Nursing Jobs in Mountain Lakes, NJ

RN Case Manager Part Time Observation Unit Ridgewood Campus

$46.64 - $58.29 / hour

POSITION SUMMARY: To coordinate and facilitate patient care through the Valley Hospital Health Care System as it relates to a multidisciplinary approach to patient care and utilization of resources. EDUCATION: Bachelor's degree required. ANCC case management certification preferred. EXPERIENCE: Minimum five years experience in utilization review management and/or case management preferred. Minimum 5 years experience as a registered nurse required. SPECIAL SKILLS: Registered Nurse. Licensed in State of New Jersey. Current acute care clinical knowledge with broad base medical/surgical background. Demonstrates effective interaction and communication (oral, writing, presenting) skills. Ability to perform work accurately and pay attention to details, often changing from one task to another without loss of efficiency or composure. Ability to function competently in stressful situations and a changing work environment related to changing patient needs. Ability to work cooperatively within the health-system; with patients and family members; and with multidisciplinary team members (i.e. , physicians, Rehab, Respiratory, DI, Lab, etc.). Ability to utilize effective time management to set priorities, perform job related responsibilities, and respond quickly to emergency situations. Ability to use critical thinking and clinical reasoning skills effectively problem-solve and provide case management services. Job Location The Valley Hospital-Paramus Shift Day (United States of America) Benefits Medical/Prescription, Dental & Vision Discount Program (Full Time/Part Time Employees) Group Term Life Insurance and AD&D(Full Time Employees) Flexible Spending Accounts and Commuter Benefit Plans Supplemental Voluntary Benefits ( e.g. Short-term and Long-term Disability, Whole Life Insurance, Legal Support, etc.) 6 Paid Holidays, Paid Time Off (varies), Wellness Time Off, Extended Illness Retirement Plan Tuition Assistance Employee Assistance Program (EAP) Valley Health LifeStyles Fitness Center Membership Discount Day Care Discounts for Various Daycare Facilities SalaryJoining Valley Health System means becoming part of a dedicated team that values the highest quality of care in a supportive environment. In our commitment to high performance and reliability, we encourage and recognize exceptional individual performance through our industry leading compensation practices including a starting salary and benefits in accordance with your role, experience, education, and licensure. Actual individual salaries vary depending on these factors. The salary listed does not include other forms of compensation or benefits.Pay Range: $46.64 - $58.29 (per hour) EEO Statement Valley Health System does not discriminate on the basis of ancestry, age, atypical hereditary cellular or blood trait, civil union status, color, creed, disability, domestic partnership, gender, gender identity or expression, familial status, genetic information, liability for service in the Armed Forces of the United States, marital status, medical condition or illness, mental or physical handicap, national origin, nationality, perceived disability, pregnancy, race, refusal to submit to genetic testing or make available results of such tests, religion, sex, sexual orientation, veteran’s status or any other protected basis, in accordance with all applicable Federal, State and Local laws. This applies to all areas of employment, including recruitment, hiring, training and development, promotion, transfer, termination, layoff, compensation, benefits, social and recreational programs, and all other conditions and privileges of employment.

