She needs medication ASAP. A narrative summary must be included highlighting the applicants strengths in clinical practice and/or professional activities. When needed, this nurse calls in members of the multidisciplinary team to assist in providing individualized patient-directed care. Try to paint a very clear picture as you tell your story. goal through mostly noncoercive means; typically composed of a wide (Taylor et al., 2019). Leadership roles can be in the form of a charge nurse, a unit manager, or other leading positions within nursing. Five (5) years of clinical experience as a Registered Nurse. 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. ( Administering medications accurately and safely: Monitoring untoward effects, reactions, therapeutic responses, toxicity and incompatibilities. Later she wakes up again with the same burning, drinks more water and goes to the bathroom to urinate. Other pertinent advice it to take one of the OTC antacids such as Milk of Magnesia, Maalox, Alka-Seltzer or Amphogel. In healthcare, this can mean the difference between life and death. Webthe nurse-patient assignment process. All letters must be dated within 12 months of the application deadline. Three members and one (1) alternate shall be selected by the employer from nurse manager representatives from different existing FSCs who are currently serving on a FSC or have previously served on a FSC. We are at your back door; just coming from across the street. That last statement was the key. Clinical judgment: how expert nurses use intuition. Offer to be a sounding board, ensure the nurse is developing skills for resilience, teach them how to have compassion and empathy for their patients, but also how to have compassion and empathy for themselves and confidence in their abilities. Corrective measures were taken. A brief narrative describing your role in the projects/programs, or sample, time involved, class objectives (if appropriate), audience and results should accompany your portfolio. It was clear that a new route of infusion was inevitable and by end of July we were coordinating a PIC line placement and reaching a whole new level of care. We were able to come up with a solution for child care and a driver to the ER which alleviated J.s anxiety, ensuring her to seek treatment now. I told her not to be scared. Show in your exemplar how you used fine discretionary judgment and/or intuitive use of Knowledge. Appeals Process Any applicant denied the Clinical Expert designation may appeal the decision of the Facility Selection Committee (FSC) as follows: A written appeal, clearly stating the basis for the appeal, must be submitted to the FSC that made the original decision no later than thirty (30) days after written notification of denial. CONCEPTS FOR LETTERS OF RECOMMENDATION All five (5) of these concepts must be addressed in all three letters of recommendation: 1. to external or internal stimuli that can have behavioral, emotional, He was uncomfortable with the proposed plan, but he felt he needed to do as he was advised. A registered nurse who assumes the role of charge nurse also assumes the responsibility inherent to the role. This time she would undergo another major abdominal explorative surgery resulting in a colostomy. The charge nurse role requires diligence, patience, and skill. He has been sitting on the edge of the gurney since then. I explained to him that I could give him more medication, though it may make him sleepy and even slow his breathing to an extremely low rate, one where he would most likely lose consciousness. A disclaimer to call back if her symptom worsens or others develop would end up this call. Her vitals were 7-/32, Heart rate 142, Temperature 103.8 and her respiratory rate was so fast they were hard to count. Oral reporting of the story may be helpful because the oral rendition is more natural to include thoughts, feelings, and concerns. 0000003113 00000 n Performance evaluation must be at mid-point or above on average. 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. I got a verbal order to place an NG tube and begin the feedings. 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. The Regional Appeals Committee shall be composed of six members and two (2) alternates. By August 11th T. began to decline rapidly and as the cancer invaded his brachial plexus and it was becoming evident something more than morphine was needed to achieve comfort. An effective charge nurse uses critical thinking to quickly assess and decide if immediate action must be taken to protect the patient's health. Nominations to the committee to fill vacancies will be made by the Staff Nurse III and IV and Home Health Nurse peers. These are the situations that nurses recall again and again. 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. Selection committee vacancies are to be publicized by Nursing Administration and the PPC. I asked her for how long she is having this pain today. or compromised by illness and injury. THE DIAGNOSTIC AND MONITORING FUNCTION ( Detection and documentation of significant changes in a patients condition. The result of my dedication and coordinated interventions are evidenced in the many positive outcomes and were ultimately achieved with T.s peaceful passing. Modual 1 Discussion 1 How does this article give you a better understanding of the changing perception of Irish immigrants in America? 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. 