Browse books, pocket cards, practice tools, certification reviews, products and more. It was wonderful to see her personality start to immerse. Nursing Exemplar 2018.docx. Health care disparities are differences in health outcomes between (Letters of recommendation written for charge nurses should address clinical skills and not Charge Nurse Duties.) In a way, trapping the schizophrenic and preventing the patient from using their coping mechanisms in dealing with their symptoms. threatening complications. This number must equal twenty-four (24) hours or more in order for a nurse to meet the hours worked qualification. Photocopies of CEs, CMEs, college credit certification, need to be included in the portfolio when the application is submitted. D) The client has a right to informed consent. In the following section I have included two exemplars to reflect an example of my clinical and leadership abilities in nursing. 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. Five (5) years of clinical experience as a Registered Nurse. I directed the physician to call the ED for the physician to physician report prior to transport by ambulance. The nurse acts as an I suspected that the end was nearing, and sat with this patient to talk to him about his plan for the day. For a nurse on disability (UCD) or Workers Compensation integration of the number of weeks will be subtracted from the number of total weeks. 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. The questions and concerns were many and the information I reiterated time and time again, explaining the antibiotics, the troughs that would need to be drawn and what each of those meant. Upon my assessment, he was pale and warm to touch. 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. Thinking back about the report I had received about Mr. Y., what precipitated his arrival to the ED, and my interaction with him during the morning assessment, I did not feel that Mr. Y. was bipolar (on a manic upswing) or had intended on deliberately hurting himself. In general, charge nurses must have at least three years of experience as a staff nurse. How have these accomplishments had an impact. Disease (COPD), Disseminated Intravascular Coagulation (DIC), Quality Improvement Cycle: Plan- 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. To the family, this was a crisis and their most desperate coping mechanisms were emphasized. Benner, P. (1987). Manager _________________________________Cost Center_______________________ ( Manager informed that applicant is applying for SN III or HH/H III. Fortunately she arrived there safely. How to check the stoma, prepare the peri-skin and how to change the appliance. Becoming a charge nurse is often less about education and training and more about ambition, personality, gaining nursing experience, and performance. Additional letters of recommendation may be submitted in case one or more letters do not meet requirements. The Staff Nurse III initiates appropriate teaching and coaching of patients and their families. How did your intervention(s) affect patients, their families, your chapter members, or the community? r { X Y x^x Was his condition changing or was he just anxious over the change in circumstance? As a Would Care Champion, my assessment of the dressings on his feet was a priority. 4. 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. Development is a dynamic and continuous process as one This guide covers the most important traits for charge nurses to be effective leaders and improve patient outcomes. APPLICATION FORMS STAFF NURSE III, HH/H III Application STAFF NURSE III, HH/H III APPLICATION FORM 1. be aware of what constitutes malpractice or professional negligence. sw,% Remember, youre nominating your chapter for an award, so you want your submission to be stellar! 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. ( Contingency planning. 2. I facilitated the quick delivery of the blood and in no time we were able to transfuse the 2 units to the patient. 0000000872 00000 n I worked with patients in the past that the hallucinations, whether auditory or visual, were so debilitating that they could not interact with the world because they were so occupied with their hallucinations they couldnt get past that to true reality. Later the patient went to CT, returned and was transferred to a trauma center. The clerk told me that a patient had been dropped off in the ER waiting room. 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. I knew that the patients vital signs were deteriorating. active transport, and capillary filtration (Taylor et al., 2019). to initiate mechanisms to dissipate heat (through vasodilation and Iv|7:On-uBV?N[!NC She got impatient about too many questions. in performing and directing client care, and then begin to visualize (Ricci, Kyle, & You may use the typical abbreviated telling of the nursing practice situation but should be written in first- person. care and possess strong interpersonal skills often assume additional E'[i;T3^umhiBC CcM! I made a template of each of the six devices opening and drew a diagram of their respective locations so anyone needing to replace any of these devices would not have to start from scratch. ( Contingency management: Rapid matching of demands and resources in emergency situations. Some of them were bags that normally are used for urostomies that would allow me to turn the valve at the end of the bag to remove the drainage without actually having to change the whole device. I then called that physician to let her know my assessment and concerns. Three fundamental responsibilities for charge nurses include planning, coordinating, and evaluating unit nursing activities. Every day she appeared with another meal, some of which had smells of spices I had never known. The team also encouraged his daughter to take a more active role in his care which she was willing to do. I quickly looked through her history and CIPS and began to triage her through the Postpartum protocol. I had an uneasy feeling that we were missing something. For those interested in pursuing this role, it's important to analyze strengths and weaknesses. Charge nurses can't change the number of hours on the unit, but they can manage how those hours are spent. I have continued to keep my trauma nursing core courses (TNCC). His hospital stay will require diabetic control, restoring blood flow to bilateral lower extremities, wound care to necrotic diabetic ulcers and restoring proper nutrition. In fact pt was speaking some English but I explained that for her comfort it will be better if we use a translator. Descriptions of additional professional contributions may be submitted in case one or more do not meet requirements. Some examples of successful exemplars follow. She thanked me and put the phone down. Mentors must sign the final application.to validate that all required application elements are complete. As well as I may know a patient, I must always be cautious not to draw a conclusion too soon. I have to explain again in simple words why is so important to get to ED, why she needs to take an ASA immediately and what is going to happened if she does not get there on time. American Association of Critical-Care Nurses. or a large area of rural residents. 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). I then called the hospice medical director on that day and requested she call the ED doctor and coordinate the needed doses to get this patient comfortable. Checking labs confirmed where my thought process was going, her albumin was very low and that would really delay her wound healing. 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. 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