Current performance evaluation at the mid-point or above on average. My IV skills are excellent, but over the course of his admissions multiple IV sticks became more difficult. activate coagulation factors in the blood plasma, and initiate the In planning for the admission of rights & duties in legal matters are better able to protect themselves I quickly looked through her history and CIPS and began to triage her through the Postpartum protocol. I opened the protocol Urinary Tract/Flank Pain Female. Whether the patient is not responding to a particular therapy, this nurse has an inquisitive need to search continually for the reasons. You can take as much space as you feel is necessary to tell your story. I then went to the hospice team and discussed the possibility relief with the PCA function. I was correct; Mrs. B. was discharged with the tube feedings. 0000000950 00000 n WebRNss ppracttice. 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. As the chairperson of the above committee I am verifying that ________________________________(Name) attends the committee on a regular basis makes an individual contribution ___________________________Chairpersons signature Date: _____________________ Other Useful Information STAFF NURSE III, HH/H III Application The RN Clinical Ladder is optimized through a three-way supportive relationship between (a) Applicant, (b) Facility Selection Committee, and (c) Regional Appeals Committee. The charge nurse's role is to gather information from all sources and represent this information on the public display board. She told me she had never seen this type of injury and thanked me for the help and instruction. Charge nurses delegate tasks and share their up-to-date skills with colleagues, new nurses, and students alike. As I continued my triage, I asked why she hadnt called last night when the HA was 9/10. This helped to ensure the therapeutic required to help this patient. Maintains a flexible role to resource constraints. Remember the important elements who, what, when, where, why, and how, and be sure to incorporate them into your story. I had the privilege and honor of being part of this patients final journey, and am a better nurse for it. At that point the surgeon would be ready to begin closing the cavity. WebWriting Exemplars Page 1 of 3 Adapted from: Presentation Notes: Nurse Action Days (2006) Christine M. Pacini, PhD, RN Director, Center for Professional Development, Research and Innovation University of Michigan Health Systems Introduction - Definitions An exemplar is a story of a real patient that is told in order to illustrate an RNs She said no to all. Facility Selection Committee Names of the Selection Committee Members will be posted on the Associations bulletin board in each facility. 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. (Ricci, Kyle, & Her parents live in Mexico and 2 yrs ago when she visited they were fine. It describes in detail a particular clinical situation that includes the nurses thoughts, feeling, intentions actions, critical thinking and Nurses become proficient The team also encouraged his daughter to take a more active role in his care which she was willing to do. It takes pressure off of one person and raises morale on the unit when nurses know their ideas are valued. I was aware that lateral positioning opted the most possible injury to the patient if not properly taken care of. Write the exemplar in your own words. (see letter attached) The Helping Role: I am a confident and caring professional who is dedicated to achieving positive patient outcomes. 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. Your self-evaluation represents an opportunity for you to review and reflect on your past accomplishments, current activities, future interests, strengths, and areas for improvement. This time she would undergo another major abdominal explorative surgery resulting in a colostomy. It ddescribes in detail a particular clinical situation that includes the nursess thhoughtts, feelinngs, intentions, actions, critical thinking, and decision-making process. Clinical judgment: how expert nurses use intuition. She also told me that the facility did not have the Morphine prn as ordered and that they would not be able to obtain any narcotic from the pharmacy until tomorrow The patient had been hospitalized for confusion and the discharge diagnosis was Urinary Tract Infection. problems and intervene early to prevent life-threatening He stated, Please take away my pain, Im ready to rest and stop fighting. A charge nurse oversees a hospital unit or department. How did your intervention(s) affect patients, their families, your chapter members, or the community? WebStart with a charge nurse position. I was able to make her feel at ease while she balanced breastfeeding and talking by asking about the well-being of her daughter and if she was latching on. During this time I gained experience from people suffering at different severities of their mental illness. Paid time divided by number of applicable weeks equals paid hours per week. They are the circumstances that eventually become milestones to nurses (Harvey & Tveit, 1994). Phototherapy, or light therapy, is exposure to specific wavelengths. Each and every patient visit must be treated uniquely. While the following seven traits are important to many leadership positions, they are essential for nurses who care for and protect vulnerable patients. Because of my experience identifying clinical signs and symptoms, I was able to take the essentials steps to ensure my patients well-being. 6w} Those interested in the charge nurse role must hold registered nurse (RN) licensure in the state where they practice and have at least three years of hands-on clinical experience. I asked that one family member be allowed to stay tonight and she agreed. The BP machine gave a malfunction error message with the first attempt. I intuitively knew when to be with this patient and his family and when to leave them alone. Performance evaluation must be at mid-point or above on average. The medical record was not unusual for the scheduled procedure. University of Massachusetts, Boston. A staff nurse provides direct care at the patient's bedside like administering medication, changing dressings, and inserting intravenous lines. %%EOF $JI=SM0V;$E)@z;;_zX6Juq(hx\n5. Date________________________ Unit/Shift_________________________Facility___________________________________ 4 Mailing Address ___________________________________________________________ 5. also advocates for others unable to make decisions for themselves, as WebOne Clinical Exemplar; Minimum of 3 professional goals; Professional Resume or Curriculum Vitae; Please be sure that your portfolio is complete prior to submission. Instructions: Please complete this form and return it to the applicant before __________ (date). This nurses confidence imparts trust to the patient and the patients family, who recognize that the Staff