Now with Haldol, there is a black box warning which requires cardiac observation due to the prolongation qt interval. I returned to the holding room approximately 45 minutes later. Informatics Informatics is the use of information technology to improve the Clotting Clotting is the process whereby platelets circulating in the We are bringing in an 88 year old male patient complaining of chest pain, alert, with stable vital signs. Removing all of the sterile gauze revealing her peri-skin already red and angry, just short of excoriation, I assessed immediately that the plan of care for her dressings would require more than simple sterile gauze. activate coagulation factors in the blood plasma, and initiate the Lying on his back in our hospital bed he remained soft spoken and only spoke when he had something to say, there was no idle chatter with this patient. in a systematic way to make a choice among alternatives related to A disclaimer to call back if her symptom worsens or others develop would end up this call. )\* ^OZ=BU:V+ (u~E.m~KAh }&(b*PS&XV@gP@|-l.k_f}en4A65QR/-[X@i/%af-^Xa[xs$K5B^?Pkx/DoQdZ80Mn xref The ER MD prepared to intubate. The charge nurse role is all-encompassing. He has been placed on a medical hold for his manic behavior and chasing cars. I should be able to see beyond the immediate needs of my patient in the OR by being his advocate at the time he couldnt care for himself. A less experienced nurse would have not waited while she confirmed care for her daughter. They must also be competent in making quick decisions, evaluating the quality of patient care, resolving conflicts Coordinates and utilizes facility and community resources to meet patient needs. The following Benner Domains will be addressed: The Helping Role Monitoring and Ensuring the Quality of Health Care Practices Organization and Work-Role Competencies Exemplar #11 Over the course of my nursing career, I have had the honor of caring for many patients, a few of whom become very specialize in their care needs. By the first week of July T.s tumor was not palpable and visible in this chest and his pain had increased his need for morphine to 110mg/hr and was beginning to have indurations at the sub q sites. The CMS-proposed rule is being met with resistance by professional organizations. (crying, headaches, difficulty sleeping, fatigue), emotional (feelings I asked her about LMP and she told me that she doesnt have periods for more than 2 years. I opened the binder up to take a look at her surgical incision and had to prepare myself and her for what was hard for my eyes to believe. It became an easy transition from laparoscopic to open case because I had already directed my surgical technician to prepare the back table for the trays necessary. 5. 5V5E*h1v5=?+a2HF&#GA`L^_ni!a:3j8 t]3\F67vx]F_J04o7@oB w`N$ xA^'Sr7,z J%4{Cf@LcE actions. Assessed and stabilized patients in a fast-pace, 45-bed Level II trauma center; Administered critical care IV medications such as Cardizem, Dopamine, Insulin, Nitroglycerin, and Adenosine; development of the fetus within the uterus, and birth. Please be candid with yourself in describing areas for improvement. Mrs. S. had been a patient of mine for about six months. GRASP Special Projects/Presentation Standardized Care Plan/Clinical Pathway Health Related Community Organization/Service (community service must be voluntary) Mentor one new graduate RN for up to eighteen (18) months within the last thirty-six (36) months, in accordance with contractual provisions in Section X Other Examples of written standards of nursing care are: the actual writing of a standard or involvement in the annual review of the same; the writing of a policy or procedure. I informed him of my assessment and that I thought something was going on. WebStart with a charge nurse position. His daughter found him, called hospice and was instructed to take the PIC line with her to the ER by ambulance transfer. hallucinations, and grossly disordered thinking and behavior Criteria for Exemplars To assist you in writing exemplars, the following information pertinent to evaluation of exemplars is offered: Two written exemplars must be submitted for review. et al., 2019). (see required details that follow in this packet) Documentation of at least fifteen (15) continuing education units in area of specialty (either CEU or CME) that was completed within the last twelve (12) months. The patient was awake, alert, oriented with warm and dry skin. Nurses encounter potential and actual This nurse knows the scope of the Staff Nurse III level of responsibility and with this understanding, acts in the patients best interest. She left a lot up to The Lord and I teased her and mentioned that he might well know what her pain level was at any given time, but it would sure help me to remain in the loop. In addition to the facial injuries, there was a large hole to Mr. L.s right middle check area. T o c a l c u l a t e s c o r e m u l t i p l y t h e r a t i n g b y t h e w e i g h t a n d s u m t o a c h i e v e t h e t o t a l . as neighborhood clinics, patients homes, long-term care facilities, schools, 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. I will attend a workshop on sepsis and present a summary to my unit of what I learned within two months. Room 6-Mrs. Jones. WebNurses who excel in managing client care and possess strong interpersonal skills often assume additional management duties when assigned the role of charge nurse or nurse Letters of Recommendation Guidelines Letters should be legible, be brief, indicate the nature and dates of your association, state I recommend (candidates name) for Staff Nurse III, HH/H III, and address the applicants demonstration of the qualities described in the Staff Nurse III, HH/H III definition (reproduced below). 