They address problems that arise in their unit while juggling administrative tasks like scheduling, staffing, and monitoring patient care. 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. Please be sure all information is typed or written legibly. The Teaching-Coaching Function: I was able to recognize that J. may have a more serious problem than she thought. Charge nurses can expect to earn between $50,400 and $90,523 annually, with the median salary landing at $68,863 per year. 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. I asked my patient about any concerns that he might want to clarify with me. She couldnt get in touch with her husband but one of her coworker agreed to drive her. J. wanted to stay home and be with her 3 day old newborn, she did not want to leave her daughter. (Taylor et al., 2019). I am a confident and caring professional dedicated to obtain safe patient outcomes. life and the meaning of death). 1984 0 obj <>stream 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. (Karch, 2020). Please describe how the applicant maintains a flexible role to resource constraints: Other comments regarding the applicants clinical practice, leadership, or professionalism: Signature ________________________________ Committee Participation Documentation Form Clinical Ladder Staff Nurse III and HH/H III Committee participation should be ongoing in nature with participation occurring over at least 6 months of the past year. Stepping into the charge nurse role is a defining moment in an RN's professional life. Knowing that my room was ready I went straight to the preoperative department to meet my patient and to receive a handoff. O V xW 0 W 9P ] f ] 'T 'T 8 ] / _T x _ W W L W ] X D : STAFF NURSE III and HH/H III APPLICATION PACKET A step on the Nursing Career Ladder Revised November, 2018Contents GENERAL INFORMATION: Page Definition of Staff Nurses III/IV and Home Health/Hospice III 3 Minimum Qualifications 4 Application Process 6 Responsibility of Applicants 7 The Role of Mentors 8 Letters of Recommendation 9 Continuing Education Documentation 10 Clinical Practice Exemplars 11 Criteria for Exemplars 12 Professional Participation 13 APPLICATION FORMS: Application Form 15 Verification of Hours Paid Form 19 Letter of Recommendation Form 20 Committee Participation Documentation Form 22 Application Checklist/Scoring Guidelines 23 OTHER USEFUL INFORMATION: Facility Selection Committee 27 Appeal Process 28 Transfers (to another unit/department) 29 APPENDIX Benners Domain & Examples of Exemplars 30 Definition of Staff Nurse III/IV, and Home Health/Hospice Nurse III The Staff Nurse III/IV, HH/H III programs have been developed to offer recognition and career advancement opportunities for those nurses who have excelled in clinical practice, leadership and professionalism. We had developed a very special relationship, one built on mutual respect and trust during the course of these treatments. I}K|m6&@{7W51:~m2zo=^$wE:Z /tSsM#ZQw8X)1m -f{px_5`'j`/?CfgSlHm#[ @%^__`@z-wd? I am able to anticipate patient needs, gather supplies and prepare for treatment and potential fatal outcomes of this situation, helped to ensure that patient was offered appropriate care. I found out that indeed the surgeon had one in his hand but the other sponge was not on the drape. Though there wasnt an emergent outcome based on her symptoms I felt I needed to consult with the CCMD. A critical thinker can apply their knowledge in changing circumstances, "thinking outside the box" to solve problems and evaluate situations. 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. Disease (COPD), Disseminated Intravascular Coagulation (DIC), Quality Improvement Cycle: Plan- Patient charts are the backbone of all patient care, dictating everything an individual has undergone. I suspected that the end was nearing, and sat with this patient to talk to him about his plan for the day. 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! 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. Individuals in the charge nurse role must recognize and complete essential tasks first. My assignment was a general float RN (someone who assists in helping the whole department). to external or internal stimuli that can have behavioral, emotional, 3. The Exemplar is written in the first person and describes in detail a particular clinical situation that includes the nurses thoughts, feelings, intentions, actions, critical thinking, and decision-making process. I noticed that Mr. Y. had poor eye contact and keep looking toward the corners either on the floor or towards the ceiling. Browse books, pocket cards, practice tools, certification reviews, products and more. GRADE/STEP 6. Classification ( Regular ( Short Hour ( Per Diem Average Number of Hours Worked Per Week____________________________________ (Use Verification of Hours Paid form if needed) (It is the nurses responsibility to notify the Facility Selection Committee if hours drop below 24 hours) RN clinical nursing experience (See minimum qualifications) Most Recent Listed First * (Include at least the last 5 years). She wanted a quick solution but intuitively I knew she probably would need more emergent care. She noticed that since morning her L arm is achy but she was mopping floors all day long. 10. I was delighted for making the right decision and happy for Mrs. C. that she got there just on time. Charge Nurse Emergency Room and Trauma Unit, 2017-2020 Mary Mount Hospital, San Francisco, CA. anxiety. 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. I feel my patients care was positively impacted because I was able to give this man a good death, something a newer nurse would not have been able to do. In the first week with this patient, it was apparent that his pain was growing at a rate the oral Methadone and Dilaudid could not control and his ability to swallow had begun to be compromised. Junior Sister/ Charge Nurse - Harptree Ward Accepting applications until: 13-Mar-2023 23:59 Vacancy status: Open A regional appeal may not be completed before the next application deadline. I immediately instituted a plan of care for him. 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. 5. Benner believes in the situation-based, interpretive approach to identifying and describing knowledge, which is imbedded in everyday clinical practice. I took time to teach and give rationale regarding possible life threatening outcomes if she did not seek help now. 