Nursing; Feeling; University of Massachusetts, Boston NUR 347. (LogOut/ Learning is the process by which a person acquires or increases 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). Nursing staff, patients, and management are more likely to engage with and take advice from a respectful charge nurse. (Norris & Tuan, 2020), Assessment Assessment is the systematic and continuous collection, analysis, I quickly prioritized my patient load so as I would not be interrupted in the middle of Mr. R.s would care. ( Interpreting kinds of pain and selecting appropriate strategies for pain management and care. An effective charge nurse uses critical thinking to quickly assess and decide if immediate action must be taken to protect the patient's health. The Staff Nurse III grasps the whole picture and so is in control of the situation, able to create order out of chaos. 10. Little did I know that during this affirmation she would call me up to the altar and introduce me to her congregation as The Angel that God had sent to her. The night shift informed me that Mr. P ruled out, as both sets of troponins and both EKGs were within his normal limits. If the nurse goes on non-paid status (no sick leave) the leave of absence cannot exceed three (3) months. Admission, discharges, and intensity of patient care can create chaos within minutes. Telling him not to be scared that it was okay for him to let go was one of the hardest things I ever had to say. Home Health/Hospice III only A current license to practice as a Registered Nurse in California. It was around this point in his care he started needing increased assistance with his ADLs so I assessed the need for a HHA and a referral was made. Below are some guidelines to assist in writing a recommendation. Charge nurses need high organizational and critical thinking skills to successfully handle sudden issues that may come up. The surgeon started dissecting and everything turned out to be smooth again. Webnurse acts as an advocate by protecting the personal rights of clients and providing all necessary information so that clients are able to make informed decisions. I was delighted for making the right decision and happy for Mrs. C. that she got there just on time. You will have to manage staffing, shift schedules, and solve more complicated matters that arise during your shift. Attend local workshops for applicants. This top honor receives additional recognition and awards. I took the time to elicit and understand her interpretation of her illness and that having a newborn to care for may cause her to minimize her symptoms. Although I was initially impressed at Mr. L.s ability to speak and remain awake. 9. No one expects perfection, but charge nurses should not try to cover up their mistakes. to minimize the effects of injury or infection, remove the damaged tissue, i. My patient and his wife were both counting on me. The Applicant-Mentor relationship is required, and, ideally, the relationship would start at least one month before the application deadline. Coagulation (DIC), Attention Deficit Hyperactivity rights & duties in legal matters are better able to protect themselves They must also be competent in making quick decisions, evaluating the quality of patient care, resolving conflicts Candidates will be asked to clearly present either one or both exemplars. The NGT was placed successfully after the first attempt. 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. body, as well as the impact of human behavior and environment on the Unit/Shift _________________/___________ Facility__________________________________ Phone: WORK___________________ HOME___________________ OTHER______________ R.N. WebNursing recognition occurs on many levels and in many ways. Which action by the charge nurse is most Technical skills are the manual skills needed in nursing to handle If there had yet been an appropriate time to step out of my shell and attempt to be a leader, it certainly did not seem to be in the midst of almost constant crisis and occasional chaos. J. denied any chest pain, swelling, fever, dizziness or heavy bleeding. At the door, was an elderly, though healthy appearing man who said he had just stopped by to get his BP checked in the Health Ed office. I quickly had to focus on the current dilemma that she was experiencing. In her case acting fast it will be the only way to prevent her deterioration. I was always a step ahead helping everyone in the team. Choose a mentor from the local FSC mentor list. He said sewing her intestines up is like sewing together cubes of butter. Her pulse was irregular. The ED MD thanked me for my good suggestion in performing a tracheotomy versus intubation. 0000001561 00000 n These tests are run 6 hours after the initial set of labs, meaning they were not drawn with result back until after 2300. PROBATIONARY REVIEW 8. Licensure, DHHS, DHSR), Inflammatory Bowel Disorders The MD disagreed at this point and stated her plan was to use a fiber optic scope as she placed the ET tube. I sat at his bedside, holding his hand. 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! Now faith in God is great, but I had to constantly encourage her to verbalize to me her discomfort and pain. By the first week of July T.s tumor was not palpable and visible in this chest and his pain had increased his need for morphine to 110mg/hr and was beginning to have indurations at the sub q sites. WebAbstract. I knew that it was going to be a long day but I love doing urology cases after all. the nurse and the client during which the nurse focuses on the clients ( Combating the hazards of immobility: Preventing and intervening with skin breakdown, ambulating and exercising patients to maximize mobility and rehabilitation, preventing respiratory complications. Caring for Mr. R. became tricky at times because he had six children from a previous marriage. I gave a detailed report to the recovery room nurse. ii Teaching Activities Community teaching must be voluntary. Date________________________ Unit/Shift_________________________Facility___________________________________ 4 Mailing Address ___________________________________________________________ 5. 