LPN

Part-time

8 months ago

Licensed Practical Nurse

Sunrise Senior Living Randolph, NJ

When you join Sunrise Senior Living, you will be able to use your unique skills to empower residents to live longer, healthier, and happier lives. Not only will you build meaningful relationships with residents, their families, and team members alike, you will also gain joy in serving others and deep fulfillment in your work. Explore how you can follow your passions and shed light on meaningful ways to serve, grow, and shine together. Sunrise Senior Living was again certified as a Great Place to Work® by Activated Insights. This is the 8th time Sunrise has received this top culture and workplace designation, highlighting the special place Sunrise is to be a part of. COMMUNITY NAME Sunrise of Randolph Job ID 2025-230370 JOB OVERVIEW The LPN Medication Care Manager is responsible for providing the highest degree of quality care and services by administering medication and treatments in a safe organized manner. Responsibilities include but are not limited to administration of medications, documentation of medication administration, conducting SHUs, and providing resident care while demonstrating the Mission for Sunrise Senior Living, “to champion the quality of life for all seniors” in accordance with federal, state/provincial, and local laws, standards and regulations and Sunrise Senior Living policies to promote the highest degree of quality care and services to our residents. RESPONSIBILITIES & QUALIFICATIONS Essential Duties As a part of the Sunrise team, supporting our Mission, Principles of Service and Core Values is a fundamental part of this job. Our foundational belief is the sacred value of human life. The unique responsibilities for this role include but are not limited to the essential functions listed as follows: Medication Administration Provide the highest degree of quality care and services by administering medication and treatments in a safe organized manner. Review, read, notate, and initial the electronic health record to document and learn about pertinent information about residents. Receive medication updates from Resident Care Director (RCD) or Wellness Nurse. Administer, assist with, and observe medications and treatments for each resident using the medication administration record and the Six Rights of Medication Pass (“Right” resident, medication, dosage, time, route, right to refuse). Ensure that medications are passed according to times utilizing a mobile medication cart. Document and initial as medications are given and ensure that appropriate documentation is completed for refusal or missed doses. Maintain confidentiality of all resident information including resident medication among other residents. Report all resident concerns and unavailable medication while administering the medication to the RCD or Wellness Nurse. Restock medication cart after all medication passes. Assist in checking medication regardless of packaging system. Assess the residents to determine need for “as needed medication” and appropriately document and report to supervisor. Count all narcotics with another Medication Care Manager (MCM) or Lead Care Manager (LCM) each shift and report discrepancies to the RCD or Wellness Nurse. Maintain and clean the Medication Room, medication carts, and treatment carts for neatness, cleanliness, availability of medications, and expired medications. Follow re-fill process for medications. Help residents maintain independence and promote dignity and physical safety of each resident adhering to the Sunrise Principles of Service. Strive to understand and respond to each resident with empathy, always remaining mindful of the resident’s unique communication patterns, history, and basic human needs. Practice routinely good standard care precautions of cleanliness, hygiene, and health. Audit medication carts. Resident Care Notify RCD of any resident and/or family concerns. Attend and actively participates in daily Cross Over meetings facilitated by the LCM. Conduct Service and Health Updates as directed by RCD. Participate in the development of the Individualized Service Plans (ISP). Transcribe orders. Risk Management and General Safety Partner with community team to ensure community is in compliance with national/provincial regulations pertaining to occupational health and safety requirements, promoting Risk Management programs and policies, and adhering to safety rules and regulations. Practice safety procedures at all times including Personal Protective Equipment (PPE), fire extinguishers, Safety Data Sheets (SDS), and Lockout Tagout procedures. Report all accidents/incidents immediately. Report all unsafe and hazardous conditions/equipment immediately. Ensure any cords, carts, equipment, and other hazards are always kept out of the way, not blocking exits, and in compliance with fire codes. Comply with all infection control techniques, placement of bio-hazard containers, removal techniques, procedures, and policies. Understand and practice the proper method of attending to and disposing of, and the possibility of exposure to, blood borne pathogens, bodily fluids, infectious waste, sharp sticks, and hazardous materials. Report occupational exposures to blood, body fluids, infectious materials, sharp sticks and hazardous chemicals immediately. Ensure oxygen tanks are stored safely, exchange guest/resident’s tanks when empty, and monitor to make sure liters of oxygen are at prescribed levels. Training and Contributing to Team Success Participate as a member of a team and commit to working toward team goals. Demonstrate in daily interactions with others, our Team Member Credo. Commit to serving our residents and guests through our Principles of Service. Contribute to the overall engagement programs and processes (customer and team member engagement) including participating in the team member engagement survey and engagement improvement planning workshops. Attend regular meetings; Town Hall, Department Team, Cross Over, Medication Technician and others as directed by the Supervisor/Department Coordinator. Attend regular training by RCD and neighborhood coordinators. May be designated as shift supervisor. May supervise other medication care managers. Maintain compliance in assigned required training and all training required by state/province or other regulating authorities as applicable to this role to ensure that Sunrise standards are always met. Perform other duties as assigned. Core Competencies Ability to make choices and decisions and act in the resident’s best interest Ability to react and remain calm in difficult situations Ability to handle multiple priorities Possess written and verbal skills for effective communication and level of understanding Demonstrate good judgment, problem solving and decision-making skills Experience and Qualifications To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed throughout this job description are representative of the knowledge, skills, and abilities required. LPN, LVN, or state/province specific licensed nurse credential In states/provinces where appropriate, must maintain certifications Maintain the following certifications and ongoing training and re-education as required by Sunrise and state/provincial regulations: o CPR and First Aid Must be at least 18 years of age Previous experience working with seniors preferred Desire to serve and care for seniors As applicable, all Sunrise team members who drive a Sunrise vehicle must sign the Driver job description and understand the key essential duties for safety and regulatory compliance ABOUT SUNRISE Ready to take the next step and make a bigger impact than you ever imagined? As part of our team, you will help brighten the future for everyone at Sunrise and beyond. That is why we make it a priority to celebrate the unique ways you bring moments of togetherness and joy to everyone you serve. And when combined with the support, benefits, and growth opportunities we offer, the result is a career that PositivelyShines with everything you need to reach your goals – at work and in your life. We also offer benefits and other compensation that include: Medical, Dental, Vision, Life, and Disability Plans Retirement Savings Plans Employee Assistant Program / Discount Program Paid time off (PTO), sick time, and holiday pay Daily Pay offered to get paid within hours of a shift (offered in the U.S. only) Tuition Reimbursement In addition to base compensation, Sunrise may offer discretionary and/or non-discretionary bonuses. The eligibility to receive such a bonus will depend on the employee’s position, plan/program offered by Sunrise at the time, and required performance pursuant to the plan/program. Some benefits have eligibility requirements Apply today to learn why Sunrise Senior Living is a certified Great Place to Work® PRE-EMPLOYMENT REQUIREMENTS Sunrise considers the health and safety of its residents, family members, and team members to be one of its highest priorities. Employment with Sunrise is conditioned on completing and passing a drug test (which does not include marijuana), participating in testing requirements (e.g. Tuberculosis Test, Physical Evaluation). Covid-19 and Influenza vaccination is only required to the extent mandated by applicable federal, state, and local laws and authorities. COMPENSATION DISCLAIMER Selected candidates will be offered competitive compensation based on geographic location of community/office, skills, experience, qualifications, and certifications/licenses (where applicable).

