical Center, a Magnet® hospital and part of the newly formed Luminis Health, is seeking an transformational and innovative nursing leader for the Intensive Care/Intermediate Care Unit. These are exciting times at AAMC as we also embark upon cardiac surgery scheduled to start in late Spring of 2020. Position Objective Within the shared governance model, this individual is responsible for comprehensive function and outcomes of defined clinical areas to include compliance with regulations, human resource issues, fiscal accountability, patient satisfaction and service excellence. Participates in the planning and development of programs. Serves as a collaborative partner with the medical staff, the community and the organization at large. Essential Functions Directs overall operational functions for assigned areas. Sets priorities for data collection for identified performance improvement programs which are related to organization’s goals and priorities. Projects volumes, needs, and clinical services on an annual basis justifying variances and initiating corrective actions to adjust variances accordingly. Directs the ongoing activities of personnel related to skills competency targets and adherence to staffing policies to assure efficiency of resources. Functions as an expert in the management of patient care in the clinical area. Facilitates and participates in ongoing teams designed to plan, communicate, implement, and evaluate optimal patient care delivery systems. Ensures that effective ongoing communications and information sharing occurs at the inter/intra departmental levels. Develops annual staff development goals for assigned area and performs routine staff appraisal to address professional growth per hospital Required Minimum Experience : Five years of relevant clinical experience plus three years of management experience. Education Requirements Minimum education requirement for nursing degree is bachelor of science Masters degree in nursing or related field required Licensure/Certification Registered Nursing License from Maryland Board of Nursing American Heart Association Healthcare Provider BLS Professional nursing or leadership certification preferred Working Conditions, Equipment, Physical Demands: There is a reasonable expectation that employees in this position will be exposed to blood-borne pathogens. Physical Demands – Medium work. Exerting up to 50 pounds of force occasionally, and/or up to 30 pounds of force frequently, and/or up to 10 pounds of force constantly to move objects. The physical demands and work environment that have been described are representative of those an employee encounters while performing the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions in accordance with the Americans with Disabilities Act. The above job description is an overview of the functions and requirements for this position. This document is not intended to be an exhaustive list encompassing every duty and requirement of this position; your supervisor may assign other duties as deemed necessary.

Position Objective: Contributes to the provision of high-quality, cost-effective healthcare as a provider of direct and indirect patient care and by effective of the health care team. Functions as a competent member of the health care team. Essential Job Duties : Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 1. Clinical Decision Making/Judgment Demonstrates clinical nursing knowledge and skill in the specialization of the unit. Demonstrates the ability to apply the nursing process effectively in the care of culturally diverse patients and families. Demonstrates the ability to utilize all applicable laws, policies, standards, guidelines and evidence-based practice in the provision of patient/family care. Organizes and reprioritizes patient care activities based on subtle and overt and/or environmental changes. Consistently and thoroughly assesses patients to collect data and identify learning needs according to established standards and policies. Utilizes a systematic, continuous and complete analysis of assessment data to develop individualized problem lists for assigned patients. Develops and individualizes a plan of care for each patient in accordance with established standards, appropriate prioritization of problems/needs, and mutually agreed upon goals. Efficiently implements the patient’s plan of care in accordance with applicable standards, policies, procedures and guidelines. Demonstrates proficiency in medication administration, pain management and other unit or initiative specific skills. Continuously evaluates the effectiveness of the plan(s) of care, making revisions and recommendations based on analysis of patient responses to interventions. 