WebA nurse manager has created a culture of empowerment among the nursing staff. Knowing the treatment protocols, I was able to place an appropriate sized IV line, perform the EKG, and monitor the patients condition until his transfer to a higher level of care. Three letters of recommendation dated within the last 12 months RN peer familiar with the applicant's practice Nursing supervisor familiar with the applicant's practice Health Team member (MD, PT, Social Worker, etc.) UMHS Professioonal Develoopment Framework Websitte She told me that 6 years ago she used to tae a medication in the morning that made her urinate a lot. Managing acid-base balance is an important role of the nurse, A less experienced nurse would have let her call back when she went to breastfeed. In addition to handling and monitoring the current situation, this nurse anticipates and plans for potential change in the patients condition, adapting to the patients needs as they arise. I was able to recognize potentially serious physiological symptoms but also psychological needs and her response to care. This infusion, as with any, required much long range planning before the infusion could be started. information. Informatics is the use of information technology to improve the quality, Candidates who have taken more CEs/CMEs will be rated higher. threatening complications. Applicants will be notified of the date of the Facility Selection Committee meeting within fourteen (14) days of the applicable application deadline. He ordered Ativan 1 mg oral or sublingual every 4 hours as needed for shortness of breath. The concept of palliative sedation was discussed with the core IDG. I asked her how her daughter was doing and if she was having any trouble breast feeding. It involves conception (the Remember the important elements who, what, when, where, why, and how, and be sure to incorporate them into your story. I have the great pleasure and privilege of continuing to care for Mr. P. FYI, I am happy to report that his index cards have now been updated! 29 0 obj<>stream advocate by protecting the personal rights of clients and providing all Name of Committee: _______________ Date Joined: _______________ Committee Charter/Purpose: Committee meeting schedule: Monthly Every other month Quarterly Other Individuals contribution to the committee: (Please list how/what you contribute to the committee or how you share the information with your staff.) HW6S9MR,Y VO@#M&@_I(KEvdR '(vIGAU%NC.yNF~ui+r}kWua}x2/)>#M~qU? These concepts may be addressed in letters of recommendation in addition to the five required concepts above: 6. 2020), Thermoregulation Thermoregulation is regulation of the bodys temperature by cells Application Process Application packets for Staff Nurse III or HH/H III are available from the nursing office/staffing office or the HYPERLINK "https://nursescholars.kaiserpermanente.org/programs/represented-nurse/nursing-career-ladder/" https://nursescholars.kaiserpermanente.org/programs/represented-nurse/nursing-career-ladder/ website and contain written guidelines for the completion of the application. Webthe nurse-patient assignment process. Loss occurs when a valued person, object, or She was being monitored, had an IV, and was receiving oxygen. Comfort Comfort is a persons sense of psychosocial, emotional, and physical Perioperative nurses have the responsibility for continual assessment of the complex interplay of ever changing variables that would affect the surgical outcomes. I went further and asked other questions and her answers allowed me to anticipate problems. Stepping into the charge nurse role is a defining moment in an RN's professional life. The day shift MD, Dr. S, was given report from his night shift colleague, again with discharge plan of home with follow-up with primary as needed. The education process began immediately on how to gown and glove to protect him, our staff and his family and friends. to external or internal stimuli that can have behavioral, emotional, APPLICATION FORMS STAFF NURSE III, HH/H III Application STAFF NURSE III, HH/H III APPLICATION FORM 1. Applicants who are denied the applicable clinical ladder classification will receive, in writing, the rationale for the decision, highlighting the areas of deficiency. I also gave him a run-down of what would occur in the OR including the awake time out that we were doing to ensure that the whole team was on board about the surgical plan, correct procedure, and correct site and side. Nursing exemplar.pdf. ( Combating the hazards of immobility: Preventing and intervening with skin breakdown, ambulating and exercising patients to maximize mobility and rehabilitation, preventing respiratory complications. IADLs include those complex skills needed for independent They are experienced in clinical encounters and often act as a resource for decision-making for the nurses unit. These guidelines were developed to assist you in assembling the various components of your professional portfolio. Committee work may be hospital or professionally based GRASP PPC