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. As I continued to follow Mr. P, he had increased confusion, changes in vital signs and increasingly abnormal liver studies. Disorder (ADHD), Regulatory Agencies (OSHA, The exemplars must be reflective of events that occurred in the last twenty four (24) months. I became the point of care for this mans treatments. standards, and, as a result, well-reasoned (Taylor et al., 2019). and nonverbally (Videbeck, 2020). Verification of Hours Paid Form (if applicable) Performance Evaluation within the last 12 months at midpoint or above on average. (Norris & Tuan, 2020). I asked her how her daughter was doing and if she was having any trouble breast feeding. WebWhat is an exemplar? She stopped taking it after losing her insurance. sweating) or to preserve warmth through vasoconstriction and ( Building and maintaining a therapeutic team to provide optimum therapy. I gave him an idea of how he would be positioned during his surgery. The Ativan was not going to do that, just imprison him with his hallucinations. These are just some examples of questions to ask yourself as you write your exemplar. against liability or loss of professional licensure. Are you seeking a leadership role in nursing? assumes the role of learner when there are identifiable learning During this time I gained experience from people suffering at different severities of their mental illness. The Staff Nurse III intuitively recognizes similarities and differences between situations and accordingly modifies the teaching plan to meet individual needs. I was able to discuss with him the process of dying, answering questions as he would process the information. My assignment was a general float RN (someone who assists in helping the whole department). My experience with Mr. P reinforced my core belief that I always need to be my patients advocate. I knew I could not let Mr. P be discharged. American Association of Critical-Care Nurses. By taking the time to wait for her while she met her daughters needs, I demonstrated I was her advocate by meeting her needs. %PDF-1.6 % A charge nurse is responsible for the effective performance of a particular nursing shift or team. Charge Nurse Emergency Room and Trauma Unit, 2017-2020 Mary Mount Hospital, San Francisco, CA. The Staff Nurse III is available when the physician makes rounds, partly to contribute pertinent information towards formulating the plan of care and partly to gather information that might help the patient and the family to better understand the situation. range. Additional exemplars may be submitted in case one or more do not meet requirements. Paid time divided by number of applicable weeks equals paid hours per week. X-RAY prior to the Endoctracheal Tube placement didnt show a bullet lodged anywhere in the facial region. 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. WebLeadership Exemplar March 2013 (10 months into nursing school): For my second Med/Surg clinical, I worked in the Emergency Department, an assignment I requested. This nurse does whatever is possible to integrate the patients beliefs and practices into the plan of care. I assisted her and taught her that following the ET tube, she could place the NGT without any further injury. I explained to Mrs. C. that her symptoms may be related to her heart. Knowledge of the patients past medical history is important, but it is equally important to maintain your objectivity and to make no assumptions. The charge nurse role requires diligence, patience, and skill. This nurse takes responsibility for the team itself by building and nurturing it. 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. I knew that at that moment I would need to meet my patients need as well as his family on a personal level. 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. Leadership roles can be in the form of a charge nurse, a unit manager, or other leading positions within nursing. Informatics is the use of information technology to improve the quality, These cognitive He denied any shortness of breath but he had some slight nausea associated with this event. If you give a benzodiazepine such as Ativan, to a schizophrenic, you slowed the body, but not the mind. Name_______________________________________ 2. These guidelines were developed to assist you in assembling the various components of your professional portfolio. Interpersonal skills are a non-negotiable asset that must be exhibited via examples throughout your resume. The nurse informed me the IV push was every thirty minutes and did not feel comfortable requesting more. public health nursing, which are population-based and focus on the health He looked worried and replied, I have no feeling in my feet. affect ones health. The person using these methods is the teacher. While the following seven traits are important to many leadership positions, they are essential for nurses who care for and protect vulnerable patients. ( Experiences of an illness: Anticipating patient care needs. F j k l $ ` a$gdL $ ` a$ gdm :]:^ $a$ After the flurry of activity, I noted the patient appeared to be quite restless in the bed. The Helping Role I was able to help my patient at the time he couldnt take care of himself. I listened and encouraged her to voice her religious convictions, so she could re-affirm her belief system without giving criticism or judgment. After assessing the patient and not really coming to a clear outcome I felt uncomfortable with giving her an appointment or a message. Mr. R. ended up having his left foot amputated after he received a diagnosis of MRSA. quality, efficiency, or delivery of health care (Hinkle & Cheever, 2018). 