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.”