Performance Improvement Policy and Procedure Other The applicant may document the role of the committee (charter), meeting frequency, and your contribution by completing the optional form on committee participation documentation included in this packet. are met. Together with other members of the health care team, the patient and the family, the Staff Nurse III initiates the plan of care. Management is the process of leading and directing all Mrs. C. also thought that is not that serious she needs to go. grooming, feeding, and toileting. altruism, autonomy, human dignity, integrity, and social justice. I touched his arm and said Dont you worry, that is what I get paid to do. My IV skills are excellent, but over the course of his admissions multiple IV sticks became more difficult. By August, 6th T. required 230mg.hr to maintain comfort. Recognizing that the team as a whole is an integral part of any individual members effectiveness, this nurse fosters team effort with understanding that to provide patient care, every member must collaborate with the other nurses and physicians on the team. The EKG verified that the patient was in complete heart block. 8. He surely did not have his Mr. P smile and he was just not right. CHESAPEAKE, Va. Chesapeake Regional Healthcare (CRH) honored four outstanding nurses during its Nurse Exemplar Awards ceremony held Monday night. She asked me to make a promise that her husband could join her back in celebrating their 50th wedding anniversary to renew their wedding vow. While we waited the 5 for resting BP, he talked about how he had been feeling pretty tired for at least a month and just didnt seem to have any energy. 4. This was a case requiring more time than most and yet proved to be one of the most rewarding. That diagnosis did not prepare me for what would soon follow. (LogOut/ Letters of Recommendation Guidelines Letters should be legible, be brief, indicate the nature and dates of your association, state I recommend (candidates name) for Staff Nurse III, HH/H III, and address the applicants demonstration of the qualities described in the Staff Nurse III, HH/H III definition (reproduced below). During my assessment I observed the patient unable to stay focused and consistently looking at the corners leading me to speculate he was having hallucinations. The physician asked me to place a bulk type dressing to the head before the patient was transported to CT. I suspected that Mr. Y. was suffering from a thought disorder such as schizophrenia or schizoaffective disorder rather than a mood disorder such as bipolar. I showed the family that I was happy to assist them by treating them as I would my own family. I also initiated type and cross matching to be certain that units of blood would be available for my patient since the order was just typed and screened. A newer nurse would have been less effective in this role simply from discomfort with death, and the inexperience would leave this patient with a sense of loneliness and isolation. I asked how much she weighs and she said that she doesnt know but she is not so heavy. I noticed that Mr. Y. had poor eye contact and keep looking toward the corners either on the floor or towards the ceiling. All applicants that meet minimum qualifications are interviewed unless the applicant withdraws their application Interview Date _____________ Application Form: All sections of application form are filled out completely and accurately. He told me, I feel like I cant catch my breath, and Im hurting more than yesterday. Mrs. Kinney told me she was entrusting her husband to me. They announced that the counts were correct including the instrument counts. IV started and 324 aspirin given. I immediately called the Central Processing Unit to ensure that I had the instrument trays that we would need in case we did the case open instead of laparoscopic. in origin. alterations in perfusion in all types of clients and must detect finally, the larger organization. I gather all my data and in my SBAR presentation I described her symptoms and I emphasized that women at her age and menopausal, can have atypical chest pain. The Diagnostic and monitoring function was displayed when I had the foresight to see the extent of the patients injury, and anticipate the deterioration of the pats condition. You assume the role of teacher and your patient In the first week with this patient, it was apparent that his pain was growing at a rate the oral Methadone and Dilaudid could not control and his ability to swallow had begun to be compromised. For any Registered Nurse hired into a position of less than twenty-four (24) hours, the following calculations apply: Paid time is calculated by determining total paid hours for the year minus the number of vacation hours taken in week blocks. Doing what I thought was the impossible he had opened up to me about many things. Knowing that rapid blood loss could occur during kidney procedures, I prepared all my homeostasis agents. (Taylor et al., 2019), Spirituality is anything that pertains to a persons relationship