RN Oncology Full-time
Arnot Health

Registered Nurse - Medical Oncology

$38.50 - $50 / hour

MAIN FUNCTION:


The Level II Medical Oncology Nurse is accountable for provision of professional nursing care for Falck Cancer Center (FCC) patients, family members and care givers in collaboration with the oncology services team, assuming an expanded role. Responsible for helping the patient, family and care giver understand the effects of cancer and its treatment and providing instruction and support for meeting daily needs, assuming an expanded role, which may include charge nurse, preceptor, and committee member responsibilities. The medical oncology nurse assures that nursing practice is consistent with the Arnot Health and FCC nursing policies and procedures and, as appropriate, ANA/ASCO/ONS Standards of Oncology Nursing Practice guidelines. Reports to the Nurse Manager and works in collaboration with physicians on clinical matters.




DUTIES AND RESPONSIBILITIES:




Direct Patient Care





  1. Conducts patient/family nursing assessment including physiologic, psychosocial, and developmental components. Provides competent and efficient direct patient care under medical orders of physicians. Independently safely and effectively administers chemotherapy and medications, assists during outpatient procedures (bone marrow biopsies, etc.), draws blood and collects other specimens as needed.





  1. Documents assessments, patient care, medication administration, patient/family education, patient/family responses and care planning according to FCC /oncology standards.





  1. Implements age-specific, culturally, and spiritually competent nursing interventions and education to address patient/family needs and response to procedures, therapies, and medications.





  1. Identifies patient problems and coordinates individualized health teaching of patients, family and care givers, developing a plan of care following standards and long-term goals.





  1. Collaborates with FCC and the Arnot Health oncology services teams, including physicians, radiation therapy nurse and technicians, and other professional staff, in delivering high quality patient care. Facilitates continuity of patient care.





  1. Evaluates basic and complex patient/family response to procedures, therapies and medications identifying concerns/issues and revising plan of care based on patient and/or family response.





  1. Responds effectively to patient telephone calls and follow up to assess patient, family and care giver status and revises care plans, or arranges for appropriate intervention with appropriate communication skills.





  1. As new treatment modalities are developed and implemented obtains training and skills appropriate to assisting with procedures.




SERVICE EXCELLENCE



  1. Maintains positive relationships with all members of the healthcare team. Listens and communicates effectively with healthcare members, patients and families





  1. Resolves conflict positively and in a timely manner, working directly with co-workers to address issues





  1. Treats patients, family and staff with kindness, courtesy and respect for diverse viewpoints and cultures





  1. Treats co-workers with courtesy, consideration, respect, and trust; Functions as an effective member of the team





  1. Demonstrates flexibility in scheduling and assignments to meet patient and unit goals




EDUCATION, INSTITUTIONAL AND COMMUNITY INVOLVEMENT, OTHER





  1. Participates in the Quality Improvement activities of the FCC and the Arnot Health (i.e. QIA). Assists with collection of data to support performance improvement activities.





  1. Demonstrates professional image, attitude, and behaviors consistent with the philosophy of the Arnot Health, the FCC, as well as the nursing profession. Consistently maintains good interpersonal and communicative skills with hospital personnel, FCC staff, physicians, patients/families, and the general public.





  1. Accepts and acts on constructive feedback from leadership, peers, and colleagues in a positive manner.





  1. Maintains and assures availability of timely patient support and teaching materials, supplies and equipment.





  1. Reviews and evaluates evidence from literature and best practice standards for application to patient and unit needs. Assumes responsibility for continuing education relevant to personal and professional learning.





  1. Participates in the Arnot Health, FCC and department committees and staff meetings. Attends and completes all mandatory education as required for position.





  1. Employee understands and demonstrates the importance of satisfying the needs of the customer/patient by interaction with him/her in a friendly and caring way, being attentive to the customer's needs, both psychologically and physically, and by taking the initiative to maintain communication with the customer to provide a secure and pleasant experience with the Arnot Health.



  1. It is understood that this job description lists typical duties for the classification and is not to be considered inclusive of all duties which may be assigned.




EDUCATION:


Registered professional nurse with current NYS license. BSN preferred. Demonstrated competence and progressive leadership experience in nursing. Specialized preparation through education and experience in oncology/chemotherapy administration. ONS Chemotherapy/Biotherapy competency required and maintained. ONS certification preferred. Current BLS required.