2. Nurse-Patient Family Relationships Demonstrates the ability to assess the patient’s/family’s learning needs, readiness to learn, learning style, and presence of barriers to learning. Demonstrates the ability to develop, implement and evaluate teaching plans for patient populations in unit specialty in accordance with applicable standards. Demonstrates the ability to apply knowledge of growth and development across the life span to the care of patients. Provides direct patient care to patients and families in a culturally, developmentally and ethically appropriate manner. Plans of care address the physical, psychosocial, spiritual and learning needs of the patient/family. 3. Clinical Scholarship Participates in QI, CPI and risk management activities at the unit, department or organizational level. Demonstrates the ability to effectively perform and improve all processes in order to achieve excellence with regard to AAMC’s quality standards and benchmarks. Supports the use of evidence based guidelines and organizational policies and procedures to promote safe patient care and a safe practice environment. 4. Clinical Leadership Participates in unit shared governance according to departmental standards. Participates in the education and orientation of new staff. Delegates patient care activities as appropriate; evaluates delegated activities for expected patient care outcomes. Employs real time computer documentation when completing patient record. Educational/Experience Requirements: Graduate of an accredited school of nursing Adherence to the credentialing requirements of AAMC as stated in the nursing bylaws. Required License/Certifications: Current licensure as a registered nurse by the Maryland Board of Nursing. CPR – American Heart Association Healthcare Provider certification NRP – Neonatal Resuscitation required within one (1) year of hire Working Conditions, Equipment, Physical Demands: There is a reasonable expectation that employees in this position will be exposed to blood-borne pathogens. Physical Demands – Medium work. Exerting up to 50 pounds of force occasionally, and/or up to 30 pounds of force frequently, and/or up to 10 pounds constantly to move objects. The physical demands and work environment that have been described are representative of those an employee encounters while performing the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions in accordance with the Americans with Disabilities Act. The above job description is an overview of the functions and requirements for this position. This document is not intended to be an exhaustive list encompassing every duty and requirement of this position; your supervisor may assign other duties as deemed necessary.

Position Objective: Conducts concurrent and retrospective chart review for clinical, financial, and resource utilization information. Provides intervention and coordination to decrease avoidable delays and denial of payment. Essential Job Duties: Chart Review : Reviews the medical record by applying utilization review criteria, to assess clinical, financial, and resource utilization; enters clinical review in EPIC; maintains close communication with external reviews, care coordinators, and providers; reconciles and records days authorized in EPIC 2. Denial Management : Monitors and identifies patterns or trends in utilization management; monitors potential and actual denials and collaborates with care coordinator for any follow up necessary; documents actions taken to avoid denial; assists Care Coordinator in communicating with the patient denied hospital days with work toward resolution and discharge. 3. Care Coordination: Collaborates with the Care Coordinator to achieve optimal and efficient patient outcomes while decreasing length of stay, avoidable delays and denied days; utilizes Physician Advisor and administrative personnel for unresolved issues; identifies opportunities for expedited appeals and collaborates with the care coordinator and Physician Advisor to resolve payer issues. 4. Process improvement initiatives Participates in nursing unit and department clinical outcome projects as well as process improvement initiatives of care management. Educational/Experience Requirements: Bachelor’s of Science in Nursing. Three years of clinical nursing in an acute care hospital setting. Required License/Certifications: Current RN license from Maryland Board of Nursing. Working Conditions, Equipment, Physical Demands: There is a reasonable expectation that employees in this position will be exposed to blood-borne pathogens. Physical Demands – Medium work. Exerting up to 50 pounds of force occasionally, and/or up to 30 pounds of force frequently, and/or up to 10 pounds of force constantly to move objects. The physical demands and work environment that have been described are representative of those an employee encounters while performing the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions in accordance with the Americans with Disabilities Act. The above job description is an overview of the functions and requirements for this position. This document is not intended to be an exhaustive list encompassing every duty and requirement of this position; your supervisor may assign other duties as deemed necessary.

