Nursing Jobs in Hawthorne, NY
$132,411.29 - $153,840.32 / year
Description The Assistant Nurse Manager for Intermediate Care Stepdown IMCU is a Registered Professional Nurse with broad knowledge and skills who assumes the role of a clinical leader in the daily functioning of the unit and oversight of quality patient care delivery, in conjunction with, or in the absence of, the Nurse Manager. Responsibilities Patient Care 1. Leads nursing practice using the tenets of the Professional Practice Model of Relationship Centered Care and the Care Delivery Model of Modified Primary Nursing for the promotion of the patient experience. 2. Demonstrates proficiency in all aspects of Purposeful Hourly Rounding (PHR) and role models expected behaviors. 3. Ensures the integration of PHR into clinical activities to enhance Relationship Centered Care. 4. Assists in the validation of staff members round hourly on all patients by direct observation and patient feedback. 5. Assesses staff competency in PHR and provides consistent meaningful feedback with more focused feedback as needed. 6. Conducts rounding of all patients on a daily basis when Nurse Manager is away and as assigned 7. Communicates quantitative and qualitative information regarding the patient experience and staff engagement to the staff and the Interdisciplinary Patient Care Team that leads to the development and implementation of an action plan. 8. Collaborates with the physician dyad and escalates concerns as appropriate. 9. Follows up on all patient concerns in a timely manner and provides service recovery as needed. 10. Demonstrates caring, respect, compassion, empathy and active listening through dialogue, body language and actions. Patient Experience 1. Role models the tenets of Mount Sinai Relationship Centered Care (MSHRCC) through facilitation of the following actions but not limited to: Admission Welcome, Bedside Shift Report, HELP, AM/PM Care, 5 Minute Sit Down, Purposeful Hourly Rounding (PHR), Medication Review, Discharge Wrap Up, and MD/RN Unit Collaboration. 2. Huddles with staff at the start of assigned shift for assigned unit(s) identifying high-risk patients who require special attention. 3. Communicates to nursing leadership concerns or issues identified during huddle and throughout shift. 4. Initiates service recovery for patients and family members who have concerns and escalates to Clinical Nurse Manager/Associate Director of Nursing/designee or Patient Relations as needed. 5. Interprets and communicates patient experience scores and benchmarks and keeps staff informed of progress and areas of opportunity. 6. Considers the patients values, preferences, expressed needs and knowledge in all aspects of care. 7. Empowers staff to use evidence-based practices to increase understanding of patients perceptions of care. 8. Demonstrates caring, respect, compassion, empathy and active listening through dialogue, body language and actions. Quality and Safety 1. Supports and leads a safe, therapeutic and efficient patient-centered care environment for professional practice. 2. Identifies and investigates issues or variances in practice/operations by participating in the RCA process and implements corrective action plans on assigned shift. 3. Collects data for unit(s) chart reviews, assessment of compliance with nurse sensitive indicators, HAIs and other patient safety goals metrics as assigned 4. Fosters a fair and open culture that encourages error and near-miss occurrence reporting. 5. Participates in interdisciplinary quality improvement teams using the principles of high reliability. 6. Reviews unit progress, changes and compliance with quality and safety metrics with clinical nurses and other members of the healthcare team. 7. Responds to escalations of potential safety hazards or gaps from best practice by correcting concerns following institutional chain of command protocol. 8. Monitors institutional information technology infrastructure and corrects gaps in clinical nurse documentation. 9. Leads staff participation in quality and safety initiatives and mandated compliance measures. 10. Demonstrates accountability for all unit quality and safety practices and compliance, and ensures required evaluation of staff competencies is maintained. Operations and administration 1. Supports implementation of the mission, vision, goals and objectives of the department, throughout the clinical service and individual patient care units. 2. Provides administrative and clinical oversight to ensure that all activity (staffing, support services, inter disciplinary collaboration, resources and financial viability) supports the goals of the organization. 3. Works collaboratively with physician dyads and the healthcare team to promote patient care and regulatory standards. 4. Assists in the compliance of a nursing unit with all regulatory agency mandates, including the regulations of NYS DOH and The Joint Commission. 5. Oversees patient care delivery, throughput, staffing and processes to ensure efficient and effective operations on assigned shift. 