The LVN/LPN provides direct and indirect patient care services requiring clinical competence within the scope of practice in accordance with state requirements. In collaboration with the healthcare team, under the supervision of a Registered Nurse (RN), the LVN/LPN works to maintain safety, provide patient comfort and care and improve the overall patient experience in the medical surgical setting.
The LVN/LPN provides direct and indirect patient care services requiring clinical competence within the scope of practice in accordance with state requirements. In collaboration with the healthcare team, under the supervision of a Registered Nurse (RN), the LVN/LPN works to maintain safety, provide patient comfort and care and improve the overall patient experience in the medical surgical setting.
St. Mary's Medical Center is now hinring for PRN Respiratory Therapists RRT/CRT to join our team. Under the direction and authorization of the medical director and cardiopulmonary director, the RCP II is responsible for performing respiratory therapeutic and pulmonary diagnostic procedures as ordered by the physician. Emphasis will be toward the assessment, planning, implementation and documentation of care, with consideration of age and population specific needs and requirements of the patient. In the absence of a supervisor, may be assigned/identified as Lead RCP, having responsibility for the section or department during their shift.
- 12 hour shifts
- Flexible Hours
- New PRN rates
- Experienced RRT or CRT Required
We are looking for Telemetry Registered Nurses to join our team at St. Mary's Medical Center. In our Telemetry unit you will be reviewing, and interpreting data measured by sophisticated equipment, while caring for critically ill patients. We are looking for individual that enjoy educating patients about their medical condition while, providing advice and emotional support to patients and their family members.
Our Telemetry Registered Nurses can respond quickly and accurately to changes in condition and/or response to treatment. If you want to be a part of a close, communicative, and collaborative team providing excellent patient care this is your opportunity.
#Registerednurses #RN #Telemetry #patientcare #LI-AM5
Being part of our Crtical Care Registered Nurse Float Pool, your love for variety will be satisfied by floating among our ICU and ER Floors at Providence Medical Center. We are looking for RN’s who are independent, flexible and confident of their skills. We provide an awesome orientation, advanced training and strong leadership/mentors; An excellent opportunity to enhance your skills. You will also be part of a close, very collaborative and supportive Nursing Team. As if all the above wasn’t enough, we also provide a verycompetitive compensation rate.
#registerednurse #RN #nursing #floatpool #LI-AM5
#RegisteredNurse #Floatnurse #RN #LI-AM5
We are looking for Registered Nurses just like you to join our Emergency Room team. We are looking for Nurses that can work at a fast pace, can make quick decision, and make a thorough evaluation of our Patient’s injuries.
Emergency room nurses are commonly responsible for bone setting, blood transfusions, wound care, and so much more. In this role, there is no fixed tasks so it can be stressful but, rewarding at the same time. In our ER you will actively communicate with the Physicians and ER team and working as a team to provide the best care for our patients.
If you love not having a fixed routine and work well under pressure apply below.
#LI-AM5
#RegisteredNurse #RN #Patientcare #EmergencyRoom #emergencyservices #ER #Triage
The Cardiac Invasive Lab Tech performs multiple roles within the cardiac laboratory, including assisting physician(s) with invasive cardiac laboratory procedures and conducting various cardiac tests to monitor patients’ heart and blood vessel conditions using diverse cardiology equipment.
Responsibilities may also include:
- Preparing procedure rooms
- Prepping patients for procedures
- Obtaining and recording patient information
- Assisting physicians in procedure by circulating and scrubbing procedures
- X-ray fluoroscopy proficiency
- Acquire/measure/calculate hemodynamic date
- Performing blood work analysis
- Operate intracardiac ultrasound
- Clean procedure rooms and preparing instruments for sterilization.
Prefer applicants with at least (1) year of vascular or cardiovascular lab experience.
#cathlab #Cardiovascularradiologist #Radiology #ARRT #Cardio #LI-AM5
The paramedic is directly accountable for the care given to patients in the Emergency Department. He / She communicates with the physician about the changes in the patients clinical condition including results of the diagnostic studies and symptomatology. Is able to respond quickly and accurately to changes in the condition and/or response to treatment. Is knowledgeable about EMTALA regulations and reporting of child/adult abuse to appropriate agencies.
