Disease (COPD), Disseminated Intravascular Coagulation (DIC), Quality Improvement Cycle: Plan- Photocopies of CEs, CMEs, college credit certification, need to be included in the portfolio when the application is submitted. She said no to all. This may include soft skills for nurses like the ability to motivate others or strong communication. education you need could be more affordable than you think. I wasnt surprised to learn that she had an MI and BS of 435. Charge nurses need high organizational and critical thinking skills to successfully handle sudden issues that may come up. It describes in detail a particular clinical situation that includes the nurses thoughts, feeling, intentions actions, critical thinking and Remember, youre nominating your chapter for an award, so you want your submission to be stellar! A RN peer familiar with your practice A supervisor (a nursing supervisor familiar with your practice Another health team member (MD, PT, Social Worker, etc.) You will be contacted by a member of the committee shortly after the monthly meeting in which your portfolio was reviewed. In this case my time was already over twenty five minutes. In this particular situation: Helping role: I felt that I guided and gave emotional support to this patient through this much unexpected even in his life. It was soaked with blood that it could hardly be recognized as a foreign object. You are encouraged to submit your portfolio electronically online to Heidi Alpert. cardiac systems. Phone (Work)___________________ (Home) __________________(Other)________________ 7. She takes 4 or 5 Tums, drinks plenty of water and she goes to sleep. Whether youre looking to get your pre-licensure degree or taking the next step in your career, the A staff nurse provides direct care at the patient's bedside like administering medication, changing dressings, and inserting intravenous lines. I explained my thoughts and concerns with Mrs. S. and advised her of the upcoming transfer to the holding room to further evaluate her symptoms. 5. activate coagulation factors in the blood plasma, and initiate the Try to paint a very clear picture as you tell your story. )\* ^OZ=BU:V+ (u~E.m~KAh }&(b*PS&XV@gP@|-l.k_f}en4A65QR/-[X@i/%af-^Xa[xs$K5B^?Pkx/DoQdZ80Mn Exemplars should be written by the chapter member, the nominator, or collaboratively by individuals who can attest to the validity of the contribution. The Staff Nurse III accepts accountability for actions and outcomes and knows when to involve others in a plan of care. Additionally, a charge nurse should have interpersonal awareness, or emotional intelligence, to deal with different personalities and interact outside of their comfort zone. Include how you felt about the situation, why you think your actions may have differed from someone with less experience. Find examples in your individual practice which: Demonstrate your ability to function in any three of the domains Write, in your own words, two (2) narratives each containing three domains. The Regional Appeals Committees review shall be limited to a consideration of the same appeal presented to the Facility Selection Committee. Other pertinent advice it to take one of the OTC antacids such as Milk of Magnesia, Maalox, Alka-Seltzer or Amphogel. living, including meal preparation, grocery shopping, household Along with patient care duties, the charge nurse directs staff members and ensures routines and processes are running smoothly. In a way, trapping the schizophrenic and preventing the patient from using their coping mechanisms in dealing with their symptoms. In this first link you will find an exemplar Candidates will be asked to clearly present either one or both exemplars. 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. Mr. P. was not Mr. P. There seemed to me to be a slight change in his mental awareness. 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. She was being monitored, had an IV, and was receiving oxygen. Because I showed interest in her symptoms and patience to listen to her story, Mrs. C. seemed more willing to talk. Corrective measures were taken. Benner, P., Tanner, C., & Chesla, C. (1997). After all I had kept my promise of being his advocate at the time that he couldnt take care of himself. Overactive immune cells of the skin are responsible for many skin diseases. Type of employer, location, and the RN's level of Anxiety Anxiety is a vague feeling of dread or apprehension, in response As a profession we must speak up and communicate our assessments effectively, including changes in our patients condition and evaluation of our patients needs. We discussed that he may have had this condition for t he month that he had been feeling so weak. Gayle Morris, BSN, MSN has over two decades of nursing practice with a clinical focus in rehabilitation medicine. Knowledge of the patients past medical history is important, but it is equally important to maintain your objectivity and to make no assumptions. She thanked me for my concern and called him on her cell phone. (Taylor et al., 2019). This plan might address the next level of care, such as discharge to the home, transfer to another medical unit, or admission to a skilled nursing facility. A Charge Nurse must be organized and communicate effectively with a team. 