When he arrived in the procedure room, he did a quick assessment of the patient, called the ED and advised that the patient would be coming over ASAP. I found out that indeed the surgeon had one in his hand but the other sponge was not on the drape. 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. Relationship to Applicant: ( RN Peer ( Supervisor/Manager Dates: from ________ to _______ ( Health Team Member (MD, PT, Social Worker, etc.) J. wanted to stay home and be with her 3 day old newborn, she did not want to leave her daughter. Responsibility of Applicants Provide the best possible documentation of his/her clinical practice, leadership, and professionalism to the Facility Selection Committee ahead of or before the deadline (March 1, July 1, or November 1). 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. All my laboratory requisitions were ready in case anesthesia personnel needed it. Charge nurses must generally possess excellent skills in communication, organization and leadership. All of these or even one of these would have delayed her care which would have resulted in a very bad outcome. They announced that the counts were correct including the instrument counts. The Staff Nurse III, then, draws not only upon past experiences but also upon inquisitiveness, intuition and an organized use of the nursing process to anticipate problems and intervene before the patients condition deteriorates. The letter should reflect the following areas of practice and include specific examples of how the applicant demonstrates expertise in each of the following areas: Please feel free to contact Heidi Alpert x33879 or any other member of the CN III Review Board for assistance. A less experienced nurse would have just sent a message since her symptoms did not warrant an emergent outcome or even an appointment. I told her I was sorry she was having these HAs and I would do everything I could to get her help. She couldnt remember the name of it. Duties and Responsibilities. The Role of Mentors As an applicant for Staff III/IV, HH/H III, you must select a mentor to assist you in the application process. Discover potential problems that may arise if the rule is approved. Impending shock was inevitable. X-RAY prior to the Endoctracheal Tube placement didnt show a bullet lodged anywhere in the facial region. WebClinical exemplars can be defined as a way nurses share their experiences in the clinical setting to identify the significance of caring that is essence in the nursing profession. Attending his funeral, which was very difficult for me, I felt compelled to stand up and speak on behalf of my brief encounter with this incredible person. She just wanted a message and something stronger for her pain but I intuitively knew something more was going on her and I felt she needed more urgent care. I went to check and see who could be there. By August 11th T. began to decline rapidly and as the cancer invaded his brachial plexus and it was becoming evident something more than morphine was needed to achieve comfort. The simple task of scheduling a PIC line placement now became a serious nursing challenge. I determined that it was and scheduled an urgent appointment for her with the on-call physician in the Medicine Department. Upon entering her room and greeting her with what I say to each and every one of my patients each day at handoff, Hi, I am Denise, and I get the privilege of being your nurse today. The Local Facility Selection Committee will maintain current listing of Mentors. I asked the clerk what was going on after hearing a cry for help. The Staff Nurse III draws upon the patient, family and significant other as resources. She is a janitor and does a lot of physical work. I instructed both surgeons to look for it as well as the surgical tech. Remember the important elements who, what, when, where, why, and how, and be sure to incorporate them into your story. perception, attention, comprehension, and memory. At the end of the call you may have an ER recommendation, and appointment, advice or other dispositions. She couldnt get in touch with her husband but one of her coworker agreed to drive her. health care for its inhabitants (Taylor et al., 2019). past experiences, and sociocultural influences and expectations. I intuitively knew when to be with this patient and his family and when to leave them alone. Fifteen (15) CEUs in her/his area of clinical specialty in the past year. 3. It ddescribes in detail a particular clinical situation that includes the nursess thhoughtts, feelinngs, intentions, actions, critical thinking, and decision-making process. I was able to support this family in their time of grief because I had support from my teammates. TThe exemplar is written in the first person. High risk patients (HBP, Diabetes, High Cholesterol, Obesity, family history of heart attack) with typical chest pain should be evaluated in ED. I went through the process of hooking up the tube feedings; knowing all too well that her recovery would be slow and the probability of her going home on tube feedings was very real. Below are some guidelines to assist in writing a recommendation. g paid time): Application: I year total hours ________/week. A less experienced nurse would have not waited while she confirmed care for her daughter. I implored her to be patient and answer a few more questions. Please describe and critique your current nursing practice in a Clinical Exemplar. The Nurse of the Year will be revealed on May 13, 2015 in the Deaconess Legacy Conference Room at Nurses are advanced to Clinical Nurse III based upon proficiency in clinical performance. The one thing all these admissions had in common was his request for me to be his nurse. There are a group of H2 blockers that block acid production in the stomach and they are also OTC: Pepcid AC (Famotidine), Cimetidine (Tagamet HB) Ranitidine (Zantag 75). I knew the fear and frustration this family was feeling about it their mother was going to be safe and have her pain controlled. problems and intervene early to prevent life-threatening She stated that she would have tried to perform a tracheotomy if the intubation was not successful after one attempt. It had become evident that the family was becoming overwhelmed with his care and the MSW worked with the family to get care giving for four to six hours per day. 2. However, charge nurses must show the willingness to learn and seek out those who can teach them. I felt that I can connect her last night symptoms to cardiac ischemia but I needed more information to confirm it. She said no to all. The physician asked me to place a bulk type dressing to the head before the patient was transported to CT. Knowledge of the patients past medical history is important, but it is equally important to maintain your objectivity and to make no assumptions. 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.) It only took that statement and a short conversation that followed to realize that she was a very spiritual person and I would definitely need to include her beliefs in my plan of care. Facility No. Instructions: Please complete this form and return it to the applicant before __________ (date). She said she felt fine the next day but then woke up last night with another severe HA. Staff Nurse I Staff Nurse II Staff Nurse III Shelanda Baichoo Maureen Carrier Beth Norton Julie Chevalier The intubation began was successful without compromising the airway. Interested in presenting at NTI? d) Effective Management of Rapidly Changing Situations- Contingency management: Rapid matching of demands and resources in emergency situations T.s admission to the ER was clear example of my ability to use resources and coordinate with the patients goals as my guide The following Benner Domains will be addressed: The helping role The teaching-coaching function The diagnostic & ensuring the quality of health care practices Monitoring & ensuring the quality of health care practices Administering & Monitoring therapeutic interventions & regimens EXEMPLAR #9 Mr. R. is in his 70s and was admitted with diabetes and peripheral neuropath. When I assessed his abdomen, he was slightly tender with positive bowel sounds and he continued to complain of slight nausea. Anxiety Anxiety is a vague feeling of dread or apprehension, in response Then you put relevant pieces together and solve the mystery. In nursing terms you make the best disposition that fits patients needs. While I was waiting for an interpreter I was looking in CIPS to find some information about 49 years old, Mrs. C.. Culture Your staff is experienced nurse 49 y.o. 3. Management is the process of leading and directing all Describe in the exemplar, how you personally made a difference. Monitoring and ensuring quality: In this situation, the knowledge that complete heart block is not a stable arrhythmia guided my decisions. I Just Dont Feel Right. A Story of Ms. X. 6. The Facility Selection Committee is comprised of: Nurse Executive, Director of Nursing Practice (DONP) or designee 2 RN managers (appointed by the Nurse Executive/DONP or designee) 1 Staff Nurse III (minimum) 1 Staff Nurse actively involved in a professional committee 2 Staff Nurse IVs or HH II or III Alternates: a substitute in the same category to be used as needed. GRADE/STEP 6. (Taylor, et al., 2019), Culture Culture is a shared system of beliefs, values, and behavioral A self-evaluation is a tool used to reflect on your current professional practice and progression to date. Her parents live in Mexico and 2 yrs ago when she visited they were fine. Oxygenation refers to the process of providing cells with oxygen Whether the patient is not responding to a particular therapy, this nurse has an inquisitive need to search continually for the reasons. Registered nurses must be knowledgeable and skillful in performing the charge nurse role. r { X Y x^x development of the fetus within the uterus, and birth. 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. Her passion fo Nurse Leadership Careers & Salary Outlook, Best Online MSN in Nursing Leadership Programs, Clinical Nurse Specialist (CNS) Career Guide, Do Not Sell or Share My Personal Information, 2023 NurseJournal.org, a Red Ventures Company. WebThe median annual salary of a charge nurse is $68,911, according to PayScale. Clinical decision making is purposeful, goal-directed effort applied F You can structure the narrative of your self-evaluation in whatever way is most meaningful to you. and novice nurse 27 y.o. I got a call one day at Kaiser from the facility requesting that I stop by to see him. Only last night she got scared because of a bad dream that woke her up in cold sweats and she couldnt catch her breath to wake up her husband. She said no. Coping behaviors may be positive or negative in terms of how they GRASP Special Projects/Presentation Standardized Care Plan/Clinical Pathway Health Related Community Organization/Service (community service must be voluntary) Mentor one new graduate RN for up to eighteen (18) months within the last thirty-six (36) months, in accordance with contractual provisions in Section X Other Examples of written standards of nursing care are: the actual writing of a standard or involvement in the annual review of the same; the writing of a policy or procedure. We hear the news: the ED is holding three medical/surgical patients, one telemetry patient, two critical patients receiving mechanical ventilation, and five psychiatric patients. After receiving report I was able to visual see Mr. Y. from the nurses station. I made sure I coordinated with pharmacy to ensure there was never a short supply of medication, arranged dressing changes