with a If a person struggles with organization, interpersonal skills, humility, or nurse burnout, it's time to work on those areas. joining of the sperm from the male with the ovum from female), In this way you will be able to determine whether everything you wanted to convey is easily understood and that your story is clear. Phone (Work)___________________ (Home) __________________(Other)________________ 7. Everyone gathers in the break room for shift brief. I intuitively knew when to be with this patient and his family and when to leave them alone. I acknowledged her feelings of being overwhelmed and allowed her to express her frustrations. I stayed focused and organized at all times and was able to achieve the best outcome. Cognition Cognition is the brains ability to process, retain, and use I quickly had to focus on the current dilemma that she was experiencing. of the whole community, community-based care centers on individual and Zr|P%R(oW)GSZnKex&Eg"%,S@C)t^AMg~)*v)&Xft{::.M';LwdRj/w0d[y#xs[N8>YiOav`xd5vaAaf,{/r2q/%Iyr22L;v,0sv+\~a-|nav&f~_\ >7fs0i-u; PhX4US > va>!1)>9\`a}fP5T0X@,>Y6GU&aZ7-}=c n'4WgR-q,B++'.cwvbo~TbP 4ux$plUzZ90G,;4r.V'R.2x]ibe/lx`Rp|Kt; 5V5E*h1v5=?+a2HF&#GA`L^_ni!a:3j8 t]3\F67vx]F_J04o7@oB w`N$ xA^'Sr7,z J%4{Cf@LcE ABOUT THE FACILITY SELECTION COMMITTEE The Committee shall be co-chaired by Nurse Executive/DONP or designee and a Staff Nurse III/IV or HH III. A self-evaluation is a tool used to reflect on your current professional practice and progression to date. No one would have questioned my care and maybe even said good job in keeping Mr. Y. comfortable by dosing him with Ativan. in performing and directing client care, and then begin to visualize Collaboration Collaboration is functioning effectively within nursing and Assessed and stabilized patients in a fast-pace, 45-bed Level II trauma center; Administered critical care IV medications such as Cardizem, Dopamine, Insulin, Nitroglycerin, and Adenosine; problems and intervene early to prevent life-threatening I wasnt surprised to learn that she had an MI and BS of 435. She doesnt know what else to do. It is highly recommended that you address all questions in section 5: Clinical Exemplar in order to avoid having your advancement delayed. All of these or even one of these would have delayed her care which would have resulted in a very bad outcome. This paid time is then divided by number of weeks, which is calculated by taking the fifty-two (52) weeks in a year minus the weeks of vacation blocks minus California Nurses Association option week if taken, minus approved leave of absence up to three (3) months time. He even said that it could have been a wrong count if I didnt insist on finding the sponge. Individuals can find a mentor where they work or by networking with more experienced charge nurses. All my laboratory requisitions were ready in case anesthesia personnel needed it. This nurse guides patients through emotional and developmental change. The letter stated that my patient had been diagnosed with a subarachnoid hemorrhage and that the QA nurse wanted to thank me for my triage and comprehensive thinking. I reassured him that as long as he told me or his doctor what his wishes were, we would do our best to carry out whatever his wishes may be. This guide covers the most important traits for charge nurses to be effective leaders and improve patient outcomes. Impending shock was inevitable. This may have been acceptable, but not the right thing to do. She said her daughter seemed to be latching on okay and getting enough fluids. This nurse stepped back and stated, Im afraid to push his loose teeth down this throat or even worse make his fracture worse. csjessie In seeking letters of reference from colleagues, it is best to ask someone who can speak to your clinical practice. A charge nurse's role is difficult and often complicated. Antibiotics were started and he was transferred to BIDMC within 48 hours of arriving to the ED with what we thought was Mr. Ps usual chest pain. Promotes a multi-disciplinary approach to patient care. Mrs. B. had so many antibiotics and each day when her husband and family would arrive, I would take the time and patiently go over each category of medication and what each one did. Later she wakes up again with the same burning, drinks more water and goes to the bathroom to urinate. Performance evaluations are found on the MyHR website> KP & Me> Performance Management. This nurse knows the scope of the Staff Nurse III level of responsibility and with this understanding, acts in the patients best interest. It was clear that a new route of infusion was inevitable and by end of July we were coordinating a PIC line placement and reaching a whole new level of care. They are the circumstances that eventually become milestones to nurses (Harvey & Tveit, 1994). Nurses encounter potential and actual Facility No. Ask your manager or your C.N.A. Expand your skills with Care of the Acutely Ill Pediatric Patient Respiratory Bundle. Because I showed interest in her symptoms and patience to listen to her story, Mrs. C. seemed more willing to talk. (Norris & Tuan, 2020), Assessment Assessment is the systematic and continuous collection, analysis, In fact pt was speaking some English but I explained that for her comfort it will be better if we use a translator. I answered and Needham Fire came on line. Examples of health related community work are: a school demonstration project, involvement in a respite program, active participation in a health fair or health screening, teaching a first aid course. Applicant Name ______________________________ 3. 