Show in your exemplar how you used fine discretionary judgment and/or intuitive use of Knowledge. This nurse knows when to work with and through another person to achieve positive outcomes, when negotiating solutions with other, the Staff Nurse III is able to provide a rationale for recommendations and past actions. NAME AND LOCATION OF FACILITY 4. in which they simultaneously send and receive messages both verbally We use cookies and other tools to enhance your experience on our website and to analyze our web traffic. I believe a less experienced nurse would not have thought about hemorrhage since the symptoms were getting better. 10. Mr. P underwent an ERCP with a sphincterotomy and a biliary stent was placed for a small intra-hepatic bile abscess. I had to catch my breath and make sure that my face didnt reveal what my mind was thinking. I also needed to teach the family how to operate this pump at a pace which would provide them with the knowledge they needed to become independent, without causing anxiety in a situation growing in intensity. 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. By taking the time to wait for her while she met her daughters needs, I demonstrated I was her advocate by meeting her needs. Culture He stated, Please take away my pain, Im ready to rest and stop fighting. ADMINISTERING AND MONITORING THERAPEUTIC INTERVENTIONS AND REGIMES ( Starting and maintaining intravenous therapy with minimal risks and complications. Senior Nurse Writer I assisted her and taught her that following the ET tube, she could place the NGT without any further injury. geographic area, whether a small neighborhood within a large urban area She wanted a quick solution but intuitively I knew she probably would need more emergent care. Though all of these diagnoses are an Axis I in the Diagnostic and Statistical Manuel of Mental Disorders, they are not treated the same. As the anesthesiologist focused on maintaining the patients stability, he required my help and undivided attention to facilitate therapeutic regimen management. Additionally, the applicant must have a Mentor signature on their application to validate that all elements are complete The applicant must: Meet minimum qualifications (see previous page) Submit a complete application portfolio containing the following: Staff Nurse III or HH/H III Application Form with a required Mentors signature.. Verification of Hours Paid form (if applicable) Signed performance evaluation within the last twelve (12) months of application. As I heard the alarm in anesthesia cart. Ask your manager or your C.N.A. At the bottom of the page, you will find a link to View your Performance or Development history this link will allow you to print out all of your completed performance evaluations. You've got a message from ER about ad mission of patient suspected to measles within the next 30 minutes Chewing an ASA reduces the formation of blood clots thus maintaining the blood flow. In the following section I have included two exemplars to reflect an example of my clinical and leadership abilities in nursing. A day came when he asked me what would happen next, What happens when I cant talk anymore. She could take up to 10 at once with no relief. GRADE/STEP 6. In many units, the charge nurse monitors patient care, administers resources, schedules nursing staff, and assigns patients. hallucinations, and grossly disordered thinking and behavior The Deaconess Nurse of the Year is selected from the exemplars. And so our relationship began . 5. The patient and family needed teaching regarding the physical changes T. was experiencing and the emotional and spiritual impact of those changes needed to be considered. I answered and Needham Fire came on line. Choose a mentor from the local FSC mentor list. From years of nursing experience and a continued expansion of clinical knowledge, the Clinical Expert (SN III & IV or HH/H III) is a skilled practitioner who demonstrates leadership by: Identifying, communicating and fulfilling patient needs; Coordinating and utilizing facility and community resources to meet patient needs; Promoting a multi-disciplinary approach to patient care; Assuming a teaching-coaching role with other nurses and health team members, and; Maintaining a flexible approach to resource constraints. I then aged the Team Lead physician. C) The nurse witnessed the consent. a drug, despite the harm that it causes (Taylor et al., 2019). I explained everything to the charge nurse and requested that a one-time exception to the policy of no overnight guests be made. This was a case requiring more time than most and yet proved to be one of the most rewarding. I told her she could put me on speaker phone so she could effectively feed her daughter, which she agreed to do. A disclaimer to call back if her symptom worsens or others develop would end up this call. %PDF-1.6 % ventilation, respiration, and perfusion (Taylor et al., 2019). 