6. Supports and monitors unit budgets, including capital equipment allocation, budget variances, management of OT and vacancies according to MSHS financial goals. 7. Maintains patient/employee confidentiality in the management of information. 8. Participates in the evaluation of nursing staff performance and mentors, coaches, counsels and disciplines staff as needed. 9. Monitors availability and maintenance of nursing equipment and supplies. 10. Participates in regular staff meetings to ensure communication with staff about progress, changes and compliance with all hospital policies and procedures. 11. Encourages, recognizes and rewards staff participation in quality and safety initiatives, compliance and successes. 12. Facilitates organizational change initiatives by using effective strategies. 13. Participates in a shared decision making model by establishing a structure of shared governance, just culture and staff engagement in practice councils, departmental meetings and initiatives. 14. Interprets and implements collective bargaining agreements affecting staff. 15. Responds to protest of assignment in a timely manner as detailed in the collective bargaining agreement and discusses the resolution in unit staff meetings. Professional Development 1. Performs as a clinical leader who actively creates and supports nursing practice and an environment of care that reflects clinical excellence. 2. Organizes the environment of care to support clinical colleagues, patients and their families and members of the healthcare team. 3. Projects and cultivates a professional image to colleagues by communicating caring, respect, compassion, empathy and trust. 4. Incorporates ethical principles into decision making for patient and family in collaboration with the clinical nursing staff and the healthcare team. 5. Fosters a spirit of scholarship, inquiry, life-long learning and innovation for self and others. 6. Acquires and disseminates knowledge and skills relative to the role, patient population, clinical specialty and global or local health community needs. 7. Leads shared decision making through unit/service practice councils, nursing department and hospital committees, and clinical service/unit initiatives. 8. Serves as a professional role model and preceptor for new leadership staff and students. 9. Integrates the values of research and evidence-based practice and its application to nursing practice and the environment of care. 10. Contributes to the profession of nursing through leadership and participation inprofessional organizations. Qualifications Education Requirements Bachelor of Science with a major in nursing required; Masters in nursing or health related field preferred. Experience Requirements 2 years minimum clinical nursing experience with some Charge Nurse/supervisory experience preferred. Must have relevant clinical competence in area of nursing practice assigned Licensing and Certification Requirements (if applicable) Licensed as a registered nurse with current registration in New York State ACLS, BLS Additional Skills Epic (preferred) Employer Description Strength through Unity and Inclusion The Mount Sinai Health System is committed to fostering an environment where everyone can contribute to excellence. We share a common dedication to delivering outstanding patient care. When you join us, you become part of Mount Sinai’s unparalleled legacy of achievement, education, and innovation as we work together to transform healthcare. We encourage all team members to actively participate in creating a culture that ensures fair access to opportunities, promotes inclusive practices, and supports the success of every individual. At Mount Sinai, our leaders are committed to fostering a workplace where all employees feel valued, respected, and empowered to grow. We strive to create an environment where collaboration, fairness, and continuous learning drive positive change, improving the well-being of our staff, patients, and organization. Our leaders are expected to challenge outdated practices, promote a culture of respect, and work toward meaningful improvements that enhance patient care and workplace experiences. We are dedicated to building a supportive and welcoming environment where everyone has the opportunity to thrive and advance professionally. Explore this opportunity and be part of the next chapter in our history. About the Mount Sinai Health System: Mount Sinai Health System is one of the largest academic medical systems in the New York metro area, with more than 48,000 employees working across eight hospitals, more than 400 outpatient practices, more than 300 labs, a school of nursing, and a leading school of medicine and graduate education. Mount Sinai advances health for all people, everywhere, by taking on the most complex health care challenges of our time — discovering and applying new scientific learning and knowledge; developing safer, more effective treatments; educating the next generation of medical leaders and innovators; and supporting local communities by delivering high-quality care to all who need it. Through the integration of its hospitals, labs, and