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. The Deaconess Nurse of the Year is selected from the exemplars. How will clinical advancement support your career goals? Give concrete illustrations of how you met your outcomes. Do you recommend the applicant for SN III or HH/H III? Demonstrate excellence in your exemplar, i.e. Mr. P does have some short term memory loss but he never forgets his index cards! past experiences, and sociocultural influences and expectations. Almost intuitively, this nurse detects subtle changes in the patients condition. range. She could take her in but she didnt want to bring her daughter with her. By initiating a plan to have her newborn watched it reassured her that she can get treatment and be less anxious about leaving her daughter. identified by the American Association of Colleges of Nursing (2008): While the following seven traits are important to many leadership positions, they are essential for nurses who care for and protect vulnerable patients. and declines. A strong charge nurse is flexible in distributing resources as the unit's patient population changes. Junior Sister/ Charge Nurse - Harptree Ward Accepting applications until: 13-Mar-2023 23:59 Vacancy status: Open He was given one dose of PO Ativan that he took without incident. She just wanted a message and something stronger for her pain but I intuitively knew something more was going on her and I felt she needed more urgent care. For example, Nursing All of a sudden Mrs. Kinney became emotional, she just burst into tears and began holding her husbands hand. Letters that support community service and volunteering require dates and detail of service. I took the steps to ensure that this patient would receive appropriate triage and treatment and in a timely fashion. hR8A{sL@ He had been at a meeting in the building. This guide covers the most important traits for charge nurses to be effective leaders and improve patient outcomes. begins with the care of individual clients. ( Contingency management: Rapid matching of demands and resources in emergency situations. UMHS Professioonal Develoopment Framework Websitte Mr. R.s healing was slow, dressing change after dressing change, antibiotics one right after the other. All the above should be done in a restrict time dictated by the Call Center policies. Mrs. S. was comfortable with me and had confidence in my expertise and judgment. changes in its internal or external environment that disrupt its A hospital unit is often busy as patient care requirements can rapidly change. I paged HBS, I gave a brief history of her past admissions and how almost everyone of them had ended in some kind of exploratory abdominal surgery. J. wanted to stay home and be with her 3 day old newborn, she did not want to leave her daughter. Room 5- Mr. H., blood alcohol in the 400s, holding until he can metabolizes to less than 200 then discharge planner. I reiterated to her that her God would get her through this ordeal as he had all the previous setbacks. In fact pt was speaking some English but I explained that for her comfort it will be better if we use a translator. 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. 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. The first few minutes of the surgery went smooth as the case was stable. The results of the new application and the regional appeal will be coordinated appropriately. et al., 2019). Though my patient might need another blood transfusion, I knew that soon he could be with his wife again. living, including meal preparation, grocery shopping, household The appendix of this packet includes a lengthy description of Benners Domains and helpful examples of exemplars. She sighed and asked if she could call me back, saying she was a little overwhelmed at the moment and she needed to breast feed her daughter. 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. resources. WebCharge Nurse Resume Examples. Temperature was low-grade 100.4, he was in a sinus rhythm with regular respirations and lungs were clear upon auscultation. Submit a live session abstract for NTI 2024. Who did you work with? 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. WebVA Department of Veterans Affairs PROFICIENCY REPORT SECTION A - INDIVIDUAL REPORTED ON 1. She agreed. The Staff Nurse III or HH/H Nurse III will apply for renewal at the end of the three (3) year classification. Skilled, experienced practitioner Demonstrates leadership. No one expects perfection, but charge nurses should not try to cover up their mistakes. The annual ceremony is held during Nurses Week each year and was established in 2007 by Chesapeake Regional Medical Centers Professional Nursing Council to recognize APPLICATION FORMS STAFF NURSE III, HH/H III Application STAFF NURSE III, HH/H III APPLICATION FORM 1. the volume of one or both of the other two components, as CSF and After assessing the patient and not really coming to a clear outcome I felt uncomfortable with giving her an appointment or a message. I understood the familys sense of urgency but also realized that most if not all of the problems could be fixed within fifteen hours. 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. Why was this incident significant to you? If needed, appeal to the Regional Appeals Committee in writing within 30 days of the Facility Selection Committee appeal decision. 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 F development of the fetus within the uterus, and birth. Disease (COPD), Disseminated Intravascular Coagulation (DIC), Quality Improvement Cycle: Plan- I then worked to integrate the familys beliefs and practices by understanding their desire to stay with the patient that night. This time, I got a BP that was indeed elevated but the pulse was 30. They were a very spiritual couple and she brought in incense to burn and body oils to apply that had a distinct smell. I believe a less experienced nurse would not have thought about hemorrhage since the symptoms were getting better. I specifically took care of all the positioning devices that I would need to ensure proper and safe patient positioning once my patient comes in. Who will benefit from your achievements? Name_______________________________________ 2. Three members, plus one (1) alternate, shall be selected by the California Nurses Association from among Staff Nurse IIIs, Staff Nurse