I immediately instituted a plan of care for him. The rapid change in the patients condition under anesthesia was crucial. (Videbeck, 2020). begins with the care of individual clients. Multitasking is a quality that I possessed as an OR nurse. Everyone gathers in the break room for shift brief. What new knowledge or insights were gained from this experience and describe how this has impacted your current practice, Realistic and reflect aspirations for the future that stretch your capabilities, Feasible within the framework of your professional role. The following Benners Domains will be addressed: The Helping Role Monitoring and Ensuring the Quality of Health Care Practices Organization and Work-Play Competencies Exemplar #7 My patient was discharged from the hospital at 7 pm, forty minutes before I got the call from her family. All of these or even one of these would have delayed her care which would have resulted in a very bad outcome. You can take as much space as you feel is necessary to tell your story. I assured her these feelings are normal and valid, but she said I was concerned about her HA so I would wait for her to go get her daughter, and told her to take her time. My calm, reassuring approach and this familys readiness to learn, was an intricate part of being able to increase the complexity of his care and allow T. to remain at home. h ( Building and maintaining a therapeutic team to provide optimum therapy. 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. Successful applicants need to become familiar with requirements to maintain their new status including renewal requirements. Almost 30% of RNs work in such nonacute patient management, finances, and transportation. He did have a negative work-up and, yes, he could have been sent home last night but he wasnt. They soon realized I understood their concerns and was there to help. an immediate risk to a clients life or long-term health. joining of the sperm from the male with the ovum from female), Names of the Facility Selection Committee Members will be posted on the Associations bulletin board in each facility. The lowest 10 percent earned less than $52,080, and the highest 10 percent earned more than $111,220. On one hand was a patient who was elderly pulse of 30-40, slightly clammy who had been officially seen by any in the clinic or worked up for this condition and on the other hand is a new physician whose being told that this patient can wait several days before getting definitive treatment by physicians who hadnt even seen the patient. The induction went smoothly. 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. This was a case requiring more time than most and yet proved to be one of the most rewarding. Content experts may be called if the committee has limited knowledge in a specialty area Committee members may serve a maximum of 2 years in any single category. Each day, across thousands of medical-surgical inpatient nursing units, charge nurses make decisions about which nurse will care for each patient. grooming, feeding, and toileting. (LogOut/ This nurse can expect physicians to respond in a timely manner, whether they are called upon to change or provide written orders, or to discuss possible changes in standing policies. It would have been very easy for me to go along with the discharge plan. Nutrition being so important in her wound healing; I recognized that she needed tube feedings. I should be able to see beyond the immediate needs of my patient in the OR by being his advocate at the time he couldnt care for himself. She was able to trust me and agree to go to the ER. Room 5- Mr. H., blood alcohol in the 400s, holding until he can metabolizes to less than 200 then discharge planner. For Home Health Only: Requirements for HH/H III: ____________________________________________ I obtained my PHN: In (date) __________________________________________ I am a case manager: From (date) ___________________To (date)___________ 9. I couldnt advise patients to take any of these drugs without having her past history. 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. This incident with Mr. P. taught me a great lesson that I now incorporate into my nursing practice. She had plenty to deal with already she sure didnt need diarrhea. It takes an individual who possesses clinical nursing competencies, compassion, and empathy. The colleague should describe your practice. Charge nurse resume sample Here is the complete sample of a charge nurse resume that would help you to curate your own. Mr. R. ended up with bilateral below the knee amputations. Cognition Cognition is the brains ability to process, retain, and use 4. She is a janitor and does a lot of physical work. (The diagnostic and monitoring function) From my past nursing practice I recognized similarities with other atypical presentation of cardiac ischemia and I explained to Mrs. C. in terms she could easily understand the rationale of my interpretation. generate new tissue, and facilitate healing (Norris & Tuan, 2020). 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. A staff nurse provides direct care at the patient's bedside like administering medication, changing dressings, and inserting intravenous lines. I talked to the supervisor of the facility and was told that there was a mention of hospice but no order for hospice. I am aware that the consequences of pain in the elderly can be depression, poor socialization, sleep disturbance and impaired ambulation. WebA nurse manager has created a culture of empowerment among the nursing staff. At this time, radiology had two doctors out on jury duty, the self care learning nurses were maxed out and T. was on a waiting list. I used my presence with this patient to guide him through some emotional changes. The Staff Nurse III draws upon the patient, family and significant other as resources. I had an uneasy feeling that we were missing something. The Charge Nurse is an exemplar for compassion, acceptance, respect and empathy honoring nursing as a distinct discipline and supporting an environment focused on healing and wellness. 