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. You will have to manage staffing, shift schedules, and solve more complicated matters that arise during your shift. I then called the hospice medical director on that day and requested she call the ED doctor and coordinate the needed doses to get this patient comfortable. I know that all my patients deserve the best care that I can give them. APPLICATION FORMS STAFF NURSE III, HH/H III Application STAFF NURSE III, HH/H III APPLICATION FORM 1. I asked if the symptoms are related to meals, if she has them at night and how often. Relationship to Applicant: ( RN Peer ( Supervisor/Manager Dates: from ________ to _______ ( Health Team Member (MD, PT, Social Worker, etc.) Mrs. R. had brought him some home-made soups and such, which I encouraged because he was not fond of our food. His family arrived at that time. 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. I asked her when her sister in law would be there and if she could take her to the hospital if need be. + 5 > @ A n x y z { ! I could have done my morning assessment, made sure he was safe and fed, and left his treatment to that. While I was waiting for an interpreter I was looking in CIPS to find some information about 49 years old, Mrs. C.. Guidelines for Clinical Nurse III Portfolios, 2023 Beth Israel Deaconess HospitalNeedham |, CardioVascular Institute at BIDNeedham, Center for Wound Care and Hyperbaric Medicine, Joslin Diabetes Center Affiliate at Beth Israel DeaconessNeedham, Core Curriculum in Adult Primary Care Medicine, Pulmonary Medicine, Critical Care, and Sleep, Clinical Nurse Advancement Program Application , Develops solid nurse/patient relationships, Demonstrates the ability to care proficiently for patient populations within their unit setting, Works with patients, their significant others and health care team to identify goals and plans of care including transition of care, Makes sound decisions by analyzing and integrating all patient data and nursing principles, Evaluates patient care outcomes and revises plan of care as needed, Prioritizes needs of individual patients in relation to other unit activities, Uses current literature in daily clinical practice, Makes clinical decisions based on documented findings, Takes initiative for professional development beyond standard requirements, Attends in-services/presentations beyond the unit specific requirements, Utilizes appropriate patient teaching methods and teaching materials to address patient learning needs, Consistently models high standards of nursing practice, Demonstrates accountability in ones practice, Offers and accepts assistance to/from colleagues, Demonstrates the ability to reflect on ones own practice, Demonstrates effective and professional communication, Identifies issues and problem solves issues to ensure resolution, Supports colleagues, shares expertise, and serves as a role model, preceptor, and/or mentor, Promotes teamwork and a positive work environment, Promotes the development of collaborative relationships with peers and other health professionals through open, clear, and concise communication, Develops positive relationships with interdisciplinary colleagues, Application for Clinical Nurse Advancement, Two letters of reference written by peer colleagues (see Guidelines for Letter of Recommendation), Director endorsement via a narrative summary of most recent performance evaluation, Self-evaluation of professional performance. He then went on to say that Mr. P had been evaluated by 2 other ED physicians and we only admitted him to OBS because of the time of night. By the middle of the call Mrs. C. was able to understand what my intentions are and by the end of the call she trusted me and she followed my advice. Writing Exemplars word doc.doc - Microsoft Word Common salary in the U.S.: $26.65 per hour. Learning is the process by which a person acquires or increases Nutrition Nutrition is the study of the nutrients and how they are handled by the She told me that 6 years ago she used to tae a medication in the morning that made her urinate a lot. to minimize the effects of injury or infection, remove the damaged tissue, In a professional and competent manner I was able to educate and explain the risk of a brain hemorrhage after delivery and the possibility of this happening now. His overall appearance was clean, including his hair appeared washed and combed, and his nails short and clean. APPLICATION ONLY: DATES: FROM - TO AREA OF PRACTICE EMPLOYER 1. quality efforts are ongoing and that quality can always be improved WebAs a forward-thinking multi-award winning Trust and a digital exemplar committed to improving patient care, our world-leading research and innovations are having a positive local and global impact. The physician also asked another nurse in the room to place a Nasogastric Tube to decompress the stomach. Monitoring and Ensuring the Quality of Health Care Practices: OB-GYN is not my specialty, but I have taken approximately 7,000 calls over the last 8 years in this queue. I was able to preserve this mans sense of dignity and personhood through my expertise and presence. Who was affected by the work that you achieved? 0 It ddescribes in detail a particular clinical situation that includes the nursess thhoughtts, feelinngs, intentions, For example, Nursing He came to my unit for reinduction chemotherapy. He ordered Ativan 1 mg oral or sublingual every 4 hours as needed for shortness of breath. Ted was started on thirty mg/hr and was receiving tremendous relief. I was willing to have Mr. P admitted and have a negative work-up than for him to be discharged and return critically ill. I was able to pass this data on to ED physician and the Psychiatric services LCSW who came to assess Mr. Y.. I realized Mr. P was unable to express his concerns or fear about his discharge. 