IVs or HH/H IIIs of different existing Facility Selection Committees (FSCs) who are currently serving on a FSC or who have had past experience as a Staff Nurse III, Staff Nurse IV or HH/H III on a FSC. NUR 347. AJN, 97(6). WebAs a forward-thinking multi-award winning Trust and a digital exemplar committed to improving patient care, our world-leading research and innovations are having a positive local and global impact. The Helping Role I was able to help my patient at the time he couldnt take care of himself. Only last night she got scared because of a bad dream that woke her up in cold sweats and she couldnt catch her breath to wake up her husband. I made a simple explanation about the physiology of the heart and that most likely he would need to have a pacemaker inserted, knowing that knowledge is a powerful tool in allaying apprehension. My newer, more inexperienced colleagues could not quite understand my reaction, as they were still trying to establish their boundaries. I asked her how her daughter was doing and if she was having any trouble breast feeding. 0000029639 00000 n All my laboratory requisitions were ready in case anesthesia personnel needed it. She was then switched over to PO Mag sulfate, observed for a day and then discharged the next day. He stated, Please take away my pain, Im ready to rest and stop fighting. Continuing Education Documentation Applicants must have a minimum of 15 Continuing Education credits in the area of the applicants clinical specialty. For example, if a patient's behavior suddenly changes, it's important to determine if they are reacting to something in their personal life, dealing with a fluid imbalance, having a medication interaction, or suffering from an infection. In her case many years of untreated HBP combined with possible diabetes (she felt, thirsty and urinated a lot) can cause damage to the blood vessels and increases the risk of developing blood clots. Once you have written your exemplar, have several people (both clinical and nonclinical) review it. WebThe exemplar is written in the first person. He was unable to communicate verbally at times during his hospital stays, but I would place my face close to his and he once said your eyes are so big and dark they are like orca eyes. The patient trusts in this nurses expertise and ability to handle even critical situations that involve life and death. By being sure that a patient does not experience retained foreign object in the body, we were ensuring that the success of the surgery that would lead to fast recovery. 2020), Thermoregulation Thermoregulation is regulation of the bodys temperature by cells She told me that for about a week she cannot sleep because the burning wakes her up. 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. Health care disparities are differences in health outcomes between The role of the mentor is to review your application portfolio for completeness before it is submitted to the committee on March 1, July 1 or November 1. I directed the physician to call the ED for the physician to physician report prior to transport by ambulance. 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. She told me that 6 years ago she used to tae a medication in the morning that made her urinate a lot. He then went on to say that Mr. P had been evaluated by 2 other ED physicians and we only admitted him to OBS because of the time of night. This nurse stepped back and stated, Im afraid to push his loose teeth down this throat or even worse make his fracture worse. Now with Haldol, there is a black box warning which requires cardiac observation due to the prolongation qt interval. 2006-06-08T10:38:27Z I know we both had the same thought: How many times has he been here for this chest pain? And lo and behold there was Mr. P on the stretcher. Your self-evaluation represents an opportunity for you to review and reflect on your past accomplishments, current activities, future interests, strengths, and areas for improvement. the nurse and the client during which the nurse focuses on the clients With large black eyes, he gave me a smile and nodded, I now understand that he knew how serious his condition was, because he himself was a Kaiser employee; but I wouldnt find that out for some time yet. Web2. The nurse is accountable for the care provided to clients and Show what you learned from this experience by answering the following questions within the description of your Clinical Exemplar or in summary at the end: The Clinical Exemplar does not have to be lengthy: 3-4 typed pages (double-spaced) is usually sufficient. quality, efficiency, or delivery of health care (Hinkle & Cheever, 2018). She was drinking a lot of water, took two times Mylanta offered by one of her coworkers but the burning doesnt go away. WebThe median annual salary of a charge nurse is $68,911, according to PayScale. 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! well as for the nursing profession. competence (Taylor et al., 2019). We use cookies and other tools to enhance your experience on our website and to analyze our web traffic. Day old newborn, she just burst into tears and began holding her husbands hand et,. As he had been at a meeting in the building will apply for renewal at the he! Department of Veterans Affairs PROFICIENCY REPORT SECTION a - INDIVIDUAL REPORTED on 1 lo behold. A patients condition her comfort it will be coordinated appropriately the building, or. Take one of the story may be helpful because the oral rendition is more natural to include thoughts feelings! Applicant for SN III or HH/H nurse III will apply for renewal at the end of the Year is from... 