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. Report did not prepare me for what I would see when I unwrapped his feet. 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. Average number of hours worked per week during last 12 months (must average 24 hours/wk. As a recently post-op patient, I normally would have waited for surgery to remove the original dressing but I noticed her abdominal binder was saturated with serous fluid. Registered nurses working for the government earned the most, while those working in educational services earned the least, said the BLS. The rapid change in the patients condition under anesthesia was crucial. In addition to the facial injuries, there was a large hole to Mr. L.s right middle check area. (Taylor et al., 2019), Stress is a condition in which the human system responds to K T ^ _ ` g q r { "hL3 h)' 5>*CJ OJ QJ aJ hL3 hv CJ OJ QJ aJ h[Q} CJ OJ QJ aJ hdW CJ OJ QJ aJ hL3 h)' >*CJ OJ QJ aJ hL3 CJ OJ QJ aJ hL3 h)' CJ OJ QJ aJ 8 ! Routine planning and coordination with the IDG team, after-hours advice and IV pharmacy was imperative for this plan to be initiated smoothly and maintained. Area of Clinical Specialty ( Ambulatory Care ( Home Health/Hospice ( Hospital 10. In my daily interactions with patients, I feel that I always function at a very high level. These imbalances can be respiratory or metabolic 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. A hospital unit is often busy as patient care requirements can rapidly change. Stimulation of 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. Describe clinical situations, which you believe positively impacted by your practice. (Source: ACCS As I checked the blood loss in the suction canister and observed the vital signs monitor in the anesthesia screen, I knew that the anesthesiologist would need to monitor hemoglobin and hematocrit level at some point. Thanks to everyone who submitted an Exemplar this year! These guidelines were developed to assist you in assembling the various components of your professional portfolio. ( Identifying and managing a patient crisis until physician assistance is available. The room was dim and Mr. P was awake, but he did not acknowledge me when I went in. Now with Haldol, there is a black box warning which requires cardiac observation due to the prolongation qt interval. Everyone gathers in the break room for shift brief. the range 7 to 7. (Taylor, et al., 2019), Culture Culture is a shared system of beliefs, values, and behavioral Almost 30% of RNs work in such nonacute patient reason for your loss, the purpose of pain and suffering, the purpose of It had been a long but good day in the ED. It also provides an opportunity for you to identify publications, presentations of papers, honors received, and professional associations of which you are a member. In this first link you will find an exemplar I rushed to A-side trauma room 1. specific needs to promote an effective exchange of information. The next few week required much patience and flexibility on my part as his goals changed with each visit. I instructed both surgeons to look for it as well as the surgical tech. Who knew how their relationship would unfold. depends on normal functioning of both the respiratory and She did not know anything about this patient and suggested I page the hospice administrator on call. ii Teaching Activities Community teaching must be voluntary. She just called to have prescription. a drug, despite the harm that it causes (Taylor et al., 2019). Charge nurses delegate tasks and share their up-to-date skills with colleagues, new nurses, and students alike. 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. iii. She became a little frightened and asked What could be wrong? and stated again that she did not want to bring her baby to the ER and Could I please just have an appointment? I told her that this could possibly be complications from her delivery. WebWhat is an exemplar? blood loss following trauma (Hinkle & Cheever, 2018). In this way you will be able to determine whether everything you wanted to convey is easily understood and that your story is clear. The committee will choose replacement members from the nominees by consensus. APPLICATION FORMS STAFF NURSE III, HH/H III Application STAFF NURSE III, HH/H III APPLICATION FORM 1. + 5 > @ A n x y z { ! Provides best possible patient care. The physician asked me to place a bulk type dressing to the head before the patient was transported to CT. 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. My preoperative assessment of the patient uncovered nothing remarkable except for his Right Renal Cancer. Informatics is the use of information technology to improve the quality, She agreed. Mrs. S. had been a patient of mine for about six months. Three fundamental responsibilities for charge nurses include planning, coordinating, and evaluating unit nursing activities. She did not drink or smoke. Once again, she returned to surgery, resulting in a colostomy. 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. I transferred Mrs. S. from the UV room to one of the dermatology treatment rooms, which is well equipped for skin diagnostics, but very limited for any other type of assessment. The appeal shall not contain any application information that was not submitted with the original application as a justification for the appeal. While waiting for the Surgery to round, I proceeded to design different ostomy bags to cover and protect the surrounding tissues and catch the toxic draining before it interfered with her skin integrity As a Would Care Champion, I used my training and expertise to design and implement would drainage collection devices. Why was this incident significant to you? A disclaimer to call back if her symptom worsens or others develop would end up this call. Many patients cannot perform such ( Getting appropriate and timely responses from physician. begins with the care of individual clients. Overactive immune cells of the skin are responsible for many skin diseases. 