during a routine weekly visit, communicated changes with after hours and weekend staff so crisis were managed and changes in condition were coordinated smoothly thus minimizing stress for the family. Type the exemplars in a clear, professional, understandable style. Skilled, experienced practitioner Demonstrates leadership. The following Benner Domains will be addressed: The helping role The teaching-coaching function The diagnostic & ensuring the quality of health care practices Monitoring & ensuring the quality of health care practices Administering & monitoring therapeutic interventions & regimens Exemplar #10 I can still remember the first time I set eyes on Mrs. B.s chart. Please use additional pages if needed or replicate this format in a separate document. Mr. R. ended up with bilateral below the knee amputations. ( Interpreting kinds of pain and selecting appropriate strategies for pain management and care. It was wonderful to see her personality start to immerse. Work in the area of clinical specialty with the Employer an average of twenty-four (24) hours per week over the past year. Coping is any behavior that is used to decrease stress and I started by reviewing my patients record in Health Connect and found out that my patient was a 72 year old male. A mentor can be either a member of the Facility Selection Committee or a Staff Nurse III/IV, Home Health III who can offer suggestions to improve the application portfolio of staff prior to submission. Joelle Jean, RN, FNP-BC has been a nurse for more than 10 years and family nurse practitioner for over three years. These signatures certify that calculations are correct as of the specified date. Newly diagnosed atrial fibrillation, receiving blood thinners, waiting admit to a telemetry bed. By now I knew that I have to ask questions. (Taylor et al., 2019), Functional Ability Functional ability is a persons ability to perform activities of daily I will achieve my CEN within the next six months. Ask for timely assistance from a mentor or Facility Selection Committee members. disabilities, sexual orientation, health insurance, and access to health care The urgency in her voice, the last night bad dream that gave her cold sweats and shortness of breath, an achy arm since morning, all could be very well signs of cardiac ischemia. She stated she wanted to try an Ibuprofen first and was going to call afterwards if the HA did not get better. The quality and content of the material presented in your portfolio is what will be reviewed. 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. 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. I started searching the floor and all areas of the drapes. When she had insurance she had one and it worked for her. I knew I was taking a risk that I could have been wrong but it was well worth the risk when I had such a strong conviction we were missing something. Knowing T. did not want to be in the hospital, I reassigned my patients for the day and began coordinating a new PIC line placement and transfer to home. She agreed. The Staff Nurse III or HH/H Nurse III will apply for renewal at the end of the three (3) year classification. Almost 30% of RNs work in such nonacute patient ADMINISTERING AND MONITORING THERAPEUTIC INTERVENTIONS AND REGIMES ( Starting and maintaining intravenous therapy with minimal risks and complications. specializing in Geriatric care for 8 years with a proven track record in dementia care. Current performance evaluation at the mid-point or above on average. Needham, Massachusetts 02492. I was one of his primary nurses this admission, partly because of the complexity of the care required with the chemotherapy administration, and partly because I had earned this patients trust on a prior admission. This compensation does not influence our school rankings, resource guides, or other editorially-independent information published on this site. I knew this patient and his family would take a great deal of my time, so I enlisted my coworkers to assist with my other patients needs in case I was unavailable. hallucinations, and grossly disordered thinking and behavior (Hinkle & Cheever, 2018), Health Policy Health policy refers to the laws that a nation establishes to After introducing myself to them, I began checking Mr. Kinneys identification bracelet, consent form, and operative site marking. I wasnt convinced at all, I told both surgeons not to close the cavity yet until I had a visual of the 2 missing sponges. Formal In-service/Presentation Informal In-service/Presentation Community Teaching (community teaching must be voluntary) Health care related research Development and/or presentation of patient education programs. Names of the Facility Selection Committee Members will be posted on the Associations bulletin board in each facility. I was also able to be a confident and caring advocate for her 3 day old daughter as well, as the best care for the baby would be a healthy mother. I told them that unless I see it physically it was always a possibility that it was still inside the patient. Critical thinking is an approach to thinking that is systematic, To meet this goal I first needed to realize this was a first time mother of a 3 day old newborn who was sleep deprived, overwhelmed and in pain. WebCharge Nurse Resume Examples. Exemplars include information about any of the following: how you felt about the situation why you felt that your actions were important; why the actions were important; why the actions may have been different from someone with less experience Describe in the exemplar, a clinical situation that was positively impacted by your practice. Progression His speech was no longer rapid but tangential, requiring several incidents of prompting to stay focused on the subject at hand. 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