schools, Mount Sinai offers comprehensive health care solutions from birth through geriatrics, leveraging innovative approaches such as artificial intelligence and informatics while keeping patients’ medical and emotional needs at the center of all treatment. The Health System includes more than 9,000 primary and specialty care physicians; 13 joint-venture outpatient surgery centers throughout the five boroughs of New York City, Westchester, Long Island, and Florida; and more than 30 affiliated community health centers. We are consistently ranked by U.S. News & World Report's Best Hospitals, receiving high "Honor Roll" status, and are highly ranked: No. 1 in Geriatrics, top 5 in Cardiology/Heart Surgery, and top 20 in Diabetes/Endocrinology, Gastroenterology/GI Surgery, Neurology/Neurosurgery, Orthopedics, Pulmonology/Lung Surgery, Rehabilitation, and Urology. New York Eye and Ear Infirmary of Mount Sinai is ranked No. 12 in Ophthalmology. U.S. News & World Report’s “Best Children’s Hospitals” ranks Mount Sinai Kravis Children's Hospital among the country’s best in several pediatric specialties. The Icahn School of Medicine at Mount Sinai is ranked No. 11 nationwide in National Institutes of Health funding and in the 99th percentile in research dollars per investigator according to the Association of American Medical Colleges. Newsweek’s “The World’s Best Smart Hospitals” ranks The Mount Sinai Hospital as No. 1 in New York and in the top five globally, and Mount Sinai Morningside in the top 20 globally. Equal Opportunity Employer The Mount Sinai Health System is an equal opportunity employer, complying with all applicable federal civil rights laws. We do not discriminate, exclude, or treat individuals differently based on race, color, national origin, age, religion, disability, sex, sexual orientation, gender, veteran status, or any other characteristic protected by law. We are deeply committed to fostering an environment where all faculty, staff, students, trainees, patients, visitors, and the communities we serve feel respected and supported. Our goal is to create a healthcare and learning institution that actively works to remove barriers, address challenges, and promote fairness in all aspects of our organization. Compensation The Mount Sinai Health System (MSHS) provides salary ranges that comply with the New York City Law on Salary Transparency in Job Advertisements. The salary range for the role is $132411.29 - $153840.32 Annually. Actual salaries depend on a variety of factors, including experience, education, and operational need. The salary range or contractual rate listed does not include bonuses/incentive, differential pay or other forms of compensation or benefits. $132,411.29 - $153,840.32 / year
Description The Assistant Nurse Manager for Mount Sinai Queens Medical/Surgical unit is a Registered Professional Nurse with broad knowledge and skills who acts as clinical leader in the daily functioning of the unit and oversight of quality patient care delivery, in conjunction with, or in the absence of, the Clinical Nurse Manager. Responsibilities Patient Care 1.Leads nursing practice using the tenets of the Professional Practice Model of Relationship Centered Care and the Care Delivery Model of Modified Primary Nursing for the promotion of the patient experience. 2.Demonstrates proficiency in all aspects of Purposeful Hourly Rounding (PHR) and role models expected behaviors. 3.Ensures the integration of PHR into clinical activities to enhance Relationship Centered Care. 4.Validates staff members round hourly on all patients by direct observation and patient feedback. 5.Assesses staff competency in PHR and provides consistent meaningful feedback with more focused feedback as needed. 6.Conducts rounding of all patients on a daily basis (Monday-Friday.) 7.Communicates quantitative and qualitative information regarding the patient experience and staff engagement to the staff and the Interdisciplinary Patient Care Team that leads to the development and implementation of an action plan. 8.Collaborates with the physician dyad and escalates concerns as appropriate. 9.Follows up on all patient concerns in a timely manner and provides service recovery as needed. 10.Demonstrates caring, respect, compassion, empathy and active listening through dialogue, body language and actions. Patient Experience 1.Role models the tenets of Mount Sinai Relationship Centered Care (MSHRCC) through facilitation of the following actions but not limited to: Admission Welcome, Bedside Shift Report, HELP, AM/PM Care, 5 Minute Sit Down, Purposeful Hourly Rounding (PHR), Medication Review, Discharge Wrap Up, and MD/RN Unit Collaboration. 2.Huddles with staff at the start of each shift, identifying high-risk patients who require special attention. 3.Communicates to nursing leadership concerns or issues identified during huddle and throughout shift. 4.Initiates service recovery for patients and family members who have concerns and escalates to Clinical Nurse Manager/Associate Director of Nursing/designee or Patient Relations as needed. 