Nurse III is a competent advocate. The following Benners Domain will be addressed: The Helping Role The Teaching Coaching function Effective Management of Rapidly Changing Situation Organizational and Work Role competencies Exemplar #12 It promised to be a relatively straightforward day in OR Room 3. The Staff Nurse III not only notifies appropriately people but also takes immediate action. My room had been scheduled for Right Laparoscopic Nephrectomy followed by 3 more cystoscopy cases. The annual ceremony is held during Nurses Week each year and was established in 2007 by Chesapeake Regional Medical Centers Professional Nursing Council to recognize I knew it was going to be a busy day. This was one such patient. During the week T. needed his morphine rates increased to 180 mg/hr with an eighty mg bolus every twenty minutes and twenty-four hour totals of 4.350 mg morphine IV was needed for good pain control. The family was calling to ask that the patient be readmitted to the hospital immediately. Fluids & Electrolytes Fluid and electrolyte balance refers to the bodys maintaining I received report, in room 7, Mr. F..-GI Bleed, will need blood. Nurses are advanced to Clinical Nurse III based upon proficiency in clinical performance. See calculation below. B) The family needs to agree to surgery. 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. I informed him of my assessment and that I thought something was going on. You will be contacted by a member of the committee shortly after the monthly meeting in which your portfolio was reviewed. They soon realized I understood their concerns and was there to help. personal desire to increase well-being and health potential (Taylor He was added to my caseload in June when his nurse retired. Adequate perfusion 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. 5V5E*h1v5=?+a2HF&#GA`L^_ni!a:3j8 t]3\F67vx]F_J04o7@oB w`N$ xA^'Sr7,z J%4{Cf@LcE Admission, discharges, and intensity of patient care can create chaos within minutes. ( Maintaining a flexible stance toward patients, technology and bureaucracy. I facilitated the quick delivery of the blood and in no time we were able to transfuse the 2 units to the patient. After I triaged through all the emergent, transfer and appoint today boxed, I felt it was time to negotiate and find a safe outcome that would balance the members operational needs. (New Applicants for Staff Nurse III/IV, HH/H III) The staffing/payroll office will assist in this calculation if needed. Use This Template Alfie Jonas Charge Nurse 458 635 9654 alfie@hiration.com San Francisco, CA www.linkedin.com/in/alfie SUMMARY She had plenty to deal with already she sure didnt need diarrhea. A regional appeal may not be completed before the next application deadline. Attend local workshops for applicants. I was assigned to the Trauma Bay and was notified by the charge nurse that we had an incoming cardiac arrest. By the time he was awake she was just fine. Candidates will be asked to clearly present either one or both exemplars. Applications are accepted and reviewed monthly on a rolling basis. She states that she had some complications after delivery. 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 stayed just long enough to get him tucked in and off I went as I was done for the day. This infusion, as with any, required much long range planning before the infusion could be started. well as for the nursing profession. Analgesics including opiods, can be used safely and effectively in the elderly. or a large area of rural residents. I reassured her that it was common for new moms to feel this way. Where will the work you have accomplished lead the chapter and your community? The result of my dedication and coordinated interventions are evidenced in the many positive outcomes and were ultimately achieved with T.s peaceful passing. It may be a clinical situation that went unusually well, an incident in which there was breakdown (i.e., things did not go as planned), a situation that is very typical, or a situation that you think captures the essence of nursing. She got impatient about too many questions. Individuals can find a mentor where they work or by networking with more experienced charge nurses. His primary concern now was his break though pain which was so intense he could not get the Methadone or the Dilaudid increased at a rate that could provide relief. She agreed, but she needed to call her husband to come home and watch the baby while her sister in law took her. I was completely comfortable handling this call and started the process of gaining the familys trust. 6. Nursing Philosophy and Concept Curriculum Map, 2/16/2016). I Just Dont Feel Right. A Story of Ms. X. Cognitive abilities include reasoning, judgment, The facility did have Ativan available. sw,% All of these or even one of these would have delayed her care which would have resulted in a very bad outcome. I knew that the patients vital signs were deteriorating. She just got a new job and she has insurance now with Kaiser. I explained that I dont have any information in my computer about her health problems and it would be to her benefit to further clarify her symptoms. I questioned the surgical technician about the 2 missing sponges and I was told that the surgeon had one sponge in his hand and that the other one was resting on the drape. Please contact a member of the Facility Selection Committee to determine how to access these example exemplars. I reiterated to her that her God would get her through this ordeal as he had all the previous setbacks. A less experienced nurse would have just sent a message since her symptoms did not warrant an emergent outcome or even an appointment. Before, working in the ED, I worked in locked psychiatric facilitates for several years. NUR 347. Everyone gathers in the break room for shift brief. A day came when he asked me what would happen next, What happens when I cant talk anymore. I provided an RN to RN report to the holding room personnel and helped them settle Mrs. S., who appeared even more anxious than before. After she lost her insurance she took Tums that helped for awhile but no more now. She thanked me for my patients and kindness. %PDF-1.4 % Charge nurses must be able to multitask and stay calm under pressure. I arranged transfer to the holding room for Mrs. S. and for the on call doctor to see the patient in that location. Once again, the thought crossed my mind to have him come back after lunch, but I had this vague uneasiness that t here was something deeper going on with his health. Most important is to give a disclaimer. All Selection Committee meetings will be scheduled within thirty (30) days of the applicable deadlines. agrees to be morally responsible for the consequences of his or her Change), You are commenting using your Facebook account. 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. TThe exemplar is written in the first person. 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