0000022826 00000 n Descriptions of additional professional contributions may be submitted in case one or more do not meet requirements. blood can shift and brain tissue comply. F j k l s nnY )hm h'k B*CJ$ OJ QJ ^J aJ$ ph %hm h)' B*CJ OJ QJ ^J ph &h= h)' 56CJ OJ QJ ^J aJ #h= h)' 5CJ OJ QJ ^J aJ hm h)' 5OJ QJ ^J h)' j h)' Uj h)' 5CJ U h)' 5OJ QJ (j hfQ 5>*OJ QJ UmH nH u h)' CJ( OJ QJ h)' 5>*OJ QJ While waiting for the Surgery to round, I proceeded to design different ostomy bags to cover and protect the surrounding tissues and catch the toxic draining before it interfered with her skin integrity As a Would Care Champion, I used my training and expertise to design and implement would drainage collection devices. This nurses confidence imparts trust to the patient and the patients family, who recognize that the Staff Nurse III is a competent advocate. I transferred Mrs. S. from the UV room to one of the dermatology treatment rooms, which is well equipped for skin diagnostics, but very limited for any other type of assessment. She left a lot up to The Lord and I teased her and mentioned that he might well know what her pain level was at any given time, but it would sure help me to remain in the loop. They would have dismissed it as sleep deprivation and anxiety over being a new mom and sent a message. The feeling of uncertainty, first because of his Renal Cancer and worst, the fear of impending lose of a loved one in surgery. Culture I believed that moving the patient back to the hospital was not the safe and appropriate action. The Teaching-Coaching Function: I was able to recognize that J. may have a more serious problem than she thought. It is common to find a lack of reflection on what has been learned from the Clinical Exemplars. ( Maintaining a flexible stance toward patients, technology and bureaucracy. I was able to support this family in their time of grief because I had support from my teammates. I recommended and facilitated a PICC line insertion so I would have a more permanent access and a way to draw the endless lab tests that would follow creating less pain and trauma for my patient. et al., 2019). Work in the area of clinical specialty with the Employer for the last two years. Family dynamics became uncomfortable at times but taking care of my patient included his whole family. of clients and must detect problems and intervene early to prevent life- xb```f``. @18p_DRqK{I-{pR>|&x4a`z`"So2]JVi& bn@ Worked as Home Health/Hospice nurse with the employer for at least three (3) of the last five years, or two (2) years as Home Health /Hospice nurse with the employer and one (1) year home health experience within a Medicare certified home health agency. gas (ABG) analysis is used to determine blood pH, and homeostatic Reciprocal compensation occurs among A narrative summary must be included highlighting the applicants strengths in clinical practice and/or professional activities. I had an uneasy feeling that we were missing something. His speech is rapid and unable to give us much of a medical history. The clerk told me that a patient had been dropped off in the ER waiting room. WebExemplar status is the highest of four possible program levels, recognizing our commitment to providing the highest level of geriatric care. I used that experience, my medical knowledge base, my extensive knowledge of COPS and stargate, past HX and the current symptoms to ensure that J. received the safest and timely care possible. needs. Almost intuitively, this nurse detects subtle changes in the patients condition. reason for your loss, the purpose of pain and suffering, the purpose of Mr. R.s healing was slow, dressing change after dressing change, antibiotics one right after the other. Blood loss brings about disturbance in fluid and electrolyte imbalance that could rapidly alter cardiovascular, neurologic and neuromuscular functions. Photocopies of CEs, CMEs, college credit certification, need to be included in the portfolio when the application is submitted. When do you anticipate seeing positive results, if you havent already? Continuing Education must be within the 12 months before the application deadline. Required Documentation/Checklist (it is recommended that you assemble your portfolio in the following order): Please be sure that your portfolio is complete prior to submission. Through a conversation involving the doctor, this patient, and myself; we decided on an action plan to control his pain which had started to increase daily. A less experienced nurse would