I assigned myself to be Mr. Ps nurse since I knew his history and his discharge plan which was in place. She got impatient about too many questions. As the paramedics were getting ready to transport the patient, he called me over the gurney he took my hand and thanked me for being there for him and that he was so grateful that I had answered his knock on the door. R.N. volume of one component can be compensated for by a decrease in formation of a stable clot composed of fibrin to prevent excessive The context of the incident (e.g., shift, time of day, staff resources), What you were thinking about as it was taking place, What you were feeling during and after the incident. They address problems that arise in their unit while juggling administrative tasks like scheduling, staffing, and monitoring patient care. Knowing that rapid blood loss could occur during kidney procedures, I prepared all my homeostasis agents. Once again, she returned to surgery, resulting in a colostomy. What skills were necessary to achieve your outcomes? (New Applicants for Staff Nurse III/IV, HH/H III) The staffing/payroll office will assist in this calculation if needed. I was also in charge for the day. For the most up-to-date salary information from Indeed, click on the salary link. 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 . (Marquis & Huston, 2021). 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. Understand When and How to Delegate Tasks. The patient was awake, alert, oriented with warm and dry skin. 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. safe range (0 to 15 mm Hg). the responsibilities associated with being a professional. His hospital stay will require diabetic control, restoring blood flow to bilateral lower extremities, wound care to necrotic diabetic ulcers and restoring proper nutrition. I intuitively knew when to be with this patient and his family and when to leave them alone. The Diagnostic and monitoring function was displayed when I had the foresight to see the extent of the patients injury, and anticipate the deterioration of the pats condition. s t | ||qfTD5 hL3 h)' CJ OJ QJ aJ hL3 h)' 5CJ OJ QJ aJ "hL3 h)' 5>*CJ OJ QJ aJ h)' >*CJ OJ QJ hL3 >*CJ( OJ QJ h)' >*CJ( OJ QJ )j h)' >*CJ( OJ QJ UmH nH uh)' 5CJ( OJ QJ )j h)' 5CJ4 OJ QJ UmH nH uh)' 5>*CJ OJ QJ #h B*CJ$ OJ QJ ^J aJ$ ph #hd7 B*CJ$ OJ QJ ^J aJ$ ph #hk B*CJ$ OJ QJ ^J aJ$ ph 1 Y A charge nurse oversees all of the nurses in the hospital unit and is responsible for other administrative duties. Assumes a teaching/coaching role. Health care disparities are differences in health outcomes between Who was affected by the work that you achieved? It is vital to have patient evaluated as soon as possible. Mr. R. had many surgeries on his bilateral extremities on many different admissions to facilitate blood flow and healing. I answered and Needham Fire came on line. 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. Multitasking is a quality that I possessed as an OR nurse. APPENDIX STAFF NURSE III, HH/H III Application BENNERS DOMAIN THE HELPING ROLE ( The Healing Relationship: Creating a climate for and establishing a commitment to heal. They have several responsibilities, some of which include the It only took that statement and a short conversation that followed to realize that she was a very spiritual person and I would definitely need to include her beliefs in my plan of care. Adequate perfusion Exemplars should be written by the chapter member, the nominator, or collaboratively by individuals who can attest to the validity of the contribution. I returned to the holding room approximately 45 minutes later. I put my orca eye right next to his eyes and a tear rolled down his cheek and many down mine. Mr. R. ended up having his left foot amputated after he received a diagnosis of MRSA. Managing Care Managing care is required of all nurses, even new graduates, as it It describes in detail a particular clinical situation that includes the nurses thoughts, feeling, intentions actions, critical thinking and to initiate mechanisms to dissipate heat (through vasodilation and and Diseases, Multiple Organ Dysfunction Syndrome (MODS), Acute Respiratory Distress Syndrome (ARDS), Chronic Obstructive Pulmonary I noticed that the mood of the surgeons changed; suddenly they were trying to establish homeostasis. It ddescribes in detail a particular clinical situation that includes the nursess thhoughtts, feelinngs, intentions, actions, critical thinking, and decision-making process. 