0000003113 00000 n Social Services and Discharge Planners were no on my list to summon to start preparing for his departure to a rehab facility. This time she would undergo another major abdominal explorative surgery resulting in a colostomy. I talked to the CCMD and my SBART. Mr. P does have some short term memory loss but he never forgets his index cards! 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. By now I knew that I have to ask questions. This helped to ensure the therapeutic required to help this patient. As a later outcome, I also discussed with the assistance Chief of medicine the prior negative experiences that had been incurred by out new physicians. 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. Charge nurses must generally possess excellent skills in communication, organization and leadership. Fortunately she arrived there safely. Mrs. S. had been a patient of mine for about six months. 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. 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. (The helping role) I listened to her concerns and using my knowledge and experience I tried to establish a relationship between her acute symptoms and past health problems. The night shift informed me that Mr. P ruled out, as both sets of troponins and both EKGs were within his normal limits. 7. "hL3 h)' 5>*CJ OJ QJ aJ hL3 h[Q} >*CJ OJ QJ aJ h)' CJ OJ QJ aJ h[Q} CJ OJ QJ aJ hY CJ OJ QJ aJ hL3 CJ OJ QJ aJ h@ CJ OJ QJ aJ hL3 h)' CJ OJ QJ aJ hL3 h)' >*CJ OJ QJ aJ 3 I gave her the appropriate disclaimer in case things worsened. A newer nurse would have been less effective in this role simply from discomfort with death, and the inexperience would leave this patient with a sense of loneliness and isolation. 0000029878 00000 n Leadership Activities Hold a Charge Nurse, Chief Nurse Rep, Nurse Rep or other CNA leadership position Receive Relief in Higher Classification for Charge Nurse or Supervisor Committee or Task Force, e.g. I gave a detailed report to the recovery room nurse. c) The Diagnostic and Monitoring Function - Anticipating problems: Future thinkA great deal of my time in this case was spent anticipating problems and putting back up plans in place. This guide covers the most important traits for charge nurses to be effective leaders and improve patient outcomes. Read the results of our latest national nurse work environments study, and see why Healthy Work Environments matter in this critical time. He even said that it could have been a wrong count if I didnt insist on finding the sponge. active transport, and capillary filtration (Taylor et al., 2019). 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! Choose a suitable charge nurse resume format. Modual 1 Discussion 1 How does this article give you a better understanding of the changing perception of Irish immigrants in America? Pharmacology Pharmacology is the study of the biological effects of chemicals During Hospital Week the nurse exemplars are additionally recognized at the annual service awards banquet. },e.eI8i6n=_Xz^|M/^,/XN0'a}}c~ There was a lot of activity noted in the room. My experience with Mr. P reinforced my core belief that I always need to be my patients advocate. As a self-directed professional, this nurse is confident and well prepared. information on which to base their decisions. in a systematic way to make a choice among alternatives related to She had six, yes six, drains coming out of her abdomen. I told her to tell her sister-in-law if the situation became unsafe to pull over and call 911. 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. these receptors sends sensory messages to the anterior hypothalamus The Staff Nurse III involves the patient and family in interpreting the kinds of pain the patient experiences and uses this input to select strategies for pain management and control. Each year, staff members nominate their peers to become recipients of 11 different nurse exemplar awards: APN Exemplar (recognizing an outstanding Advanced She couldnt get in touch with her husband but one of her coworker agreed to drive her. 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. E Nursing Exemplar 2018.docx. She thanked me for my concern and called him on her cell phone. I was almost finished with the dressing when the nurse began to place the NGT in the right nare. Phone (Work)___________________ (Home) __________________(Other)________________ 7. The Deaconess Nurse of the Year is selected from the exemplars. I understood the familys sense of urgency but also realized that most if not all of the problems could be fixed within fifteen hours. I explained to him that soon his pain would be over and he would once again have the ability to walk on both legs again. And so our relationship began . The exemplars must be reflective of events that occurred in the last twenty four (24) months. (Norris & Tuan, 2020). Blood pressure was also within normal limits. 