EXPERIENCE:


Three-to-five-year experience as a Medical Oncology Nurse strongly preferred.




CARDIOPULMONARY RESUSCITATION (CPR) REQUIREMENTS:


Basic Life Support (BLS) required within 90 days of hire date.




GENERAL & PERSONAL:


Ability to maintain good interpersonal relationships among staff, physicians, and other hospital personnel. Must possess competent communicative skills, with ability to effectively relate to a wide cross section of individuals, including hospital personnel, FCC staff, physicians, as well as with patient/families and the general public.




PHYSICAL DEMANDS:


Appreciable physical effort required; lifting, pulling, pushing, and moving patients of various size, capabilities and abilities. Some lifting, reaching, and stooping. Required to be on feet much of the time.




EXPOSURE CATEGORY:


Category I. Tasks that involve exposure to blood, body fluids or tissues. Direct, routine handling of hazardous


drugs (HDs). This includes administering, and cleaning up antineoplastic agents, posing a risk of skin absorption,


inhalation, or accident. Adherence to PPE and safe handling policies required.

Share this job

Share to FB Share to LinkedIn Share to Twitter

Related Jobs

Guthrie

Registered Nurse - Emergency Services - Full Time Night 7p-7a

Up To $25,000 Sign On Bonus For Qualified RNs! Position Summary: The Registered Nurse (RN) provides professional, comprehensive nursing care for patients in an acute care environment. Accountable for the delivery of coordinated, safe, compassionate, therapeutic, evidence‐based quality care to patients and families, based on individual physical, emotional, and spiritual needs, and appropriate care strategies throughout the lifespan. Practices in accordance with the Nurse Practice Act in the state of employment, the American Nurses Association (ANA) Code of Ethics for Nurses, and the ANA scope and standards of practice. Essential functions and specific skills for the job are found in the unit specific onboarding checklist and in standards that are applicable to the specialty. Education, License & Cert: • Registered Nurse in the State of Practice. • BSN in Nursing preferred. • Any previously agreed upon effective date for obtaining a Bachelor's degree in nursing between individuals and facilities will remain in effect, including those who transition to their position from the NLRN Program. • Any contract with specific time frames for obtaining a bachelor’s degree in nursing will supersede the above point and will remain in effect. • Specialty Certification is preferred • BLS certification. • ACLS is unit dependent. Experience: The Registered Nurse must be a registered nurse currently licensed in the state of employment with at least one year of experience. Alternately, the Registered Nurse may have less than one year of experience if they have been transitioned to their position from the Newly Licensed Registered Nurse Residency (NLRN) Program. The Registered Nurse must meet the individual nursing unit specifications regarding educational requirements during employment. Must maintain BLS certification. ACLS is unit dependent. Specifications regarding educational requirements during employment are determined by the Nursing Department and Nursing Unit. Essential Functions: 1. Employs Nursing Professional Practice: Assesses, diagnoses, plans, implements, and evaluates patients' care. Develops updates and coordinates the patients' plan of care to achieve patient goals and to optimize outcomes and transitions across the continuum. Monitors, records, and communicates patient condition as appropriate. Performs and maintains the currency of essential competencies as required by a specific area of hire and population served. 2. Advocates: Effectively advocates for ethical and holistic care by partnering in care planning to promote the autonomy, dignity, rights, values, and beliefs of those we serve. 3. Facilitates Learning: Fosters a learning environment for patients/families, nursing, and other members of the healthcare team, including student; Facilities formal and informal learning for patients/families, nursing, other members of the healthcare team, and community. 4. Aligns Practice with Safety and Quality: Accountable for safety, identifies and corrects problems, and integrates evidence and best practice into nursing care; uses data and evidence to improve patient outcomes. Aligns patient safety, self‐safety, and environmental safety as equally important for best outcomes. 5. Engages in Professional Development: Engages in ongoing professional development; practices at the top of license within the legal parameters of the Nurse Practice Act, the ANA Code of Ethics for Nurses, and specialty standards. Promotes a culture of inquiry that explores, integrates, and disseminates research and evidence‐based practice. 6. Leader in Practice Setting & Community: demonstrates leadership as change agents using the collaborative leadership skills of advocacy, influence and innovation. In partnering with colleagues appropriately delegates, coordinates care, and collaborates with others as equal members of the inter‐professional care team to integrate nursing knowledge. Models professional behaviors as a representative of the nursing profession. 7. Participates in the planning and presentation of educational programs. 8. It is understood that this description is not intended to be all‐inclusive and that other duties may be assigned as necessary in the performance of the position. Other Duties: 1. Proficiency in Information Technology, such as electronic health records, communication systems, computers, and equipment necessary to perform essential functions of the position. 2. Skilled to work with a wide range of staff as part of an interdisciplinary team, including physicians, nurses, and ancillary staff. 3. Ability to use independent, critical judgment in all aspects of patient care delivery. 4. Demonstrated interpersonal skills that convey a positive and supportive attitude. 5. Ability to effectively manage multiple responsibilities, urgent responses, and challenging situations.
Guthrie