5.Interprets and communicates patient experience scores and benchmarks and keeps staff informed of progress and areas of opportunity. 6.Considers the patient’s values, preferences, expressed needs and knowledge in all aspects of care. 7.Empowers staff to use evidence-based practices to increase understanding of patients’ perceptions of care. 8.Demonstrates caring, respect, compassion, empathy and active listening through dialogue, body language and actions. Quality and Safety 1.Designs, supports and leads a safe, therapeutic and efficient patient-centered care environment for professional practice. 2.Identifies and investigates issues or variances in practice/operations by participating in the RCA process and implements corrective action plans. 3.Fosters a fair and open culture that encourages error and near-miss occurrence reporting. 4.Leads interdisciplinary quality improvement teams using the principles of high reliability. 5.Reviews unit progress, changes and compliance with quality and safety metrics with clinical nurses and other members of the healthcare team. 6.Responds to escalations of potential safety hazards or gaps from best practice by correcting concerns following institutional chain of command protocol. 7.Monitors institutional information technology infrastructure and corrects gaps in clinical nurse documentation. 8.Leads staff participation in quality and safety initiatives and mandated compliance measures. 9.Demonstrates accountability for all unit quality and safety practices and compliance, and ensures required evaluation of staff competencies is maintained. Operations and administration 1.Supports implementation of the mission, vision, goals and objectives of the department, throughout the clinical service and individual patient care units. 2.Provides administrative and clinical oversight to ensure that all activity (staffing, support services, inter disciplinary collaboration, resources and financial viability) supports the goals of the organization. 3.Works collaboratively with physician dyads and the healthcare team to promote patient care and regulatory standards. 4.Maintains a nursing unit in compliance with all regulatory agency mandates, including the regulations of NYS DOH and The Joint Commission. 5.Oversees 24 hour patient care delivery, throughput, staffing and processes to ensure efficient and effective operations. 6.Prepares, implements and monitors unit budgets, including capital equipment allocation, budget variances, management of OT and vacancies according to MSHS financial goals. 7.Maintains control of established positions and manages the recruitment and retention of qualified staff. 8.Maintains patient/employee confidentiality in the management of information. 9.Evaluates nursing staff performance and mentors, coaches, counsels and disciplines staff as needed. 10.Monitors availability and maintenance of nursing equipment and supplies. 11.Conducts regular staff meetings to ensure communication with staff about progress, changes and compliance with all hospital policies and procedures. 12.Encourages, recognizes and rewards staff participation in quality and safety initiatives, compliance and successes. 13.Facilitates organizational change initiatives by using effective strategies. 14.Leads a shared decision making model by establishing a structure of shared governance, just culture and staff engagement in practice councils, departmental meetings and initiatives. 15.Interprets and implements collective bargaining agreements affecting staff. 16.Responds to protest of assignment in a timely manner as detailed in the collective bargaining agreement and discusses the resolution in unit staff meetings. Professional Development 1.Performs as a clinical leader who actively creates and supports nursing practice and an environment of care that reflects clinical excellence. 2.Organizes the environment of care to support clinical colleagues, patients and their families and members of the healthcare team. 3.Projects and cultivates a professional image to colleagues by communicating caring, respect, compassion, empathy and trust. 4.Incorporates ethical principles into decision making for patient and family in collaboration with the clinical nursing staff and the healthcare team. 5.Fosters a spirit of scholarship, inquiry, life-long learning and innovation for self and others. 6.Acquires and disseminates knowledge and skills relative to the role, patient population, clinical specialty and global or local health community needs. 7.Leads shared decision making through unit/service practice councils, nursing department and hospital committees, and clinical service/unit initiatives. 8.Serves as a professional role model and preceptor for new leadership staff and students. 9.Integrates the values of research and evidence-based practice and its application to nursing practice and the environment of care. 10.Contributes to the profession of nursing through leadership and participation inprofessional organizations. Qualifications Education Requirements Bachelor of Science with a major in nursing required; Masters in nursing or health related field preferred. 