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. These imbalances can be respiratory or metabolic I explained everything to the charge nurse and requested that a one-time exception to the policy of no overnight guests be made. Zr|P%R(oW)GSZnKex&Eg"%,S@C)t^AMg~)*v)&Xft{::.M';LwdRj/w0d[y#xs[N8>YiOav`xd5vaAaf,{/r2q/%Iyr22L;v,0sv+\~a-|nav&f~_\ >7fs0i-u; PhX4US > va>!1)>9\`a}fP5T0X@,>Y6GU&aZ7-}=c n'4WgR-q,B++'.cwvbo~TbP 4ux$plUzZ90G,;4r.V'R.2x]ibe/lx`Rp|Kt; I also gave a suggestion to the physician on alternatives methods of care displaying signs of confidence and experience while remaining a patient advocate throughout the process The following Benner Domains will be addressed: Helping Role Diagnostic and monitoring function Administration and monitoring therapeutic interventions and regimes Monitoring and ensuring quality of health care practices Exemplar #6 Time to leave for lunch had already passed and I was just getting ready to clock out when I hear a knock on the entrance floor from the waiting room. D) The client has a right to informed consent. (Taylor et al., 2019). situation is changed or becomes inaccessible such that its value is A disclaimer to call back if her symptom worsens or others develop would end up this call. I had Floseal and Surgicele on board; both were effective means of helping to control bleeding. I didnt want to hang up with her without knowing if her husband was able to come home in case she just decided not to come in. I explained that placing an NGT through his nose might tract into his brain and there is no clear evidence on the extent of his facial injuries. 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. agrees to be morally responsible for the consequences of his or her 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. ( Presencing: Being with a patient maximizing the patients participation and control in his recovery. Remember that the charge nurse role is about leading a group of highly educated, motivated individuals. 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 . Current license to practice as an RN in California. Dr. S said Mr. P did not voice any complaints to him and he looked ok. I immediately paged the surgeon on call, notified HBS, who recommended I do what I could to protect the surrounding skin, made a referral for the Would Care RN and then got the would care/ostomy cart. The count board showed 30 laparotomy sponges but the sponge counter showed 28 sponges. Once you have written your exemplar, have several people (both clinical and nonclinical) review it. threatening complications. Cross). I rushed to A-side trauma room 1. (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. Whether the patient is not responding to a particular therapy, this nurse has an inquisitive need to search continually for the reasons. Quality improvement is a process and model that ensures that or a large area of rural residents. The Staff Nurse III is self-directed in ways consistent with the physicians scope of responsibility knowing whats required in order to best serve patients. bloodstream collect at the site of vascular injury, form a plug, living (ADLs) and instrumental activities of daily living (IADLs). I told her not to be scared. I asked him about his pain and he still had some but was unable to give a 1 to 10 scale number; he pointed to his chest. Applicants will be notified of the Committees decision within ten (10) business days of the interview. This nurse knows the scope of the Staff Nurse III level of responsibility and with this understanding, acts in the patients best interest. Where will the work you have accomplished lead the chapter and your community? Transfers Transfers to: 1. I noticed that the mood of the surgeons changed; suddenly they were trying to establish homeostasis. By this time, the doctor who had been thrust into this situation, (because he hadnt left the clinic for lunch), returned to tell me that the ED physician had requested that he call the cardiologist on call who in turn requested that he make an appointment for the patient in a few days. The Staff Nurse III follows every avenue to ensure that these individuals thoroughly understand the illness, the plan of care, the medical procedures used and the implication these have for the patient. While awaiting a physicians assistance during a crisis, the Staff Nurse III confidently manages the patients care by making decisions and effectively directing others. Additional letters of recommendation may be submitted in case one or more letters do not meet requirements. In the same visit, it was necessary to instruct and coordinate the technical side of managing his pain. I acknowledged her fears of her husbands surgery and assured her that the whole surgical team would be doing their best to render a safe and successful surgery. ethnicity, poverty, biological sex, age, mental health, educational level, I was able to promote calmness in spite of deteriorating patient condition. Comfort Comfort is a persons sense of psychosocial, emotional, and physical 1. I stayed focused and organized at all times and was able to achieve the best outcome. 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. He surely did not have his Mr. P smile and he was just not right. 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. Coagulation (DIC), Attention Deficit Hyperactivity Being a cardiac nurse, I immediately placed a heart monitor on her she was in atrial fibrillation and I feared she was also becoming septic. Iv|7:On-uBV?N[!NC Please use additional pages if needed or replicate this format in a separate document. Not sure where he has been receiving his medical or psychiatric care. ( Combating the hazards of immobility: Preventing and intervening with skin breakdown, ambulating and exercising patients to maximize mobility and rehabilitation, preventing respiratory complications. On August 6th T. climbed out of his bed during the night and pulled out his line. She states that she had some complications after delivery. 