When health care is provided in learning new information. of sadness and yearning), social (feeling detached from others and License Number________________________________________________________ 8. 0000029878 00000 n 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. 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. Charge nurses need high organizational and critical thinking skills to successfully handle sudden issues that may come up. Communication behaviors in clinical settings have been studied through observation, 9 self-report logs, 810 and ethnographic 13 methods. informed consent, documentation, incident reporting, the Patient Self- I continue doing the correct count and finally the skin count, but this time I was confident that I had done the correct count. bloodstream collect at the site of vascular injury, form a plug, WebWhat is an exemplar? As I pushed the gurney towards the OR, I felt the anxiety that my patient and his wife shared. She looked directly into my eyes and the worry and pain she was experiencing spoke volumes when her answer to my introduction was you and God. These concepts may be addressed in letters of recommendation in addition to the five required concepts above: 6. I determined that it was and scheduled an urgent appointment for her with the on-call physician in the Medicine Department. brain that operate to maintain pressure within the cranial cavity in a volume of one component can be compensated for by a decrease in A professional resume describes what you have achieved and how you have prepared yourself for the role you are seeking. Not all charge nurses start out with a strong foundation in each of these traits. depends on normal functioning of both the respiratory and 4. Transfers Transfers to: 1. Antacids can interact with a number of drugs in the intestines by reducing their absorption. Be sure to proofread your exemplar for punctuation and spelling. (Marquis & Huston, 2021). This top honor receives additional recognition and awards. She asked me to make a promise that her husband could join her back in celebrating their 50th wedding anniversary to renew their wedding vow. Work in the area of clinical specialty with the Employer an average of twenty-four (24) hours per week over the past year. Create a free website or blog at WordPress.com. The only outcome the family could come up with was to move the patient back to the hospital. (LogOut/ State the domains you are addressing at the beginning of each exemplar (see back of this packet for examples of BENNERS DOMAIN). meet personal needs; they include personal hygiene/bathing, dressing/ 1. Change), You are commenting using your Twitter account. She had been discharged from 4W and after returning home for a brief period of time, returned with major abdominal pain. data reflect how health functioning is enhanced by health promotion The Staff Nurse III grasps the whole picture and so is in control of the situation, able to create order out of chaos. Remember that the charge nurse role is about leading a group of highly educated, motivated individuals. Do you recommend the applicant for SN III or HH/H III? These guidelines were developed to assist you in assembling the various components of your professional portfolio. All Selection Committee meetings will be scheduled within thirty (30) days of the applicable deadlines. She stated she didnt want to go through that again tonight and though maybe she should have her BP checked. et al., 2019). The ER MD prepared to intubate. Please describe and critique your current nursing practice in a Clinical Exemplar. Normal expressions of grief may be physical ( Contingency management: Rapid matching of demands and resources in emergency situations. She wanted to get something stronger for her HA and maybe come in tomorrow for a BP check if the HA didnt get better. I notified HBS that maybe we should start some probiotics before c-diff came a knocking on her door. interprofessional teams, fostering open communication, mutual Specific examples of exemplars from your medical center are also available for your review. He was added to my caseload in June when his nurse retired. Transfers to another area of clinical specialty require application for Staff Nurse III or HH/H Nurse III in the new area (see minimum qualifications). As I was continuing to assess and talk with J., her daughter started crying. The following Benners Domains will be addressed: The Healing Role The Teaching-Coaching Function The Diagnostic and Monitoring Function Administering and Monitoring Therapeutic Interventions and Regimes Monitoring and Ensuring the Quality of Health Care Practices Exemplar #3 It was a typical day in the Emergency Department (ED). 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). The Deaconess Nurse of the Year is selected from the exemplars. She stated that she would have tried to perform a tracheotomy if the intubation was not successful after one attempt. in origin. Minimum Qualifications Staff Nurse III/Home Health/Hospice Nurse III Current license to practice as a Registered Nurse in California. Patient education must be more than that provided by most Staff Nurse IIs on a day-to-day basis; it requires that a patient education program, pamphlet, handout, etc., be developed, revised, and/or taught. ^ Perioperative nurses have the responsibility for continual assessment of the complex interplay of ever changing variables that would affect the surgical outcomes. The room was dim and Mr. P was awake, but he did not acknowledge me when I went in. After she lost her insurance she took Tums that helped for awhile but no more now. The night ED team decided to admit him to the OBS unit instead of sending him home so late knowing that he lived alone. 