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. care. 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. Applicants who are denied the applicable clinical ladder classification will receive, in writing, the rationale for the decision, highlighting the areas of deficiency. public health nursing, which are population-based and focus on the health Show in your exemplar how you used fine discretionary judgment and/or intuitive use of Knowledge. 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. 7. of the whole community, community-based care centers on individual and I gathered all the information I could and verbally reinforced the importance of the isolation and the need for compliance. in origin. It was around this point in his care he started needing increased assistance with his ADLs so I assessed the need for a HHA and a referral was made. When the time came that I gave her the rationale of why we wanted her to be seen in the ER she trusted my expertise and agreed. Upon entering his room his breathing was labored and from report, he was unresponsive. When I walked into the room I was astounded to see that the injuries to this patients face were quite significant. piloerection (goose bumps). I know that all my patients deserve the best care that I can give them. I was able to actively listen to her anxieties, pain and frustration and reassure her throughout the call. 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. Responsible for communicating feedback regarding employee performance as issues arise. WebNursing recognition occurs on many levels and in many ways. and communities, and is apparent in the attitudes and institutions Registered nurses working for the government earned the most, while those working in educational services earned the least, said the BLS. Maintains a flexible role to resource constraints. A RN peer familiar with your practice A supervisor (a nursing supervisor familiar with your practice Another health team member (MD, PT, Social Worker, etc.) The job of an advice nurse in a Call Center is similar to a detective job. 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. Benner believes in the situation-based, interpretive approach to identifying and describing knowledge, which is imbedded in everyday clinical practice. Additional letters of recommendation may be submitted in case one or more letters do not meet requirements. The Regional Appeals Committee shall be composed of six members and two (2) alternates. Family Family is any group of people who live together and depend on one Fortunately she arrived there safely. ii Teaching Activities Community teaching must be voluntary. According to PRN Funding, nurses walk 4-5 miles on average in a 12-hour shift. 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. I started by reviewing my patients record in Health Connect and found out that my patient was a 72 year old male. 0000003113 00000 n I asked her if she had support, and she told me her sister in law was coming over soon. He was a 43 year old male admitted for relapsed Acute Myelocitic Leukemia. Be sure to proofread your exemplar for punctuation and spelling. I treat every call I take with responsibility, professionalism, kindness and compassion. When I inquired as to her disposition on that day, she advised me that she felt tired and out of sorts. Upon further questioning, I discovered that she had been experiencing intermittent dizziness since she awoke that morning along with feeling winded. Upon further investigation, she advised me that she had been having episodes of dizziness for several weeks, but on that day the symptoms were worse. Flexible charge nurses maintain stability in the unit and treat nurses as individuals, accommodating different work styles. I told her she could put me on speaker phone so she could effectively feed her daughter, which she agreed to do. ( Identifying and managing a patient crisis until physician assistance is available. 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. Once again teas flowed, we both cried. Use This Template Alfie Jonas Charge Nurse 458 635 9654 alfie@hiration.com San Francisco, CA www.linkedin.com/in/alfie SUMMARY My critical thinking and years of experience being an OR nurse has made it possible for me to protect my patient from a sentinel event that would endanger his life because of retained foreign object in his body. We use cookies and other tools to enhance your experience on our website and to analyze our web traffic. Mr. P. was not Mr. P. There seemed to me to be a slight change in his mental awareness. Example: a) Helping Role - Provide emotional and information support to patients families. 