I had Floseal and Surgicele on board; both were effective means of helping to control bleeding. I became the point of care for this mans treatments. Stimulation of Recognizing that the team as a whole is an integral part of any individual members effectiveness, this nurse fosters team effort with understanding that to provide patient care, every member must collaborate with the other nurses and physicians on the team. against liability or loss of professional licensure. It was my job to ensure my patients safety at all times. For an informal chat, contact our Nurse Talent Specialist, Jane Jarvis, on 01977 630830 or NurseTalentSpecialist@exemplarhc.com. WebNursing recognition occurs on many levels and in many ways. I coordinated with the radiology nurses and the patient was able to go from the ED to radiology for his new PIC line and then home with the transportation the MSW had helped to arrange. 0000002625 00000 n normal balanced state and are perceived as a challenge, threat, or T o c a l c u l a t e s c o r e m u l t i p l y t h e r a t i n g b y t h e w e i g h t a n d s u m t o a c h i e v e t h e t o t a l . NAME (Last, First, Middle) 2. The administrator did not know anything about this patient. The upper and lower jaw was loose and appeared to be floating. He has been placed on a medical hold for his manic behavior and chasing cars. 3. These guidelines were developed to assist you in assembling the various components of your professional portfolio. Some of them were bags that normally are used for urostomies that would allow me to turn the valve at the end of the bag to remove the drainage without actually having to change the whole device. The physician also asked another nurse in the room to place a Nasogastric Tube to decompress the stomach. Leadership is the process of persuading and influencing others toward a H2 blockers can be used if symptoms dont subside but they cannot be used more than 2 weeks. Nurses who excel in managing client He expressed his appreciation for being on top of things. I always felt at ease knowing that everything was accounted for. ( Getting appropriate and timely responses from physician. The boundaries for I notified HBS that maybe we should start some probiotics before c-diff came a knocking on her door. The Staff Nurse III grasps the whole picture and so is in control of the situation, able to create order out of chaos. affect ones health. document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); Welcome to Tracys ProfessionalPortfolio. 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. the body (the acidity and alkalinity of body fluids). 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). 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. In planning for the admission of 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. STAFF NURSE III, HH/H III SIGNATURE PAGE FOR MENTOR Mentors Name________________________ Mentor Signature______________________ Date ________________________________ STAFF NURSE III, HH/H III RECEIPT OF APPLICATION FORM Application Submission: Date application submitted:_________________________________Time application received:__________________________________ Application received by:____________________________________ Note: please provide applicant with a signed copy of this page as verification of receipt of SN III/ HH/H III application.) I immediately intervened by speaking with his nurse and educating her regarding the needs in this case. grooming, feeding, and toileting. 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). Multitasking is a quality that I possessed as an OR nurse. I continued to use active listening skills throughout the rest of the call. Diagnostic and monitoring function: Through all my years of training and experience, I have gained a high level of self-confidence and the ability to make nursing/medical diagnoses with a high degree of accuracy. Examples of successful exemplars are shown below. Verification of Hours Paid Form (if applicable) Performance Evaluation within the last 12 months at midpoint or above on average. 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.) Unit/Shift _________________/___________ Facility__________________________________ Phone: WORK___________________ HOME___________________ OTHER______________ R.N. Nursing Exemplar 2018.docx. WebAbstract. I knew the fear and frustration this family was feeling about it their mother was going to be safe and have her pain controlled. I advised that I needed to take him to the procedure room so that he could lie down. Ability to Give specific examples to reinforce your statements. Thanks to everyone who submitted an Exemplar this year! Describe clinical situations, which you believe positively impacted by your practice. ( Providing emotional and information support to patients families. 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. Courses that are approved by the BRN or the Continuing Medical Education (CME) shall be applicable. There was a bullet entry, yet no exit wound. She told me that she is calling because of the burning in the mouth of her stomach. She explained to me that she had just delivered a baby girl 3 days ago, and she had awakened in the middle of the night last night with a moderate to severe HA. I asked her how severe her HA was last night and she said it was 9/10 but now it was 4-5/10. (see letter attached) The Helping Role: I am a confident and caring professional who is dedicated to achieving positive patient outcomes. I then aged the Team Lead physician. She got impatient about too many questions. 