RN-Same Day Surgery (Full-time, Varied,9am to 7:30pm)

CarePoint Health Bayonne, NJ

About Us CarePoint Health is one of New Jersey’s leading health care systems comprised of three long-standing and highly-regarded hospitals – Christ Hospital in Jersey City, Hoboken University Medical Center and Bayonne Medical Center. CarePoint united three area hospitals to provide 360-degree-coordinated care by integrating the medical facilities and physician networks associated with these institutions. With over 4,500 employees, CarePoint is the largest private employer in Hudson County, New Jersey and each year provides care to over 300,000 individuals. CarePoint prides itself on its patient-focused approach to care delivery, with an emphasis on preventative medicine, health education, and disease management. Leveraging its vast network of physicians and healthcare experts, CarePoint is quickly becoming recognized as a leader in the broader healthcare landscape as it pioneers creative solutions to address urgent population health needs. What You'll Be Doing Provides total, comprehensive care to patients by applying the nursing process utilizing the nursing process, which includes assessment, planning, implementation and evaluation. in an organized and systematic manner according to institutional policy in keeping with patient safety principles. Completes initial assessment according to policy, reassesses patient condition per policy Reviews preoperative paperwork and follows up to ensure completion Anticipates changes in the patient’s clinical data and adjusts plan of care Collaborates with the patient, significant others and ancillary departments and functions as part of the multidisciplinary health care team whose goal is to provide care that is continuous and well-coordinated Prioritizes and organizes work assignment and adjusts priorities based on changing situations. Provides for actual and anticipated education needs and includes education to meet these needs in the plan of care Performs effectively in emergency situations Communicates proactively to the health care team plan of care changes in patient condition, the patient progress, the discharge plan and other relevant information Documents patient care and required safety checks accurately and legibly Participates in Quality Improvement activities and improve performance including team membership. Demonstrates competent professional practice and engages in opportunities for professional growth. Contributes to the productivity and professional environment of the department. Promotes Professional practice and atmosphere What We're Looking For RN NJ Licensure BSN preferred Acute care experience preferred, At least 1-2 years PACU and SDS experience preferred in acute care setting BLS certification, ACLS Preferred, PALS and within 6 months of hire Technical skills, Computer Skills Certification in ASPAN or specialty preferred What We Offer • Competitive pay• Medical, dental, and vision insurance• 401k with Company match• Generous paid time off• Paid Holidays• Tuition Reimbursement• Advancement and career development opportunities Influenza Vaccination is a requirement for employment at CarePoint Health. If you are not currently vaccinated you will be required to receive the vaccination prior to hire date if you are offered employment, unless you request and receive an approved medical or religious exemption from CarePoint. CarePoint Health is an Equal Opportunity Employer encouraging diversity in the workplace. All qualified applicants will receive consideration for employment without regard to race, color, national origin, gender, age, religion, disability, sexual orientation, veteran status, marital status, or any other characteristic protected by law.