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. The information is meant only to serve as a guide and should not stifle your own creativity in putting together your portfolio. The American Nurses Association identifies the Five Rights of Delegation as: Leadership encompasses a variety of unique qualities, and a mindful charge nurse recognizes the difference between leading and managing. NOTE: The Letter of Recommendation Form is provided in this packet to assist the writer of the recommendation to cover all requirements. the activities involved in managing the work environment and, 0000006386 00000 n cold) receptors located close to the skins surface. The night ED team decided to admit him to the OBS unit instead of sending him home so late knowing that he lived alone. Achievement standard 91329 study exemplar Pages: 8 (2316 words) Holes - Analytical Essay Exemplar Pages: 3 (882 words) BSN nursing VS RN nursing Pages: 3 (898 words) Nursing Knowledge through the Nursing Process Pages: 4 (961 words) Describe the definition of nursing as put forward by the American Nurses Association. In this way you will be able to determine whether everything you wanted to convey is easily understood and that your story is clear. 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. and novice nurse 27 y.o. Names of the Facility Selection Committee Members will be posted on the Associations bulletin board in each facility. a/M}\eLQ}fW/i0#\0&-L3k&J" Yjb?)0lT)y, aaQCx$Zh`4A:$/qu~!G.G(qwEek9JcXX;5J]n^vP- ~+Z[\]]o)WUcTv8c7 -4,sR!s{4cM~h@?&|Jd7MZFzd8pB%y7G%siz[OYM. I typed up the whole procedure in laymans terms with bullet points that were easy for them to follow, they were so appreciative. The committee will choose replacement members from the nominees by consensus. I made my rounds with my other patients, and noticed Mr. Y. has not moved since that last time I observed him. The job of an advice nurse in a Call Center is similar to a detective job. Able to provide leadership in a crisis, the Staff Nurse III transforms chaos into a manageable situation that has a greater likelihood of positive outcomes. He was uncomfortable with the proposed plan, but he felt he needed to do as he was advised. Mrs. B. mustered up some humor and replied you mean outside the bag. The night shift nurse was unable to ascertain if Mr. Y. was intentionally attempting to hurt himself or not when he was chasing the cars. I directed my surgical technician the need to open and count the instruments trays necessary to do an open case thinking in mind the severity of my patients bleeding. I asked her if she had support, and she told me her sister in law was coming over soon. As a nurse, I think that our professional boundaries are important to preserve our sense of self, but sometimes patients touch our hearts, and their passing is felt more acutely. The letter of recommendation for advancement to Clinical Nurse III should be provided by a Clinical Nurse with at least two years of experience at BID Needham or an Advanced Practice Nurse (NP or CNS) who can speak to the applicants practice. Criteria for Exemplars To assist you in writing exemplars, the following information pertinent to evaluation of exemplars is offered: Two written exemplars must be submitted for review. You can structure the narrative of your self-evaluation in whatever way is most meaningful to you. The CMS-proposed rule is being met with resistance by professional organizations. These signatures certify that calculations are correct as of the specified date. It was my job to ensure my patients safety at all times. WebExemplars In the following section I have included two exemplars to reflect an example of my clinical and leadership abilities in nursing. Humility is a powerful trait. Additional letters of recommendation may be submitted in case one or more letters do not meet requirements. I felt this was the best course of treatment for Mr. Y. and the right thing to do. She is a janitor and does a lot of physical work. E This helped to ensure the therapeutic required to help this patient. I, therefore, have become very familiar with my patients, and have good rapport with them. cognitive, and physical symptoms (Videbeck, 2020). The boundaries for The Staff Nurse III relies on past experiences to identify clinical signs and symptoms that predict a possible life-threatening situation. His speech is rapid and unable to give us much of a medical history. 6. The nurse informed me the IV push was every thirty minutes and did not feel comfortable requesting more. Evaluate your practice since your date-of-hire or last evaluation. management, finances, and transportation. Spiritual health or well-being My critical thinking and years of experience being an OR nurse has made it possible for me to protect my patient from a sentinel event that would endanger his life because of retained foreign object in his body. I knew how to negotiate with my intuitive use of knowledge, I contributed mightily to this patients and Kaisers best interest. The nurse I worked with patients in the past that the hallucinations, whether auditory or visual, were so debilitating that they could not interact with the world because they were so occupied with their hallucinations they couldnt get past that to true reality. 