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. I had a heavy assignment that day and soon realized that the complex wound care box on our grasp sheet would not begin to reflect the amount of nursing care that this man would require. :.KfXy4\_@,xyBl=SO7dkavd[o>tyL4!zD#V8KoLK8maFv\{L((&fB~*D (6[N?Ip`/bxV`JJ *VHbhIJgJ;qVUryJTG H#,(@u[6I8=BQuU@HU=WQ0t$#nJnzsDOk. Throughout the crisis, the Staff Nurse III draws upon excellent clinical skills and judgment, along with lessons learned from the past experience. The night ED team decided to admit him to the OBS unit instead of sending him home so late knowing that he lived alone. She had been discharged from 4W and after returning home for a brief period of time, returned with major abdominal pain. 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. Admission, discharges, and intensity of patient care can create chaos within minutes. A key component of this nurses professionalism is the consistent choice to maintain and projects both caring and sensitively toward patients, using touch and presence. Write your exemplar so that others a patient, a family member, someone from the general public or even the medical field, and most importantly the award reviewers can grasp the nature of your work and its value to patients, your community, and society as a whole. Include how you felt about the situation, why you think your actions may have differed from someone with less experience. WebExemplar status is the highest of four possible program levels, recognizing our commitment to providing the highest level of geriatric care. I immediately instituted a plan of care for him. Some salaries range from $16.33 to $36.11 per hour. The Staff Nurse III or HH/H Nurse III will apply for renewal at the end of the three (3) year classification. This time, I got a BP that was indeed elevated but the pulse was 30. See Guidelines for Letter of Recommendation. The nursing staff feels that they have the information, support, and resources to perform their tasks efficiently and effectively, and they also have opportunities for advancement, continued education, and input into nursing policies. I immediately noted multiple head depressions related to being hit by a hammer numerous times. You will be contacted by a member of the committee shortly after the monthly meeting in which your portfolio was reviewed. She couldnt get in touch with her husband but one of her coworker agreed to drive her. My IV skills are excellent, but over the course of his admissions multiple IV sticks became more difficult. An effective charge nurse uses critical thinking to quickly assess and decide if immediate action must be taken to protect the patient's health. This allowed him to be able to participate more in his care. The family was calling to ask that the patient be readmitted to the hospital immediately. With much team effort and the cooperation of many departments Ted was home that evening. An exemplar is a story, not a case study or a report. 2. I returned to the holding room approximately 45 minutes later. See calculation below. complications. Nominations to the committee to fill vacancies will be made by the Staff Nurse III and IV and Home Health Nurse peers. especially in high-acuity settings. ( Providing an early warning signal: Anticipating breakdown and deterioration prior to explicit confirming diagnostic signs. The Deaconess Nurse of the Year is selected from the exemplars. In this first link you will find an exemplar 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. Through a conversation involving the doctor, this patient, and myself; we decided on an action plan to control his pain which had started to increase daily. I noticed that the mood of the surgeons changed; suddenly they were trying to establish homeostasis. Without a leader with strong organizational skills, a unit can spiral into dysfunction and disorder. After receiving report I was able to visual see Mr. Y. from the nurses station. Do-Study-Act. Benner believes in the situation-based, interpretive approach to identifying and describing knowledge, which is imbedded in everyday clinical practice. WebOne Clinical Exemplar; Minimum of 3 professional goals; Professional Resume or Curriculum Vitae; Please be sure that your portfolio is complete prior to submission. A charge nurse is responsible for the effective performance of a particular nursing shift or team. Cognition Cognition is the brains ability to process, retain, and use Please describe and critique your current nursing practice in a Clinical Exemplar. I treat every call I take with responsibility, professionalism, kindness and compassion. Once again, she returned to surgery, resulting in a colostomy. 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.) She agreed. R.N. Nurses can I reassured her that it was common for new moms to feel this way. 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. I stayed focused and organized at all times and was able to achieve the best outcome. 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. The Regional Appeals Committee shall be composed of six members and two (2) alternates. Choose a mentor from the local FSC mentor list. As I didnt have any information in CIPS I asked her if she is taking any medication prescribed by a doctor. I will achieve my CEN within the next six months. She states that she had some complications after delivery. ( Anticipating and preventing periods of extreme work overload within a shift. I recommended and facilitated a PICC line insertion so I would have a more permanent access and a way to draw the endless lab tests that would follow creating less pain and trauma for my patient. The appendix of this packet includes a lengthy description of Benners Domains and helpful examples of exemplars. ( Using goals therapeutically. His family arrived at that time. I made my rounds with my other patients, and noticed Mr. Y. has not moved since that last time I observed him. She was afebrile, voiding clear urine, had no history of kidney stones and denied any pain. Blood loss brings about disturbance in fluid and electrolyte imbalance that could rapidly alter cardiovascular, neurologic and neuromuscular functions. 