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. I will develop an information sheet for caring for patients with chest tubes within three months. against liability or loss of professional licensure. When the patient is on the line you ask questions, clarify them, look at the history, search in CIPS for past visits, diagnosis, labs, medications, allergies, look for other resources available for that particular case. The CCMD agreed with my evaluation and ED with a driver was the best outcome. By integrating my experience, my computer skills and ability to provide a calming environment, I successfully gained her confidence and trust. For example, Nursing Because the family brought the medication to the ED, the doctors could see the amount of pain made he was on from the pump settings and a peripheral IV was started. Area of Clinical Specialty ( Ambulatory Care ( Home Health/Hospice ( Hospital 10. Lab results were within normal limits and I made it a point that the patient had been typed and screened for possible blood transfusion. On my last day with this patient, he was still able to communicate his needs to me. 2. trailer A narrative summary must be included highlighting the applicants strengths in clinical practice and/or professional activities. The purpose of the exemplar is to communicate the chapters contributions and accomplishments that > u kJ bjbjUU o ?g?g5 2 ~ ~ / / / 0 0 0 8 >0 "2 t 0 W 4 ( 4 : 4 4 5 k V V V V V V V $ nZ $] W Q / i k W ~ ~ 4 5 [ bW _ _ _ ~ R 4 / 5 V _ V _ _ r J * " 'T 5 # unique to particular groups. ORGANIZATION AND WORK-ROLE COMPETENCIES ( Coordinating, ordering and meeting multiple patients needs and requests: Setting priorities. Communication behaviors in clinical settings have been studied through observation, 9 self-report logs, 810 and ethnographic 13 methods. Verification of Hours Paid Form (if applicable) Performance Evaluation within the last 12 months at midpoint or above on average. formation of a stable clot composed of fibrin to prevent excessive Photocopies of CEs, CMEs, college credit certification, need to be included in the portfolio when the application is submitted. AJN, 97(6). 0000000016 00000 n Through my therapeutic communication techniques I was able to connect into the deepest fear that my patient and his wife had within them. C) The nurse witnessed the consent. paid time): Application: I year total hours ________/week. This nurse combines flexibility with expertise to ensure that the team provides patients with consistent and safe care around the clock, even in the fact of work overload, acute staff shortage and the inexperience of new team members. Charge nurses also offer feedback when needed or provide more support as necessary. Examples of successful exemplars are shown below. Across the Life Span, Disseminated Intravascular endstream endobj 5 0 obj <> endobj 4 0 obj <>/ProcSet[/PDF/Text]>>/Type/Page>> endobj 21 0 obj <>/ProcSet[/PDF/Text]>>/Type/Page>> endobj 24 0 obj <>/ProcSet[/PDF/Text]>>/Type/Page>> endobj 27 0 obj <>/ProcSet[/PDF/Text]>>/Type/Page>> endobj 41 0 obj <>stream Name of Committee: _______________ Date Joined: _______________ Committee Charter/Purpose: Committee meeting schedule: Monthly Every other month Quarterly Other Individuals contribution to the committee: (Please list how/what you contribute to the committee or how you share the information with your staff.) The team also encouraged his daughter to take a more active role in his care which she was willing to do. Nurses can Signed Performance evaluation based on the applicable performance standards for each year at the midpoint or above on average Electronic and hand signatures are accepted; however, AACC requires hand signatures of RN managers on the evaluation. the range 7 to 7. The charge nurse role requires diligence, patience, and skill. I had the family bring in a new bag of morphine and talked the ED nurse through the programming of the CADD pump and instructed her to start the infusion via the peripheral line while we were waiting for the PIC placement. NUR 347. Based on her symptoms and her story (takes Tums with no help) an advice to try taking one the antacids first was appropriate. I was able to support this family in their time of grief because I had support from my teammates. THr="^PgsF#r/tJeD($ALF7$q#Wc1m0H Monitoring and Ensuring the Quality of Health Care Practices First I asked the operator to page the on-call hospice nurse to see if he/she had any awareness of this 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. My patient and his wife were both counting on me. As a confident and caring professional, dedicated to my patients independence, I was able to guide this patient as he started his final journey. in performing and directing client care, and then begin to visualize normal balanced state and are perceived as a challenge, threat, or 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. Five (5) years of applicable RN experience within the last five years. Assist the Facility Selection Committee in making the best decision possible. In this exemplar I used the following Benners domains of nursing practice: The helping role The teaching- Coaching function The diagnostic and monitoring function Effective management of rapidly changing situations Monitoring and Ensuring the Quality Of health Care Practices Exemplar #1 In one evening I received a call on the Spanish line. 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