Jemilat Siju, DNP, MSN, Vice President and Chief Nursing Officer for Ambulatory Care

Where can a nurse deliver culturally sensitive, age-specific nursing care for adult and pediatric patient populations while performing assessment, screening, patient education, and direct patient care? Ambulatory Care at the Mount Sinai Health System.

Jemilat Siju, DNP, MSN, RN, ANP-BC, OCN, is the Vice President and Chief Nursing Officer for Ambulatory Care for the Mount Sinai Health System. Dr. Siju says, “Care within the ambulatory setting is multispecialty and a place to learn and grow. If you are a nurse and looking for an exciting, collegial environment in which teamwork flourishes and nurses have a voice, ambulatory care is for you!”

Ambulatory care nursing is a unique realm of nursing practice that addresses health care needs for entire communities, population groups, families, and individuals. The ambulatory setting is not about delivering episodes of care, but rather, looking at the holistic patient.

Patients enter the ambulatory world with complex health issues they must grapple with while living in their communities and homes. Social determinants of health are at the forefront as each ambulatory nurse determines how the patient’s prescribed medical plan impacts the patient’s quality of life, well-being, and overall health in their home setting.

“In my role, I am trying to achieve an ideal ambulatory care platform that is a place where nurses feel empowered and have a voice, as the voice of the nurse is extremely important to  patient care quality and outcomes,” Dr. Siju says. “The goal is to create alignment and standardization across ambulatory, so that the care looks and feels the same as much as possible, regardless of what part of the Health System you are in.” She adds, “It is not cookie-cutter, but the core of the care we bring to our patients must be of the highest quality.”

The newly established Ambulatory New Graduate Fellowship Program at Mount Sinai immerses RN fellows in the growing ambulatory sector. The first cohort of students has started, with continuing plans to admit fellows twice a year.

“A nurse might be hired into pediatrics, but while in the fellowship program you get exposure to other ambulatory specialties—for example, adult health, ambulatory surgery, cardiology, etc.—with the aim of supporting you in discovering your true niche,” Dr. Siju says. “We are educating you in the classroom and providing built-in rotations where you may spend a day in the life of a cardiac nurse, even though you are working in pediatrics.”

Exposing new graduates in the fellowship program to ambulatory care helps them identify personal strengths and their desires for professional fulfillment. Dr. Siju says, “We can facilitate the process for new graduates to find their niche—sometimes we think we know what specialty we would like to work in, but later find out that we are built to do something else. Ambulatory Care at Mount Sinai supports you in finding your professional niche.”

Nursing ambulatory fellows rotate through several specialties with advanced team members, including rounds with Infection Prevention and learning about their preventive role in ambulatory care. Towards the end of the program, RN fellows have an opportunity to work with nursing leadership on a departmental quality improvement project or an evidence-based practice project to advance their leadership and research capabilities. In addition to the fellowship program for new graduate nurses, Mount Sinai has a robust supportive clinical environment for our experienced nurses as well.

She continues, “Nurses get an enriched experience in ambulatory care. Patients are still complex enough with their health care needs and nurses can address what happens to them in their community and how this impacts their health and access to care.”

Dr. Siju says, “I went through nursing school the long route—starting in an associate degree program, then obtaining my bachelor’s and then master’s degrees. When doing my associate degree, I worked as a nursing assistant on a surgical floor and really thought I wanted to be a surgical nurse; I loved it and I loved the nurses. But one day the Chief Nursing Officer looked at me and said, ‘You will be a great oncology nurse,’ and I thought if she saw that in me, then why not?” Following 18 months of work in oncology, her nurse leader suggested she consider a role in nursing leadership and so she did, working as a nurse manager for two years and growing in leadership experience since.

Dr. Siju joined Mount Sinai in 2012 as Nurse Manager for Mount Sinai Beth Israel’s Oncology Ambulatory Infusion Program and transitioned into ambulatory care in 2017. She pioneered the Nurse Leadership Course for the Mount Sinai Phillips School of Nursing and serves as an adjunct faculty member.

Dr. Siju has worked for Mount Sinai longer than any other employer because, she says, “Mount Sinai has created a growth pathway for me. When I feel like I need to continue growing and want something to keep me on my toes, Mount Sinai has been successful in making that happen for me. Every time I have felt like I needed to grow, I have had an opportunity here to do so. Many others have invested in my professional growth, and I am committed to paying it forward by doing the same for others. I look forward to an opportunity to work with you in ambulatory care.”

Robin Ferrer, MBA, MSN, RN, Vice President of Emergency Services

Patients sometimes experience the Emergency Department (ED) as a place where things are uncertain, unexpected, and people may look and behave strangely—a bit like Lewis Carroll’s “Through the Looking-Glass,” Robin Ferrer, MBA, MSN, RN, likes to say.

“Emergency Departments are the looking glass into the hospital,” Mr. Ferrer, Vice President of Emergency Services for the Mount Sinai Health System, says, “and for some people, their impression of the Mount Sinai organization lies with that visit to one of our emergency departments.”