Registered Nurse Procedural - OR - Per Diem

Position Summary: The Registered Nurse (RN) provides professional, comprehensive nursing care for patients in an acute care environment. Accountable for the delivery of coordinated, safe, compassionate, therapeutic, evidence‐ based quality care to patients and families, based on individual physical, emotional, and spiritual needs, and appropriate care strategies throughout the lifespan. Practices in accordance with the Nurse Practice Act in the state of employment, the American Nurses Association (ANA) Code of Ethics for Nurses, and the ANA scope and standards of practice. Essential functions and specific skills for the job are found in the unit specific onboarding checklist and in standards that are applicable to the specialty. Education, License & Cert: - Registered Nurse in the State of Practice. - BSN in Nursing preferred. - Any previously agreed upon effective date for obtaining a Bachelor's degree in nursing between individuals and facilities will remain in effect, including those who transition to their position from the NLRN Program. - Any contract with specific time frames for obtaining a bachelor’s degree in nursing will supersede the above point and will remain in effect. - Specialty Certification is preferred - BLS certification. - ACLS is unit dependent. - PALS is unit dependent Experience: - The Registered Nurse must be a registered nurse currently licensed in the state of employment with at least one year of experience. Alternately, the Registered Nurse may have less than one year of experience if they have been transitioned to their position from the Newly Licensed Registered Nurse Residency (NLRN) Program. - The Registered Nurse must meet the individual nursing unit specifications regarding educational requirements during employment. - Must maintain BLS certification. - ACLS is unit dependent. - Specifications regarding educational requirements during employment are determined by the Nursing Department and Nursing Unit. Essential Functions: 1. Employs Nursing Professional Practice: Assesses, diagnoses, plans, implements, and evaluates patients' care. Develops updates and coordinates the patients' plan of care to achieve patient goals and to optimize outcomes and transitions across the continuum. Monitors, records, and communicates patient condition as appropriate. Performs and maintains the currency of essential competencies as required by a specific area of hire and population served. 2. Advocates: Effectively advocates for ethical and holistic care by partnering in care planning to promote the autonomy, dignity, rights, values, and beliefs of those we serve. 3. Facilitates Learning: Fosters a learning environment for patients/families, nursing, and other members of the healthcare team, including student; Facilities formal and informal learning for patients/families, nursing, other members of the healthcare team, and community. 4. Aligns Practice with Safety and Quality: Accountable for safety, identifies and corrects problems, and integrates evidence and best practice into nursing care; uses data and evidence to improve patient outcomes. Aligns patient safety, self‐ safety, and environmental safety as equally important for best outcomes. 5. Engages in Professional Development: Engages in ongoing professional development; practices at the top of license within the legal parameters of the Nurse Practice Act, the ANA Code of Ethics for Nurses, and specialty standards. Promotes a culture of inquiry that explores, integrates, and disseminates research and evidence‐ based practice. 6. Leader in Practice Setting & Community: demonstrates leadership as change agents using the collaborative leadership skills of advocacy, influence and innovation. In partnering with colleagues appropriately delegates, coordinates care, and collaborates with others as equal members of the inter‐ professional care team to integrate nursing knowledge. Models professional behaviors as a representative of the nursing profession. 7. Participates in the planning and presentation of educational programs. 8. It is understood that this description is not intended to be all‐ inclusive and that other duties may be assigned as necessary in the performance of the position. Other Duties: 1. Proficiency in Information Technology, such as electronic health records, communication systems, computers, and equipment necessary to perform essential functions of the position. 2. Skilled to work with a wide range of staff as part of an interdisciplinary team, including physicians, nurses, and ancillary staff. 3. Ability to use independent, critical judgment in all aspects of patient care delivery. 4. Demonstrated interpersonal skills that convey a positive and supportive attitude. 5. Ability to effectively manage multiple responsibilities, urgent responses, and challenging situations.
Guthrie