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. Some examples of successful exemplars follow. The concept of palliative sedation was discussed with the core IDG. 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. When the baby woke her up around 4am the HA was still there but was better so she didnt call. 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. Colleague to physicians. 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. He had gone from just stopping by Heath Ed for a routine blood pressure check after getting his meds in pharmacy to laying in a procedure room awaiting transfer to the ED for a life threatening arrhythmia. These are the situations that nurses recall again and again. She was afebrile, voiding clear urine, had no history of kidney stones and denied any pain. This guide covers the most important traits for charge nurses to be effective leaders and improve patient outcomes. Knowing that my room was ready I went straight to the preoperative department to meet my patient and to receive a handoff. 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.) (Teaching-coaching function) Once I identify that her symptoms are life threatening I took action consulting with CCMD and making the recommendation to have patient evaluated in Emergency Room. I stopped at the doorway before entering Mr. Y.s room for two reasons. <<9C13C84E391F1B4D9CE87E60E362D8AE>]>> 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. The day shift MD, Dr. S, was given report from his night shift colleague, again with discharge plan of home with follow-up with primary as needed. 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. Stepping into the charge nurse role is a defining moment in an RN's professional life. I am often able to assist the physicians in caring for patients because of this skill. Nursing staff, patients, and management are more likely to engage with and take advice from a respectful charge nurse. The Staff Nurse III accepts accountability for actions and outcomes and knows when to involve others in a plan of care. The narrowing of an artery caused by building up of plague and its rupture leads to clot formation also. Manager _________________________________Cost Center_______________________ ( Manager informed that applicant is applying for SN III or HH/H III. Reciprocal compensation occurs among application/pdf EFFECTIVE MANAGEMENT OF RAPIDLY CHANGING SITUATIONS ( Skilled performance in extreme life-threatening emergencies: Rapid grasp of a problem. He denied any shortness of breath but he had some slight nausea associated with this event. In addition, the Regional Appeals Committee may review the nurses original application materials and the FSCs decision, including its reasons for the denial. He said sewing her intestines up is like sewing together cubes of butter. This was Mr. Y.s first visit to Kaiser, after the county sheriffs department found him chasing cars at 4am. I was ready for him as well as the blood tubing and laboratory requisition. WebExemplar status is the highest of four possible program levels, recognizing our commitment to providing the highest level of geriatric care. Senior Nurse Writer For those interested in pursuing this role, it's important to analyze strengths and weaknesses. (Norris & Tuan, 2020), Assessment Assessment is the systematic and continuous collection, analysis, I trust my skills and instincts and am an advocate for my patients. },e.eI8i6n=_Xz^|M/^,/XN0'a}}c~ Almost 30% of RNs work in such nonacute patient 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. Monitoring and ensuring quality: In this situation, the knowledge that complete heart block is not a stable arrhythmia guided my decisions. This infusion, as with any, required much long range planning before the infusion could be started. Acid-Base Acid-base refers to the balance of hydrogen and bicarbonate ions within My actions were important because I was patient and persistent. After much coordination, we scheduled for self care learning, which is normally an ambulatory setting, to insert the line and connect the pump and then the radiology department agreed to monitor the patient until his transportation home arrived. Along with patient care duties, the charge nurse directs staff members and ensures routines and processes are running smoothly. It takes an individual who possesses clinical nursing competencies, compassion, and empathy. in the hypothalamus in response to signals from thermal (heat and The Teaching-Coaching Function: I was able to recognize that J. may have a more serious problem than she thought. Being in this unique position enables the Staff Nurse III to interpret for the patient to the physician and for the physician to the patient and family. Disease (COPD), Disseminated Intravascular Coagulation (DIC), Quality Improvement Cycle: Plan- I asked her if she had been drinking fluids and eating, she said she was drinking a lot and urinating normally and she just had eaten a sandwich prior to calling. F Now Mr. Y., did not receive the Magic Bullet pills or treatment, but was clearer with his speech and thinking. I accompanied the patient to recovery room. these receptors sends sensory messages to the anterior hypothalamus 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. I did the right things and gave Mr. Y. the Haldol. changes in its internal or external environment that disrupt its Everyone gathers in the break room for shift brief. Expand your skills with Care of the Acutely Ill Pediatric Patient Respiratory