Position Objective: Contributes to the provision of high-quality, cost-effective healthcare as a provider of direct and indirect patient care and by effective of the health care team. Functions as a competent member of the health care team. Essential Job Duties : Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 1. Clinical Decision Making/Judgment Demonstrates clinical nursing knowledge and skill in the specialization of the unit. Demonstrates the ability to apply the nursing process effectively in the care of culturally diverse patients and families. Demonstrates the ability to utilize all applicable laws, policies, standards, guidelines and evidence-based practice in the provision of patient/family care. Organizes and reprioritizes patient care activities based on subtle and overt and/or environmental changes. Consistently and thoroughly assesses patients to collect data and identify learning needs according to established standards and policies. Utilizes a systematic, continuous and complete analysis of assessment data to develop individualized problem lists for assigned patients. Develops and individualizes a plan of care for each patient in accordance with established standards, appropriate prioritization of problems/needs, and mutually agreed upon goals. Efficiently implements the patient’s plan of care in accordance with applicable standards, policies, procedures and guidelines. Demonstrates proficiency in medication administration, pain management and other unit or initiative specific skills. Continuously evaluates the effectiveness of the plan(s) of care, making revisions and recommendations based on analysis of patient responses to interventions. 2. Nurse-Patient Family Relationships Demonstrates the ability to assess the patient’s/family’s learning needs, readiness to learn, learning style, and presence of barriers to learning. Demonstrates the ability to develop, implement and evaluate teaching plans for patient populations in unit specialty in accordance with applicable standards. Demonstrates the ability to apply knowledge of growth and development across the life span to the care of patients. Provides direct patient care to patients and families in a culturally, developmentally and ethically appropriate manner. Plans of care address the physical, psychosocial, spiritual and learning needs of the patient/family. 3. Clinical Scholarship Participates in QI, CPI and risk management activities at the unit, department or organizational level. Demonstrates the ability to effectively perform and improve all processes in order to achieve excellence with regard to AAMC’s quality standards and benchmarks. Supports the use of evidence based guidelines and organizational policies and procedures to promote safe patient care and a safe practice environment. 4. Clinical Leadership Participates in unit shared governance according to departmental standards. Participates in the education and orientation of new staff. Delegates patient care activities as appropriate; evaluates delegated activities for expected patient care outcomes. Employs real time computer documentation when completing patient record. Educational/Experience Requirements: Graduate of an accredited school of nursing Adherence to the credentialing requirements of AAMC as stated in the nursing bylaws. Required License/Certifications: Current licensure as a registered nurse by the Maryland Board of Nursing. CPR – American Heart Association Healthcare Provider certification NRP- Required within one year of hire at AAMC Working Conditions, Equipment, Physical Demands: There is a reasonable expectation that employees in this position will be exposed to blood-borne pathogens. Physical Demands – Medium work. Exerting up to 50 pounds of force occasionally, and/or up to 30 pounds of force frequently, and/or up to 10 pounds of force constantly to move objects. The physical demands and work environment that have been described are representative of those an employee encounters while performing the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions in accordance with the Americans with Disabilities Act. The above job description is an overview of the functions and requirements for this position. This document is not intended to be an exhaustive list encompassing every duty and requirement of this position; your supervisor may assign other duties as deemed necessary.