Mr. Ferrer joined Mount Sinai Health System in early 2021, as New York was continuing to experience COVID-19 hospitalizations and illness while facing the challenge of vaccinating millions of people. Mr. Ferrer oversees clinical operations and nursing personnel across all Emergency Departments for Mount Sinai Health System. His leadership role advocates for the advancement and improvement of Emergency Services. “I think the pandemic had a big impact on our front lines, particularly the ED, where we are the first receivers of patients. One week was managing COVID-19 and the next week was managing something entirely different,” he says. “The biggest challenge for staffing in the ED is at the nursing level, by virtue of what nurses do—being primary caregivers at the bedside, managing most of the services and treatments, getting patients to their CT scans and X-rays, hooking up IVs, making sure medications are given and orders are completed.”

Mr. Ferrer, who also serves as an adjunct professor at the College of Mount Saint Vincent, teaching Business and Health Care Administration, is committed to helping others move forward. “My ultimate goal as a leader is to enable other people to be successful. I have always said, when I don’t feel myself doing that, I should question why I am in leadership.”

Mr. Ferrer frequently references two population groups he is responsible for: patients and staff. “Successfully taking care of staff and the environment where they work will result in positive patient outcomes.” He adds, “Patients are ultimately the beneficiaries of every decision we make. I want to be sure when we make a decision, that it is grounded in principle and the patient will benefit from the outcome, and our staff will feel the decision represents a step in the right direction.”

Mr. Ferrer grew up in New York City in what he describes as a “pretty dire situation.” As a child he was sent to the Milton Hershey School in Hershey, Pennsylvania, and now sees that experience as a buttress for his personal journey towards leadership and a desire to help and support others.

“Milton Hershey School is where I learned leadership skills and discipline. I didn’t know anyone when I arrived, but I found myself surrounded by an army of people willing to help and support me to be successful,” he says. “I understand we all have a story, and we need to take a moment to listen and appreciate where people come from and how their past has enabled their future. That resonates with me most.”

Mr. Ferrer started as a bedside nurse in the Emergency Department at NewYork-Presbyterian/Columbia University Irving Medical Center and quickly felt a gravitation towards leadership. After completing his Master of Business Administration from the College of Mount Saint Vincent in New York City, Mr. Ferrer spent the next 15 years in leadership roles. As Director of Operations at NewYork Presbyterian Hospital, Mr. Ferrer managed multiple service lines and departments, including the Adult Emergency Department, Psychiatric Emergency, Outpatient Psychiatry, Respiratory Therapy, Hemodialysis, and the Pulmonary Function Lab.

Giving people a chance and reflecting on his own experience of having others provide strong mentorship and guidance has influenced Mr. Ferrer’s belief that new nurse graduates can be successful starting their career in the Emergency Department. He says, “Before I started, there was some hesitancy about taking new graduates into the ED.”

When Mr. Ferrer inquired about that hesitancy, the response was almost always the same: they don’t have experience. “I said to myself, these new graduates just finished school and are bursting with excitement, ready to go, and hungry for an opportunity. Why don’t we just provide appropriate onboarding and training so they can be a part of our team?”

Fast forward 18 months, and the Mount Sinai Emergency Department Nursing Fellowship program now boasts of a 98 percent retention rate. This 24-week program includes simulations, online modules, and hands-on training. Fellows are paired with an experienced registered nurse from the ED staff and work with nurse preceptors. Mr. Ferrer believed new graduate nursing students could successfully transition to practice in the ED. “The driving force was putting together a robust curriculum so after six months nurses would feel comfortable and safe with the resources around them.” He continues, “We are going into our fifth cohort and have 32 people who started this month across all of our emergency departments who are new graduates from all over the country.”

“Give people an opportunity and a chance and set them up for success, and you will be astounded by how well people do just by giving them that opportunity.”

Kristin Lewicki, RN, BSN

Kristin Lewicki, RN, BSN, is a staff nurse at The Mount Sinai Hospital and recently received a letter of praise from a grateful patient’s family member:

“I would like you to know of the above-and-beyond, excellent care that my husband has received from Ms. Lewicki. He is very ill, and his case is complicated. Throughout this and previous stays, he has had the great good fortune to be under the care of Nurse Lewicki for a majority of the time. I can say with complete honesty that never, in any other hospital, has he ever had such compassionate and professional and thorough treatment as hers. She cares for his physical and medical needs seamlessly, while also sensitive to the human being as an individual. I know when he is cared for by her, he is in the safest, most capable hands. Ms. Lewicki is a gem, and I’m so thankful your hospital put her in our path to be a bright light in a long, rough journey for my husband and our family.”

Destiny R. Campbell, MSN, RN, Interim Nurse Manager Oncology, echoes these words. “Kristin has a heart of gold and goes above and beyond to ensure her patients feel welcomed, safe, and heard.”

Kristin is humble when responding to these words of praise. “I’m beyond grateful to be recognized and honored by such a prestigious medical health system,” she says. “When you work with the best, you show up and bring your best! I love being a nurse and offer my heart and soul to every patient and peer. My job brings many challenges—physically, mentally, and emotionally—but the rewards of human connection are beyond everlasting. My patients have made being a nurse a gift that I can share.”