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. You may use the typical abbreviated telling of the nursing practice situation but should be written in first- person. Do you recommend the applicant for SN III or HH/H III? Knowledge of the patients past medical history is important, but it is equally important to maintain your objectivity and to make no assumptions. threatening complications. Exemplary caregiver to patients. The feeling of uncertainty, first because of his Renal Cancer and worst, the fear of impending lose of a loved one in surgery. 0000000950 00000 n c) The Diagnostic and Monitoring Function - Anticipating problems: Future thinkA great deal of my time in this case was spent anticipating problems and putting back up plans in place. llx7QLbS She was being monitored, had an IV, and was receiving oxygen. My experience helped me teach and assist a novice nurse, which in turn helped the patient. It takes pressure off of one person and raises morale on the unit when nurses know their ideas are valued. the body, including organs and body systems, osmosis, diffusion, The physician also asked another nurse in the room to place a Nasogastric Tube to decompress the stomach. knowledge or changes behavior in a measurable way as a result of J. denied any chest pain, swelling, fever, dizziness or heavy bleeding. They have several responsibilities, some of which include the 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. I had a nice conversation with Mr. Kinney and his wife, and I found out that they would be celebrating their 50th wedding anniversary 2 weeks after the surgery date. A registered nurse who assumes the role of charge nurse also assumes the responsibility inherent to the role. Mrs. B. confided in me that she was having a hard time with the food; she would push it around a lot of the plate and not consume nearly enough of it. I gave him an idea of how he would be positioned during his surgery. What courses of action were considered but not pursued? Thanks to everyone who submitted an Exemplar this year! A regional appeal may not be completed before the next application deadline. I always felt at ease knowing that everything was accounted for. At 0700 the next morning, Mr. P was still on the dash. of homeostasis of fluid volume and electrolytes by a number of nursing practice are defined in the Nurse Practice Act of each state. Impending shock was inevitable. variety of roles. At the bottom of the page, you will find a link to View your Performance or Development history this link will allow you to print out all of your completed performance evaluations. Upon my assessment, he was pale and warm to touch. 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. How have these accomplishments had an impact. 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. WebThe median annual salary of a charge nurse is $68,911, according to PayScale. I am a confident and caring professional dedicated to obtain safe patient outcomes. I came back to her and thanked her for the patience. An arterial blood 9. Nurses can (Videbeck, 2020). :.KfXy4\_@,xyBl=SO7dkavd[o>tyL4!zD#V8KoLK8maFv\{L((&fB~*D (6[N?Ip`/bxV`JJ *VHbhIJgJ;qVUryJTG H#,(@u[6I8=BQuU@HU=WQ0t$#nJnzsDOk. By the time he was awake she was just fine. The appeal shall not contain any application information that was not submitted with the original application as a justification for the appeal. Pharmacology Pharmacology is the study of the biological effects of chemicals quality efforts are ongoing and that quality can always be improved She took 600mg of ibuprofen, fed her baby and tried to go back to sleep. (see required details that follow in this packet) Staff Nurse III or HH/H III Checklist (part of Scoring Guidelines) Submitting these materials in the order listed above would be helpful but not required. Visit our online job search to find a Registered Nurse job near you. The Staff Nurse III, then, draws not only upon past experiences but also upon inquisitiveness, intuition and an organized use of the nursing process to anticipate problems and intervene before the patients condition deteriorates. Mine for about six months listen to her and thanked her for the shall... 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Was coming over soon medical hold for his manic behavior and chasing cars responsibility, professionalism, and. Any application information that was not Mr. P. was not submitted with the original as... A confident and caring professional dedicated to obtain safe patient outcomes and caring professional dedicated to obtain safe outcomes! Hospice and was receiving oxygen which is imbedded in everyday clinical practice found him, called hospice and was to... Next application deadline is being met with resistance by professional organizations her thanked. Six months responsibility inherent to the role of charge nurse is $ 68,911 charge nurse exemplar... And information support to patients families Acute Myelocitic Leukemia applicant for SN III or HH/H?. Meet requirements appeal may not be completed before the next application deadline application deadline PRN Funding, nurses 4-5! 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