Position Objective: Contributes to the provision of high-quality, cost-effective healthcare as a provider of direct and indirect patient care and by effective of the health care team. Functions as a competent member of the health care team. Essential Job Duties : Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 1. Clinical Decision Making/Judgment Demonstrates clinical nursing knowledge and skill in the specialization of the unit. Demonstrates the ability to apply the nursing process effectively in the care of culturally diverse patients and families. Demonstrates the ability to utilize all applicable laws, policies, standards, guidelines and evidence-based practice in the provision of patient/family care. Organizes and reprioritizes patient care activities based on subtle and overt and/or environmental changes. Consistently and thoroughly assesses patients to collect data and identify learning needs according to established standards and policies. Utilizes a systematic, continuous and complete analysis of assessment data to develop individualized problem lists for assigned patients. Develops and individualizes a plan of care for each patient in accordance with established standards, appropriate prioritization of problems/needs, and mutually agreed upon goals. Efficiently implements the patient’s plan of care in accordance with applicable standards, policies, procedures and guidelines. Demonstrates proficiency in medication administration, pain management and other unit or initiative specific skills. Continuously evaluates the effectiveness of the plan(s) of care, making revisions and recommendations based on analysis of patient responses to interventions. 2. Nurse-Patient Family Relationships Demonstrates the ability to assess the patient’s/family’s learning needs, readiness to learn, learning style, and presence of barriers to learning. Demonstrates the ability to develop, implement and evaluate teaching plans for patient populations in unit specialty in accordance with applicable standards. Demonstrates the ability to apply knowledge of growth and development across the life span to the care of patients. Provides direct patient care to patients and families in a culturally, developmentally and ethically appropriate manner. Plans of care address the physical, psychosocial, spiritual and learning needs of the patient/family. 3. Clinical Scholarship Participates in QI, CPI and risk management activities at the unit, department or organizational level. Demonstrates the ability to effectively perform and improve all processes in order to achieve excellence with regard to AAMC’s quality standards and benchmarks. Supports the use of evidence based guidelines and organizational policies and procedures to promote safe patient care and a safe practice environment. 4. Clinical Leadership Participates in unit shared governance according to departmental standards. Participates in the education and orientation of new staff. Delegates patient care activities as appropriate; evaluates delegated activities for expected patient care outcomes. Employs real time computer documentation when completing patient record. Educational/Experience Requirements: Graduate of an accredited school of nursing Adherence to the credentialing requirements of AAMC as stated in the nursing bylaws. Required License/Certifications: Current licensure as a registered nurse by the Maryland Board of Nursing. CPR – American Heart Association Healthcare Provider certification ACLS is required within one year of hire. Working Conditions, Equipment, Physical Demands: There is a reasonable expectation that employees in this position will be exposed to blood-borne pathogens. Physical Demands – Medium work. Exerting up to 50 pounds of force occasionally, and/or up to 30 pounds of force frequently, and/or up to 10 pounds of force constantly to move objects. The physical demands and work environment that have been described are representative of those an employee encounters while performing the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions in accordance with the Americans with Disabilities Act. The above job description is an overview of the functions and requirements for this position. This document is not intended to be an exhaustive list encompassing every duty and requirement of this position; your supervisor may assign other duties as deemed necessary. featured-job

Position Objective: Contributes to the provision of high-quality, cost-effective healthcare as a provider of direct and indirect patient care and by effective of the health care team. Functions as a competent member of the health care team. Essential Job Duties : Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 1. Clinical Decision Making/Judgment Demonstrates clinical nursing knowledge and skill in the specialization of the unit. Demonstrates the ability to apply the nursing process effectively in the care of culturally diverse patients and families. Demonstrates the ability to utilize all applicable laws, policies, standards, guidelines and evidence-based practice in the provision of patient/family care. Organizes and reprioritizes patient care activities based on subtle and overt and/or environmental changes. Consistently and thoroughly assesses patients to collect data and identify learning needs according to established standards and policies. Utilizes a systematic, continuous and complete analysis of assessment data to develop individualized problem lists for assigned patients. Develops and individualizes a plan of care for each patient in accordance with established standards, appropriate prioritization of problems/needs, and mutually agreed upon goals. Efficiently implements the patient’s plan of care in accordance with applicable standards, policies, procedures and guidelines. Demonstrates proficiency in medication administration, pain management and other unit or initiative specific skills. Continuously evaluates the effectiveness of the plan(s) of care, making revisions and recommendations based on analysis of patient responses to interventions. 