Registered Nurse - Acute Care - Per Diem

Position Details: Per Diem - Robert Packer Hospital - Towanda Campus – Acute Care unit Department Details: Acute Care Towanda is a 10-bed acute care unit that primarily focuses on an interdisciplinary care approach for medical patients with the Medical Hospitalist Service. All bedside acute care nurses at Guthrie benefit from the added support of our Virtual RNs located in our Pulse Center. They provide assistance with a variety of tasks, enabling bedside nurses to spend more time on direct patient care. Position Summary: The Registered Nurse (RN) provides professional, comprehensive nursing care for patients in an acute care environment. Accountable for the delivery of coordinated, safe, compassionate, therapeutic, evidence-based quality care to patients and families, based on individual physical, emotional, and spiritual needs, and appropriate care strategies throughout the lifespan. Practices in accordance with the Nurse Practice Act in the state of employment, the American Nurses Association (ANA) Code of Ethics for Nurses, and the ANA scope and standards of practice. Essential functions and specific skills for the job are found in the unit specific onboarding checklist and in standards that are applicable to the specialty. Education, License, & Certification(s): - Registered Nurse in the State of Practice - BSN in Nursing preferred - Any previously agreed upon effective date for obtaining a Bachelor's degree in nursing between individuals and facilities will remain in effect, including those who transition to their position from the NLRN Program - Any contract with specific time frames for obtaining a bachelor’s degree in nursing will supersede the above point and will remain in effect - Specialty Certification is preferred - BLS certification - ACLS is unit dependent Experience: The Registered Nurse must be a registered nurse currently licensed in the state of employment with at least one year of experience. Alternately, the Registered Nurse may have less than one year of experience if they have been transitioned to their position from the Newly Licensed Registered Nurse Residency (NLRN) Program. The Registered Nurse must meet the individual nursing unit specifications regarding educational requirements during employment. Must maintain BLS certification. ACLS is unit dependent. Specifications regarding educational requirements during employment are determined by the Nursing Department and Nursing Unit. Essential Functions: - Employs Nursing Professional Practice: Assesses, diagnoses, plans, implements, and evaluates patients' care. Develops updates and coordinates the patients' plan of care to achieve patient goals and to optimize outcomes and transitions across the continuum. Monitors, records, and communicates patient condition as appropriate. Performs and maintains the currency of essential competencies as required by a specific area of hire and population served - Advocates: Effectively advocates for ethical and holistic care by partnering in care planning to promote the autonomy, dignity, rights, values, and beliefs of those we serve - Facilitates Learning: Fosters a learning environment for patients/families, nursing, and other members of the healthcare team, including student; Facilities formal and informal learning for patients/families, nursing, other members of the healthcare team, and community - Aligns Practice with Safety and Quality: Accountable for safety, identifies and corrects problems, and integrates evidence and best practice into nursing care; uses data and evidence to improve patient outcomes. Aligns patient safety, self-safety, and environmental safety as equally important for best outcomes - Engages in Professional Development: Engages in ongoing professional development; practices at the top of license within the legal parameters of the Nurse Practice Act, the ANA Code of Ethics for Nurses, and specialty standards. Promotes a culture of inquiry that explores, integrates, and disseminates research and evidence-based practice - Leader in Practice Setting & Community: demonstrates leadership as change agents using the collaborative leadership skills of advocacy, influence and innovation. In partnering with colleagues appropriately delegates, coordinates care, and collaborates with others as equal members of the inter-professional care team to integrate nursing knowledge. Models professional behaviors as a representative of the nursing profession. Participates in the planning and presentation of educational programs - It is understood that this description is not intended to be all-inclusive and that other duties may be assigned as necessary in the performance of the position Other Duties: - Proficiency in Information Technology, such as electronic health records, communication systems, computers, and equipment necessary to perform essential functions of the position - Skilled to work with a wide range of staff as part of an interdisciplinary team, including physicians, nurses, and ancillary staff - Ability to use independent, critical judgment in all aspects of patient care delivery - Demonstrated interpersonal skills that convey a positive and supportive attitude - Ability to effectively manage multiple responsibilities, urgent responses, and challenging situations Benefits Summary: A nursing career with Guthrie means being part of a focused organization that provides each team member an opportunity to advance and grow. We have invested in resources to empower our employees to succeed and use their passion and talent to provide excellence. You take care of our patients. We take care of you. - Generous shift differentials - Career advancement opportunities - Tuition reimbursement - Excellent benefits - Experiential PTO accrual - Competitive salary - Rewarding career - Magnet driven - Refinancing support with SoFi To see why nurses love Guthrie, click HERE! “We are more than a team, we’re family. And we’re committed to hold each other to the highest professional standard so our patients get the best care every time they choose Guthrie.” – Jennifer Hepinger, RN
Guthrie