have just sent a message since her symptoms did not warrant an emergent outcome or even an appointment. I could see that this nurse was nervous about placing an NGT tube but prepared for insertion by using a 16F NGT. Before, working in the ED, I worked in locked psychiatric facilitates for several years. Although I was initially impressed at Mr. L.s ability to speak and remain awake. r { X Y x^x They have several responsibilities, some of which include the geographic area, whether a small neighborhood within a large urban area Verification of Hours Paid Form (This form should be completed for any Registered Nurse who is NOT hired into a twenty-four (24) hour position or more) 1. WebRNss ppracttice. Responsible for communicating feedback regarding employee performance as issues arise. Her faith got her through the news, after her anesthesia wore off. J. denied any chest pain, swelling, fever, dizziness or heavy bleeding. Though my patient might need another blood transfusion, I knew that soon he could be with his wife again. The Staff Nurse III commands the respect of colleagues on the medical staff. WebYou're the charge nurse during evening shift. Classification ( Regular ( Short Hour ( Per Diem Average Number of Hours Worked Per Week____________________________________ (Use Verification of Hours Paid form if needed) (It is the nurses responsibility to notify the Facility Selection Committee if hours drop below 24 hours) RN clinical nursing experience (See minimum qualifications) Most Recent Listed First * (Include at least the last 5 years). Use This Template Alfie Jonas Charge Nurse 458 635 9654 alfie@hiration.com San Francisco, CA www.linkedin.com/in/alfie SUMMARY I told him that I was just speaking and acting on behalf of my patient. A mentor is an advisor and teacher who can guide an aspiring or new charge nurse. unique to particular groups. Being a cardiac nurse, I immediately placed a heart monitor on her she was in atrial fibrillation and I feared she was also becoming septic. He has a long history of PAD with severe lower extremity necrosis. She stopped taking it after losing her insurance. Common salary in the U.S.: $26.65 per hour. She told me she had never seen this type of injury and thanked me for the help and instruction. Normally we do not see the outcomes of ER visits, but a few weeks after this call I received a letter from QA. expectations that provides social structure for daily living. danger. Active participation in quality activities which must be of an ongoing nature with participation occurring over at least six (6) months of the past year, e.g., PPC, Safety Committee, organizationally sanctioned peer group or committee, RNQL. should result in a positive or rewarding Experience for the patient. It is vital to have patient evaluated as soon as possible. I went to check and see who could be there. professional organizations and by individual and group lobbying of For example, if a patient's behavior suddenly changes, it's important to determine if they are reacting to something in their personal life, dealing with a fluid imbalance, having a medication interaction, or suffering from an infection. As a charge nurse, you have to be resourceful and handle different issues beyond taking care of a set number of patients. (Monitoring and Ensuring the Quality of Health Care Practices) The Following Benners Domain will be addressed: The Helping Role The Diagnostic and Monitoring Function Monitoring and ensuring the Quality of Health Care Practices Exemplar #2 In the dermatology clinic, I have patients who come in regularly for their Narrow Band UVB (ultraviolet B wave) phototherapy treatments. goal through mostly noncoercive means; typically composed of a wide PAGE 41 PAGE 2 PAGE 2 Applicant Name: __________________________________ Date: ________________________ Unit/Dept/Shift: ____________________________ Facility: _________________ KFH TPMG Area of Specialty: Ambulatory Care Home Health/Hospice Hospital A s c o r e o f a t l e a s t 1 0 0 i s r e q u i r e d f o r a n a p p l i c a n t t o b e g r a n t e d a S N I I I / H H / H I I I c l a s s i f i c a t i o n . A Charge Nurse must be organized and communicate effectively with a team. The family told me that the patient was unable to push a call button and barely drinks 16 ounces of fluid per day. A charge nurse is a registered nurse lead that supervises a medical unit. As I heard the alarm in anesthesia cart. 0000002625 00000 n formation of a stable clot composed of fibrin to prevent excessive client and the nurse. R.N. By being sure that a patient does not experience retained foreign object in the body, we were ensuring that the success of the surgery that would lead to fast recovery. Once again teas flowed, we both cried. This includes considering each individual nurse's knowledge, skills, and abilities. Interpersonal skills are a non-negotiable asset that must be exhibited via examples throughout your resume. The administrator did not know anything about this patient.

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