0000000872 00000 n Critical thinking is an approach to thinking that is systematic, I explained to him that I could give him more medication, though it may make him sleepy and even slow his breathing to an extremely low rate, one where he would most likely lose consciousness. However, charge nurses can go by different titles which may affect salary. As I was continuing to assess and talk with J., her daughter started crying. According to the Bureau of Labor Statistics, the median annual wage for registered nurses in the United States which includes charge nurses was $73,300 in 2019. List of concepts and examples. abilities are essential for many important tasks, including making He has a long history of PAD with severe lower extremity necrosis. and communities, and is apparent in the attitudes and institutions Her current admission to 4E had been in response to her diagnosis and pancreatitis after her knee replacement. An honest evaluation can help pinpoint the education, information, and training needed to develop stronger skills. Candidates will be asked to clearly present either one or both exemplars. I made my rounds with my other patients, and noticed Mr. Y. has not moved since that last time I observed him. The Helping Role I was able to help my patient at the time he couldnt take care of himself. WebVA Department of Veterans Affairs PROFICIENCY REPORT SECTION A - INDIVIDUAL REPORTED ON 1. A charge nurse must understand staff members' skills, abilities, and knowledge to appropriately delegate tasks and procedures. I stayed to help get Mr. P triaged; this was fairly quick for me since I had taken care of him so many times. 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). WebRNss ppracttice. I instructed both surgeons to look for it as well as the surgical tech. She returned two months later to invite me to her Church to witness what she called Her Affirmation to God. This helped to ensure the therapeutic required to help this patient. The nurse must practice within these prescribed boundaries, as well as I assisted in maintaining the pts airway during and after the intubation. I knew the fear and frustration this family was feeling about it their mother was going to be safe and have her pain controlled. Please use additional pages if needed or replicate this format in a separate document. Communication behaviors in clinical settings have been studied through observation, 9 self-report logs, 810 and ethnographic 13 methods. She was drinking a lot of water, took two times Mylanta offered by one of her coworkers but the burning doesnt go away. In her case acting fast it will be the only way to prevent her deterioration. The MD voiced a concern that if I was the front line person and I was wrong, I would be the person experiencing the manic patient first hand. Licensure, DHHS, DHSR), Inflammatory Bowel Disorders I took the time to really listen to her history and her feelings. When she had insurance she had one and it worked for her. I anticipated based on the injuries that things could change very quickly. Phototherapy, or light therapy, is exposure to specific wavelengths. (Taylor, et al., 2019), Culture Culture is a shared system of beliefs, values, and behavioral Without a leader with strong organizational skills, a unit can spiral into dysfunction and disorder. Attend a Facility Selection Committee meeting for interview and presentation of exemplar(s) and clarification of other parts of the application portfolio if needed. In the best interest of this patient I was able to adapt when she needed to breastfeed her daughter and put me on speaker phone. Manager _________________________________Cost Center_______________________ ( Manager informed that applicant is applying for SN III or HH/H III. Mrs. S. was an elderly frail woman. After a week of hearing there was no way to get this patient scheduled, I took this case to the managers of the radiology and self care learning departments. This is why I was amazed he was awake and attempting to speak. and Diseases, Multiple Organ Dysfunction Syndrome (MODS), Acute Respiratory Distress Syndrome (ARDS), Chronic Obstructive Pulmonary Clotting Clotting is the process whereby platelets circulating in the Give concrete illustrations of how you met your outcomes. I was stunned by the turn of events, bleeding became significant; both surgeons attempts to control bleeding were unsuccessful. Friendly and extroverted, she had shared much of her personal life and appeared comfortable with me and confident in my judgment and skills. ii Teaching Activities Community teaching must be voluntary. During Hospital Week the nurse exemplars are additionally recognized at the annual service awards banquet. 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Culture he stated, Please charge nurse exemplar away my pain, Im ready to rest stop... Per hour best care that i can give them and talk with J., her daughter crying! Many important tasks, including his hair appeared washed and combed, and Knowledge to appropriately tasks! To speak and clean his concerns or fear about his discharge up this call at with! During and after the intubation couldnt take care of himself would not have thought about hemorrhage since symptoms...