2. Nurse-Patient Family Relationships Demonstrates the ability to assess the patient’s/family’s learning needs, readiness to learn, learning style, and presence of barriers to learning. Demonstrates the ability to develop, implement and evaluate teaching plans for patient populations in unit specialty in accordance with applicable standards. Demonstrates the ability to apply knowledge of growth and development across the life span to the care of patients. Provides direct patient care to patients and families in a culturally, developmentally and ethically appropriate manner. Plans of care address the physical, psychosocial, spiritual and learning needs of the patient/family. 3. Clinical Scholarship Participates in QI, CPI and risk management activities at the unit, department or organizational level. Demonstrates the ability to effectively perform and improve all processes in order to achieve excellence with regard to AAMC’s quality standards and benchmarks. Supports the use of evidence based guidelines and organizational policies and procedures to promote safe patient care and a safe practice environment. 4. Clinical Leadership Participates in unit shared governance according to departmental standards. Participates in the education and orientation of new staff. Delegates patient care activities as appropriate; evaluates delegated activities for expected patient care outcomes. Employs real time computer documentation when completing patient record. Educational/Experience Requirements: Graduate of an accredited school of nursing Adherence to the credentialing requirements of AAMC as stated in the nursing bylaws. Required License/Certifications: Current licensure as a registered nurse by the Maryland Board of Nursing. CPR – American Heart Association Healthcare Provider certification ACLS is required within one year of hire. Working Conditions, Equipment, Physical Demands: There is a reasonable expectation that employees in this position will be exposed to blood-borne pathogens. Physical Demands – Medium work. Exerting up to 50 pounds of force occasionally, and/or up to 30 pounds of force frequently, and/or up to 10 pounds of force constantly to move objects. The physical demands and work environment that have been described are representative of those an employee encounters while performing the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions in accordance with the Americans with Disabilities Act. The above job description is an overview of the functions and requirements for this position. This document is not intended to be an exhaustive list encompassing every duty and requirement of this position; your supervisor may assign other duties as deemed necessary. featured-job

Position Objective: Promotes the delivery of high-quality, cost-effective health care through the provision of expert clinical education. Collaborates with the leadership team in the planning and implementation of organizational and departmental goals. Creates a climate of innovation through role modeling, consultation, research, and facilitation of learning in collaboration with the clinical education team, unit specific leadership, and department staff. Essential Job Duties: Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Provides education to staff on regulatory standards and compliance, current clinical practice issues, and safety standards Coordinates, facilitates, and evaluates the orientation process for new unit staff. Participates in processes to determine unit competencies and to assure competence of staff. Collaborates with other departments and nursing areas to ensure consistency and to avoid duplication. Participates in unit-specific and hospital-wide quality improvement activities, actively participates in the activities of the Clinical Education Council. Maintains staff education tracking records. Collaborates with the Clinical Director and Unit Leadership in the area of specialty to achieve departmental and organizational goals. Attends on-going educational opportunities that support best-practice initiatives and provides summary presentations to applicable groups within the organization. Participates in the evaluation and interview of job candidates and makes recommendations regarding appropriate fit for organization and specific unit. Participates in staff performance evaluations and develops individual educational plans to facilitate staff competency and performance. Encourages staff participation in seminars, meetings, in-services, and shared governance activities. Offers guidance to staff in pursuit of continued professional development. Educational/Experience Requirements: Minimum education level – Bachelor`s Degree in Nursing. Master`s Degree in Nursing preferred. Minimum of three years as a Registered Nurse in a care setting applicable to the service or initiative. Demonstrated experience in nursing staff development or nursing leadership with knowledge of nursing staff development theory or principles of adult education required. Outside applicants seeking a Clinical Educator position must be able to demonstrate that they have met the required criteria at previous employment. Required License/Certifications: Specialty Certification and Professional Organization Membership are required for the position. American Heart Association HealthCare Provider BLS Professional Organization Membership required. Current licensure as a registered nurse by the Maryland Board of Nursing. Adherence to credentialing requirements of AAMC as stated in the nursing bylaws. Working Conditions, Equipment, Physical Demands: There is a reasonable expectation that employees in this position will be exposed to blood-borne pathogens. Physical Demands – Light work. Exerting up to 20 pounds of force occasionally, and/or up to 10 pounds of force frequently, and/or a negligible amount of force constantly to move objects. If the use of arm and/or leg controls requires exertion of forces greater than that for sedentary work and the worker sits most of the time, the job is rated for light work. The physical demands and work environment that have been described are representative of those an employee encounters while performing the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions in accordance with the Americans with Disabilities Act. The above job description is an overview of the functions and requirements for this position. This document is not intended to be an exhaustive list encompassing every duty and requirement of this position; your supervisor may assign other duties as deemed necessary.