6. At the back of my mind, I knew the promise that I had made to my patient and his wife. 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. The attending said a low grade temp was not of concern and it was ok to send him home with this as all of his other vital signs were within normal limits and his cardiac work-up was negative. altruism, autonomy, human dignity, integrity, and social justice. the activities involved in managing the work environment and, 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. Through an intuitive use of knowledge, fine discretionary judgment, experience and leadership, the Clinical Expert is able to provide the best possible patient care in a safe environment. familiar with the applicant's practice Each letter must meet all of these criteria: - Indicate nature & dates of association - Clearly recommend the applicant for SN III - Address 5 key concepts CEU Documentation: 15 CEUs in clinical specialty in the past year Exemplars: Two exemplars reflective of events in the last 24 months Exemplar #1 Exemplar #2 Each exemplar must meet all of these criteria: - Identify the 3 domains addressed at beginning of exemplar - Demonstrate how applicant functioned in the identified 3 domains - Describe any of the following: how applicant felt about situation, why applicant felt actions were important, why applicants actions were important , why applicants actions were different from someone with less experience . 1. NUR 347. Patient education must be more than that provided by most Staff Nurse IIs on a day-to-day basis; it requires that a patient education program, pamphlet, handout, etc., be developed, revised, and/or taught. (Taylor et al., 2019). Fifteen (15) CEUs in area of clinical specialty in the past year. All of a sudden Mrs. Kinney became emotional, she just burst into tears and began holding her husbands hand. information on which to base their decisions. Recognizing their need for spiritual support, I made arrangements and facilitated the movement of several patients so he could have his privacy and experience his cultural/spiritual rituals without offending other patients. 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. 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. Some salaries range from $16.33 to $36.11 per hour. It takes an individual who possesses clinical nursing competencies, compassion, and empathy. WebRNss ppracttice. Staff Nurse I Staff Nurse II Staff Nurse III Shelanda Baichoo Maureen Carrier Beth Norton Julie Chevalier Applicants may request a regional appeal in writing (e-mail is ok) within 30 days of the FSC appeal decision to Matt Boyer, C.N.A., 155 Grand Ave, Oakland, CA 94612, mboyer@calnurses.org AND Jyotsna Battle, Kaiser Permanente, Patient Care Services, 1950 Franklin St, 17th Floor, Oakland, CA 94612, HYPERLINK "mailto:Regional-Appeals-Committee-NCAL@kp.org" Regional-Appeals-Committee-NCAL@kp.org The applicant should include their facility, their mailing address, and the reason for their appeal (clear and convincing evidence of procedural error or bias). She said her daughter seemed to be latching on okay and getting enough fluids. Mr. R. was eventually sent to a rehab facility to learn to use his prosthetic leg. Fortunately she arrived there safely. It is a testament to my practice and professionalism that Dr. S quickly responded to my concerns regarding Mr. P. Without hesitation Dr. S went and re-assessed Mr. P. Upon his reassessment Dr. S. also noticed that Mr. P. grimaced when he palpated his abdomen and Mr. P verbalized that his stomach hurt. All applicants that meet minimum qualifications are interviewed unless the applicant withdraws their application Interview Date _____________ Application Form: All sections of application form are filled out completely and accurately. This may include soft skills for nurses like the ability to motivate others or strong communication. She told me she had never seen this type of injury and thanked me for the help and instruction. of sadness and yearning), social (feeling detached from others and She had plenty to deal with already she sure didnt need diarrhea. I asked my patient about any concerns that he might want to clarify with me. 5V5E*h1v5=?+a2HF&#GA`L^_ni!a:3j8 t]3\F67vx]F_J04o7@oB w`N$ xA^'Sr7,z J%4{Cf@LcE This is why I was amazed he was awake and attempting to speak. The center even incentivizes nurses joining particular units via a net sign-on bonus of $3,000, while in the same vein clinical nurse specialists and nurse practitioners can earn an impressive $8,000. Interested in presenting at NTI? Temperature was low-grade 100.4, he was in a sinus rhythm with regular respirations and lungs were clear upon auscultation. Because of my education and experience, I am able to observe even small subtle changes in their demeanor, voice, color etc. (Teaching-coaching function) Once I identify that her symptoms are life threatening I took action consulting with CCMD and making the recommendation to have patient evaluated in Emergency Room. In contrast to community health and It was not for me to question their rituals. In this case my time was already over twenty five minutes. Descriptions of additional professional contributions may be submitted in case one or more do not meet requirements. The Staff Nurse III relies on past experiences to identify clinical signs and symptoms that predict a possible life-threatening situation. education you need could be more affordable than you think. 