We are looking for a skilled Radiology Technologist to work with closely with patients when performing radiologic imaging procedures. The Radiology Technologist 's responsibilities include explaining procedures to patients, positioning patients and equipment, performing examinations, developing film, and maintaining and operating specialized radiologic equipment. The Radiology Technologist is also responsible for ensuring patients' safety by covering any areas not being imaged to prevent unnecessary exposure to radiation. You may become specialized in a particular radiographic procedure, such as MRI Technologist s, CT Technologist s, or Mammography Technologist s.
To be successful as a radiology Technologist, you should have strong technical skills, as well as good people skills when working with patients. You should be considerate and compassionate and have the physical stamina to lift heavy equipment and physically disabled patients.
#x-ray #Radiology #Radiographic #Radiologytech #RadTECH #LI-AM5
#radtech #radiology #CT #MRI #R #ARRT #LI-AM5
The Registered Nurse is responsible for the delivery of safe patient care utilizing the nursing process of assessment, planning, implementation and evaluation. Provides direct patient care within the scope of practice. The Registered Nurse also directs and guides patient/family teaching and activities of other nursing personnel while maintaining standards of care within the Medical/Surgical Unit. The Registered Nurse is directly responsible and accountable for the care given to his/her assigned patients. He / She communicates with physician about changes in the patient’s clinical condition including cardiac monitoring, results of diagnostic studies and symptomatology. Is able to respond quickly and accurately to changes in condition and/or response to treatment.
The House Supervisor is a Registered Nurse who assumes administrative responsibility for the management of all department service functions on his/her shift. Makes frequent rounds throughout facility to monitor the delivery of care, oversee the quality of services and direct patient care activities as needed. Directly supervises, provides support to and communicates with all staff house-wide. In the absence of the Hospital Administrative staff, the administrative scope and responsibility is extended to all services within the hospital. Ensures efficient operations and patient flow throughout the hospital. Performs direct patient care, only as needed, within the scope of practice and competence. Ensures all temporary agency personnel are deployed and oriented in compliance with hospital policy. Assist medical staff with scheduling after hour procedures and calling in stand-by call staff members. Enhances the patient/family experience through supportive interactions and explanations of hospital policies as needed.
The Nurse Assistant in the Med Surg/Telemetry Department is an unlicensed non-certified assistive person who assists with activities of daily living, provides basic nursing care to non-critical patients and assists in maintenance of a safe environment under the direction and supervision of the Registered Nurse in charge of the team and/or unit.
The Unit Secretary is directly accountable to the Director of MST, and indirectly to the Charge Nurse, and / or House Supervisor. The Unit Secretary is an unlicensed person who performs indirect care in the department setting. Facilitates the communication needs of the department. Transcribes physician orders from records (in the absence of CPOE and EMR clinical documentation system) with notation and signature by nursing staff. Prepares and complies records on the Emergency Room. Orders supplies for the unit, prepares and completes each patients chart for necessary forms needed on a daily basis. Able to assist nursing staff for duties involving indirect patient care.
The Registered Nurse is responsible for the delivery of safe patient care utilizing the nursing process of assessment, planning, implementation and evaluation. Provides direct patient care within the scope of practice. The Registered Nurse also directs and guides patient/family teaching and activities of other nursing personnel while maintaining standards of care in the Med/Surg/Telemetry Unit. The Registered Nurse is directly responsible and accountable for the care given to his/her assigned patients. He / She communicates with physician about changes in the patient’s clinical condition including cardiac monitoring, results of diagnostic studies and symptomatology. Is able to respond quickly and accurately to changes in condition and/or response to treatment.
Assists the Pharmacist, under his or her supervision, in the daily operation of the Pharmacy.
Assists the Pharmacist, under his or her supervision, in the daily operation of the Pharmacy.
Assists the Pharmacist, under his or her supervision, in the daily operation of the Pharmacy.
Performs security services, including electronic surveillance, and systematic manual Security Officers’ rounds. Coordinates facility response to various potential problems for patients, employees, and visitors. Enforces policy & procedure, ensuring equitable enforcement. Follows guidelines and perpetual monitoring techniques, towards establishing a safe workplace for employees and a safe environment of care. Works with the Environment of Care committee to ensure a multi-disciplinary approach to security and safety. Participates in employee awareness and education. Driving as needed for company business.