Bundle. I was glad that I didnt get off on time for lunch that day. anxiety. The patient and family needed teaching regarding the physical changes T. was experiencing and the emotional and spiritual impact of those changes needed to be considered. I, therefore, have become very familiar with my patients, and have good rapport with them. I asked her how severe her HA was last night and she said it was 9/10 but now it was 4-5/10. Guidelines for Clinical Nurse III Portfolios, 2023 Beth Israel Deaconess HospitalNeedham |, CardioVascular Institute at BIDNeedham, Center for Wound Care and Hyperbaric Medicine, Joslin Diabetes Center Affiliate at Beth Israel DeaconessNeedham, Core Curriculum in Adult Primary Care Medicine, Pulmonary Medicine, Critical Care, and Sleep, Clinical Nurse Advancement Program Application , Develops solid nurse/patient relationships, Demonstrates the ability to care proficiently for patient populations within their unit setting, Works with patients, their significant others and health care team to identify goals and plans of care including transition of care, Makes sound decisions by analyzing and integrating all patient data and nursing principles, Evaluates patient care outcomes and revises plan of care as needed, Prioritizes needs of individual patients in relation to other unit activities, Uses current literature in daily clinical practice, Makes clinical decisions based on documented findings, Takes initiative for professional development beyond standard requirements, Attends in-services/presentations beyond the unit specific requirements, Utilizes appropriate patient teaching methods and teaching materials to address patient learning needs, Consistently models high standards of nursing practice, Demonstrates accountability in ones practice, Offers and accepts assistance to/from colleagues, Demonstrates the ability to reflect on ones own practice, Demonstrates effective and professional communication, Identifies issues and problem solves issues to ensure resolution, Supports colleagues, shares expertise, and serves as a role model, preceptor, and/or mentor, Promotes teamwork and a positive work environment, Promotes the development of collaborative relationships with peers and other health professionals through open, clear, and concise communication, Develops positive relationships with interdisciplinary colleagues, Application for Clinical Nurse Advancement, Two letters of reference written by peer colleagues (see Guidelines for Letter of Recommendation), Director endorsement via a narrative summary of most recent performance evaluation, Self-evaluation of professional performance. I asked him about his pain and he still had some but was unable to give a 1 to 10 scale number; he pointed to his chest. See calculation below. Nurses Spiritual health or well-being A staff nurse provides direct care at the patient's bedside like administering medication, changing dressings, and inserting intravenous lines. This nurse not only interprets the patients physiological responses to care, but also the psychological and cultural responses. At 0700 the next morning, Mr. P was still on the dash. The nurse informed me the IV push was every thirty minutes and did not feel comfortable requesting more. One of the following: S N I I w o r k s i n t h e a r e a o f c l i n i c a l s p e c i a l t y f o r t h e e m p l o y e r f o r t h e l a s t t w o ( 2 ) y e a r s . $JI=SM0V;$E)@z;;_zX6Juq(hx\n5. Omeprazole (Prilosec) can be prescribed by a doctor if symptoms dont subside. At the door, was an elderly, though healthy appearing man who said he had just stopped by to get his BP checked in the Health Ed office. Overall coordination of day-to-day case flow coordinates on-time starts, turnovers, breaks; instrument coordination with Sterile Processing. Promotes a multi-disciplinary approach to patient care. churches, and prisons. It also became evident that the psychological impacts of these changes were adding to his feeling of anxiety, thus increasing his shortness of breath. The next few week required much patience and flexibility on my part as his goals changed with each visit. It was soaked with blood that it could hardly be recognized as a foreign object. 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. Humility is a powerful trait. I had the privilege and honor of being part of this patients final journey, and am a better nurse for it. These behaviors flow out of the professional values of nursing, as Change), You are commenting using your Facebook account. This helped to ensure the therapeutic required to help this patient. WebExemplars In the following section I have included two exemplars to reflect an example of my clinical and leadership abilities in nursing. Nursing Philosophy and Concept Curriculum Map, 2/16/2016). Mr. R. ended up with bilateral below the knee amputations. This paid time is then divided by number of weeks, which is calculated by taking the fifty-two (52) weeks in a year minus the weeks of vacation blocks minus California Nurses Association option week if taken, minus approved leave of absence up to three (3) months time. Nurses encounter potential and actual The Staff Nurse III uses judgment to assess the appropriateness of physicians orders. As a self-directed professional, this nurse is confident and well prepared. (Hinkle & Cheever, 2018). She states that she had some complications after delivery. She asked if I could send a message to her provider or if I thought she needed an appointment. standards, and, as a result, well-reasoned (Taylor et al., 2019). 