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 Staff Nurse III draws on knowledge of the literature and of other expert opinions to recognize when a patients cultural background influences the response to care and to the illness. Those interested may also seek advice and support from online resources, or ask nurses in positions of leadership. She stated that she would have tried to perform a tracheotomy if the intubation was not successful after one attempt. She stated to me that she is not sure they are related because I felt fine all day yesterday. I asked her how she was feeling during the call and she said her HA was mild to moderate but she was able to function. With the help of a translator I found out that she lost her insurance about 6 yrs ago. A strong charge nurse is flexible in distributing resources as the unit's patient population changes. Anticipating that the current orders would not be sufficient to control his pain and air hunger, I paged the MD in charge of his care and requested an increase of medication, informing the physician that I felt that death was soon to come, but this patient needed more pain control than currently managed. He had been admitted to our OBS unit over night. reason for your loss, the purpose of pain and suffering, the purpose of During the interview: Candidates will be asked to answer questions about any aspect of the portfolio contents in a clear, knowledgeable, and succinct fashion. ( The coaching function: making culturally avoided aspects of an illness approachable and understandable. I went to check and see who could be there. Complete the online application form on our website. These traits allow a successful charge nurse to coordinate work and resources, meet changing requirements, and help their unit produce positive patient outcomes. CONCEPTS FOR LETTERS OF RECOMMENDATION All five (5) of these concepts must be addressed in all three letters of recommendation: 1. Nursing exemplar.pdf. 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.) Patience, and, ideally, the relationship would start at least one month before the application deadline therapeutic! Happy for Mrs. C. that her symptoms may be submitted in case one or more do not meet requirements ruled... Help and instruction assisted her and taught her that following the et Tube, she just into! Not successful after one attempt her deterioration Registered nurse in California nurse, a unit manager, or nurses. Up having his left foot amputated after he received a diagnosis of MRSA ( someone who assists in helping whole... Per week i went to check and see who could be there have tried to perform a tracheotomy if intubation! You need could be there the intubation was not for me to question their rituals you a. Strategies for pain management and care on many levels and in many ways OTHER______________! To use his prosthetic leg doing urology cases after all NGT without any further injury upon auscultation ( 15 CEUs! With his hallucinations temperature was low-grade 100.4, he was in a sinus rhythm with regular and... Even small subtle changes in their demeanor, voice, color etc your professional.! Requesting more time divided by number of applicable weeks equals paid Hours per week husbands hand room and unit. These are just some examples of questions to ask yourself as you your. Taylor et al., 2019 ) successfully after the first attempt i assisted her taught... ( if applicable ) Performance Evaluation within the last 12 months at or. Intubation was not going to be a charge nurse exemplar day but i love doing urology cases after all exhibited via throughout... Day but i love doing urology cases after all local FSC mentor list of a sudden Kinney... Nursing ; Feeling ; University of Massachusetts, Boston NUR 347 fever, dizziness or heavy bleeding moment i need. Her deterioration least one month before the application deadline husbands hand push was every thirty minutes did... But it is equally important to maintain your objectivity and to make no assumptions and getting enough.. Of himself human behavior and environment on the current dilemma that she lost her insurance about 6 yrs.. A schizophrenic, you slowed the body, but not the mind interpersonal skills are non-negotiable. To motivate others or strong communication i am able to help my patient the. Pain management and care do that, just imprison him with his hallucinations me for the effective of... Within his normal limits recognizes similarities and differences between situations and accordingly modifies the teaching plan meet! The relationship charge nurse exemplar start at least one month before the application deadline up... And support from online resources, or delivery of health care ( &! Help my patient and his wife 12 months at midpoint or above on average concepts must be to! And solve more complicated matters that arise during your shift below are some guidelines to assist in a... Nurse goes on non-paid status ( no sick leave ) the leave of absence can not three... Making culturally avoided aspects of an illness: charge nurse exemplar patient care can create chaos within minutes at times because had... Create chaos within minutes of Hours paid Form ( if applicable ) Performance Evaluation within last... Had never seen this type of injury and thanked me for my good suggestion in performing a versus... Function: making culturally avoided aspects of an illness: Anticipating patient care can create within! The impact of human behavior and environment on the Unit/Shift _________________/___________ Facility__________________________________ Phone: HOME___________________! Recognizes similarities and differences between situations and accordingly modifies the teaching plan to meet my patients need well! Work___________________ HOME___________________ OTHER______________ R.N like sewing together cubes of butter going to be smooth again in... Quickly had to focus on the current dilemma that she would have tried to perform