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. I gather all my data and in my SBAR presentation I described her symptoms and I emphasized that women at her age and menopausal, can have atypical chest pain. I checked all the instrumentations and surgical supplies with my surgical technologist. identified by the American Association of Colleges of Nursing (2008): is the condition that exists when the persons universal spiritual J. wanted to stay home and be with her 3 day old newborn, she did not want to leave her daughter. I knew that the patients vital signs were deteriorating. These concepts may be addressed in letters of recommendation in addition to the five required concepts above: 6. The room was dim and Mr. P was awake, but he did not acknowledge me when I went in. (Taylor et al., 2019). The surgeon started dissecting and everything turned out to be smooth again. A charge nurses salary will vary based on geographical location, as well as experience and type of hospital or unit. 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. Though all of these diagnoses are an Axis I in the Diagnostic and Statistical Manuel of Mental Disorders, they are not treated the same. We are bringing in an 88 year old male patient complaining of chest pain, alert, with stable vital signs. Required Documentation/Checklist (it is recommended that you assemble your portfolio in the following order): Please be sure that your portfolio is complete prior to submission. 3. This may have been acceptable, but not the right thing to do. 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. Writing Exemplars word doc.doc - Microsoft Word SIGNATURE (PAYROLL)_____________________________________________________ SIGNATURE OF MANAGER___________________________________________________ DATE______________________________________ Letter of Recommendation Form The Staff Nurse III and HH/H III functions in the clinical setting as an exemplary care giver to patients, a model of proficiency for co-workers, and a colleague to physicians. While I was waiting for an interpreter I was looking in CIPS to find some information about 49 years old, Mrs. C.. geographic area, whether a small neighborhood within a large urban area Clinical Practice Exemplars Historical Background: The SN III/HH/H III classification is recognition of excellent clinical nursing practice. I quickly looked through her history and CIPS and began to triage her through the Postpartum protocol. Some specialty units require even more time. They were upset and afraid that their mother would not get the pain medicine she may need and asked if one of the family members could spend the night in the patients room to observe and assist her. 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. ( Providing comfort and communication through touch. How to check the stoma, prepare the peri-skin and how to change the appliance. This nurse stood back and said Whats wrong? I explained to the nurse that because of the patients facila injury it would be safer to place the NGT orally. They soon realized I understood their concerns and was there to help. These tests are run 6 hours after the initial set of labs, meaning they were not drawn with result back until after 2300. (see required details that follow in this packet) Staff Nurse III or HH/H III Checklist (part of Scoring Guidelines) Submitting these materials in the order listed above would be helpful but not required. Please contact a member of the Facility Selection Committee to determine how to access these example exemplars. While working I heard someone yell for help and it sounded as if it were coming from A side. The simple task of scheduling a PIC line placement now became a serious nursing challenge. What influenced your decision-making to do certain things or take specific actions? meet personal needs; they include personal hygiene/bathing, dressing/ WebA nurse manager has created a culture of empowerment among the nursing staff. ( Administering medications accurately and safely: Monitoring untoward effects, reactions, therapeutic responses, toxicity and incompatibilities. My preoperative assessment of the patient uncovered nothing remarkable except for his Right Renal Cancer. of sadness and yearning), social (feeling detached from others and I asked her for how long she is having this pain today. I put my orca eye right next to his eyes and a tear rolled down his cheek and many down mine. Flexible charge nurses maintain stability in the unit and treat nurses as individuals, accommodating different work styles. threatening complications. Charge nurses identify problems and solve related issues. She denied that the HA got worse with sitting up or better with lying down. ( Identifying and managing a patient crisis until physician assistance is available. In this case my time was already over twenty five minutes. Please use additional pages if needed or replicate this format in a separate document. I gathered all the information I could and verbally reinforced the importance of the isolation and the need for compliance. I then called that physician to let her know my assessment and concerns. When health care is provided in The additional caregivers and team members that were brought in to assist with T.s care were there to provide the family with the respite they needed to be wife and daughter rather than primary caregiver in the end. informed consent, documentation, incident reporting, the Patient Self- A nurse's workday is unpredictable. They address problems that arise in their unit while juggling administrative tasks like scheduling, staffing, and monitoring patient care. et al., 2019). 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. Knowing T. did not want to be in the hospital, I reassigned my patients for the day and began coordinating a new PIC line placement and transfer to home. 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Who is dedicated to achieving positive patient outcomes became the point of care for this mans treatments departments Ted home.