Registered Nurse, Emergency Medical Services, Full Time, Nights

Valley Health System Paramus, NJ

$44 - $55 / hour

Position Summary Performs professional and technical duties to render comprehensive Critical Care Nursing in the emergency and non-emergency transportation setting. Education Bachelor`s degree in Nursing required. Current/valid State of New Jersey license (or legal permission to work from the New Jersey Board of Nursing). Current New Jersey State certified EMT-B or EMT-P or must obtain New Jersey State certified EMT-B or EMT-P within six months of hire. Certification in either CEN, CCRN or CTRN. BLS, ACLS, and PALS through the American Heart Association. Experience At least one year experience in the Critical Care Nursing and/or pre-hospital or emergency transportation field. Skills Current and valid State of New Jersey license (or legal permission to work from the New Jersey Board of Nursing). Current New Jersey State certified EMT-B or EMT-P or must obtain New Jersey State certified EMT-B or EMT-P within six months of hire. Certification in either CEN, CCRN or CTRN. Current and valid New Jersey driver's license. BCLS, ACLS and PALS certifications. Highly adaptable with strong interpersonal skills. Sound written and verbal communication skills. Job Location 599 Valley Health Plaza Shift Night (United States of America) Benefits Medical/Prescription, Dental & Vision Discount Program (Full Time/Part Time Employees) Group Term Life Insurance and AD&D(Full Time Employees) Flexible Spending Accounts and Commuter Benefit Plans Supplemental Voluntary Benefits ( e.g. Short-term and Long-term Disability, Whole Life Insurance, Legal Support, etc.) 6 Paid Holidays, Paid Time Off (varies), Wellness Time Off, Extended Illness Retirement Plan Tuition Assistance Employee Assistance Program (EAP) Valley Health LifeStyles Fitness Center Membership Discount Day Care Discounts for Various Daycare Facilities SalaryJoining Valley Health System means becoming part of a dedicated team that values the highest quality of care in a supportive environment. In our commitment to high performance and reliability, we encourage and recognize exceptional individual performance through our industry leading compensation practices including a starting salary and benefits in accordance with your role, experience, education, and licensure. Actual individual salaries vary depending on these factors. The salary listed does not include other forms of compensation or benefits.Pay Range: $44.40 - $55.50 (per hour) EEO Statement Valley Health System does not discriminate on the basis of ancestry, age, atypical hereditary cellular or blood trait, civil union status, color, creed, disability, domestic partnership, gender, gender identity or expression, familial status, genetic information, liability for service in the Armed Forces of the United States, marital status, medical condition or illness, mental or physical handicap, national origin, nationality, perceived disability, pregnancy, race, refusal to submit to genetic testing or make available results of such tests, religion, sex, sexual orientation, veteran’s status or any other protected basis, in accordance with all applicable Federal, State and Local laws. This applies to all areas of employment, including recruitment, hiring, training and development, promotion, transfer, termination, layoff, compensation, benefits, social and recreational programs, and all other conditions and privileges of employment.