The Environmental Service Technician is responsible for maintaining a high level of cleanliness within the hospital and adjacent buildings, which may require traveling from one facility to another without assistance. Respond to and initiate communication by phone, handheld radios, pagers etc.
Provides appropriate patient nutritional care. Assesses the nutritional status of patients, formulates a care plan, coordinates its implementation, and evaluates its impact and effectiveness. Provides nutrition education to patients/families. Approves supplements as appropriate and assists in the development of a hospital formulary appropriate to the patient population.
The Registered Nurse is responsible for the delivery of safe patient care utilizing the nursing process of assessment, planning, implementation and evaluation. Provides direct patient care within the scope of practice. The Registered Nurse also directs and guides patient/family teaching and activities of other nursing personnel while maintaining standards of care within the Medical/Surgical Unit. The Registered Nurse is directly responsible and accountable for the care given to his/her assigned patients. He / She communicates with physician about changes in the patient's clinical condition including cardiac monitoring, results of diagnostic studies and symptomatology. Is able to respond quickly and accurately to changes in condition and/or response to treatment.
The Registered Nurse is responsible for the delivery of safe patient care utilizing the nursing process of assessment, planning, implementation and evaluation. Provides direct patient care within the scope of practice. The Registered Nurse also directs and guides patient/family teaching and activities of other nursing personnel while maintaining standards of care within the Medical/Surgical Unit. The Registered Nurse is directly responsible and accountable for the care given to his/her assigned patients. He / She communicates with physician about changes in the patient's clinical condition including cardiac monitoring, results of diagnostic studies and symptomatology. Is able to respond quickly and accurately to changes in condition and/or response to treatment.
The Certified Surgical Technologist I is responsible for the preparation of sterile supplies and instruments for each assigned procedure, maintaining sterile field during case and providing surgeon with sterile supplies and instruments during assigned procedures. The Certified Surgical Technologist I is an employee with a minimum of 0-1 years’ experience or an employee who is proficient in the following surgical specialties: General Surgery, Urology, Minor Vascular, GYN, Minor Orthopedics, and Minor Neurosurgery/Neurospine. For applicable cases, the Certified Surgical Technologist I is proficient in performing cases laparoscopically, open, or robotically assisted. The employee will demonstrate independent practice in the role of primary scrub technician and will be able to assume the role of camera holder, retractor holder, limb holder, uterine manipulator on more complicated cases.
The Registered Nurse is responsible for the delivery of safe patient care utilizing the nursing process of assessment, planning, implementation and evaluation. Provides direct patient care within the scope of practice. The Registered Nurse also directs and guides patient/family teaching and activities of other nursing personnel while maintaining standards of care within the Medical/Surgical Unit. The Registered Nurse is directly responsible and accountable for the care given to his/her assigned patients. He / She communicates with physician about changes in the patient's clinical condition including cardiac monitoring, results of diagnostic studies and symptomatology. Is able to respond quickly and accurately to changes in condition and/or response to treatment.
The Registered Nurse is responsible for the delivery of safe patient care utilizing the nursing process of assessment, planning, implementation and evaluation. Provides direct patient care within the scope of practice. The Registered Nurse also directs and guides patient/family teaching and activities of other nursing personnel while maintaining standards of care within the Medical/Surgical Unit. The Registered Nurse is directly responsible and accountable for the care given to his/her assigned patients. He / She communicates with physician about changes in the patient's clinical condition including cardiac monitoring, results of diagnostic studies and symptomatology. Is able to respond quickly and accurately to changes in condition and/or response to treatment.
The Registered Nurse is responsible for the delivery of safe patient care utilizing the nursing process of assessment, planning, implementation and evaluation. Provides direct patient care within the scope of practice. The Registered Nurse also directs and guides patient/family teaching and activities of other nursing personnel while maintaining standards of care within the Medical/Surgical Unit. The Registered Nurse is directly responsible and accountable for the care given to his/her assigned patients. He / She communicates with physician about changes in the patient's clinical condition including cardiac monitoring, results of diagnostic studies and symptomatology. Is able to respond quickly and accurately to changes in condition and/or response to treatment.