Registered Nurse - Emergency Services - Per Diem Primary

Position Summary: The Registered Nurse (RN) provides professional, comprehensive nursing care for patients in an acute care environment. Accountable for the delivery of coordinated, safe, compassionate, therapeutic, evidence‐ based quality care to patients and families, based on individual physical, emotional, and spiritual needs, and appropriate care strategies throughout the lifespan. Practices in accordance with the Nurse Practice Act in the state of employment, the American Nurses Association (ANA) Code of Ethics for Nurses, and the ANA scope and standards of practice. Essential functions and specific skills for the job are found in the unit specific onboarding checklist and in standards that are applicable to the specialty. Education, License & Cert: - Registered Nurse in the State of Practice. - BSN in Nursing preferred. - Any previously agreed upon effective date for obtaining a Bachelor's degree in nursing between individuals and facilities will remain in effect, including those who transition to their position from the NLRN Program. - Any contract with specific time frames for obtaining a bachelor’s degree in nursing will supersede the above point and will remain in effect. - Specialty Certification is preferred - BLS certification. - ACLS is unit dependent. - PALS is unit dependent Experience: - The Registered Nurse must be a registered nurse currently licensed in the state of employment with at least one year of experience. Alternately, the Registered Nurse may have less than one year of experience if they have been transitioned to their position from the Newly Licensed Registered Nurse Residency (NLRN) Program. - The Registered Nurse must meet the individual nursing unit specifications regarding educational requirements during employment. - Must maintain BLS certification. - ACLS is unit dependent. - Specifications regarding educational requirements during employment are determined by the Nursing Department and Nursing Unit. Essential Functions: 1. Employs Nursing Professional Practice: Assesses, diagnoses, plans, implements, and evaluates patients' care. Develops updates and coordinates the patients' plan of care to achieve patient goals and to optimize outcomes and transitions across the continuum. Monitors, records, and communicates patient condition as appropriate. Performs and maintains the currency of essential competencies as required by a specific area of hire and population served. 2. Advocates: Effectively advocates for ethical and holistic care by partnering in care planning to promote the autonomy, dignity, rights, values, and beliefs of those we serve. 3. Facilitates Learning: Fosters a learning environment for patients/families, nursing, and other members of the healthcare team, including student; Facilities formal and informal learning for patients/families, nursing, other members of the healthcare team, and community. 4. Aligns Practice with Safety and Quality: Accountable for safety, identifies and corrects problems, and integrates evidence and best practice into nursing care; uses data and evidence to improve patient outcomes. Aligns patient safety, self‐ safety, and environmental safety as equally important for best outcomes. 5. Engages in Professional Development: Engages in ongoing professional development; practices at the top of license within the legal parameters of the Nurse Practice Act, the ANA Code of Ethics for Nurses, and specialty standards. Promotes a culture of inquiry that explores, integrates, and disseminates research and evidence‐ based practice. 6. Leader in Practice Setting & Community: demonstrates leadership as change agents using the collaborative leadership skills of advocacy, influence and innovation. In partnering with colleagues appropriately delegates, coordinates care, and collaborates with others as equal members of the inter‐ professional care team to integrate nursing knowledge. Models professional behaviors as a representative of the nursing profession. 7. Participates in the planning and presentation of educational programs. 8. It is understood that this description is not intended to be all‐ inclusive and that other duties may be assigned as necessary in the performance of the position. Other Duties: 1. Proficiency in Information Technology, such as electronic health records, communication systems, computers, and equipment necessary to perform essential functions of the position. 2. Skilled to work with a wide range of staff as part of an interdisciplinary team, including physicians, nurses, and ancillary staff. 3. Ability to use independent, critical judgment in all aspects of patient care delivery. 4. Demonstrated interpersonal skills that convey a positive and supportive attitude. 5. Ability to effectively manage multiple responsibilities, urgent responses, and challenging situations.
Guthrie