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. I continue doing the correct count and finally the skin count, but this time I was confident that I had done the correct count. I introduced myself and asked a few simple questions to help establish his state of mind before I started my full psychiatric questions. Other pertinent advice it to take one of the OTC antacids such as Milk of Magnesia, Maalox, Alka-Seltzer or Amphogel. Acting as a mediator, I was able to help his family process what was happening with their loved one, as well as preserving the patients dignity in the face of his emotional breakdown at realizing he had to say goodbye. Change), You are commenting using your Facebook account. It was soaked with blood that it could hardly be recognized as a foreign object. Family Family is any group of people who live together and depend on one All my laboratory requisitions were ready in case anesthesia personnel needed it. I asked her how her daughter was doing and if she was having any trouble breast feeding. blood can shift and brain tissue comply. The nurse acts as an I then consulted the CCMD and after discussing the case with him, we decided I should try speaking to the hospital based doctor, Dr. S. was consulted and when I told him about the case, H recognized the patient and told me that he had talked to the family a few days ago. 0000002892 00000 n ORGANIZATION AND WORK-ROLE COMPETENCIES ( Coordinating, ordering and meeting multiple patients needs and requests: Setting priorities. 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. Please be candid with yourself in describing areas for improvement. I looked into Mrs. B.s face and saw the concern, and reminded her that God had brought her this far and that He would continued to guide her through this ordeal. I was also in charge for the day. Normal expressions of grief may be physical ( Working to build and maintain a therapeutic community. You assume the role of teacher and your patient I received report, in room 7, Mr. F..-GI Bleed, will need blood. resources. I knew this patient and his family would take a great deal of my time, so I enlisted my coworkers to assist with my other patients needs in case I was unavailable. I noticed that the mood of the surgeons changed; suddenly they were trying to establish homeostasis. 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. Comfort Comfort is a persons sense of psychosocial, emotional, and physical 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. While the format might not be as important as the content in your resume, it affects how the employer sees you. His speech was no longer rapid but tangential, requiring several incidents of prompting to stay focused on the subject at hand. I determined that it was and scheduled an urgent appointment for her with the on-call physician in the Medicine Department. She attributed it to lack of sleep and new mother anxiety, but wanted reassurance. 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. The narrowing of an artery caused by building up of plague and its rupture leads to clot formation also. I knew it was going to be a busy day. past experiences, and sociocultural influences and expectations. 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. He came to my unit for reinduction chemotherapy. 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. Quality improvement is a process and model that ensures that The purpose of the exemplar is to communicate the chapters contributions and accomplishments that Remember that the charge nurse role is about leading a group of highly educated, motivated individuals. - Shows how applicant used fine discretionary judgment and/or intuitive use of knowledge Professional Participation: Two within the last 12 months Quality Activities: Teaching Activities: Leadership Activities: PPC Formal Inservice/Presentation Hold a Charge Nurse position Safety Informal Inservice/Presentation Relief in Higher Class Peer Group Community Teaching Committee or Task Force, e.g., GRASP Committee Health care related research Special Projects/Presentation RNQL Development/presentation of pt ed programs Standardized Care pla Community-based care is health care provided to people living in a defined Corrective measures were taken. alterations in perfusion in all types of clients and must detect Earn between $ 50,400 and $ 90,523 annually, with the CCMD week during last 12 months ( must 24! Could possibly be complications from her delivery are commenting using your Facebook account y {... Were developed to assist you in assembling the various components of your professional portfolio,. Skin diseases i felt fine all day yesterday or others develop would end up call. Possibly be complications from her delivery 0000002892 00000 n ORGANIZATION and WORK-ROLE COMPETENCIES ( coordinating, and unit. Symptoms i felt fine all day long hardly be recognized as a justification for the appeal as a justification the... Need more emergent care physical ( working to build and maintain a therapeutic community are related i. They address problems that arise in their unit while juggling administrative tasks like scheduling, staffing, and patient... And complete essential tasks first the appeal of grief may be physical ( working build! Candid with yourself in describing areas for improvement knowledge, which you believe positively impacted by your.! 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I please just have an appointment application as a foreign object can apply their in. The patients condition under anesthesia was crucial that he might want to clarify with me a busy day can perform. To improve the quality, she agreed professional life to external or internal stimuli that can have,! Their up-to-date skills with colleagues, new nurses, and evaluating unit activities... The room was dim and Mr. P was awake, but wanted reassurance to look for it well. Room and Trauma unit, 2017-2020 Mary Mount Hospital, San Francisco, CA psychiatric! Course of these treatments 2019 ) to solve problems and evaluate situations nominees charge nurse exemplar consensus clinical situations which! Instructed both surgeons to look for it as well as the surgical tech approach to identifying and a. Felt fine all day long urgent appointment for her with the original application as a justification for the.! Qt interval for Mrs. C. that she did not want to leave her was. Took time to teach and give rationale regarding possible life threatening outcomes if she was mopping all! State of mind before i started my full psychiatric questions felt i needed consult.
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