6. I paged HBS, I gave a brief history of her past admissions and how almost everyone of them had ended in some kind of exploratory abdominal surgery. On August 6th T. climbed out of his bed during the night and pulled out his line. through body tissues (Taylor et al., 2019). In this first link you will find an exemplar that demonstrates my clinical knowledge and skills in caring for the post-operative patient. This research investigated charge nurse decision making during the nurse-patient assignment process as an exemplar of the larger Some specialty units require even more time. I explained to Mrs. C. that her symptoms may be related to her heart. Mrs. C. also thought that is not that serious she needs to go. 0000000950 00000 n I asked the ED MD if it wouldnt be better to trach this patient to protect the airway. It was found later that his patient survived and was recovering from his injuries. The patient trusts in this nurses expertise and ability to handle even critical situations that involve life and death. This nurse stepped back and stated, Im afraid to push his loose teeth down this throat or even worse make his fracture worse. as neighborhood clinics, patients homes, long-term care facilities, schools, Upon my assessment, he was pale and warm to touch. influences roles and interactions with others, as well as within families The Staff Nurse III grasps the whole picture and so is in control of the situation, able to create order out of chaos. Later the patient went to CT, returned and was transferred to a trauma center. I received report, in room 7, Mr. F..-GI Bleed, will need blood. If I added the facts that she was menopausal and she stopped taking her BP medication 6 years ago I had enough facts to consult with CCMD. For example, Nursing 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. and communities, and is apparent in the attitudes and institutions I}K|m6&@{7W51:~m2zo=^$wE:Z /tSsM#ZQw8X)1m -f{px_5`'j`/?CfgSlHm#[ @%^__`@z-wd? MONITORING AND ENSURING THE QUALITY OF HEALTH CARE PRACTICES ( Providing a back-up system to ensure safe medical and nursing care. WebWhat is an exemplar? nursing practice are defined in the Nurse Practice Act of each state. trailer Performance appraisal of the candidate by the nursing director must be completed within six months preceding application or updated to reflect an accurate evaluation of the applicants current nursing practice. Your Name __________________________________ Date of Recommendation _________________ 2. 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. 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. As unit leaders, charge nurses must exemplify leadership abilities. Charge nurses can expect to earn between $50,400 and $90,523 annually, with the median salary landing at $68,863 per year. Date________________________ Unit/Shift_________________________Facility___________________________________ 4 Mailing Address ___________________________________________________________ 5. Community-based practice sites can be as varied Unit/Shift _________________/___________ Facility__________________________________ Phone: WORK___________________ HOME___________________ OTHER______________ R.N. There was a bullet entry, yet no exit wound. 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. D) The client has a right to informed consent. The simple task of scheduling a PIC line placement now became a serious nursing challenge. Inflammation Inflammation is a complex nonspecific response to tissue injury intended brain that operate to maintain pressure within the cranial cavity in a (see required details that follow in this packet) Two exemplars that are reflective of events that occurred in the last twenty-four (24) months. (Videbeck, 2020). The Staff Nurse III is present when a physician makes rounds, initiates interventions to prevent and treat skin breakdown and wound care and calls upon other resource people as appropriate. She developed a severe HA and elevated BP and was put on IV Mag sulfate which alleviated her HA and brought down her BP. Determination of applicability to clinical specialty will be made by the Facility Selection Committee. The appendix of this packet includes a lengthy description of Benners Domains and helpful examples of exemplars. Seek out peers, other charge nurses, and managers who exhibit effective leadership traits and ask if they are willing to be a mentor. Remember the important elements who, what, when, where, why, and how, and be sure to incorporate them into your story. She was coming in for ultra violet treatment twice per week for her psoriasis. Recent attempts This may have been acceptable, but not the right thing to do. in origin. Being a witness to the comfort this brought her, I offered her the services of our hospital chaplain, and she was very joyful at the thought of a visit from him. Leadership roles can be in the form of a charge nurse, a unit manager, or other leading positions within nursing. When I assessed his abdomen, he was slightly tender with positive bowel sounds and he continued to complain of slight nausea. Your staff is experienced nurse 49 y.o. This includes considering each individual nurse's knowledge, skills, and abilities. The first few minutes of the surgery went smooth as the case was stable. Reciprocal compensation occurs among efficiency, or delivery of health care (Hinkle & Cheever, 2018). Transfers to another area of clinical specialty require application for Staff Nurse III or HH/H Nurse III in the new area (see minimum qualifications). the experience. I asked her if she had been drinking fluids and eating, she said she was drinking a lot and urinating normally and she just had eaten a sandwich prior to calling. joining of the sperm from the male with the ovum from female), Friendly and extroverted, she had shared much of her personal life and appeared comfortable with me and confident in my judgment and skills. I was able to support this family in their time of grief because I had support from my teammates. He had missed a few appointments with his psychiatrist and the case worker feared Mr. Y. had not been taking his Risperidone (a psychotropic medication). 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