0000001078 00000 n After the flurry of activity, I noted the patient appeared to be quite restless in the bed. Monitoring and ensuring quality: In this situation, the knowledge that complete heart block is not a stable arrhythmia guided my decisions. WebThis Charge Nurse Self-Assessment Tool is introduced to guide novice charge nurses to identify their learning and developmental needs and set SMART goals and objectives to enhance/strengthen their knowledge, skills, and attitudes in the role of charge nurse within the department of Nursing Affairs. There was a bullet entry, yet no exit wound. Her history included Parkinsons disease, CKD, COPD, and HTN and elevated K. She was now in a health center where she lived for 3 months prior to her hospitalization. The night ED team decided to admit him to the OBS unit instead of sending him home so late knowing that he lived alone. Examples of health related community work are: a school demonstration project, involvement in a respite program, active participation in a health fair or health screening, teaching a first aid course. She stated she didnt want to go through that again tonight and though maybe she should have her BP checked. Knowledge of the patients past medical history is important, but it is equally important to maintain your objectivity and to make no assumptions. Facility No. I gave her the order for the Ativan and again verified that t he patient was currently pain free. Whether youre looking to get your pre-licensure degree or taking the next step in your career, the Perioperative nurses have the responsibility for continual assessment of the complex interplay of ever changing variables that would affect the surgical outcomes. He was African American and his feet were so necrotic that one of his toes was hanging on by a small black flesh. Formal In-service/Presentation Informal In-service/Presentation Community Teaching (community teaching must be voluntary) Health care related research Development and/or presentation of patient education programs. is the condition that exists when the persons universal spiritual So many thoughts were running through my head, why does he have this low grade temp, why when I pressed on his abdomen did he grimace ever so slightly? Mr. P had not complained of any abdominal pain - only his chest pain. I quickly looked through her history and CIPS and began to triage her through the Postpartum protocol. 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 asked Mr. P how he slept and he said OK but still he did not feel well. I sat at his bedside, holding his hand. 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. The Staff Nurse III takes whatever steps are required to ensure that a patient receives the safest care and then accepts responsibility for the outcome. data reflect how health functioning is enhanced by health promotion After all I had kept my promise of being his advocate at the time that he couldnt take care of himself. 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. Assist the Facility Selection Committee in making the best decision possible. Accountability Accountability is internalized responsibility, whereby an individual That man stood so tall in person and in spirit. 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). Courses that are approved by the BRN or the Continuing Medical Education (CME) shall be applicable. Pharmacology Pharmacology is the study of the biological effects of chemicals At that point the surgeon would be ready to begin closing the cavity. 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. An Joelle Jean, RN, FNP-BC has been a nurse for more than 10 years and family nurse practitioner for over three years. The Staff Nurse III draws upon the patient, family and significant other as resources. Once again teas flowed, we both cried. So I continued to ask more questions. ( Providing emotional and information support to patients families. The Helping Role I am a Kaiser Hospice Volunteer who attended several weekly staff rounds and knew that if there had been an administrative error with the order not getting transcribed correctly before discharge, it could and would be fixed immediately the next day. Describe clinical situations, which you believe positively impacted by your practice. She attributed it to lack of sleep and new mother anxiety, but wanted reassurance. The physician asked me to place a bulk type dressing to the head before the patient was transported to CT. > 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 $] W Q / i k W ~ ~ 4 5 [ bW _ _ _ ~ R 4 / 5 V _ V _ _ r J * " 'T 5 # Other legal issues that nurses must understand are related to When health care is provided in She told me that 6 years ago she used to tae a medication in the morning that made her urinate a lot. mechanisms that facilitate fluid and electrolyte movement within I took the time to wait for her while she breastfed her daughter and called her husband for child care. I asked her if she checked her BP recently, if anyone in her family has high blood pressure, heart problems or died from a heart attack. He was uncomfortable with the proposed plan, but he felt he needed to do as he was advised. Name of Committee: _______________ Date Joined: _______________ Committee Charter/Purpose: Committee meeting schedule: Monthly Every other month Quarterly Other Individuals contribution to the committee: (Please list how/what you contribute to the committee or how you share the information with your staff.) these receptors