The Registered Nurse is responsible for the delivery of safe patient care utilizing the nursing process of assessment, planning, implementation and evaluation. Provides direct patient care within the scope of practice. The Registered Nurse also directs and guides patient/family teaching and activities of other nursing personnel while maintaining standards of care within the Medical/Surgical Unit. The Registered Nurse is directly responsible and accountable for the care given to his/her assigned patients. He / She communicates with physician about changes in the patient's clinical condition including cardiac monitoring, results of diagnostic studies and symptomatology. Is able to respond quickly and accurately to changes in condition and/or response to treatment.
To prepare quality food according to established food safety policies in a sanitary environment.
The Registered Nurse is responsible for the delivery of safe patient care utilizing the nursing process of assessment, planning, implementation and evaluation. Provides direct patient care within the scope of practice. The Registered Nurse also directs and guides patient/family teaching and activities of other nursing personnel while maintaining standards of care in the Med/Surg/Telemetry Unit. The Registered Nurse is directly responsible and accountable for the care given to his/her assigned patients. He / She communicates with physician about changes in the patient's clinical condition including cardiac monitoring, results of diagnostic studies and symptomatology. Is able to respond quickly and accurately to changes in condition and/or response to treatment.
Registered Nurse is responsible for the delivery of safe patient care utilizing the nursing process of assessment, planning, implementation and evaluation. The Registered Nurse also directs and guides patient/family teaching and activities of other nursing personnel while maintaining standards of professional nursing. Is able to respond quickly and accurately to changes in condition and/or response to treatment. Provides for a safe environment for patients and visitors. Utilizes the chain of command when necessary to ensure patient well-being and appropriateness of care to neonates from post delivery stabilization through discharge. NICU- Provides direct patient care within the scope of practice with assistance to neonates.
SOCIAL SERVICE II: To provide emotional support, crisis intervention and counseling for Pediatrics, Adolescents, Adults, Older Adults and their significant others to cope with a multiplicity of social and emotional problems; information and referral; referrals for financial assistance and supportive services to patients and families with problems that are related to treatment services, illness, disability or trauma. To provide case management & milieu management, complete psychosocial assessments, assist in the development and re-evaluation of Treatment Plans and work as a member of an interdisciplinary team, and to coordinate discharge planning. Complete necessary documentation and maintain clinical record for each client during their length of stay.
The Pharmacist Tech - PRN assists the Pharmacist, under his or her supervision, in the daily operation of the Pharmacy.
The Registered Nurse is directly responsible for the care given to his/her assigned patients. He/She communicates with the physician about changes in the patient’s clinical condition including hemodynamic monitoring, results of diagnostic studies and abnormal results and symptomatology. Is able to respond quickly and accurately to changes in condition and/or response to treatment. Maintains patient privacy and confidentiality.
The Registered Nurse is directly responsible for the care given to his/her assigned patients. He/She communicates with the physician about changes in the patient’s clinical condition including hemodynamic monitoring, results of diagnostic studies and abnormal results and symptomatology. Is able to respond quickly and accurately to changes in condition and/or response to treatment. Maintains patient privacy and confidentiality.
The Registered Nurse is directly responsible for the care given to his/her assigned patients. He/She communicates with the physician about changes in the patient’s clinical condition including hemodynamic monitoring, results of diagnostic studies and abnormal results and symptomatology. Is able to respond quickly and accurately to changes in condition and/or response to treatment. Maintains patient privacy and confidentiality.
The House Supervisor is a Registered Nurse who assumes administrative responsibility for the management of all department service functions on his/her shift. Makes frequent rounds throughout facility to monitor the delivery of care, oversee the quality of services and direct patient care activities as needed. Directly supervises, provides support to and communicates with all staff house-wide. In the absence of the Hospital Administrative staff, the administrative scope and responsibility is extended to all services within the hospital. Ensures efficient operations and patient flow throughout the hospital. Performs direct patient care, only as needed, within the scope of practice and competence. Ensures all temporary agency personnel are deployed and oriented in compliance with hospital policy. Assist medical staff with scheduling after hour procedures and calling in stand-by call staff members. Enhances the patient/family experience through supportive interactions and explanations of hospital policies as needed.
The Environmental Service Technician is responsible for maintaining a high level of cleanliness within the hospital and adjacent buildings, which may require traveling from one facility to another without assistance. Respond to and initiate communication by phone, handheld radios, pagers etc.