3 years minimum clinical nursing experience with some Charge Nurse/supervisory experience preferred. Must have relevant clinical competence in area of nursing practice assigned Licensing and Certification Requirements (if applicable) BLS, ACLS Licensed as a registered nurse with current registration in New York State Employer Description Strength through Unity and Inclusion The Mount Sinai Health System is committed to fostering an environment where everyone can contribute to excellence. We share a common dedication to delivering outstanding patient care. When you join us, you become part of Mount Sinai’s unparalleled legacy of achievement, education, and innovation as we work together to transform healthcare. We encourage all team members to actively participate in creating a culture that ensures fair access to opportunities, promotes inclusive practices, and supports the success of every individual. At Mount Sinai, our leaders are committed to fostering a workplace where all employees feel valued, respected, and empowered to grow. We strive to create an environment where collaboration, fairness, and continuous learning drive positive change, improving the well-being of our staff, patients, and organization. Our leaders are expected to challenge outdated practices, promote a culture of respect, and work toward meaningful improvements that enhance patient care and workplace experiences. We are dedicated to building a supportive and welcoming environment where everyone has the opportunity to thrive and advance professionally. Explore this opportunity and be part of the next chapter in our history. About the Mount Sinai Health System: Mount Sinai Health System is one of the largest academic medical systems in the New York metro area, with more than 48,000 employees working across eight hospitals, more than 400 outpatient practices, more than 300 labs, a school of nursing, and a leading school of medicine and graduate education. Mount Sinai advances health for all people, everywhere, by taking on the most complex health care challenges of our time — discovering and applying new scientific learning and knowledge; developing safer, more effective treatments; educating the next generation of medical leaders and innovators; and supporting local communities by delivering high-quality care to all who need it. Through the integration of its hospitals, labs, and schools, Mount Sinai offers comprehensive health care solutions from birth through geriatrics, leveraging innovative approaches such as artificial intelligence and informatics while keeping patients’ medical and emotional needs at the center of all treatment. The Health System includes more than 9,000 primary and specialty care physicians; 13 joint-venture outpatient surgery centers throughout the five boroughs of New York City, Westchester, Long Island, and Florida; and more than 30 affiliated community health centers. We are consistently ranked by U.S. News & World Report's Best Hospitals, receiving high "Honor Roll" status, and are highly ranked: No. 1 in Geriatrics, top 5 in Cardiology/Heart Surgery, and top 20 in Diabetes/Endocrinology, Gastroenterology/GI Surgery, Neurology/Neurosurgery, Orthopedics, Pulmonology/Lung Surgery, Rehabilitation, and Urology. New York Eye and Ear Infirmary of Mount Sinai is ranked No. 12 in Ophthalmology. U.S. News & World Report’s “Best Children’s Hospitals” ranks Mount Sinai Kravis Children's Hospital among the country’s best in several pediatric specialties. The Icahn School of Medicine at Mount Sinai is ranked No. 11 nationwide in National Institutes of Health funding and in the 99th percentile in research dollars per investigator according to the Association of American Medical Colleges. Newsweek’s “The World’s Best Smart Hospitals” ranks The Mount Sinai Hospital as No. 1 in New York and in the top five globally, and Mount Sinai Morningside in the top 20 globally. Equal Opportunity Employer The Mount Sinai Health System is an equal opportunity employer, complying with all applicable federal civil rights laws. We do not discriminate, exclude, or treat individuals differently based on race, color, national origin, age, religion, disability, sex, sexual orientation, gender, veteran status, or any other characteristic protected by law. We are deeply committed to fostering an environment where all faculty, staff, students, trainees, patients, visitors, and the communities we serve feel respected and supported. Our goal is to create a healthcare and learning institution that actively works to remove barriers, address challenges, and promote fairness in all aspects of our organization. Compensation The Mount Sinai Health System (MSHS) provides salary ranges that comply with the New York City Law on Salary Transparency in Job Advertisements. The salary range for the role is $132411.29 - $153840.32 Annually. Actual salaries depend on a variety of factors, including experience, education, and operational need. The salary range or contractual rate listed does not include bonuses/incentive, differential pay or other forms of compensation or benefits. 