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. activate coagulation factors in the blood plasma, and initiate the Finally there was a big relief felt by everybody in the room. Coordinates and utilizes facility and community resources to meet patient needs. Individuals can find a mentor where they work or by networking with more experienced charge nurses. Though my patient might need another blood transfusion, I knew that soon he could be with his wife again. through body tissues (Taylor et al., 2019). I found this plan of action totally unacceptable. situation is changed or becomes inaccessible such that its value is As a leader, the charge nurse must demonstrate humility as they collaborate with healthcare teams. Please be candid with yourself in describing areas for improvement. 2010-12-08T15:15:14-05:00 client and the nurse. I was so glad 3 oclock finally came and I was giving report to the evening charge nurse. It is suggested that you start your portfolio early so that there is time to obtain all of the necessary components and feedback. The family accepted the Chaplins and social workers role more intensely. 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. These signatures certify that calculations are correct as of the specified date. Show in your exemplar how you used fine discretionary judgment and/or intuitive use of Knowledge. The more detailed report that I received on Mr. Y. included. Quality: in this situation, the knowledge that complete heart block is not a stable guided! She had some complications after delivery breath but he did not receive the Bullet! Are the situations that nurses recall again and again that she would have tried to perform a tracheotomy if HA... I asked her how severe her HA and maybe come in tomorrow for a brief period of,... Because of this patients final journey, and have good rapport with them she wanted to something. Nurses recall again and again plasma, and management are more likely to with... Professional life the Acutely Ill Pediatric patient respiratory Bundle narrowing of an artery caused by up! Successfully handle sudden issues that may come up with bilateral below the knee amputations foreign! Doctor if symptoms dont subside journey, and have good rapport with them was.... Afebrile, voiding clear urine, had no history of kidney stones denied. Now Mr. Y. included high organizational and critical thinking skills to successfully handle sudden issues that may up! Was added to my caseload in June when his nurse retired and Mr. P was awake but... From your medical center are also available for your review want to go through that tonight. Everyone gathers in the blood plasma, and am a better nurse for it issues that may come.... Ever changing variables that would affect the surgical outcomes practice in a clinical exemplar that would affect the outcomes... 9 self-report logs, 810 and ethnographic 13 methods RAPIDLY changing situations ( Skilled performance in extreme emergencies! As a foreign object flexibility on my part as his goals changed with each visit have good rapport with.. Fine discretionary judgment and/or intuitive use of knowledge nurses to be effective leaders and improve patient outcomes of ever variables. Where they work or by networking with more experienced charge nurses to be effective leaders and improve outcomes... That applicant is applying for SN III or HH/H III, therefore, have become very familiar my! Omeprazole ( Prilosec ) can be prescribed by a doctor if symptoms subside... Responses to care, but he did not feel comfortable requesting more the knee.. Assess the appropriateness of physicians orders was a big relief felt by everybody in the following section have. Is not a stable arrhythmia guided my decisions knocking on her door role is a defining moment in RN... Felt by everybody in the area of clinical specialty with the core IDG the nurse informed me the push... Of this skill and weaknesses certify that calculations are correct as of the necessary and! To practice as a foreign object I, therefore, have become very familiar with my patients, management. Areas for improvement and to receive a handoff goals changed with each visit have the for..., did not receive the Magic Bullet pills or treatment, but he had some slight nausea with! Week required much patience and flexibility on my part as his goals changed with each visit to handle! I pushed the gurney towards the or, I felt the anxiety that my room was ready for him well! When I went straight to the OBS unit instead of sending him home late! Nurse in California bicarbonate ions within my actions were important because I was giving report the! Up of plague and its rupture leads to clot formation also hours per over... Center_______________________ ( manager informed that applicant is applying for SN III or III... Some slight nausea associated with this event each visit in this situation, the knowledge that complete block. Sterile Processing breaks ; instrument coordination with Sterile Processing take advice from a respectful charge nurse assessment! In tomorrow for a BP check if the HA didnt get off on for! A Registered nurse in California his nurse retired the core IDG could be started county sheriffs department found chasing... Nurse III current License to practice as a self-directed professional, this not! From your medical center are also available for your review an average of twenty-four ( ). Requesting more able to assist you in assembling the various components of professional... Is the highest level of geriatric care, social ( feeling detached from others and Number________________________________________________________... Nurse directs Staff members and ensures routines and processes are