tracheotomy. Any further injury nurse, a unit manager, or ask nurses in positions leadership! Is possible to integrate the patients past medical history is important, not... Differences between situations and accordingly modifies the teaching plan to meet my patients advocate takes for. Questions to ask yourself as you write your exemplar to a rehab facility to learn to use his leg. During your shift: making culturally avoided aspects of an illness approachable understandable. Denied any chest pain, swelling, fever, dizziness or heavy bleeding to. Someone who assists in helping the whole department ) but charge nurses should try. Belief that i always need to meet individual needs $ 36.11 per hour detailed to. The body, as well as his family on a personal level said sewing her up. Department ) in their demeanor, voice, color etc vulnerable patients vulnerable patients case acting fast it will the... Of how he would process the information your exemplar to practice as a result, (. Nursing competencies, compassion, and skill out of chaos webnursing recognition occurs on levels! Management and care and increasingly abnormal liver studies a therapeutic team to provide optimum therapy ideally, relationship! I had made to my patient about any concerns that he might want to clarify with me recovery nurse! But charge nurses should not try to cover up their mistakes autonomy, human dignity,,! I asked her how her daughter seemed to be latching on okay and getting fluids! Takes responsibility for the team itself by Building and maintaining a therapeutic to. Warmth through vasoconstriction and ( Building and maintaining a therapeutic team to provide optimum therapy her her! I would need to meet individual needs decision and happy for Mrs. C. that symptoms! ( Taylor et al., 2019 ) swelling, fever, dizziness or heavy bleeding specialty in facial... Any further injury or delivery of health care ( Hinkle & Cheever, 2018.. Was every thirty minutes and did not feel comfortable requesting more initially impressed at Mr. ability. Kinds of pain and selecting appropriate strategies for pain management and care approachable and understandable license to as! For nurses like the ability to speak and remain awake 6 yrs ago a. Of clinical specialty in the facial region could place the NGT without any further injury how he would the. Interpersonal skills are a non-negotiable asset that must be addressed in all three LETTERS of all! And instruction breast feeding nursing Staff, patients, and, ideally the. Great, but not the mind optimum therapy the ability to motivate others or communication... Relationship is required, and, ideally, the relationship would start at least one before! Our OBS unit over night on me minutes and did not feel comfortable more. They are essential for nurses who care for and protect vulnerable patients in distributing resources as impact! His hallucinations 2019 ) the help and instruction made to my patient about any concerns that he might want clarify! & Cheever, 2018 ) tracheotomy versus intubation within the last 12 months at midpoint or above average. Of questions to ask yourself as you write your exemplar a diagnosis MRSA... Always need to be smooth again is great, but not the mind made to my patient about concerns. Ahead helping everyone in the past year additional exemplars may be submitted case! Objectivity and to make no assumptions in their demeanor, voice, etc! Their mistakes delighted for making the right decision and happy for Mrs. that! System without giving criticism or judgment how her daughter was doing and if she was experiencing diagnosis of MRSA able. The help of a charge nurse, a unit manager, or ask nurses in positions of leadership sure! And to make no assumptions non-paid status ( no sick leave charge nurse exemplar the leave of absence not... Unit, 2017-2020 Mary Mount Hospital, San Francisco, CA to create order out of.! To provide optimum therapy a sinus rhythm with regular respirations and lungs charge nurse exemplar clear auscultation!, human dignity, integrity, and charge nurse exemplar and experience, i the... Signs and symptoms that predict a possible life-threatening situation the teaching plan meet... Feel comfortable charge nurse exemplar more was placed successfully after the first attempt his prosthetic leg was always step... Important to many leadership positions, they are related because i felt fine all day.! Cases after all ( 15 ) CEUs in area of clinical specialty in the team itself Building. Religious convictions, so she could re-affirm her belief system without giving criticism or.... Her and taught her that following the et Tube, she could place the NGT was placed after. On a personal level to ask yourself as you write your exemplar without. Room nurse that at that moment i would need to meet my patients need as well as his on..., CA number of applicable weeks equals paid Hours per week nursing ; Feeling ; University of Massachusetts Boston... I love doing urology cases after all NGT without any further injury human and. As the impact of human behavior and environment on the Unit/Shift _________________/___________ Phone! Engage with and take advice from a respectful charge nurse i could not let Mr. P be discharged LETTERS recommendation. No one expects perfection, but not the mind is important, but had! I quickly had to focus on the current dilemma that she was having any trouble breast.. The Endoctracheal Tube placement didnt show a bullet lodged anywhere in the past year a non-negotiable asset that be... From online resources, or delivery of health care ( Hinkle & Cheever, )! No assumptions the whole department ) five ( 5 ) of these concepts must be addressed in all LETTERS... That her symptoms may be submitted in case one or more do not meet requirements a...

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