$135,000 - $183,007 / year
Position: Advanced Practice Provider (NP/PA) Monogram Health is seeking compassionate and skilled Advanced Practice Providers (Nurse Practitioners or Physician Assistants) to deliver high‑quality in‑home care to patients living with multiple chronic conditions, including diabetes, hypertension, chronic kidney disease, heart failure, COPD, depression, and other complex health needs. This role works within an integrated multidisciplinary care team (Clinical, Behavioral Health, Pharmacy, Administrative), establishing long-term patient relationships and providing continuity of care to complex patients in their homes and via telehealth. The Advanced Practice Provider has the opportunity to be part of a value-based, patient-centered care model, providing quality driven managed care with a population health focus. Highlights Schedule Patient visits occur 3-4 days/week in the patients’ home with 1-2 days/week telehealth visits (varies by market) No on‑call, overnights, weekends, including paid company holidays 30–90-minute visit lengths based on appointment type and patient needs *All schedule responsibilities may evolve with business needs Total Rewards Earn a competitive base salary commensurate with experience and education Grow your clinical skillset and earn $2,500 for every core and specialty competency you complete Invest in your longevity with a $5,000 annual anniversary bonus Maximize your income potential with up to 15% in additional bonuses that will be paid out on a quarterly or annual basis Start earning bonuses sooner — eligibility begins after just 3 months From your driveway to the patient’s house, we’ve got you covered with mileage reimbursement. Support your professional growth and continued education with reimbursement for your CEU/CME expenses. Because rest matters – 20 PTO days, 7 paid holidays, and 1 floating day to make your own. Compensation The base salary range for this role is $135,000 to $183,007 and reflects the range of experience and qualifications we may consider. Final compensation will be determined based on geographic location and job-related factors such as experience, skills, education, certifications, and internal compensation considerations. While a larger range is posted, most offers will typically fall within a narrower band based on these factors. In addition to base salary, this role is eligible for additional compensation, including bonus opportunities and a comprehensive benefits package. Responsibilities Provide evidence‑based, patient‑focused care that reduces avoidable hospitalizations and improves quality of life directly in the patient’s home Perform comprehensive assessments, including initial evaluations, annual wellness exams, follow‑ups, acute urgent visits, and post‑discharge visits. Educate patients and caregivers on disease management, preventive care, medications, and diagnostic testing Participate in recurring virtual integrated care team meetings Engage in quality assurance activities, including audits and documentation reviews, to ensure compliance with state board requirements and clinical best practices May practice in a variety of care settings beyond the patient’s home, including skilled nursing facilities (SNFs), assisted living facilities (ALFs), hospitals, and other affiliated clinical settings, as applicable. Perform point-of-care testing (A1C and Spirometry), prescribe medications, order tests, and collaborate with patient’s Monogram physician Coordinate care with PCPs, specialists, and ancillary services Complete documentation accurately and in a timely manner Position Requirements Active and unrestricted RN and NP license, or Physician Assistant license Board certification (NP: ANCC/AANP | PA: NCCPA) Current and unrestricted DEA certificate, or eligibility to obtain Minimum of two (2) years of direct patient care experience Field‑based role requiring travel to patient homes, reliable transportation, valid driver’s license, and auto insurance BLS certification (supported during onboarding) Demonstrated initiative and independent, critical thinking, and decision-making skills Knowledge of and compliance with federal/state regulations (HIPAA, OSHA) Prior experience with EHR systems (e.g. Athena, Salesforce, Epic) Previous experience conducting annual wellness or comprehensive visits preferred Background in managed care, population health, or value‑based care preferred Benefits Comprehensive Benefits - Medical, dental, and vision insurance, employee assistance program, employer-paid and voluntary life insurance, disability insurance, plus health and flexible spending accounts Financial & Retirement Support – Competitive compensation, 401k with employer match, and financial wellness resources Time Off & Leave – 20 PTO days, 7 paid holidays, and 1 floating day to make your own, and paid parental leave Wellness & Growth – Work life assistance resources, physical wellness perks, mental health support, employee referral program, and BenefitHub for employee discounts About Monogram Health Monogram Health is a leading multispecialty provider of in-home, evidence-based care for the most complex of patients who have multiple chronic conditions. Monogram health takes a comprehensive and personalized approach to a person’s health, treating not only a disease, but all of the chronic conditions that are present - such as diabetes, hypertension, chronic kidney disease, heart failure, depression, COPD, and other metabolic disorders. Monogram Health employs a robust clinical team, leveraging specialists across multiple disciplines including nephrology, cardiology, endocrinology, pulmonology, behavioral health, and palliative care to diagnose and treat health issues; review and prescribe medication; provide guidance, education, and counselling on a patient’s healthcare options; as well as assist with daily needs such as access to food, eating healthy, transportation, financial assistance, and more. Monogram Health is available 24 hours a day, 7 days a week, and on holidays, to support and treat patients in their home. Monogram Health’s personalized and innovative treatment model is proven to dramatically improve patient outcomes and quality of life while reducing medical costs across the health care continuum. 