Shift: Nights
Schedule: 11:00PM - 7:30AM
Summary:
As a Environmental Services Tech (EVS Tech) you will perform a variety of duties for the cleaning and maintenance of the hospital. The primary responsibility is to provide the highest quality of service at all times. In order to fulfill these responsibilities, EVS Tech's clean offices, patient rooms, guest rooms, bathrooms, lavatories, halls, food service areas, patient service areas, and any other area that may need attention.
Essential Duties and Responsibilities:
- Maintains appearance and cleanliness of corridors, patient floors and public areas.
- Maintains cleanliness of walls, doors, baseboards, windows, stairwells, and elevator tracks adjacent to corridors daily.
- Removes all necessary equipment left in corridors – beds, linen carts, etc.- to ensure free passage for transporter with patient coming off the elevators.
- You will maintain, set up and operate all cleaning equipment
- You will communicate with hospital team members and supervisors
- Be dependable
Medical Assistant-Urgent Care responsible for assisting physicians with patient care, clerical, environmental and organization tasks. Responsible for appointment scheduling and chart management. Provides Information to patients so they may fully utilize and benefit from the clinic services. Responsibility for Medical Assistant-Urgent Care interviews the patient or his/her representative to obtain identifying and verifying information, such as patient/s name, address, age, date of birth, social security number, occupation, insurance information and obtaining authorization. Also, have the capabilities of interfacing with the PBX operator and reception areas. Must be able to operate a computer to input and retrieve data. Ability to communicate with the population served, utilizing age specific techniques from neonatal, pediatrics, adolescents, young adults, middle adult to geriatrics. Maintain proficiency in medical terminology. Conveys a positive image of organization.
The Patient Account Registrar interviews the patient or his/her representative to obtain patient demographics. This position also secures insurance information, eligibility, benefits and authorizations as applicable. Works closely with all facets of the Admitting department including PBX operator function and reception areas. Must be able to operate a computer to input and retrieve data. Ability to communicate with the population served, utilizing age specific techniques from neonatal, pediatrics, adolescents, young adults, middle adult to geriatrics. Maintain proficiency in medical terminology. Special projects or other assignments may be given with expectations to be completed in a specified timeframe.
Medical Assistant-Urgent Care responsible for assisting physicians with patient care, clerical, environmental and organization tasks. Responsible for appointment scheduling and chart management. Provides Information to patients so they may fully utilize and benefit from the clinic services. Responsibility for Medical Assistant-Urgent Care interviews the patient or his/her representative to obtain identifying and verifying information, such as patient/s name, address, age, date of birth, social security number, occupation, insurance information and obtaining authorization. Also, have the capabilities of interfacing with the PBX operator and reception areas. Must be able to operate a computer to input and retrieve data. Ability to communicate with the population served, utilizing age specific techniques from neonatal, pediatrics, adolescents, young adults, middle adult to geriatrics. Maintain proficiency in medical terminology. Conveys a positive image of organization.
The Registered Nurse is directly responsible and accountable for the care given to his/her Telemetry assigned patients. He / She communicates with physician about changes in the patient’s clinical condition including cardiac monitoring, results of diagnostic studies and symptomatology. Is able to respond quickly and accurately to changes in condition and/or response to treatment.
The Registered Nurse is responsible for the delivery of safe patient care utilizing the nursing process of assessment, planning, implementation and evaluation. Provides direct patient care within the scope of practice. The Registered Nurse also directs and guides patient/family teaching and activities of other nursing personnel while maintaining standards of professional nursing care in Telemetry. The Registered Nurse is directly responsible and accountable for the care given to his/her patients in the Emergency Department. He / She communicates with the physician about the changes in the patients clinical condition including results of the diagnostic studies and symptomatology. Is capable of responding quickly and accurately to changes in the condition and/or response to treatment. Is knowledgeable about EMTALA regulations and reporting of child/adult abuse to appropriate agencies and Hospital Social Worker. Maintains patient privacy and confidentiality.