Per Diem Registered Nurse

Position Summary: The Registered Nurse (RN) provides professional, comprehensive nursing care for patients in an acute care environment. Accountable for the delivery of coordinated, safe, compassionate, therapeutic, evidence‐ based quality care to patients and families, based on individual physical, emotional, and spiritual needs, and appropriate care strategies throughout the lifespan. Practices in accordance with the Nurse Practice Act in the state of employment, the American Nurses Association (ANA) Code of Ethics for Nurses, and the ANA scope and standards of practice. Essential functions and specific skills for the job are found in the unit specific onboarding checklist and in standards that are applicable to the specialty. Education, License & Cert: - Registered Nurse in the State of Practice. - BSN in Nursing preferred. - Any previously agreed upon effective date for obtaining a Bachelor's degree in nursing between individuals and facilities will remain in effect, including those who transition to their position from the NLRN Program. - Any contract with specific time frames for obtaining a bachelor’s degree in nursing will supersede the above point and will remain in effect. - Specialty Certification is preferred - BLS certification. - ACLS is unit dependent. - PALS is unit dependent Experience: - The Registered Nurse must be a registered nurse currently licensed in the state of employment with at least one year of experience. Alternately, the Registered Nurse may have less than one year of experience if they have been transitioned to their position from the Newly Licensed Registered Nurse Residency (NLRN) Program. - The Registered Nurse must meet the individual nursing unit specifications regarding educational requirements during employment. - Must maintain BLS certification. - ACLS is unit dependent. - Specifications regarding educational requirements during employment are determined by the Nursing Department and Nursing Unit. Essential Functions: 1. Employs Nursing Professional Practice: Assesses, diagnoses, plans, implements, and evaluates patients' care. Develops updates and coordinates the patients' plan of care to achieve patient goals and to optimize outcomes and transitions across the continuum. Monitors, records, and communicates patient condition as appropriate. Performs and maintains the currency of essential competencies as required by a specific area of hire and population served. 2. Advocates: Effectively advocates for ethical and holistic care by partnering in care planning to promote the autonomy, dignity, rights, values, and beliefs of those we serve. 3. Facilitates Learning: Fosters a learning environment for patients/families, nursing, and other members of the healthcare team, including student; Facilities formal and informal learning for patients/families, nursing, other members of the healthcare team, and community. 4. Aligns Practice with Safety and Quality: Accountable for safety, identifies and corrects problems, and integrates evidence and best practice into nursing care; uses data and evidence to improve patient outcomes. Aligns patient safety, self‐ safety, and environmental safety as equally important for best outcomes. 5. Engages in Professional Development: Engages in ongoing professional development; practices at the top of license within the legal parameters of the Nurse Practice Act, the ANA Code of Ethics for Nurses, and specialty standards. Promotes a culture of inquiry that explores, integrates, and disseminates research and evidence‐ based practice. 6. Leader in Practice Setting & Community: demonstrates leadership as change agents using the collaborative leadership skills of advocacy, influence and innovation. In partnering with colleagues appropriately delegates, coordinates care, and collaborates with others as equal members of the inter‐ professional care team to integrate nursing knowledge. Models professional behaviors as a representative of the nursing profession. 7. Participates in the planning and presentation of educational programs. 8. It is understood that this description is not intended to be all‐ inclusive and that other duties may be assigned as necessary in the performance of the position. Other Duties: 1. Proficiency in Information Technology, such as electronic health records, communication systems, computers, and equipment necessary to perform essential functions of the position. 2. Skilled to work with a wide range of staff as part of an interdisciplinary team, including physicians, nurses, and ancillary staff. 3. Ability to use independent, critical judgment in all aspects of patient care delivery. 4. Demonstrated interpersonal skills that convey a positive and supportive attitude. 5. Ability to effectively manage multiple responsibilities, urgent responses, and challenging situations.