RN - Psych ER

Richmond University Medical Center NY

$61.65 - $67.82 / hour

It's fun to work in a company where people truly BELIEVE in what they're doing! We're committed to bringing passion and customer focus to the business. Night Shift - 12 Hours (United States of America) Job Description Uses the Nursing process to plan, implement, direct and evaluate patient care to achieve optimal patient outcomes. Works collaboratively with all other disciplines on assigned unit. Organize and implement group activities in conjunction with the unit program and other staff. Establish and foster collegial relationships with peers and other disciplines, is open and responsive to the diverse backgrounds and experience of other people and promotes an environment that is sensitive to cultural diversity. Demonstrates therapeutic & physical skills required in crisis intervention. Requirements : -Current registration in New York State as an RN, Diploma and Licensure required. -Graduate of an accredited School of Nursing. -BSN preferred. -BLS current required. -Current PMCS preferred. -One year of Psych experience required. -Excellent organization, communication and interpersonal skills needed. Salary Range: $61.653/hr - $67.819/hr (Commensurate with Education) Employment Non-Discrimination: Richmond University Medical Center is committed to equality of opportunity in all aspects of employment and provides full and equal employment opportunities to all employees and potential employees without regard to race, color, national origin, religion, gender identity, sex, sexual orientation, pregnancy, childbirth and related medical conditions and needs including lactation accommodations, physical or mental disability, age, immigration or citizenship status, veteran or active military status, genetic information, or any other legally protected status. If you like wild growth and working with happy, enthusiastic over-achievers, you'll enjoy your career with us!

Medication Aide

Full-time

8 months ago

Medication Aide

Five Star Senior Living Mount Arlington, NJ

The Opportunity The Certified Caregiver - Medication Aide position provides support for our community’s residents with the essential day-to-day tasks they can no longer perform or need help with. Certified Caregivers are responsible for administering daily medications. Duties include monitoring residents, reporting changes, and collecting samples. The ideal Certified Caregiver will be detail oriented, possess knowledge of resident care procedures and have excellent communication skills. What You’ll Do Deliver routine daily medications, either prescription or non-prescription, to residents Record medication dosages and times Observe residents and document changes in their condition Gather samples for analysis Ensure equipment is routinely inspected and cleaned Uphold all health and safety standards Follows federal, state, and agency regulations to protect own health and that of others Coordinate with different nurses to assist with resident care and medications Follow written or verbal instructions on how to manage medications Respond to resident emergency call signals, bells, or intercom systems to identify residents needs Protects confidential client information unless otherwise required to promote client safety and welfare Seeks guidance from the nurse as needed to perform tasks safely and efficient Responsibilities include customer service, administering medication, caregiving, resident safety and communication What You’ll Bring POSITION REQUIREMENTS / QUALIFICATIONS: Successful completion of a state approved Medication Aide course and is approved to assist with or administer oral and external medications, per state regulations Must demonstrate competency to perform medication administration in accordance with state regulations High School Diploma or equivalent preferred, although mandatory in certain states Applicants must be a minimum of 18 years old, or the age required by state regulations, whichever is higher Working experience alone, on a team, and on projects start to finish Strong emotional intelligence and listening skills Dedication to the medical field, especially towards working with the residents Must pass State and company background checks and drug test Take Vital signs Assisting resident with Activities of Daily Living (ADLs) Medication supervision (within the scope of the state regulations) Read, write, speak and understand the English language