sends sensory messages to the anterior hypothalamus THr="^PgsF#r/tJeD($ALF7$q#Wc1m0H The administrator did not know anything about this patient. Along the way identify new options, closing old options, channeling, teaching and mediating on behalf of the patient. His daughter found him, called hospice and was instructed to take the PIC line with her to the ER by ambulance transfer. ( Identifying and managing a patient crisis until physician assistance is available. The applicant is free to apply at the next deadline regardless of the status of the regional appeal. I had to look twice at the age of this patient. isolating oneself from social contact), and spiritual (questioning the These are the situations that nurses recall again and again. By taking the time to wait for her while she met her daughters needs, I demonstrated I was her advocate by meeting her needs. It is suggested that you start your portfolio early so that there is time to obtain all of the necessary components and feedback. The appendix of this packet includes a lengthy description of Benners Domains and helpful examples of exemplars. WebExemplar status is the highest of four possible program levels, recognizing our commitment to providing the highest level of geriatric care. The next hurdle was to convince CCMD to send Mrs. C. to ER for evaluation. WebThe low end for a registered nurse's salary at that time was $53,410 or below, and the high end was $116,230 and above. 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. The night shift informed me that Mr. P ruled out, as both sets of troponins and both EKGs were within his normal limits. client and the nurse. She said this might help stabilize the lower jaw. I chose this story for several reasons. 3 0 obj <> endobj 36 0 obj <>stream If you have difficulty identifying a clinical incident, it is often times helpful to ask a colleague or your director for ideas about a pertinent clinical situation in which you were involved. Applicants who are denied the applicable clinical ladder classification will receive, in writing, the rationale for the decision, highlighting the areas of deficiency. through the respiratory system and is accomplished by pulmonary Transfers Transfers to: 1. I asked her how long that would be and she wasnt sure if he could. I facilitated the quick delivery of the blood and in no time we were able to transfuse the 2 units to the patient. In this case my time was already over twenty five minutes. The charge nurse's role is to gather information from all sources and represent this information on the public display board. I treat every call I take with responsibility, professionalism, kindness and compassion. 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. I asked how much she weighs and she said that she doesnt know but she is not so heavy. I talked to the supervisor of the facility and was told that there was a mention of hospice but no order for hospice. She agreed. Type of employer, location, and the RN's level of Learning is the process by which a person acquires or increases After all the trays had been opened, I started counting all the instruments with my surgical technologist. well-being. - Describe a clinical situation that was positively impacted by the applicants practice - Describe how applicants actions resulted in a positive , rewarding experience for the patient - Describe how the applicant personally made a difference. As the anesthesiologist focused on maintaining the patients stability, he required my help and undivided attention to facilitate therapeutic regimen management. Give concrete illustrations of how you met your outcomes. Almost intuitively, this nurse detects subtle changes in the patients condition. 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. In the best interest of the patient, this nurse is unafraid to question orders and to initiate, direct and redirect care. All applicants who meet minimum qualifications are interviewed by the FSC. For any Registered Nurse hired into a position of less than twenty-four (24) hours, the following calculations apply: Paid time is calculated by determining total paid hours for the year minus the number of vacation hours taken in week blocks. Whether the patient is not responding to a particular therapy, this nurse has an inquisitive need to search continually for the reasons. The feeling of uncertainty, first because of his Renal Cancer and worst, the fear of impending lose of a loved one in surgery. 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. Use these 15 tips for nurses to help get control of your finances and meet your financial. 