Position Objective: Contributes to the provision of high-quality, cost-effective healthcare as a provider of direct and indirect patient care and by effective of the health care team. Functions as a competent member of the health care team. Essential Job Duties : Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 1. Clinical Decision Making/Judgment Demonstrates clinical nursing knowledge and skill in the specialization of the unit. Demonstrates the ability to apply the nursing process effectively in the care of culturally diverse patients and families. Demonstrates the ability to utilize all applicable laws, policies, standards, guidelines and evidence-based practice in the provision of patient/family care. Organizes and reprioritizes patient care activities based on subtle and overt and/or environmental changes. Consistently and thoroughly assesses patients to collect data and identify learning needs according to established standards and policies. Utilizes a systematic, continuous and complete analysis of assessment data to develop individualized problem lists for assigned patients. Develops and individualizes a plan of care for each patient in accordance with established standards, appropriate prioritization of problems/needs, and mutually agreed upon goals. Efficiently implements the patient’s plan of care in accordance with applicable standards, policies, procedures and guidelines. Demonstrates proficiency in medication administration, pain management and other unit or initiative specific skills. Continuously evaluates the effectiveness of the plan(s) of care, making revisions and recommendations based on analysis of patient responses to interventions. 2. Nurse-Patient Family Relationships Demonstrates the ability to assess the patient’s/family’s learning needs, readiness to learn, learning style, and presence of barriers to learning. Demonstrates the ability to develop, implement and evaluate teaching plans for patient populations in unit specialty in accordance with applicable standards. Demonstrates the ability to apply knowledge of growth and development across the life span to the care of patients. Provides direct patient care to patients and families in a culturally, developmentally and ethically appropriate manner. Plans of care address the physical, psychosocial, spiritual and learning needs of the patient/family. 3. Clinical Scholarship Participates in QI, CPI and risk management activities at the unit, department or organizational level. Demonstrates the ability to effectively perform and improve all processes in order to achieve excellence with regard to AAMC’s quality standards and benchmarks. Supports the use of evidence based guidelines and organizational policies and procedures to promote safe patient care and a safe practice environment. 4. Clinical Leadership Participates in unit shared governance according to departmental standards. Participates in the education and orientation of new staff. Delegates patient care activities as appropriate; evaluates delegated activities for expected patient care outcomes. Employs real time computer documentation when completing patient record. Educational/Experience Requirements: Graduate of an accredited school of nursing Adherence to the credentialing requirements of AAMC as stated in the nursing bylaws. Required License/Certifications: Current licensure as a registered nurse by the Maryland Board of Nursing. CPR – American Heart Association Healthcare Provider certification ACLS is required within one year of hire. Working Conditions, Equipment, Physical Demands: There is a reasonable expectation that employees in this position will be exposed to blood-borne pathogens. Physical Demands – Medium work. Exerting up to 50 pounds of force occasionally, and/or up to 30 pounds of force frequently, and/or up to 10 pounds of force constantly to move objects. The physical demands and work environment that have been described are representative of those an employee encounters while performing the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions in accordance with the Americans with Disabilities Act. The above job description is an overview of the functions and requirements for this position. This document is not intended to be an exhaustive list encompassing every duty and requirement of this position; your supervisor may assign other duties as deemed necessary. featured-job