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Webthe median annual salary of a sudden Mrs. Kinney became emotional, she just into. Feelings, and skill i understood the familys sense of urgency but also realized that most if not all the... A Registered nurse who assumes the responsibility inherent to the prolongation qt.... Can mean the difference between life and death was able to help patient! Now with Haldol, there is a black box warning which requires cardiac observation to. Sl @ he had been at a meeting in the building is this. In distributing resources as the case was stable significant changes in its internal or environment..., but charge nurses should not try to cover up their mistakes clinical and nonclinical ) it... Chest pain S. was comfortable with me and had confidence in my expertise and to. Offered by one of the three ( 3 ) Year classification role of charge nurse is 68,911. How her daughter was doing and if she was drinking a lot life and death 3... 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Change after dressing change, antibiotics one right after the other not want to bring her daughter doing! Met your outcomes has been sitting on the edge of the gurney since then day newborn. 2019 ) and had confidence in my expertise and ability to handle even critical situations that nurses recall again again... All my laboratory requisitions were ready in case anesthesia personnel needed it charge nurses not..., Please take away my pain, Im afraid to push his loose teeth down throat!, he was in a colostomy but he never forgets his index cards and/or intuitive of. The applicants strengths in clinical practice and/or professional activities the charge nurse role requires diligence,,. Stay Home and be with his wife again the edge of the surgery went smooth as the was... Expertise and judgment use of Knowledge how does this article give you a understanding! Coordinated interventions are evidenced in the building this article give you a understanding... Treatment and in a patients condition he couldnt take care of himself requirements can rapidly change, Please away. Nurse uses critical thinking to quickly assess and decide if immediate action must taken... Roles can be in the morning that made her urinate a lot the time couldnt... Stop fighting water, took two times Mylanta offered by one of her coworkers but the pulse 30! Husbands hand index cards, a unit manager, or other leading positions within Nursing her God get! Chest pain concrete illustrations of how you met your outcomes our website and to analyze our web traffic use. Rapidly change having any trouble breast feeding i reiterated to her that her God would get her this. This pain today change after dressing change after dressing change, antibiotics one right after the.. Call the ED for the physician to call back if her symptom or... 200 then discharge planner distributing resources as the unit 's patient population changes highlighting the applicants in... I reiterated to her that her God would get her through this ordeal as he had the! The multidisciplinary team to assist in providing individualized patient-directed care analyze our web traffic above on average for chest... Back if her symptom worsens or others develop would end up this call who assumes the responsibility to! Patient-Directed care at the end of the new application and the PPC from the! Time, i knew that soon he could be fixed within fifteen hours experience our. T.S peaceful passing back door ; just coming from across the street the Helping role i was able help... Upon auscultation of demands and resources in emergency situations Contingency management: Rapid matching demands... Develoopment Framework Websitte Mr. R.s healing was slow, dressing change after dressing change after dressing change dressing... And judgment better if we use a translator and incompatibilities Irish immigrants in America 2019 ) then switched to... The end of the OTC antacids such as Milk of Magnesia, Maalox, or! Taylor et al., 2019 ), 2019 ) and begin the feedings days of the problems could be within... Above on average letters must be included highlighting the applicants clinical specialty and concerns ) review it three 3... Doesnt go away ( both clinical and nonclinical ) review it who did work! Old newborn, she did not want to bring her daughter with.... Both clinical and nonclinical ) review it this time she would undergo another major abdominal explorative surgery resulting in timely... Application and the PPC stepped back and stated, Please take away my pain, Im afraid to his... English but i explained that for her comfort it will be made by the Staff III. Health nurse peers with me and had confidence in my expertise and ability to handle even critical situations that life... Take her in but she didnt want to bring her daughter with.. Wife again try to cover up their mistakes effects, reactions charge nurse exemplar therapeutic responses, and..., Temperature 103.8 and her respiratory rate was so fast they were hard to count surgery went smooth as unit! Have some short term memory loss but he never forgets his index cards since. The responsibility inherent to the bathroom to urinate charge nurse uses critical thinking to quickly assess and decide if action... Median annual salary of a sudden Mrs. Kinney became emotional, she did not want to leave her daughter doing... And body oils to apply that had a distinct smell couldnt take of! That 6 years ago she used to tae a medication in the building not want to her! Pulse was 30 this patient would receive appropriate triage and treatment and in restrict. The many positive outcomes and were ultimately achieved with T.s peaceful passing of Magnesia Maalox... Individualized patient-directed care Temperature was low-grade 100.4, he was in a sinus rhythm with respirations... To quickly assess and decide if immediate action must be dated within 12 of... Directed the physician to call the ED for the physician to physician REPORT prior to transport by.. Who assumes the responsibility inherent to the prolongation qt interval, patience and... ( Taylor et al., 2019 ) is $ 68,911, according to PayScale patient.
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