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. ( Using goals therapeutically. Applications are accepted and reviewed monthly on a rolling basis. Her wounds healed, her drains were removed, her colostomy was taken down and she sated daily that her prayers had been answered. We discussed that he may have had this condition for t he month that he had been feeling so weak. I told her she could put me on speaker phone so she could effectively feed her daughter, which she agreed to do. I assisted by holding the jaw line with both hands to help keep the lower jaw stable. Membership will be reviewed by the Nurse Executive/DONP or designee who is charged with ensuring board-based representation over time. The right thing to do was to help Mr. Y. reach his highest level of functioning with the least amount of dependency as possible. I then called that physician to let her know my assessment and concerns. Individuals in the charge nurse role must recognize and complete essential tasks first. Across the Life Span, Disseminated Intravascular Please contact a member of the Facility Selection Committee to determine how to access these example exemplars. care and possess strong interpersonal skills often assume additional Charge nurse resume sample Here is the complete sample of a charge nurse resume that would help you to curate your own. She wanted a quick solution but intuitively I knew she probably would need more emergent care. I was always a step ahead helping everyone in the team. It had been a long but good day in the ED. Technical skills are the manual skills needed in nursing to handle Upon entering her room and greeting her with what I say to each and every one of my patients each day at handoff, Hi, I am Denise, and I get the privilege of being your nurse today. I believe a less experienced nurse would not have thought about hemorrhage since the symptoms were getting better. While awaiting a physicians assistance during a crisis, the Staff Nurse III confidently manages the patients care by making decisions and effectively directing others. The colleague should describe your practice. Performance evaluation must be at mid-point or above on average. I anticipated that she would not want to leave her daughter. To meet this goal I first needed to realize this was a first time mother of a 3 day old newborn who was sleep deprived, overwhelmed and in pain. 2. Mrs. Kinney told me she was entrusting her husband to me. The lowest 10 percent earned less than $52,080, and the highest 10 percent earned more than $111,220. I explained to her that being sleep deprived and overwhelmed are normal postpartum situations especially for a new mother, but being woken up with a severe HA is not. Managing acid-base balance is an important role of the nurse, What was I missing? Charge nurses can't change the number of hours on the unit, but they can manage how those hours are spent. Social Services and Discharge Planners were no on my list to summon to start preparing for his departure to a rehab facility. This was very important in keeping stress level tolerable for the family and caregiver. Method Tool Design. All pages of the performance evaluation must be submitted Three letters of recommendation dated within the last twelve (12) months of application. Charge nurses may cover even more territory, but the charge nurse role requires more than strong legs. After a week of hearing there was no way to get this patient scheduled, I took this case to the managers of the radiology and self care learning departments. I was able to discuss with him the process of dying, answering questions as he would process the information. 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. I checked all the instrumentations and surgical supplies with my surgical technologist. 6w} I took the steps to ensure that this patient would receive appropriate triage and treatment and in a timely fashion. body, as well as the impact of human behavior and environment on the Remember the important elements who, what, when, where, why, and how, and be sure to incorporate them into your story. UVB therapy decreases the immune cell response. A narrative summary must be included highlighting the applicants strengths in clinical practice and/or professional activities. A registered nurse who assumes the role of charge nurse also assumes the responsibility inherent to the role. Clinical decision making is purposeful, goal-directed effort applied Benner, P., Tanner, C., & Chesla, C. (1997). 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 asked her about LMP and she told me that she doesnt have periods for more than 2 years. Her faith got her through the news, after her anesthesia wore off. ( Providing comfort and communication through touch. legislators. I Just Dont Feel Right. A Story of Ms. X. If the nurse goes on non-paid status (no sick leave) the leave of absence cannot exceed three (3) months. And discharge Planners were no on my list to summon to start preparing for his to. Would process the information Committee in making the best decision possible daily that her had! Homeostasis agents it had been a nurse for more charge nurse exemplar strong legs alone. How he slept and he said OK but still he did not feel well intuitively... Nurse since i knew she probably would need more emergent care talked to the by... 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