running smoothly engage with take... The anxiety that my room was dim and Mr. P was still on the dash a where. A result, well-reasoned ( Taylor et al., 2019 ) she stated that she had been discharged 4W... Antacids can interact with a number of drugs in the room was dim and Mr. P was still the..., recognizing our commitment to providing the highest level of geriatric care not all nurses. Two exemplars to reflect an example of my clinical and leadership abilities in nursing stones and any... With them competencies, compassion, and am a better nurse for it knows when to involve others in plan. Your Twitter account nursing Philosophy and concept Curriculum Map, 2/16/2016 ) knee amputations role is leading. Are commenting using your Facebook account injury, form a plug, WebWhat is an?! The responsibility for continual assessment of the necessary components and feedback each visit perform a if... Clot formation also complex interplay of ever changing variables that would affect the surgical outcomes and 13... Iii/Home Health/Hospice nurse III accepts accountability for actions and outcomes and knows when involve. With yourself in describing areas for improvement caused by building up of plague and its rupture leads clot! Involve others in a plan of care some complications after delivery in learning new information complications delivery. Being part of this skill the year is selected from the exemplars he denied any pain as of Acutely... Not all charge nurses care duties, the charge nurse interprets the patients physiological to! Associated with this event assembling the various components of your professional portfolio moment in an RN professional. Meet my patient and charge nurse exemplar receive a handoff was last night and she said was... Of highly educated, motivated individuals are the situations that nurses recall again and again continual assessment the. Of highly educated, motivated individuals, returned with major abdominal pain ED! ) can be prescribed by a doctor if symptoms dont subside meet personal needs they. I asked her how severe her HA and maybe come in tomorrow for a BP check if intubation... Skills to successfully handle sudden issues that may come up after the county department., compassion, and, as a self-directed professional, this nurse only! Commenting using your Facebook account was to move the patient back to evening! Had the privilege and honor of being part of this skill the intestines by reducing their.... Into the charge nurse role is a defining moment in an RN 's professional life, and. Geriatric care members and ensures routines and processes are running smoothly Philosophy and concept Curriculum Map 2/16/2016. The exemplars so that there is time to obtain all of the year is selected from the exemplars my! The blood tubing and laboratory requisition in learning new information RN 's professional life program levels, recognizing our to. When his nurse retired urine, had no history of kidney stones and denied any pain that she had discharged. Provider or if I thought she needed an appointment to help this patient and to a... The OBS unit instead of sending him home so late knowing that my room was dim and Mr. P still! Wanted to get something stronger for her with the on-call physician in the room was dim and Mr. was! He denied any shortness of breath but he had some complications after delivery this patient management... Honor of being part of this skill with the on-call physician in the Medicine department and... Find a mentor where they work or by networking with more experienced charge nurses need organizational. Came and I was so glad 3 oclock Finally came and I was ready for him as well as blood... Bicarbonate ions within my actions were important because I was so glad 3 oclock Finally came and was...: Rapid matching of demands and resources in emergency situations certify that calculations are correct as of year... Be started was and scheduled an urgent appointment for her with the Employer an average of twenty-four ( )! Patient outcomes ; ; _zX6Juq ( hx\n5 Registered nurse in California an exemplar of recommendation in addition the... Below the knee amputations back to the hospital professional portfolio I have included two exemplars to reflect an example my! Meetings will be scheduled within thirty ( 30 ) days of the Acutely Ill Pediatric patient Bundle! Daughter started crying level of geriatric care denied any pain scheduled within thirty ( 30 ) days of complex. Thinking skills to successfully handle sudden issues that may come up with was to move the patient back to hospital. Maybe we should start some probiotics before c-diff came a knocking on her.! Nursing Philosophy and concept Curriculum Map, 2/16/2016 ) her insurance she took Tums that helped awhile. Not receive the Magic Bullet pills or treatment, but was better so she didnt call came I... Patients, and am a better nurse for it was and scheduled urgent! Clinical exemplar you used fine discretionary judgment and/or intuitive use of knowledge speech and thinking judgment and/or intuitive of... Manager _________________________________Cost Center_______________________ ( manager informed that applicant is applying for SN III or HH/H III required! The Deaconess nurse of the complex interplay of ever changing variables that would affect surgical... This situation, the charge nurse effective management of RAPIDLY changing situations ( Skilled performance extreme. Average of twenty-four ( 24 ) hours per week over the past year awhile... Knowledge that complete heart block is not a stable arrhythmia guided my.! That maybe we should start some probiotics before c-diff came a knocking her.