LPN - Radiation Oncology

Village MD Florham Park, NJ

About Our Company We’re a physician-led, patient-centric network committed to simplifying health care and bringing a more connected kind of care. Our primary, multispecialty, and urgent care providers serve millions of patients in traditional practices, patients' homes and virtually through VillageMD and our operating companies Village Medical , Village Medical at Home , Summit Health , CityMD , and Starling Physicians . When you join our team, you become part of a compassionate community of people who work hard every day to make health care better for all. We are innovating value-based care and leveraging integrated applications, population insights and staffing expertise to ensure all patients have access to high-quality, connected care services that provide better outcomes at a reduced total cost of care. Please Note: We will only contact candidates regarding your applications from one of the following domains: @summithealth.com, @citymd.net, @villagemd.com, @villagemedical.com, @westmedgroup.com, @starlingphysicians.com, or @bmctotalcare.com. Job Description We are seeking a detail-oriented and highly skilled Nuclear Medical Technician to support the preparation, administration, and monitoring of radioligand therapy (RLT) in patients with specific cancers (e.g., prostate cancer, neuroendocrine tumors). The technician will work under the supervision of nuclear medicine physicians and follow strict safety protocols to ensure effective and safe delivery of therapeutic radiopharmaceuticals. Key Responsibilities: Prepare and calibrate radioligands in accordance with manufacturer guidelines and regulatory standards. Administer radioligand therapy under physician direction following established protocols. Perform patient identification, verification, and education before RLT procedures. Monitor patients during and after administration for adverse reactions and provide supportive care. Adhere to radiation safety principles (ALARA) for patients, staff, and self. Document all procedures, doses, and patient outcomes accurately in clinical records and nuclear medicine systems. Maintain and operate imaging and therapy equipment used in RLT administration. Collaborate with multidisciplinary teams including oncology, pharmacy, and radiology staff. Conduct quality assurance checks on equipment and materials used in therapy preparation and administration. Participate in continuing education and training related to new therapies and radiopharmaceuticals. Qualifications: Education: Associate’s or Bachelor’s degree in Nuclear Medicine Technology or related field. Certification: Certified Nuclear Medicine Technologist (CNMT) or ARRT(N) certification required. Licensure: State licensure as required. Experience: Experience in therapeutic nuclear medicine or radioligand therapy preferred. Skills: Strong understanding of radiopharmaceutical handling and safety. Excellent communication and patient-care skills. Proficiency with radiation detection instruments and imaging systems. Ability to follow detailed protocols and manage complex clinical workflows. Physical Requirements: Ability to lift and transport materials up to 25 lbs. Standing, walking, and moving between departments for extended periods. Use of personal protective equipment (PPE) including lead shielding and dosimeters. Work Environment: Clinical setting with controlled radiation areas. Exposure to radioactive materials and need for strict adherence to safety guidelines. Pay Range: $46.73 - $58.41 Hourly The provided compensation range is based on industry standards and salary determinations will be made based on numerous factors including but not limited to years of experience and location of position. About Our Commitment Total Rewards at VillageMD Our team members are essential to our mission to reshape healthcare through the power of connection. VillageMD highly values the critical role that health and wellness play in the lives of our team members and their families. Participation in VillageMD’s benefit platform includes Medical, Dental, Life, Disability, Vision, FSA coverages and a 401k savings plan. Equal Opportunity Employer Our Company provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to, and does not discriminate on the basis of, race, color, religion, creed, gender/sex, sexual orientation, gender identity and expression (including transgender status), national origin, ancestry, citizenship status, age, disability, genetic information, marital status, pregnancy, military status, veteran status, or any other characteristic protected by applicable federal, state, and local laws. Safety Disclaimer Our Company cares about the safety of our employees and applicants. Our Company does not use chat rooms for job searches or communications. Our Company will never request personal information via informal chat platforms or unsecure email. Our Company will never ask for money or an exchange of money, banking or other personal information prior to the in-person interview. Be aware of potential scams while job seeking. Interviews are conducted at select Our Company locations during regular business hours only. For information on job scams, visit, https://www.consumer.ftc.gov/JobScams or file a complaint at https://www.ftccomplaintassistant.gov/ .

Caregiver

Per Diem

8 months ago

Caregiver

Five Star Senior Living Mount Arlington, NJ

The Opportunity The Caregiver position provides support for our community’s residents with the essential day-to-day tasks they can no longer perform or need help with. Caregivers are responsible for helping people with their daily tasks, such as laundry, cleaning, bathing, dressing, and taking their medication. Successful Caregivers are sensitive, respectful and are passionate about helping those in need. What You’ll Do Helping with personal hygiene, including bathing, grooming, and dressing Supporting residents with medication Repositioning residents in bed and escorting them around the community Toileting, incontinent care Take vital signs, such as blood pressure, heart rate and pulse Observe and report on residents’ health, escalating any problems efficiently and effectively Detail daily reports to Nurse, or designated charge person, at end of shift Provide emotional support and serve as a source of comfort for residents and their loved ones Assist residents with mobility by helping them get in and out of bed, chairs, or wheelchairs. Assist residents with eating and drinking. Responsibilities include customer service, caregiving, resident safety and communication. What You’ll Bring POSITION REQUIREMENTS / QUALIFICATIONS: High School Diploma or equivalent preferred, although mandatory in certain states. Applicants must be a minimum of 18 years old, or the age required by state regulations, whichever is higher. Working experience alone, on a team, and on projects start to finish Strong emotional intelligence and listening skills Dedication to the medical field, especially towards working with the residents Must pass State and company background checks and drug test. Take Vital signs Assisting resident with Activities of Daily Living (ADLs) Medication supervision (within the scope of the state regulations) Read, write, speak and understand the English language.