Position Overview: The Forensic Nurse Examiner will provide specialized care utilizing medical forensic examinations for victims of sexual assault. Essential Functions: Provide timely, non-judgmental, compassionate care to patients with a complaint of sexual assault utilizing the nursing process. Perform a complete medical forensic exam including but not limited to: obtaining a detailed history for the purpose of treatment/evidence collection, completing a detailed head-to-toe assessment looking for trauma. Complete documentation of the forensic record to include use of digital photography for identification/documentation of injuries. Provides evidence collection while maintaining chain of custody according to regulatory guidelines. Administer and/or oversee all medications per program protocol. Provides emotional and social support resources. Maintain expertise and current knowledge in performing medical forensic exams related to forensic science, trauma informed care, current legal laws and statues, any changing evidence collection procedures and emerging trends. Participate in professional development, community education and prevention efforts, staff meetings and educational opportunities. Maintain a professional, collaborative working relationship with multidisciplinary team to include, but not limited to: law enforcement, state’s attorney, crime lab. Provides fact/expert witness testimony as required Educational/Experience Requirements: BSN Graduate of an accredited nursing program. 2 years of clinical experience as RN. Ability to work autonomously with excellent communication and customer service skills. In addition, must also work well with multi-disciplinary team and peers. Rotating on call shifts including days, nights, weekends and holidays Required License/Certifications : Current RN License in state of MD or compact state Current FNE-A (designates FNE – Adult, certification) and/or International Association of Forensic Nurses SANE-A certification, obtained within one year. Current BLS, TNCC preferred Working Conditions, Equipment, Physical Demands: There is a reasonable expectation that employees in this position will be exposed to blood-borne pathogens. Physical Demands – The physical demands and work environment that have been described are representative of those an employee encounters while performing the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions in accordance with the Americans with Disabilities Act. The above job description is an overview of the functions and requirements for this position. This document is not intended to be an exhaustive list encompassing every duty and requirement of this position; your supervisor may assign other duties as deemed necessary.

Position Objective: Delivers and monitors nursing services for Pathways’ patients in accordance with the facility`s philosophy. Essential Job Duties: Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions Obtains a nursing history and identifies status, changes and physical, social and psychological needs of the patient, family and significant others. Contacts and consults with provider, providing nursing and bio-psychosocial history for admission orders. Develops treatment plan and discharge planning and/or coordination of home care needs. Assumes responsibility for quality of patient care by continually assessing the patient, modifying nursing care as needed, medicating per provider orders and documenting patient’s response to care. Develops a treatment plan that reflects the assessed needs, strengths, preferences and goals of the individual served. Re-evaluates and when necessary, revises the goals and objectives and completion of objectives. Discusses areas that differ from the usual standard of care with Provider, Nursing leadership and/or Clinical Director. Increases patient’s knowledge and acceptance through continuous teaching regarding procedures, medications, discharge instructions, etc. to the patient/family. Oversees quality and continuity of care for patients by accepting individual responsibility for compliance with unit protocols thus ensuring a safe treatment approach. Supports and practices the philosophy of the unit by treating each individual with respect. Maintains accountability for own nursing practice within ethical/legal framework. Admits new patients using information collected to determine appropriateness for admission and program placement based on ASAM criteria. Demonstrates the ability to apply the nursing process effectively in the care of culturally diverse patients and families. Facilities weekly psychoeducational groups as assigned. Educational/Experience Requirements: Associate degree in nursing required. Bachelor degree in nursing preferred. Minimum of two years current experience in acute care nursing. Knowledge of basic psychiatric intervention techniques, including Psychiatric medications. Experience in phlebotomy. Possesses an empathetic understanding of patients with co-occurring disorders. Required License/Certifications: Cardiopulmonary Resuscitation Registered Nurse Working Conditions, Equipment, Physical Demands: There is a reasonable expectation that employees in this position will be exposed to blood-borne pathogens. Physical Demands – Medium Medium work. Exerting up to 50 pounds of force occasionally, and/or up to 30 pounds of force frequently, and/or up to 10 pounds of force constantly to move objects. The physical demands and work environment that have been described are representative of those an employee encounters while performing the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions in accordance with the Americans with Disabilities Act. The above job description is an overview of the functions and requirements for this position. This document is not intended to be an exhaustive list encompassing every duty and requirement of this position; your supervisor may assign other duties as deemed necessary.