Each individual performs only those waived, moderate, or highly complex tests authorized by CLIA, Bus. & Prof. Code Section 1204, and must possess a degree of skill commensurate with individual's education, training or experience and technical abilities. Each individual performing the above procedures must: 1) adhere to the laboratory's procedures for the collection, processing, analysis, and reporting of patient test results. 2) follow the laboratory's established quality control policies and procedures in documenting all corrective actions taken when test systems deviate from the laboratory's established performance specifications. 3) be capable of identifying problems that may adversely affect test performance and either correct the problem or immediately notify your immediate supervisor, Director, or Medical Director, 4) perform a wide variety of laboratory procedures requiring independent judgment using both manual and automated methods in Hematology, Blood Bank, Chemistry, Urinalysis, Coagulation, Microbiology, Immunology, and any other discipline as introduced into the laboratory, 5) perform and document maintenance; daily, weekly, monthly, or as needed on instruments and equipment as appropriate, 6) review the accuracy of patient results prior to releasing or reporting, 7) recognize age specific differences in expected results for newborns to geriatrics, 8) ensure that the testing of proficiency testing samples are tested in the same manner as patient samples and that collaboration with other laboratories is prohibited prior to the reporting of proficiency testing results to the appropriate agencies, 9) may be required to perform venipuncture or capillary puncture on various age groups from newborn to geriatrics, 10) assist in the development and maintenance of laboratory policies and procedures, 11) adheres to all department and hospital policies and procedures related to safety, infection control, emergency preparedness, and human resources, 12) in the absence of a supervisor, may be assigned/identified as Lead Tech, having responsibility for the section or department during their shift, 13) may be assigned responsibilities related to LIS and/or POC. 14) other tasks or responsibilities may be assigned by the department manager/director.
The Payroll Coordinator is responsible for timely, accurate processing and reconciliation of payroll checks. Effectively interacts with the Human Resources department, managers and group staff regarding payroll issues. Input and retrieve payroll data from the computerized system. The Payroll Coordinator works with timekeeping system to ensure accurate time keeping. Has the ability to communicate with adolescence, adulthood, late adulthood to geriatrics.
#LI-LA1
Reporting to the Director of Human Resources, the Employee Relations Manager implements and maintains the company’s labor relations programs, policies, and procedures. Employee Relations Manager will provide support to department heads and employees to resolve employee relations issues. Will provide coaching and counseling to department heads in the area of employee training, corrective action/performance improvement, terminations, investigations, and employee complaints/grievances. Will serve as a subject matter expert on Human Resources policies, procedures, and programs. Will conduct investigations on employee concerns, claims of harassment, hostile work environment, discrimination, retaliation, breach of confidentiality, etc. Will perform Employee Rounding and other special projects as assigned.
The Operating Room Tech is responsible for the preparation of sterile supplies and instruments for each assigned procedure, maintaining sterile field during case and providing surgeon with sterile supplies and instruments during assigned procedures.
Performs Diagnostic Radiographic, Cat Scan, Mammography, Bone Density, Ultra Sound or Special Procedures according to department protocols. Functions as the first line interface with customers and is successful in the accomplishment of their imaging needs. Participates in PI/ QC activities. Assists in Maintaining Performance Improvement Program. Oversees radiology area and/or staff in Manager's / Director's absence. Maintains department supplies. Promotes teamwork and good customer service.. Does scheduling for assigned sub departments and maintains supplies and equipment for assigned sub department. Responsible for Processing and transmission of Images to PACS.
The Registered Nurse is responsible for the delivery of safe patient care utilizing the nursing process of assessment, planning, implementation and evaluation. Provides direct patient care within the scope of practice. The Registered Nurse also directs and guides patient/family teaching and activities of other nursing personnel while maintaining standards of care in Telemetry Unit. The Registered Nurse is directly responsible and accountable for the care given to his/her assigned patients. He / She communicates with the physician about changes in the patient�s clinical condition including cardiac monitoring, results of diagnostic studies and symptomatology. Is able to respond quickly and accurately to changes in condition and/or response to treatment.
The Registered Nurse is responsible for the delivery of safe patient care utilizing the nursing process of assessment, planning, implementation and evaluation. Provides direct patient care within the scope of practice. The Registered Nurse also directs and guides patient/family teaching and activities of other nursing personnel while maintaining standards of professional nursing care in Telemetry. The Registered Nurse is directly responsible and accountable for the care given to his/her patients in the Emergency Department. They communicate with the physician about the changes in the patient’s clinical condition including results of the diagnostic studies and symptomatology. Is capable of responding quickly and accurately to changes in the condition and/or response to treatment. Is knowledgeable about EMTALA regulations and reporting of child/adult abuse to appropriate agencies and Hospital Social Worker. Maintains patient privacy and confidentiality.